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South Africa Struggles to Curb Maternal Mortality [Part 4 of 5]


Health experts list South Africa as one of the African countries performing poorly in efforts to reduce maternal and child mortality. The findings were reported in a survey issued by Countdown to 2015, an initiative of the UN, governments and NGOs. The goal of Countdown is to cut in half the number of deaths related to childbirth over the next seven years. The situation is blamed partly on its former system of apartheid which ended in 1994. Voice of America English to Africa service reporter Unathi Kondile in Cape Town looks at the findings of 'Countdown to 2015' with regards to South Africa.

Many experts blamed apartheid for a fragmented health care system that favored middle and upper class whites. A report by South Africa's Medical Research Council shows that only seven percent of the country's doctors serve in public health systems available to the poor.

About 75,000 children under five die each year – 30% of them newborn babies. Many are born with HIV-AIDS.

Dr. Mickey Chopra is an official of the Medical Research Council.

He says, "Ninety-five percent of women come for antenatal care in our country – more than 85% of women are delivered by a skilled attendant in a facility in South Africa. And yet we still have increasing maternal mortality and increasing child mortality. What it says is that we have this gap: people are coming to our services, but they're not getting the improvements they should be getting."

Most affected are remote areas and poor rural villages – where there are not enough health facilities. Chopra notes that South Africa's democratically elected government has had 15 years to integrate the fragmented health care systems it inherited

"We really have no excuse in South Africa. We have the financial resources; we have the commitment of government in primary health care and into the right policies. We just have to start to make things happen: re-affirm our commitment to mothers and children. Also, [we should strengthen our] priorities and facilitate some of the things I've mentioned in terms of training, facilitating services as well as [bringing] in new cadres of community workers and be creative in redressing our human resources shortages – but really put the pride back in health care in this country and show that we can make a difference."

There have been success stories, including the low-cost kangaroo mother care system. With this method, the baby is carried in a pouch around the mother's neck, much like a kangaroo carries its baby. The method is effective in keeping the infant warm, preventing infections and facilitating breast-feeding.

South Africa has also improved data collection on maternal and infant deaths, which enable health practitioners to refine their strategies for treating the problem.

Dr. Monir Islam is the director of the Department in Making Pregnancy Safer at the World Health Organization:

"What we are doing in South Africa is to look at how we can improve the quality of care of existing facilities. We're also looking at South Africa for South-to-South collaborations. Can some of the expertise we have in South Africa – can't that be used for Swaziland or Lesotho or Botswana or Kenya? So we're looking at both ways. One is to improve the quality of care, at the same time we're looking at South Africa - how we can tap into the resources you have, technical resources for South-to-South collaborations, particularly in SADC or neighboring countries."

Despite its poor ranking among the 68 countries with high child and maternal mortality, health officials say things are improving in South Africa. Since the end of apartheid, access to medical services has increased. And South Africa's Minister of Health Manto Tshabalala Msimang has sworn the government's commitment to improving the survival of the countries pregnant mothers and newborns.


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