“Women give life, and the right to life is one that we all hold sacred”, highlighted Deputy President Cyril Ramaphosa last week at the Partnership for Maternal, Newborn and Child Health 2014 Forum.
With less than 500 days remaining before the 2015 Millennium Development Goals (MDGs) deadline, the Forum reminded governments from around the globe that the fight against high maternal and childhood mortality is far from over.
The Countdown to 2015 report released during the Forum confirmed that fewer than half of the 75 countries studied would meet the target to reduce the deaths of children under the age of five by two-thirds by next year, and very few would have cut their maternal mortality ratio by three-quarters.
The report however indicates that South Africa has made significant progress especially in addressing childhood mortality. We have reduced under-five child mortality from 61 per
1 000 births in 1990 to 45 by 2012, against a MDG 2015 target of 20. It also points out that pneumonia and HIV/ADS account for 17 per cent each of under-five deaths in the country.
According to the report, maternal deaths were cut from 150 per 100 000 live births in 1990 to 140 in last year. At the Partnership Forum Health Minister Aaron Motsoaledi said: "The major causes of maternal mortality in South Africa are number one, and by far the biggest; HIV and Aids, followed by hypertension and lastly, postpartum haemorrhaging.”
The minister also stressed the importance of early and good quality antenatal services to ensure the health of both mother and baby, saying that the preference is for pregnant women to attend antenatal services from as early as 14 weeks or at the latest from 20 weeks.
Another concern is the high number of teenage pregnancies which account for 36 percent of maternal deaths, although they make up only 8 percent of the 1.2 million pregnancies reported annually.
According to Dr Jay-Anne Devjee, head of the obstetrics and gynaecology at King Dinuzulu Hospital in Durban, this is often due to the pelvises of teenagers which are not properly developed yet and “in much case they struggle to deliver naturally because their pelvises are still small.”
To address the maternal mortality rate among teenagers the Department of Health launched an extensive family-planning campaign earlier this year. As part of the campaign a new small contraceptive device known as subdermal contraceptive was made available free of charge at all public hospitals.
During the launch the Health Minister Motsoaledi, however, pointed out that the new device was not only targeted at young girls, but at all women, especially those who were advised by their doctors not to fall pregnant again following previous pregnancy-related complications.
South Africa has a number of successful initiatives in place to address maternal and childhood mortality. These include our world acclaimed antiretroviral programme, the Prevention of Mother-to-Child Transmission (of HIV) Programme; an extensive immunisation drive for children; and the African Union’s Campaign on Accelerated Reduction of Maternal and Child Mortality in Africa (CARMMA).
The latter consists of eight interventions at community and health facility level. These interventions are: early and exclusive breastfeeding, resuscitation of newborns, assessment and stimulation, immediate thermal care, clean-birth areas, hand washing, kangaroo mother care and full-facility care.
Although the implementation of CARMMA has proven successful, government is constantly working with the World Health Organisation and other bodies to improve our interventions. During last week’s Partnership Forum South Africa also adopted the Every New-Born Action Plan, which aims to end all preventable newborn deaths by 2035.
In another step, the Minister of Social Development Bathabile Dlamini recently announced a nutrition initiative planned for mothers and infants. “We will provide maternal support for expectant mothers as part of the 1000 days campaign. The campaign seeks to contribute in the reduction of maternal and child mortalities through improving access to nutrition for expectant mothers and newborn children.”
Deputy President Ramaphosa also confirmed government’s commitment towards improving the health of mothers and children, by ensuring women and their newborns receive the best care, support, stimulation and nutrition.
Over the past twenty years South Africa has come a long way in addressing maternal and childhood mortality. While we acknowledge that the road ahead is still a long one, we are confident that we have the best policies in place to move the country forward and ensure the health and wellbeing of our mothers and children.
Phumla Williams is Acting CEO of the Government Communication and Information System (GCIS)
