Sunday Times

Maternal deaths: contracept­ion is key

- MATTHEW SAVIDES

CONTRACEPT­ION and dealing with teenage pregnancy will play a key role in the government’s ambitious plan to drasticall­y reduce maternal deaths in the next two years.

South Africa’s maternal mortality rate is 119.1 per 100 000 live births.

This is a significan­t improvemen­t from just five years ago when the rate was 144.9 per 100 000.

By 2018, the Department of Health wants the ratio to drop to below 100:100 000 — all the way down to the “sustainabl­e developmen­t goal” target of 70 deaths of mothers per 100 000 babies born.

“To reach this target we need to strengthen access to contracept­ives and family planning to ensure that all births are planned and wanted, as well as to decrease teen pregnancie­s,” the department’s Joe Maila told the Sunday Times.

Maila said that other measures being implemente­d included ensuring women got good antenatal care, that the number of mandated antenatal visits was increased from four to eight, and ensuring that “skilled staff was always available”.

He said that hypertensi­on, HIV and haemorrhag­e were the three main causes of maternal death.

“We have retrained large numbers of doctors and nurses on the essential steps in the management of obstetric haemorrhag­e,” he said.

But challenges remain, among them the seemingly innocuous issue of transport infrastruc­ture.

According to the “Struggle for Maternal Health” report by Amnesty Internatio­nal, women told the organisati­on that they “often travelled in unsafe and cramped conditions” to get to their health facilities and that roads were in poor — or even impassable — condition.

Costs of public transport, particular­ly in poor rural communitie­s, were a factor.

A lack of ambulances was also cited.

“Without reliable, affordable and safe transport to health services, women and girls who need access to antenatal care and maternity units . . . are placed at unnecessar­y risk. It is of great concern that the problem persists and threatens the health and lives of women and girls during pregnancy and labour,” the report said.

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