To what extent is Fetal Alcohol Spectrum Disorder considered in policy-related documents in South Africa? A document review

Health Res Policy Syst. 2019 Apr 29;17(1):46. doi: 10.1186/s12961-019-0447-9.


Background: South Africa is considered to have the highest prevalence of fetal alcohol spectrum disorder (FASD) globally. Nevertheless, the extent to which the South African government has responded to the high FASD prevalence at the policy level is unclear. Herein, we aimed to identify targeted and generic clauses that could be attributed to the prevention and management of FASD in relevant South African policy documents.

Methods: We conducted a search of two search engines (PubMed and Google) and the websites of South African national and provincial departments from January to April 2018. A total of 33 policy documents were included in this review. Using content analysis, we sought documents that mention the terms 'fetal alcohol syndrome' and 'fetal alcohol spectrum disorder'. The Framework method was also used to thematically identify specific and generic clauses attributed to the prevention and management of FASD in South Africa.

Results: The content analysis indicated that 12 policy documents contained the searched terms. Findings from the thematic analysis showed that targeted and generic clauses for FASD exist in various policy documents. Some of the generic clauses focused on the regulation of liquor outlets, enforcement of liquor laws, and the general management of persons with mental and educational challenges. Specific clauses focused on creating platforms to improve the awareness, screening, identification and support for individuals with FASD.

Conclusions: There is a noticeable increase in the number of policy documents that considered elements of FASD enacted in the last decade. Although this study revealed the existence of targeted and generic clauses that could be attributed to the prevention and management of FASD, the sustained high prevalence of FASD in South Africa, as reported in the literature, calls for more holistic and comprehensive approaches to tackle the FASD problem in South Africa.

Keywords: Fetal alcohol spectrum disorder; South Africa; alcohol; clauses; development disabilities; guidelines; management; policy; pregnancy; prevention.

Publication types

  • Review

MeSH terms

  • Alcohol Drinking / adverse effects
  • Alcoholism / complications
  • Commerce / legislation & jurisprudence
  • Developmental Disabilities / therapy
  • Documentation*
  • Ethanol / adverse effects*
  • Female
  • Fetal Alcohol Spectrum Disorders / diagnosis
  • Fetal Alcohol Spectrum Disorders / epidemiology
  • Fetal Alcohol Spectrum Disorders / prevention & control
  • Fetal Alcohol Spectrum Disorders / therapy*
  • Government Regulation
  • Government*
  • Health Policy*
  • Humans
  • Mental Disorders / therapy
  • Pregnancy
  • South Africa / epidemiology


  • Ethanol