Background: Termination of pregnancy (TOP) is one of the most commonly performed gynaecological procedures in the world and was legalised in South Africa in 1996 with the passing of the Choice on Termination of Pregnancy Act, 1996 (Act No. 29 of 1996. Utilisation of the TOP service increased significantly after the promulgation of the Act, to the extent that 7% of pregnant women in South Africa chose to terminate their pregnancies legally in 2012. Worldwide, women most commonly state their reasons for choosing TOP as a desire to stop or postpone childbearing. Although several international studies have been done in this regard, the reasons for women requesting legalised TOP in South Africa have not been explored in depth. Methods: A qualitative study using the case-study approach and involving one-on-one open interviews with participants was done at the TOP Clinic at Soshanguve Clinic 3 with the aim of gaining more insight into this issue. Results: The following themes emerged from the interviews: formal education not completed, financial difficulties, contraceptive failure, wrong timing, reasons relating to the existing family; and problems relating to the partner. Conclusion:This study also gave insight into the complex personal and social contexts within which women make the decision to terminate their pregnancy, and the thoughtfulness with which they make their decisions.

Background: Termination of pregnancy (TOP) is one of the most commonly performed gynaecological procedures in the world and was legalised in South Africa in 1996 with the passing of the Choice on Termination of Pregnancy Act, 1996 (Act No. 29 of 1996). Utilisation of the TOP service increased significantly after the promulgation of the Act, to the extent that 7% of pregnant women in South Africa chose to terminate their pregnancies legally in 2012. Worldwide, women most commonly state their reasons for choosing TOP as a desire to stop or postpone childbearing. Although several international studies have been done in this regard, the reasons for women requesting legalised TOP in South Africa have not been explored in depth.Methods: A qualitative study using the case-study approach and involving one-on-one open interviews with participants was done at the TOP Clinic at Soshanguve Clinic 3 with the aim of gaining more insight into this issue.Results: The following themes emerged from the interviews: formal education not completed, financial difficulties, contraceptive failure, wrong timing, reasons relating to the existing family; and problems relating to the partner.Conclusion: This study also gave insight into the complex personal and social contexts within which women make the decision to terminate their pregnancy, and the thoughtfulness with which they make their decisions.

Introduction: Caesarean section (CS) is a common obstetric procedure that prevents neonatal and maternal death when performed correctly if indicated; however, CS can give rise to complications that lead to maternal and perinatal morbidity and mortality. Rates of CS are increasing worldwide, although the World Health Organization (WHO) has indicated an ideal rate of 5–15%. South African CS rates are higher than the ideal.Methods: Maternity records of 2015 were reviewed at Odi District Hospital (ODH) to assess whether ODH complies with the ideal CS rate. In this study, extracted data include date and time of CS, maternal age, parity, gestational age, total number of previous CSs, elective or emergency, indications, anaesthesia used and registration of the surgeon.Results: There were 3 336 deliveries and 1 064 CSs (32%). The majority of women were aged from 19 to 34 years (59%), 72.8% were multiparous and 54% between 37–39 weeks’ gestation. The most common (40.1%) overall and emergency indication was foetal distress. Most CSs were emergencies (61.70%). Most elective CSs were because of a previous CS and spinal anaesthesia was used in 91.73%. Medical officers performed most of the CSs (79.0%) during working hours. The CS rate of 32% was significantly higher than the ideal 5–15% and higher than in other sub-Saharan countries with similar maternal characteristics. Indications for emergency and elective CSs were similar to previous research.Conclusion: The Caesarean section rate at ODH is higher than the recommended rate. Potential CSs therefore need to be evaluated more intensely to assess the true need for surgical intervention.

Background: Paediatric meningitis remains a common cause of childhood morbidity and mortality in developing countries. In children the peak age for meningitis is six to 12 months old, with 90% of cases occurring in children younger than five years. It is imperative that a primary healthcare physician be aware of and is capable of managing this life-threatening condition as most caregivers first present to a primary healthcare physician with their sick child.Discussion: Common symptoms are headaches, photophobia, drowsiness, fatigue, unexplained crying, convulsions, irritability, and lethargy. Signs include fever, vomiting, neck stiffness and signs of increased intracranial pressure. Acute bacterial meningitis, especially meningococcal meningitis can present with petechiae and/or purpura. Cranial nerve palsy occurs commonly in cryptococcal meningitis, which can occur as part of immune reconstitution inflammatory syndrome (IRIS) after initiation of antiretroviral therapy. Older children may present with behavioural changes and localising signs such as hemiparesis and coma.Conclusion: This paper discusses the lumbar puncture technique and findings, drug and non-drug management, information on chemoprophylaxis for bacterial meningitis, and the possible complications of meningitis in children. This is an important area for the primary care physician as they are usually the first port of call by caregivers.