The “Saving Mothers 2008 – 2010” report, which summarises the findings on confidential enquiries into maternal deaths in South Africa for the period 2008 – 2010, is cause for concern. It reveals that the Institutional Maternal Mortality Ratio has increased when compared with 2005-2007. More maternal deaths were reported in 2008-2010 than in any previous years, and the MMR is still increasing.
Among the other findings are that non-pregnancy-related infections (mainly deaths in HIV-infected pregnant women complicated by TB and pneumonia) accounted for 45% of maternal deaths. Twenty-eight percent of maternal deaths were caused by haemorrhage and hypertension. The top three causes of maternal death are non-pregnancy related infections, obstetric haemorrhage and hypertension caused 70% of maternal deaths; and 81% of deaths caused by obstetric haemorrhage were avoidable.
The report recommends the prioritisation of interventions to address the three primary preventable causes of death. In the context of HIV and AIDS, measures should be taken to ensure universal knowledge in communities of the need for testing and planning pregnancies, and ensure that every maternity facility can screen for HIV infection and initiate early HAART therapy. The report also recommend the promotion of interventions to prevent deaths caused by haemorrhage, such interventions to include community education, prevention of prolonged labour, prevention of anaemia, and prioritising appropriate emergency responses in the event of haemorrhage at facilities. Further recommendations relate to hypertension, health-worker training and health-system strengthening.
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