SELECT COMMITTEE ON SOCIAL SERVICES
REPORT ON THE STUDY TOUR TO
19-25 FEBRUARY 2011
MARCH 2011
Compiled
by Dr T. Ganyaza-Twalo
Contributors: Ms M. Williams &
Mr M. Dlanga
PARLIAMENTARY
DELEGATION
- Mrs N. R. Rasmeni – ANC & Chairperson
- Ms Z. D. Rantho – ANC
- Mrs L. M. Moshodi – ANC
- Ms M. G. Boroto – ANC
- Ms B. V. Mncube – ANC
- Mr T. A. Mashamaite – ANC
- Mr M. J. R. de Villiers – DA
- Mr W. F. Faber – DA
- Mr S. H. Plaatjie – COPE
PARLIAMENTARY
OFFICIALS
- Dr Thulisile Ganyaza-Twalo – Content Advisor
- Ms Marcelle Williams – Committee Secretary
- Mr Mzuyanda Dlanga – Committee Secretary
TABLE
OF CONTENTS
PART 1: INTRODUCTION, AIMS AND
OBJECTIVES OF THE STUDY TOUR, AND METHODS OF INFORMATION COLLECTION
1.1
Introduction 1
1.2
Aims and Objectives of the Study
Tour 2
1.3
Methods of Information Collection 2
PART 2: OVERVIEW OF THE
2.1 Background
to
2.2 Situation
before the Reforms 4
2.3 Reasons
for Reform 5
2.4 Introduction
of the Health Insurance Act, 2006 5
2.5 Packaging
of the Dutch Health Care System 7
2.6 Health
Care Financing 8
2.7 Quality
Assurance and Monitoring of the Health Care System 8
2.8 Lessons
from the Dutch Health Care System 10
2.9 Recommendations
for the Parliament (Committee) 10
PART 3: INTER-COUNTRY ADOPTIONS
3.1
Background Information 11
3.2
3.2.1 Background 12
3.2.2
The principal features of the Convention
12
3.3 Adoption
in
3.4 Procedure
for Adoption 14
3.5 Learning
about Inter-Country Adoptions 15
3.6 Recommendations
for the Committee 15
PART 4: COLLABORATION BETWEEN
4.1
Introduction 16
4.2
Medical Knowledge Institute (MKI) – “Prevention through Education” 16
4.3
5.
CONCLUSION 17
REFERENCES
AND ORGANISATIONS VISITED
PART 1: INTRODUCTION, AIMS AND
OBJECTIVES OF THE STUDY TOUR, AND METHODS OF INFORMATION COLLECTION
1.1
Introduction
The NCOP’s
Select Committee on Social Services undertook a study tour to the
In
addition to learning about
Various
government departments, independent and non-governmental organisations were
visited to gather the relevant information in order to understand both
Netherland’s health care system and laws, policies and procedures that guide
inter-country adoptions. (See annexure 1 for the list of the departments and
organisations visited)
This
report therefore reflects learning from the Dutch health care system and how
the country regulates and conducts inter-country adoptions. In reporting on the
Dutch health care system, it touches on the collaborative work between the
Dutch and South African organizations; and the work done by the Dutch in
As
part of overall oversight and monitoring of committee activities, this report
is a means of 1) accounting to Parliament on the committee’s activities whilst
in
The
report is structured and/or divided into four parts. The first part of the
report includes this section which is the introduction to the report;
objectives of the study tour; and methods of information collection. The second
part provides information on
1.2
Aims
and Objectives of the Study Tour
The
aims of the study tour were to:
- Explore and learn from
- Ensure the protection of South African
children through learning about inter-country adoptions.
The
objectives of the study tour were to:
- Explore and understand
- Understand health care financing;
- Explore matters around human resource for
health care provision; and
- Explore ways and means to protect South
African children adopted by the foreign nationals.
1.3
Methods
of Information Collection
In
order to achieve the aims and objectives of the study tour, the South African
delegation held meetings with various role-players in
The
delegation first visited Parliament and met with three Members of Parliament
(MPs) from different political parties. These were Federal Party, Socialist
Democratic Party and the Labour Party. These MPs also serve on their
Parliament’s Committee on Health Care. Unfortunately at the time of the visit,
Parliament was in recess and the delegation did not get an opportunity to
witness the committee in session.
The
delegation visited and met with representatives from various organizations
and/or role-players in the
- Ministry of Health, Welfare and Sports;
- Ministry of Foreign Affairs;
- Royal Dutch Medical Association (KNMG).
