Every Death Counts:
Saving the lives of South Africa's mothers, babies and children
95 000 South African mothers, babies and children die each year in South Africa;
Many of these lives can be saved. Policy makers, managers, healthcare providers and
communities must work together to make it happen.
Three South African health reports - Saving Mothers, Saving Babies and Saving Children - provide valuable data on thousands of deaths that occur each year, and make recommendations to strengthen the quality of care provided to mothers, babies and children at the time when they need it most. The Honourable Minister of Health Manto Tshabala-Msimang highlighted these mortality audit reports when she launched three committees to oversee the audit process, on 25 February 2008, in Boksburg. She said:
“We chose to focus on this group because maternal and child health are the best indicators of the performance of the health system.”
In Every Death Counts, the authors of these three audit reports present a set |
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There are a number of factors contributing to the lack of progress in reducing deaths. HIV / Aids is a major contributing factor. HIV prevalence among pregnant women remains extremely high though progress has been made to improve testing, prevention of mother-to-child transmission (PMTCT), and provision of antiretroviral treatment. Still, each year 300 000 pregnant women with HIV need PMTCT services for themselves and their babies. Poverty and extreme inequity are barriers to accessing high quality essential services and limit the ability of families to make healthy choices.
These deaths are more than just statistics. Andiswa Mateza returned to the Eastern Cape to be closer to her family when she found she was pregnant with twins. Andiswa started experiencing very high blood |
of unified recommendations with specific actions for government officials, policy makers, health managers and healthcare providers to save lives.
Situation
Each 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 one month of age.
- in total, at least 75 000 children die before their fifth birthday.
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| Sam, an orphan, places a withered flower on the grave of his friend Luke, a fellow orphan who died of AIDS. Sam is one of 32 orphans living with caretaker Dianne Lang in Middelburg, Eastern Cape. Credit: Dianne Lang / Photoshare, 2003 |
This toll of over 260 deaths every day is due to five major health challenges:
- Pregnancy and childbirth complications
- Newborn illness
- Childhood illness
- HIV & AIDS
- Malnutrition.
South Africa needs to address these ‘Big Five’ in order to meet the Millennium Development Goals (MDGs) for maternal and child survival and for combating HIV & AIDS by 2015. South Africa is one of only a dozen countries not making progress towards the child survival MDGs.
Some countries that had similar mortality rates and similar gross national incomes to South Africa, such as Brazil, Mexico, and Egypt, are on track to meet the MDG for child survival and have halved their under-five mortality rate since 1990.
pressure when she was 22 weeks pregnant and had an emergency cesarean section to deliver the twins. The babies were both very small; the boy died just two days after birth, and the girl died at 8 weeks. Edward Mateza, Andiswa’s husband said,
“On the night of 18 January the baby stopped breathing, but there was no transport and the clinic was too far. On 19 January my wife took her to the hospital, but it was too late. On 25 January I was taking leave from work in Cape Town to visit my wife and parents so the baby could be named, but she died too soon. My baby girl was never named.”
Solutions
Solutions exist to address the ‘Big Five’ health challenges and prevent these deaths. In South Africa a high percentage of births take place in healthcare facilities, and we have high coverage for many primary healthcare interventions, such as contraception, antenatal visits, and immunisation of children. Effective life-saving interventions are in place, but what is required is high quality implementation, especially for the poorest citizens. According to Dr Robert Pattinson, report author and Director of Maternal and Infant Health Care Strategies Unit, Medical Research Council, “providing quality care means doing the right thing right, right away.”
Saving Lives
Many of these lives could be saved - over 40 000 lives each year - if well-known solutions are implemented.
“A new analysis for this report revealed that at least 40 200 babies and children could be saved every year if high-impact interventions reached all families in South Africa. A high proportion of women’s lives would also be saved with more investment in the same solutions that save the lives of babies and children.”
Dr Joy Lawn, report author and Senior Policy and Research Advisor for Save the Children USA.
