Friday, 25th of April 2008 |
CSU 17/2008: MATERNAL AND CHILD MORTALITY IN SOUTH AFRICA
South Africa, where health care is almost entirely self-financed, is
nearly unique in subsaharan Africa in seeing practically no morbidity or
mortality from malaria and measles (1 measles death in a population of 45
million in 2006!), which remain two of the big killers in the rest of the
continent. Public health and medical expenditure, at R2000 per capita per
year, gives South Africa the chance to do things which other African
countries cannot.
In this brief analysis of maternal and child mortality from South
Africa, the authors propose the following five actions by policy makers to
cut infant, child and maternal mortality.
1- Invest in the implementation of the HIV & AIDS and STI National
Strategic Plan 2007-2011, concentrating on provider-initiated testing, dual
therapy in PMTCT and universal coverage of antiretroviral therapy, and
supporting the integration of HIV & AIDS and nutrition programmes with
maternal, newborn and child healthcare packages.
This requires equitable and accessible healthcare services, prioritising
single-parent families, orphans and vulnerable children. Sustained
commitment to scale-up is the way to meet the nationally-agreed target of
reducing mother-to-child transmission of HIV to 5%.
2- Ensure full implementation of the high impact packages outlined in
this report, including high quality antenatal and intrapartum care; new
policies for the provision of postnatal care visits and support after the
fi rst week after childbirth, community and facility-based IMCI and the
Integrated Nutrition Programme. Increase funding for the highest burden
districts, redressing the current imbalance of primary health care
spending.
3- Provide an enabling environment through defi ned norms, standards and
operational plan for human resources and quipment, effective referral, and
investment in capacity-building and support for provincial and district
managers.
4- Increase monitoring and evaluation efforts through the completion of
maternal, perinatal and child mortality audits at all hospitals and request
quarterly reports for management at the district and provincial level so
these audits are linked to management action and promote higher coverage
and quality of birth and death certifi cation.
5- Develop and widely promote an agreed set of family health messages to
save the lives of mothers, newborns and children, particularly recognition
of danger signs and information regarding the care every family has the
right to receive.
Why does South Africa, like so many other countries, omit birth spacing
from its list of high impact interventions?
Good reading.
BD
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40759319 |
www.measlesinitiative.org www.technet21.org www.polioeradication.org www.globalhealthlearning.org www.who.int/bulletin allianceformalariaprevention.com www.malariaworld.org http://www.panafrican-med-journal.com/ |