Institutions
working in or in collaboration with South African organizations included:
- Medical Knowledge Institute (MKI);
- Oxfam Novib; and
- Philips Healthcare.
Regarding
inter-country adoptions, the delegation visited the following organisations:
- Hague Conference on International Law
(HccH);
- Council for Protection of Children; and
- Foster Care Centre.
The
mode of information sharing was largely through power-point presentations
followed by discussions where the MPs would be given opportunity to ask
questions to explore and probe on issues raised in the presentations. In some
instances, books were made available to learn more about topics of interest to
the delegation. Information presented in this report therefore comes from the
presentations and the books provided to the delegation on these two crucial
topics.
PART 2: OVERVIEW OF THE
2.1
Background
to
The
The
new system seeks to introduce dynamism in health care. The concept of dynamism
is premised on three strategic issues which are 1) health care and sport
nearby; 2) value and quality for your money; and 3) opportunities for people
and entrepreneurs. These three key strategic agenda issues define
The
introduction of new reforms in health care ushered in radical changes in the
roles of various actors in the system. These changes included 1) the role of
health insurers and patients; 2) supervision and management of the system was
largely moved from government to independent bodies; and 3) the provision of
social support became the responsibility of local government.
The
introduction of the new system also saw changes in the structure of the health
care system. It is best described as having three pillars which are the
providers, citizens/consumers and the insurers. Each of these role players
where expected to play a certain and crucial role to ensure the success of the
system.
2.2
Situation
before the Reforms
In
1967, a social insurance scheme replaced subsidies to inpatient long-term care,
mental health and disability services.[1]
Eligibility was broadened with long-term care, elderly care and mental health
services. In the 1970s, policy trends were around cost containment; measures to
solve the fragmented service provision; and the attempts to abolish the dual
system of social and private health insurance.
The
health care system was characterised by greater involvement of government in
the regulation of health care. Thus, the capacity of the system to deliver was
heavily regulated by government. In regulating the health care system,
government set tariffs for services provided by the medical practitioners and
health insurers.
The
previous health care system had three levels which consisted of 1) sickness
funds (2/3 = two thirds), private insurance (1/3 = one third), and 3) partial
insurance for civil servants. This system largely remained until the
introduction of new health care reforms in 2006.
2.3
Reasons for Reform
After
many attempts to reform the health care provision in
The
reason for health care reforms included the following factors:
·
Lack of cost consciousness by the
consumer,
·
Unexpected financial effects
around the income threshold,
·
Fragmented insurance market,
·
Different rules of market game,
·
Lack of transparency,
·
Lack of efficiency,
·
Lack of innovation, and
·
Long waiting lists of citizens
awaiting health care services.
During
the time of economic boom, the growing wealth, advancing medical technology and
aging population placed increasing pressure on the system. A solution to the
above-mentioned pressure, the solution was advocacy for less central regulation
and introduction of more competition in the health care system.
2.4
Introduction
of the Health Insurance Act, 2006
The
introduction of this Act saw the beginning of major changes in the structuring
of the Dutch health care system. It abolished and/or collapsed the sickness
fund, private insurance and the partial insurance for civil servants. The
fragmented health care insurance was integrated into one system which enabled
access to health care by all citizens and managed competition among actors in
health care.
The
2006 health care reforms introduced a single compulsory insurance scheme, in
which multiple private health insurers compete for the insured persons.[3]
The introduction of the health reforms radically changed the roles of different
actors, in particular the role of health insurers and patients. The supervision
and management of the system have been largely delegated from the government to
independent bodies. Importantly, the organization of social support became a
municipal responsibility.
The
public characteristics of the Health Insurance Act were:
·
Insurer is obliged to accept every
resident,
·
Insurer is responsible for
availability of insured cure,
·
Insurance is compulsory for every
resident,
·
Introduced national standard/basic
package of health care,
·
Income related premium (50%),
·
Risk equalisation,
·
Financial compensation for poor
people for a nominal premium, and
·
No premium for children.
Three
major role-players emerged as a result of the reforms in the health care
system, viz government, insurers, service providers and the insured. All these
actors play crucial roles in making the system a success. Government is
responsible for regulation and supervision of the system. This is largely done
through engagement with academic and independent institutions which conduct
research in the field of health care. Government also has an overarching
responsibility over the other actors in the health system, which includes
insurers, the insured and providers of service.
