Health department vows to stem maternal deaths

The department of health has committed itself to stemming the rising number of maternal deaths.

Alarmed by the numbers recently presented in a report by the government-appointed National Committee on Confidential Enquiries into Maternal Deaths—a 20% increase in maternal deaths between 2005 and 2007—the department held a maternal child and women’s health summit this week to establish how the deaths can be reduced.

According to the report, 38,4% of the deaths were “clearly avoidable”.

Speaking at the summit Minister of Health Dr Aaron Motsoaledi said: “It’s uacceptable that mothers die from avoidable causes.” He added that he was equally concerned about infant mortality rates.
“It is clear that we are not doing enough to decrease perinatal and child deaths in our country. South Africa is one of only 10 countries in the world that has dismally failed at bringing down infant mortality,” he said.

The ministerial committees on maternal, perinatal and child health met with the minister and discussed recommendations on how these deaths could be avoided. Professor Sithembiso Velaphi, chairperson for one of the ministerial committees, said there needed to be “more bedsides classroom teaching”.

“I see many trained staff appointed in hospitals who can’t deliver,” he said.

Some of the problems that contributed to frequent deaths are incorrect diagnoses, delays in referring patients and the infrequent monitoring of patients by healthcare workers.

Velaphi recommended the improvement of skills and in-service training for clinical instructors, emphasising the need for an improved system for taking care of babies and mothers during and after they have given birth. “Many patients die because they did not have an appropriately trained nurse or doctors to look after the patients,” he explained.

Professor Jack Moodley, also a chairperson for one of the committees, proposed that healthcare staff should be assigned to check on patients after they had been discharged. “In some areas women may develop complications once they’ve been sent home. Often they’re unable to travel back to hospitals, as mothers who have just given birth are often not strong enough to travel long distances. They then end up dying because they couldn’t get medical attention in time.”

Moodley also recommended that national guidelines be established to deal with key conditions such as hypertension during pregnancy, obstetric haemorrhage and septic abortions, which are among the top five causes of maternal deaths.

HIV-infections are the biggest killer, accounting for 43,7% of maternal deaths. To reduce these deaths Velaphi said healthcare centres should ensure women are tested during pregnancies. “If a mother tests HIV-positive, nurses and doctors working with the patient should be made clearly aware of that, beyond the coding system currently in use, so that they can take all the necessary precautions.”

Motsoaledi said his department is taking the recommendations very seriously: “To strengthen these problematic areas we need to overhaul the health system in critical areas. That’s why I asked the provincial programme managers to attend this meeting. I want to know what the bottlenecks to implementing policies, protocols and guidelines are.”

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