Every death counts: saving the lives of mothers, babies and children in South Africa.

Publication: South African Journal of Obstetrics and Gynaecology
Date: Tuesday, April 1 2008

The major health challenges affecting the lives of women, babies and children in South Africa are pregnancy and childbirth complications, newborn illness, childhood illness, HIV and AIDS, and malnutrition. The country needs to address these 'Big 5' in order to meet the Millennium Development Goals

(MDG) for maternal, newborn and child survival, and for combating HIV and AIDS by 2015, according to a new report titled 'Every death counts'.

The report, which combines three earlier reports--on the Confidential Enquiry into Maternal Deaths in South Africa, the Perinatal Problem Identification Programme (PPIP) and the Child Healthcare Problem Identification Programme (Child PIP)--states that every year in South Africa at least 1 600 mothers die due to complications of pregnancy and childbirth, 20 000 babies are stillborn and another 22 000 die before they reach 1 month of age. In total at least 75 000 children die before their fifth birthday.

Consequently maternal and child mortality in South Africa continues to be a challenge, with poverty an important underlying cause of death that is related to each of the Big 5 health challenges.

Nevertheless solutions do exist, say the authors of the three reports, who for the first time have come together to present a unified call for action on maternal and childhood deaths in South Africa, more than half of which occur needlessly. Better care requires improvement in both coverage and quality of care. In South Africa a high percentage of births take place in health care facilities and high coverage for many primary health care interventions, such as contraception, antenatal visits and immunisations for children have been achieved.

However, gaps in the health care system require strengthening, such as referral links and quality of care. Consistent, high-quality implementation, especially for the poorest citizens, is required of the interventions to address the Big 5 health challenges, most of which are part of health care packages already in policy in South Africa.

If these interventions reached all families in South Africa, as many as 40 200 babies and children could be saved every year and a high proportion of deaths prevented among mothers.

In addition, actions should be taken to reduce unwanted pregnancies and to ensure full immunisation coverage. For further future action improved data are required on mortality rates and cause of death, especially HIV status, on strategies for providing postnatal care, and on the coverage, outcomes and quality of care provided.

Source: www.mrc.ac.za

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Every death counts: saving the lives of mothers, babies and children in South Africa.

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