Figure
1 below shows the other major actors and markets in the Dutch health care
system. Insurers collect and/or receive contributions from the insured and pay
for services provided by the providers. Service providers provide health care
services to the insured and claim for their services from the insurer. The
insured receives medical care paid for in advance to the insurer.
Government (Regulation and
supervision)
Insurers
Figure
1: Actors and markets in the Dutch health care system since 2006. Taken from
the “The
The
benefits of the new health care system were the vanishing of the waiting list for
the care of medical specialists. Insurers invested much more on the quality of
care for the citizens. There was also more room for innovation in health care.
The
burdens/disadvantages of the system include intensified negotiations becomes a
burden when insurers try to improperly influence the physicians’ behaviour to
save on medical spending. A risk exists for general practitioners in their
function of gate-keeper to hospital care.
2.5
Packaging
of the Dutch Health Care System
Basically,
the Dutch health care system is characterised by two forms of delivering health
care services. These include basic and additional packages for delivery health
care services to its citizens. Basic package consist of essential medical
services and the second package is additional to the basic package meaning that
a person can choose to subscribe or not to the additional package.
2.5.1
Basic
Package: This package is determined by government and is standardized
throughout the system. This means that government is responsible for the
packaging of the basic package.
The
basic package consists of all essential medical care as determined by
government. The insurance thereof is compulsory for every citizen of the
country. There is no competition on price and quality of care between the
health insurer and health care provider.
2.5.2
Additional
Package: With this package, the responsibility for packaging of health
care services is left entirely to the insurers. The package consists of all
sorts of care services not provided for in the basic package. Therefore, there
is variation per insurer and between insurers with regards to costing of
services.
The
other difference from the basic package is that insurance is voluntary thus
giving the person a choice whether to insure or not. This additional package
also introduced competition on packages and prices between insurers. With this
competition between insurers, the persons become beneficiaries because it tends
to lower costs for these health care services.
2.6
Health Care Financing
Health
care services are financed in two ways. Firstly, government deducts fifty
percent (50%) of medical consumptions from the employees. The amount of
contribution is dependent on the income of the employee. The collected funds
are then deposited into the Risk Adjustment Fund (RAF). Some of these funds are
then disbursed to the health insurers to subsidise the medical costs incurred
by the consumers/patients.
The
consumer/patient pays the remaining 50% of medical costs to the health insurer.
The amount paid to health insurers in real terms varies as a direct result of
competition between health insurers for the insured by the various health
insurers. On average, employees spend about 3.5% of their salaries on health
care insurance.
In
financing health care service provision, children under the age of eighteen
(18) years enjoy free medical care. This means that funds from the Risk
Adjustment Fund also serve to subsidise services provided to children under the
age of 18years.
2.7
Quality
Assurance and Monitoring of the Health Care System
Providing
quality health care is central for the Dutch government. The Dutch view the
delivery of high quality care as a professional responsibility. Health care
service providers are thus required to report about the quality of service.
Four
Acts passed by Parliament serve to guide quality assurance in health care
service provision. These Acts are:
·
Health Care Market Regulation Act,
·
Quality Act,
·
Health Care Provider Accreditation
Act, and
·
The Patients Rights Act.
Supervisory
bodies ensure adherence to the quality standards set out in the Acts and
subsequent policies. These are:
- The Health Care Inspectorate, and
- The Dutch Healthcare Authority.
The
active monitoring of quality in health care involves health insurers,
consumers/patients and health care providers. Government in this process
safeguards quality, access and affordability of health care services.
An
independent coherent analysis of the performance of healthcare at system level
is reported on in the Dutch Health Care Performance Report. The report focuses
on the achievement of three system goals set out by government, which are
quality, access and affordability (costs). The report also focuses on the
impact of the health care reforms by using time trend data or international
comparisons whenever possible.
The
Royal Dutch Medical Association (RDMA) sees to the processes and procedures to
be followed to ensure that service providers are accredited and fit to provide
health care services. Service providers in this context include the hospitals
and medical practitioners. The Association developed frameworks for various
players in health care provision.
Quality Framework of Hospital
Management: The association ensures that the following
are done at hospital level:
- Hospitals are accredited to provide
health care services,
- Registration of accidents and near
accidents,
- Registration of quality indicators (such
as waiting time, necessity of re-operation, etc),
- Standard regulation for complaining
patients, and
- Performance evaluation (management
evaluates performance of salaried medical specialists).
