Better health services could save 40 000 babies

2008-03-15 00:00

Gaps in the health care system cause unnecessary deaths of mothers and babies, according to the report “Every death counts”.

The deaths of up to 40 200 South African babies and children could be prevented every single year if gaps in the health care system, including poor patient care and lack of interventions to address HIV/Aids, were addressed.

Every year at least 20 000 babies are stillborn, another 22 000 die in the first month of their lives and 1 600 mothers die from complications of pregnancy and childbirth.

Some 75 000 children die before their fifth birthday, according to the report.

“The report makes for hard reading,” says Dr Mark Patrick, a paediatrician at Grey’s Hospital and one of the report’s authors.

“We are talking about a lot of deaths. Under-five mortality appears to be increasing. Maternal mortality appears to be increasing. HIV infection among pregnant women appears to be increasing,” says Patrick.

“The fact that 260 mothers, babies and children die every day in South Africa should make people stop and think and ask why this is happening.”

A very high percentage of maternal deaths, stillbirths and child deaths are caused by inadequate care on the part of health care providers, described as “modifiable factors”.

Modifiable factors were identified in over half the cases of women who died in childbirth at clinics and over half the child deaths.

Over two-thirds of stillbirths had “avoidable factors”, including the failure of health workers to attend to pregnant women’s high blood pressure. Proper monitoring during labour could save most of the 7 300 babies dying each year either during childbirth or shortly afterwards, said the report.

Babies under four months are falling through a gap between maternal and child care programmes, with only about a quarter of these babies going to the clinic for a check-up.

Another serious gap is in HIV testing, with only around two-thirds of pregnant women being tested for HIV.

“Coverage of key HIV interventions drops at the time of childbirth and postnatal care, when it is most crucial,” notes the report.

During pregnancy and early childbirth is the only time that interventions with anti-retroviral medicine can be made to prevent mothers with HIV from passing the virus on to their babies.

In addition, HIV-positive mothers need to choose to either exclusively breastfeed their newborn babies or give them formula milk to prevent them from getting HIV.

Last month, Health Minister Manto Tshabalala-Msimang appointed three committees to look into maternal mortality, perinatal mortality and infant mortality.

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