Improving the quality of sexual and reproductive health and rights (SRHR) through pre-service training, research, and evidence-based clinical care delivery in Sub-Saharan Africa

Background
Access to safe and accessible termination of pregnancy (TOP) is a fundamental human right. This right remains legally unrecognized in many developing nations. Although South Africa has one of the most liberal laws globally, access to these services remain limited due to lack of knowledge, moral beliefs and conscientious objections from healthcare providers.
Method
Descriptive cross-sectional study was conducted to determine the knowledge, perceptions of university students (>18 years) on the morality and legality of medical abortion. A total of 482 self-administered questionnaire were distribute to a consecutively selected sample. Stata 18 SE was used to analyse data. Descriptive statistics was used to analyse data. Summary statistics was used to analyse numerical variables and presented as means (standard deviation). Frequency distribution was used to analyse categorial variables and were presented as frequency and percentage.

Results
Most participants were aged 21 – 25 years (52%), female (64.9%), unmarried (97.7%), black (99.6%), had no children (82%), at 3rd year of study (44.4%) and Christians (87%). Majority intended not to terminate pregnancy is pregnant (78%) due to need to focus on studies (43%). Most knew that abortion is legal in South Africa. About 38.5% reported would not terminate due to moral or religious beliefs. Most (65.98%) had inadequate knowledge of the law on termination. Participants’ perception on the legality and morality of abortion shows a mean score of 3 (neutrality). Those with an high morality score are less likely to choose to terminate. Those with a legality perception score are twice as likely to terminate.

Conclusion
Knowledge of the legal aspect of termination law was low among participants, although most knew that abortion is legal in South Africa. Most participants did not have a strong moral or legal option of abortion however, those who scored highly on the legality perception were likely to terminate. Those scoring high on the morality perception score were less likely to terminate.