Quality Framework for Medical
Specialists: medical specialists must adhere to the
following:
·
Registration as medical
specialists
All
specialists must receive their education at university and also receive on the
job training.
·
Re-registration every 5years
The
RDMA prescribes minimum hours of practice (16 hours patient care per week);
continuing medical education (200 hours); and quality visitation (e.g. specialists
of hospital A visit specialists of hospital B).
Quality Framework of the RDMA:
obligations for the individual medical specialist to:
·
Minimum number hours of practice,
·
Use medical guidelines,
·
Use quality indicators,
·
Continuing medical education (200
hours),
·
Quality visitation, and
·
Performance evaluation by peers.
In
summary, this is how the Dutch health care system ensures provision of high
quality health care services.
2.8
Lessons
from the Dutch Health Care System
- Reforms to achieve real or specific
objectives as analyzed by the government. Dealing with the aging
population and addressing access to health care by everyone.
- Recognition of the importance of roles
played by various actors in the health care system. That is the
government, health insurers, providers, insured/consumers and independent
institutions.
- Packaging of health care services to
benefit all, including those unemployed and cannot afford paying for
services on their own.
- Promotion of high quality health care
service provision monitored by various role players.
- Financing health care lies with all
actors in the system.
2.9
Recommendations
The
stated recommendations relate to the above-mentioned lessons from the Dutch
health care system. They take into consideration the mandate and functions of
the parliamentary committees.
- In assessing and interrogating the soon
to be introduced National Health Insurance Bill, the Committee should
probe and ascertain whether 1) the Bill is addressing an identified
problem(s); 2) there is a clear basis for the proposed reforms in health
care; 3) the proposed health care system and its programmes will actually
achieve the intended objectives and outcomes.
- Parliament, through its relevant
committees, should monitoring the implementation of the National Health
Insurance as it is critical to find gaps and areas for further
improvements. This could be done by independent institutions through
research. The committee or Parliament must therefore exercise oversight by
ascertaining from the Department of Health whether there are plans to
conducts impact studies.
- The success of the National Health Insurance will depend
partly on the involvement and role of various stakeholders inside and
outside of government. It is thus imperative for the committee to ascertain
the extent to which other critical partners are involved. Also, whether
their roles are clearly defined to assist with implementation and
evaluation of NHI.
- Cost estimates to government should guide
the means by which implementation occurs.
PART 3: INTER-COUNTRY ADOPTIONS
3.1 Background Information
In
trying to learn about practices on inter-country adoptions with a view to child
protection, the delegation visited
The
opening up of national borders, ease of travel, worker mobility and the
breaking down of cultural barriers have, along with their many benefits,
brought new risks for children. The cross border trafficking and exploitation
of children and their international displacement as a result of wars, civil
disturbance or natural disaster have become major world problems.
Children
also find themselves caught up in the turmoil of broken relationships within
transnational families, which can lead to disputes over custody and relocation,
the hazards of international parental
abduction, problems of maintaining contact between the child and parents living
in different countries, the struggle of securing cross-frontier child support,
and the pressures and profiteering which can sometimes accompany the cross-border
placement of children through inter-country adoption or shorter term
arrangements.
As
the United Nations (UN) Convention on the Rights of the Child (1989)
underlines, effective protection of children’s rights across frontiers cannot
be achieved without inter-State co-operation. The three modern Hague Children’s
Conventions have been developed over the last twenty five years, and to provide
the practical machinery to enable States to work together where they have a
shared responsibility to protect children.
About
the:
Hague Convention of Private
International Law
The
Hague Conference on Private International Law has been a pioneer in developing
systems of international co-operation, at the administrative and judicial
levels, to protect children in cross-frontier situations. This work has been
taking place for more than a century. HccH is an international
inter-governmental organisation with nearly 70 Member States from all
continents. It provides legal security and protection for persons and businesses
whose movements and activities cross national frontiers.
HccH’s
mandate is to harmonise private international law rules at the global level
through the preparation, negotiation and adoption of Hague Conventions
(multilateral treaties to which more than 120 States around the world are
currently Parties).
HccH
has a footprint in
3.2
3.2.1 Background
The
Convention on Protection of Children and Co-operation in Respect of
Inter-Country Adoption is an international framework to facilitate inter-country
adoptions. The Convention recognises the importance of a child growing up in a
family environment with love and happiness. Inter-country adoption is one of
the means to ensure that a child grows up in a family. However, it cautions
that inter-country adoption should be considered after attempts to find a
family in a country of origin has yielded negative results. The best interest
of the child and recognition of the child’s rights are paramount when
considering and facilitating inter-country adoption.
