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Dept of Health

Saving Mothers 2014-2016: Seventh triennial report on confidential enquiries into maternal deaths in South Africa: Short report

Foreword

The Saving Mother’s Reports (SMRs), as many would know are an analysis of data collected on each institutional maternal death provided by health facilities in South Africa. The SMRs are published triennially and disseminated to all hospitals, academic institutions and relevant professional bodies within the country. The analysis is done by members of the National Committee on Confidential Inquiries into Maternal Deaths; a Ministerial Committee consisting of experts in obstetrics, midwifery and anaesthesia with at least one representative from each of the nine provinces in the country. The SMRs are disseminated every three years and takes a tremendous effort by all members of NCCEMD. Therefore all members need to be thanked for their efforts in writing the various chapters in the report.

The latest SMR (2014-2016) shows a continued fall in both the numbers and mortality ratios of institutional maternal deaths since the peak in the numbers of deaths in 2009. The reduction in maternal deaths is in the main due to changes the treatment programmes for HIV positive pregnant women. Changes in antiretroviral drug (ARVs) regimen have seen a decrease of almost 47 per cent in the numbers of deaths due to non-pregnancy related infections (mainly HIV deaths) from the numbers in 2011. More specifically changes in drug regimen has seen a fall in deaths from adverse antiretroviral (ARV) drug events from 130 (2011-2014) to 27 (2014-2016). Furthermore, the NCCEMD’s recommendations to focus on reducing deaths in specific categories such as Obstetric Haemorrhage has resulted in a 22 per cent reduction of deaths in this category.

Major challenges, however, still remain and in the main these relate to quality of care, inter-facility transport, and knowledge and skills of health professionals; the quality of care is slowly improving but knowledge and skills is sometimes lacking. More effort needs to be put into respectful care and having a sense of being mindful. For the first time the NCCEMD has obtained more reliable information on “Home Deaths” and it appears that our post-partum care needs to be strengthened. Many of the women who died at home or those who return post- delivery in extremis may have been discharged too early. Finally, despite all the challenges faced by the NDOH, the minister of health needs to be thanked for making Women’s Health a priority issue.

J Moodley
Chair
National Committee on the Confidential Enquiries into Maternal Deaths

January 2018

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