Northern Province is the fourth largest Province. It has just established a level 3 hospital at the Pietersburg-Mankweng Complex. The province has a largely rural population.
The province has experienced many problems in establishing the notification of maternal deaths process. This is clearly seen by the small numbers of deaths reported relative to the population and in some months, no deaths were reported. The Department of Obstetrics and Gynaecology at the Pietersburg-Mankweng Complex has taken over responsibility for assessing cases from 1999. A process has been worked out to collect maternal deaths from all the districts in the province and reporting should improve significantly in 1999.
For these reasons, the pattern of disease shown in Table 12h.1 must be viewed with extreme caution.
Assessment of avoidable factors, missed opportunities and substandard care was not possible for the Province. However, as the population of Northern Province lives mainly in a rural setting the problems experienced by the province are likely to be similar to those experienced by the Eastern Cape, Mpumalanga and KwaZulu-Natal. Their recommendations for requiring guidelines and protocols, referral routes and criteria for referral and a skills and human resources audit would most likely also apply for the Northern Province.