Quality infrastructure key to better maternal and neonatal health

Health Minister, Dr Joe Phaahla, has acknowledged that infrastructure to provide quality care for mothers and children remains a challenge.

“Maternal and newborn experience cannot be a pleasurable moment for families unless it happens in a free, safe, respectful environment,” Phaahla said on Tuesday.

While there are infrastructure problems, he said, pace has been made to address the prevention of avoidable maternal and neonatal mortality through the establishment of the Ministerial Committees which focus on monitoring maternal, perinatal and child deaths.

The committees, according to the Minister, also produce recommendations on how these deaths can be prevented.

Phaahla was speaking at the first International Maternal Newborn Health Conference (IMNHC), organised by AlignMNH – a collective action for maternal newborn health, supported by the Gates Foundation and the United States Agency for International Development (USAID).

The conference convenes stakeholders from across the globe to accelerate solutions to improve maternal and newborn survival, prevent stillbirths and strive to achieve the ambitious targets outlined in the Sustainable Development Goals (SDGs).

Phaahla applauded government for scrapping user fees at primary healthcare (PHC) facilities and ensuring that mothers believe unhindered access to basic health services.

The provision of free services for all pregnant women and children up to five years, according to the Minister, has been critical in improving access to antenatal, intrapartum, and post-natal care for all mothers and newborns.

To ensure that every pregnant woman and her infant access a full package of maternal, neonatal and children health (MNCH) services, government has introduced basic antenatal care (ANC) plus, which includes eight antenatal care visits and early antenatal booking, and integration of HIV care, including universal antiretroviral therapy.

It also entails routine postnatal care, which is immunisation and promotion of early exclusive breastfeeding for newborns, and increased access to sexual and reproductive health services, including safe termination of pregnancy.

Phaahla said they also are investing in the training of doctors, midwives and essential management in the care of sick newborns.

“The journey of responding to the challenges that we are facing in the maternal and neonatal health service areas was never easy,” the Minister said.

South Africa, the Minister said, has reached 80% coverage for postnatal care and 80% coverage to access to management of small and sick neonates.

ANC visits, according to Phaahla, remain a challenge, which is sitting at 76%, against the 90% target. Access to a skilled birth attendant is at 78.3%, against a target of 90%.

“Other challenges in responding to gender-based violence, including violence against children and pregnant women, remain prevalent, and the high teenage pregnancy rate, with the age of young girls falling pregnant becoming younger and younger.”

However, vertical transmission of HIV infection has been reduced from almost 30% in 2002 to less than 3% in 2022. 

Meanwhile, under-five mortality declined from a high of 81 per 1 000 live births in 2003 to 28 per 1 000 live births in 2020.

“This decline is attributed to a reduction in deaths due to HIV/Aids. Purposeful efforts of strengthening HIV management and antiretroviral therapy (ART) programme to prevent vertical transmission were implemented across the country,” Phaahla said.

The other contributors include modern childhood vaccines, and addressing social determinants of health such as social grants to children and vulnerable pregnant women, which gain also contributed to food security.

Phaahla called on different countries, stakeholders and the private sector to join hands to create safe and pleasurable motherhood across the globe, irrespective of where they live or their economic situation.

The Minister stressed the need to continue to strive to achieve the reduction of the maternal mortality ratio, as envisioned in the DSG to less than 70 maternal deaths per 100 000 live births.

The goal also speaks to reducing preventable deaths of children under-five to at least as low as 25 per 1 000 live births and cutting neonatal mortality to at least as low as 12 per 1 000 live births and under-five by 2030.

Phaahla said he believes that the advent of the implementation of Universal Health Coverage in the provision of high quality maternal and newborn healthcare is an essential component that every woman needs, irrespective of social status. – SAnews.gov.za

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