The Department of Health has published South Africa’s National Strategic Plan for a Campaign on Accelerated Reduction of Maternal and Child Mortality in Africa (CARMMA). CARMMA is an African Union initiative to promote and advocate for intensified development and implementation of initiatives by Member States to reduce maternal and child mortality.
The plan recognises that maternal, perinatal and under-5 mortality in South Africa is very high.
The primary causes of maternal death are (1) Non-pregnancy related infections, mainly AIDS (50%); (2) Obstetric haemorrhage (14%); Hypertension complications (14%); Pregnancy-related infections (5%); Complications of pre-existing medical conditions (9%). 40% of maternal deaths are avoidable.
The primary causes of under-5 deaths are (1) AIDS related deaths including TB (40%); (2) Diarrhoeal diseases (11%); (3) Pneumonia (6%); (4) Severe malnutrition (5%); Deaths during the neonatal period (18%) – low birth weight (12%), infections (3%), and birth asphyxia (3%).
The campaign goal: To accelerate the reduction of maternal and child morbidity and mortality through accelerated implementation of evidence-based interventions essential to improve maternal health and child survival.
The campaign objective: To accelerate implementation of key strategies through effective advocacy for quality maternal and child health care, health system strengthening, community empowerment and involvement and effective collaboration.
Targets and indicators: to reduce by 2/3rds, by 2015, the under-5 mortality rate; to reduce the maternal mortality ratio by three-quarters by 2015; to achieve universal access to reproductive health by 2015.
Key components of CARMMA in South Africa include: intensified access to sexual and reproductive health services; advocacy and health promotion for early antenatal care and attendance; improved access to skilled birth attendants; strengthened human resources for maternal and child health; improved child survival through the promotion of breastfeeding, improve immunization and Vitamin A coverage and intensified case management of sick children; and intensified management of HIV positive mothers and children.
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