The
objectives of the Convention are to:
- Establish safeguards to ensure that
inter-country adoptions take place in the best interest of the child and
with respect for his or her fundamental rights are recognised in
international law.
- Establish a system of co-operation
amongst Contracting States to ensure that those safeguards are respected
and thereby prevent abduction, the sale of, or traffic in children.
- Secure the recognition in Contracting
States of adoptions made in accordance with the Convention.
3.2.2 The principal features of
the Convention
- The best interest of the child are
paramount
Article
4(b) of the Convention requires States to determine, after possibilities for
placement of the child within the State of origin have been given due
consideration, that an inter-country adoption is in the child’s best interests.
In determining the “child’s best interests”, the State must national solutions
are considered first; ensure the child is adoptable; preserve information about
the child and his/her parents; evaluate thoroughly the prospective adoptive
parents; match a child with a suitable family; and impose additional safeguards
where needed. This fundamental principle should thus guide the development of
an integrated national child care and protection system, of which one part is
an ethical, and child centred approach to inter-country adoption.
- Subsidiary Principle
This
principle, “Subsidiary” means that Contracting States recognise that a child
should be raised by his or her birth family or extended family whenever
possible. This implies that only after due consideration of national solutions
first that inter-country adoption should be considered and facilitated. This
principle emphasises the importance of keeping a child in the care of his/her
family or a family in the country of origin.
- Safeguards to protect children from
abduction, sale and trafficking
This
is one of the key objectives of the Convention. At the core of this safeguard
is protection of birth families from exploitation and undue pressure; and
ensuring that only children in need of a family are adoptable and adopted.
Also, it prevents regulating agencies and individuals involved in adoptions by
accrediting them in accordance with Convention standards.
- Co-operation between States and within
States
Co-operation
between States is crucial to ensure the effectiveness of the safeguards put in
place in Article 1(b) of the Convention. This in recognition of the fact that
all those involved in adoptions, whether intra- or inter-country should work
together to effect the safeguards of this Convention.
- Automatic recognition of adoption
decisions
Every
adoption which is certified to be made in accordance with the Convention
procedures, is recognised “by operation of law” in all other Contracting States
(Article 23). In effect, the Convention gives immediate certainty to the status
of the child, and eliminates the need for a procedure for recognition of
orders, or re-adoption, in the receiving country.
- Competent authorities, Central
Authorities and Accredited Bodies
The
Convention requires that only competent authorities should perform Convention
functions. These may be Central Authorities (Article 6 & 7) and accredited
bodies. Articles 6-13 of the Convention outline a system of Central Authorities
in all Contracting States and impose certain general obligations on them. The
system and general obligations include among others the co-operation with one
another through exchange of information concerning inter-country adoption; elimination
of any obstacles to the application of the Convention; and a responsibility to
deter all practices contrary to the objects of the Convention.
It
is critical for Contracting States like
Adoption
in
Domestic
and inter-country adoptions are allowed in
- Book 1 of the Civic Code, containing
provisions on the law of family and persons, particularly articles 227 –
232 on adoption.
- Act of 8 December 1998, containing
provisions on the reception in The Netherlands of foreign foster children
for adoption (hereafter referred to as the Act on the adoption of foreign
children, since this Act is the principal legal instrument governing
adoption of foreign children).
- Act of 14 May 1998, ratifying the Hague
Convention.
- Act of 14 May 1998, implementing the
Hague Convention.
- Act of 3 July 2003, on the applicable law
in adoption matters.
- Act of 21 December 1951, containing
provisions on the care and education of foster children.
- Act of 8 August 1989, containing
provisions on the care of the youth.
- Act of 19 December 1984, on Dutch
nationality.
An
order for adoption has to be made within confines of these laws as they apply
to various legal matters including citizenship. Furthermore, the provisions of
the Hague Convention are incorporated into the legal system as far as
inter-country adoption is concerned. Learn
more about the Hague Convention in 3.2 above.
Procedure
for Adoption
This
section outlines the adoption procedure in brief. This is done in steps that
the officials adhere to.
|
Step |
What |
Explanation |
|
1 |
Submitting a request for a permit in principle |
Applies for a permit in principle by sending an application to
Foundation Adoption Services. |
|
2 |
Review of the application |
Check if requirements for entering the adoption procedure are met.
