The birth control burden

The South Africa government rolled out a free implant contraceptive that has become a burden for women across the country.

BIRTH CONTROL BLUES: Implanon Nxt, a small implant that gives women up to three-years of birth control, has been causing some of its users side effects such as excessive menstrual bleeding and fatigue. Photo: Lebo Mashiloane

BIRTH CONTROL BLUES: Implanon NXT, a small implant that gives women up to three-years of birth control, has been causing some of its users side effects such as excessive menstrual bleeding and fatigue. Photo: Lebo Mashiloane



Two years ago the government introduced a free contraceptive implant to the public health sector in what it called “the biggest family-planning programme South Africa has ever seen”.

But today, many young women are queuing to get the implants removed after complaining of side effects including excessive menstrual bleeding, dramatic changes in weight and fatigue.
And at Wits, the number of requests to remove the devices now exceeds the number of people getting the implant.

According to the Wits Campus Health, the clinic is currently at a stable rate of about three implant insertions a day and have about four requests for removal.

Matapelo Chauke*, a third-year Architecture student, is one of the students who has requested her device be removed. She has been on the free contraceptive for less than a year and is now living with the regret.

“It’s a nightmare,” Chauke said.

For Chauke, her troubles began shortly after having the implant inserted. “I got it last year around June and basically from the moment I got it I started experiencing the side effects,” Chauke said.

“The implant makes me really tired, I’ve lost so much weight and I’ve been bleeding excessively.”

“Look, it’s been a great contraceptive, you really can’t have much sex with it anyway,” jokes Chauke.

Sister Yvonne Matimba, head of Campus Health, said that when administered appropriately, the implant is safe. However, in many cases the “right patients” are not selected and patients are not informed fully about how it is going to work.

“We have had some of our own patients returning for the removal procedure, and others who had the implant inserted elsewhere,” said Matimba.

However, while some people do need to have the implants removed for medical reasons, others do not.

“One patient requested the removal of her implant due to fatigue while another sited her mother’s disapproval as her reason for the removal procedure,” Matimba said. “But most of the cases the clinic received are of students experiencing excessive bleeding over a lengthy period of time.”

However, Matimba said the clinic finds that some of the requests for removal are sometimes not as a result of the real side effects but because of perceived side effects.
“We don’t encourage them to stay on it, we are too quick to remove,” said Matimba.

Removing the devices can be a problem as well. The Treatment Action Campaign told Wits Vuvuzela that doctors and nurses had not been properly trained to remove the implant during the roll-out. In Mpumalanga, they claimed doctors were refusing to remove the device.

Sister Matimba said it was a challenge to remove implants that were inserted by other nurses or doctors. “We have had cases where we have struggled to take [the device] out. There was a girl who said she could feel it but I suspect she could have put on weight and could no longer feel it.”

“What happens once you gain weight, under the surface becomes fat and fat is very soft so anything can sit in the fat tissue which means you need to go really deep to get it,” said Matimba.

The devices were rolled out in 2014, when Health Minister Aaron Motsoaledi told of plans to introduce the female contraceptive Implanon NXT, a plastic matchstick-sized rod that is inserted under the skin of a woman’s upper arm. Each device is valued at R1 700 each and was made available to women across the country.

Motsoaledi called the campaign “the biggest family-planning programme South Africa has ever seen”.

The implant has been available at Wits since 2014, however the university was not part of the government’s initial strategy plan.

“Later on they may have realised that they left the entire education institutions behind and most young females are in university so they started targeting universities, particularly those who have family planning,” said Matimba.


*not her real name

Health services at 4 teaching hospitals to be monitored

WITS University and the Gauteng Department of Health have signed an accord to tackle health delivery at four hospitals that form part of Wits’ teaching platform.

Wits vice chancellor, Adam Habib, Minister of Health, Dr Aaron Motsoaledi and Gauteng health member of the executive committee (MEC), Hope Papo, signed a developmental accord last

The four hospitals are the Chris Hani Baragwanath Academic Hospital, Helen Joseph Academic Hospital, Charlotte Maxeke Johannesburg Academic Hospital and the Rahima Moosa Mother and Child Hospital. In the accord, Wits and Gauteng Health pledged to address obstacles to health delivery and “to ensure the availability and functionality of equipment and consumables” at these hospitals.

[pullquote align=”right”]”…the event was ‘a historical moment” for Wits, the Gauteng health department and the ministry.[/pullquote]

According to Prof Ahmed Wadee, the dean of Health Sciences, the clinicians in the faculty initiated the agreement. “The university is committed to and would like to ensure that
hospital supplies and equipment are made available for patient care and for teaching and training,” said Wadee.

Doctors from the university will be part of the task team that will monitor the implementation of drug supplies and equipment. Practising medical students will benefit from the improved teaching facilities and will experience a more conducive learning environment. Approximately one thousand medical students are doing their practicals at these hospitals, Wadee said.

According to a statement, the objective of the accord is for the department and the university to work together towards better healthcare and the training of healthcare professionals. In the statement Habib said Wits doctors contribute towards keeping the health system alive and “…the event was ‘a historical moment” for Wits, the Gauteng health department and the ministry.

He said it symbolised how “decisive and committed leadership teams can engage and resolve issues of concern to the benefit of all parties and South African citizens as a whole”.
Wits will not be donating any funds to address the needs of these hospitals. The national department of health would fund equipment and other supplies.

Wadee said there was an extensive list of equipment and supplies needed by the hospital.