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How To Improve Outcomes in South Africa — Global Issues


The risk of a woman dying from pregnancy-related complications is one in 500 in high-income countries, compared with one in five in low-income countries. Credit: Travis Lupick / IPS
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For every mother’s death, another death 20 women serious pregnancy-related injury, infection and disability. Professors Salome Maswime and Lawrence Chauke explain the state of maternal health in South Africa and how it can be improved.

How does South Africa compare to other countries?

In low-income countries, the 2017 maternal mortality rate was 462/100,000 compared with 11 / 100,000 won in high-income countries. In Western Europe, the rate is as low as 5 deaths per 100,000 births. Sub-Saharan Africa has 533 deaths per 100,000 births.

The risk of a woman dying from pregnancy-related complications is 1 in 500 in high-income countries, compared with one of 45 in low-income countries.

In West and Central Africa, the maternal mortality rate is 674 per 100,000. In South Sudan it is 1,150 and 1,140 in Chad.

South Africa has one of the lowest rates in Africa (113/100,000) but much higher than the UK (7/100,000). This rate in South Africa has fallen from 150 deaths per 100,000 births in 1998 to 113 deaths per 100,000 births in 2019, according to South Africa. Demographic and health survey and National Confidentiality Requirements on Maternal Mortality.

Causes of maternal mortality in South Africa

The three leading causes of maternal death in South Africa are HIV-associated infections, obstetric haemorrhage and hypertensive disorders of pregnancy.

Pre-existing medical conditions also account for a high proportion of pregnancy-related complications in South Africa. Most deaths are still considered preventable.

A considerable amount South African women go to antenatal care at least 4 times (76%) and give birth at health facilities (96%) under the care of a qualified birth attendant (97%). Ideally, these numbers should translate into much lower maternal mortality rates. This means that there are still gaps and more work needs to be done.

The biggest challenge is still late booking. Only 47% of women who booked in the first trimester in 2016. Between 2017-2019, 72% of women who died had antenatal care. But only half booked 20 weeks in advance.

Delays in antenatal care are associated with a higher likelihood of adverse pregnancy outcomes.

A very high rate (90%) South Africans live within 7km of a medical facility and 67% lived within 2km of the medical facility. Even so, women still struggle to get to medical facilities in time. The situation is even worse for rural women due to poor road infrastructure and poor emergency referral systems.

Healthcare facilities provide varying degrees of care. Most of deaths occur in district hospitals in South Africa, where effective emergency, critical care or specialist medical services may not be available. Patients with complications did not receive higher-level care for the appropriate time.

Even with access to higher levels of care, women may face shortages of specialist, medical and nursing staff in addition to overcrowding.

A completed report includes 2017 to 2019 showed that 80% of women who died received substandard care at district hospitals. The figure in community health centers and regional hospitals is 60%. As a result, poor quality of care is a major problem in the country’s healthcare system. The same report also identified overcrowding and under-resources, including shortages of medical and nursing staff, as the main causes of poor quality of care.

Disrespectful maternal care is also a problem. Abuse in maternity services in South Africa is described as “One of the world’s greatest disgraces” in 2015. It includes verbal and physical abuse, non-consensual care, non-confidential care, neglect and neglect. In some institutions, women speak they expect to be scolded, beaten, and neglected.

Maternal mortality is an indicator of access to care and quality of care. It is also indirectly related to socioeconomic factors. Women who have access to appropriate education, housing and employment opportunities are more likely to have better health outcomes than those who do not.

Sociodemographic variables such as “race” were also link for the way women are treated.

Healthcare workers’ attitudes towards patients have an impact on women’s health-seeking behavior and health-care providers’ provision of care (at the level of delay and withholding of care).

What can be done to improve the results?

The first step is to meet the need for contraception to avoid unwanted and unwanted pregnancies. In 2012, an estimated 215 million women globally had Unmet need for contraception.

Education and health promotion at the community level will encourage women to attend antenatal care and give birth in a health facility under the care of a skilled physician.

A mother’s care should be respectful and dignified.

Efficient transportation and emergency services are needed for women to receive timely and appropriate care.

A stronger health system will improve access to high-quality obstetric care. Women who survive complications of pregnancy and childbirth in functional health system, with an efficient referral system. There is an urgent need for a responsive health care system that takes into account population and disease trends.

Need to solve the imbalance between supply and demand for health services; improve the social and economic status of women in society as well as the quality of maternal and reproductive health care services, to win the battle against maternal mortality.Conversation

Salome MaswimeProfessor of Global Surgery, University of Cape Town and Lawrence Chaukeassistant professor, University of the Witwatersrand

This article was republished from Conversation under a Creative Commons license. Read original article.

© Inter Press Service (2022) – All rights reservedOrigin: Inter Press Service



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