These requirements concern the sort of application and the age of applicants. |
|
3 |
Information sessions |
Attendance by an applicant of information sessions. Focus is on
sharing information about the child. |
|
4 |
Home study |
Child Protection Board conducts home study and thereafter advises the
Minister of Security and Justice as to the issuing of a permit in principle.
The report of the Board is also used in the country of origin to determine
which family is most suited for placement of the child eligible for adoption. |
|
5 |
Permit in principle |
The Minister of Security and Justice decides on the basis of the home
study report whether to issue a permit in principle. |
|
6 |
Mediation |
Done by a license holder mediating for children. |
|
7 |
Proposal of a child for adoption |
Through the license holder, a child may be proposed for adoption.
Prospective parents cannot choose a child. |
|
8 |
Arrival of the child in the family |
Check if all requirements are met and if all documents are in order.
This is because few countries escort adoptive children into |
|
9 |
Registering the child with the Authorities |
Formalities relating to the arrival and status of the child. |
Learning
about Inter-Country Adoptions
- Formal legal framework for inter-country
adoption which is understood by all involved with inter-country adoption.
- Contracting and embracing the provisions
of the Hague Convention thus putting them into practice when inter-country
adoptions are facilitated.
- Various actors have specified roles in
the processing of inter-country adoptions.
Recommendations
for the committee
- Through an exercise of oversight, the
Committee must establish whether the country’s inter-country adoption
processing complies with the provisions of the Hague Convention.
- The committee to establish whether there
are independent bodies facilitating the adoption of South African children
adopted by foreign nationals. Also ascertain the types of screening
processes that are currently applied for adoptive parents.
- Members of Parliament and provincial
legislatures should start a dialogue that will result in a unified
strategy to advocate for South Africans adopting South African children.
Recruitment drives should include radio air time in broadcasting the
message of SA parents adopting SA children.
PART 4: COLLABORATION BETWEEN
4.1 Introduction
Collaborative
work between South African and
4.2 Medical Knowledge Institute
(MKI) – “Prevention through Education”
MKI
is an international non-profit health organization, established in the
MKI
Initiatives:
The Mother and Child First
Training Program: this program is intended for
midwives and other healthcare employees for the prevention of the transmission
of HIV from mother to child in developing countries. Health Information Centres
have been set up in various townships for this purpose.
Clover Mama Africa: this
is a conglomerate of 33 orphanages which are provided with Health Information
Satellites thus reaching a claimed 25 000 children through courses and training
in the fields of hygiene.
Biometric Health Passport: this
project aims to issue personalised passports that have data about an
individual’s health records. However, it is still at pilot stage but should be
valuable for individuals and communities.
Happy Days Project: aims
to break the taboo that still surrounds menstruation which results in girls and
young women not receiving explanation about the development of their bodies. It
thus provides information about personal hygiene and trains female trainers to
pass on this information to disadvantaged young women.
Yoell: which
focuses on production of exclusive jewellery, handmade by HIV infected women in
4.3
The
Holland Stellenbosch Medical Foundation (HSMF) was established in 2001 by 3
Dutch pulmonologists who worked at
Aims
and Objectives:
The
Foundation raises funds in order to contribute in all modesty to sustain,
develop and improve the level of healthcare in
- Educational projects,
- Bursaries for previously disadvantaged
medical students,
- Rural health projects,
- Training programs for medical staff in
general, and
- Funding towards the purchase of essential
equipment.
The
Foundation supports medical educative projects. It conducts this work through:
- Providing bursaries for underprivileged
students;
- Providing medical and ICT equipment for
learning purposes (
- Special projects: HIV-TB project, TB
course RUDASA; and
- Avian Park Service Learning Centre.
5.
CONCLUSION
The
report introduced the purpose, aims and objectives, and how the information
presented in it was collected. It thus provided an overview of the
The
report also provided information on inter-country adoptions. It thus presented
lessons and recommendations with regards to the protection of South African
children when adopted by international citizens.
Information
on collaboration between
REFERENCES AND LIST OF
ORGANIZATIONS
1.
The
2.
Mr
3.
4.
Medical Knowledge Institute (MKI)
5.
Oxfam Novib
6.
Philips Healthcare
7.
Hague Conference on International Law (HccH)
8.
Council for Protection of Children
9.
Foster Care Centre.