THE Gauteng provincial government is to revamp its maternity services - a move which could lead to the closure of poorly supported units in Soweto.
The plans, to kick in next year, include attaching new maternity facilities to overloaded hospitals and, according to department sources, closing some of the 20 existing outlying maternity facilities, most of them in Soweto.
Hospitals such as Johannesburg General are clogged up with basic maternity cases - its level of deliveries has nearly tripled in the past five years and women are routinely discharged just six hours after giving birth. But many of the township units are poorly used.
The new units would handle most of the hospitals’ maternity cases. Chief director of health programmes Dr Carol Marshall says the question of closing existing units has not been raised, though their status is being reviewed. Other sources say closures are likely, but the province is reluctant to discuss them, given the opposition to the proposals to reshape general health services it unveiled in October. Such community health centres are also at the forefront of government’s universal health care drive.
Department figures show many of the clinics operate maternity services well below a level judged by the province to be economically viable.
The units accounted for less than 20% of the deliveries the public sector handled in the past year. The clinics’ average delivery rate in the past year was less than 99 a month, against a cost effective level of 100-150 a month.
The 18 secondary and tertiary hospitals, which are supposed to deal only with referred cases, are handling most deliveries - averaging more than 440 a month.
“Johannesburg General is being swamped by women who don’t need that level of care,” Marshall says. “It’s obvious that if you have overworked staff you don’t have the same level of care.”