According to a study released last August on behalf of Human Rights Watch, it became apparent that the attention to maternal health in South Africa was minimal, if any. Many women were neglected when they sought out care and when they were seen, they were often mistreated. Some women were pinched and slapped during labor, and others were verbally abused by nurses. One statistic shows that the maternal mortality rate has quadrupled in the last 20 years, from 150 to 625 deaths per 100,000 births, and questions have been raised given that South Africa provides free maternal health care and 87% of women give birth in hospitals or clinics.
“Some women had been chastised for being pregnant, made to clean up their own blood, or denied services because they were foreign. One South African woman delivered a stillborn baby after waiting for three hours to see a doctor at a district hospital; nurses had told her she was lying about being in labour.”
Since then South Africa has devised a plan announced yesterday, called the Campaign for Accelerated Reduction of Maternal Mortality in Africa (CARMMA), which seeks to create and maintain the “‘best practices’ to reduce maternal mortality, improve data collection and monitoring of maternal and newborn deaths, and mobilize political commitment by national authorities, civil society groups, and communities.” Data collection has been especially important, since it allows the government to set standards and create goals in order to analysis and evaluate the health care system. Another element of the campaign gives the public a voice to speak out and form complaints against the health care system if necessary. Specific practices of the campaign include a 40 unit fleet of ambulances spread across the areas of highest need, solely to address emergencies related to maternal or newborn health, since many deaths and complications have been attributed to difficulties in transportation and the length of time it takes to reach patients in need. Health care workers in the poorest provinces are also to receive more medical training with a focus on maternal emergencies and the state has also created “waiting homes” close to hospitals, where women can stay until they are ready to have their baby.
This shift towards a more proactive South African state is a great step in the right direction towards access to health and decreasing the number of health related human rights violations, but it had me thinking about the causes of maternal deaths and what is being done in that regard. Something I have briefly touched upon in my class in economic development is the troublesome cause and effect situation—is poor economic development the cause of the health issue, or was the health issue caused by poor economic development? Now in relation to this situation in South Africa, it has been said that a large portion of maternal deaths were due to HIV, hypertension, and blood loss. HIV is already an epidemic in South Africa that effects 18% of the population, which is more than any other country. Hypertension, more commonly known as high blood pressure, is a non-communicable disease (NCD), and as we have learned in class these should not be ignored either, nor should they be classified as merely being “first-world problems.” Would health policy towards providing care to prevent vertical transmission and access to ARVs be more beneficial in decreasing the number of maternal deaths? Would access to medicine that lowers blood pressure, or interventions that educate the public on better lifestyles and healthier diets be a better solution? I think that the importance of these two issues should not be forgotten as South Africa focuses on reducing maternal mortality ratio.
South Africa has recently also begun to roll out a system of health care across the country called the NHI (National Health Insurance), which provides equal access regardless of socio-economic, or employment status. This in itself is a great feat, one that not even the most developed of countries has figured out.