Northern Cape has the lowest population of all the provinces in South Africa, but also is one of the largest. There are two relatively large cities with level 2 hospitals, Kimberley and Uppington. Tertiary referrals go to the Free State from Kimberley and to the Western Cape from Uppington.
Relatively few deaths were reported from the province. It is not know whether this is because of the low population or because of poor reporting. The pattern of disease is shown in Table 12g.1. This data must be viewed with caution because of the small numbers.
Avoidable factors, missed opportunities and substandard care could not be adequately assessed because of the low numbers. However, it appears that most of the deaths are occurring in patients who have not attended antenatal care. With the vast distances in the province, there are great distances between some patients and health institutions; this finding is not surprising. At Kimberley Hospital, there is not an established high care obstetrical unit, and this organisational difficulty has lead to insufficient care being given to severely ill mothers. Furthermore, although Kimberley has a post for a full-time consultant Obstetrician and Gynaecologist, the post is not filled.
Plans are a foot to ensure that notification of all deaths occurs. This is being done by having workshops throughout the province.
To ensure as many pregnant women as possible attend antenatal care, it is proposed that all clinics include an antenatal service.
A high care obstetrical unit has been planned for Kimberley Hospital.