25 February 2008, Emperor's Palace, Boksburg, Gauteng
Programme Director,
MEC's for Health,
Country Representatives of WHO, UNICEF, UNDP, UNFPA and UNAIDS.
Committee Members,
Department of Health Officials,
Members of the media
I would like to welcome all of you to this important occasion. Today we are launching three committees that have a very important role in our effort to improve the health of our population.
The improvement of health of women and children has always been a priority in the health care planning of our democratic government. As you know, the first major health policy decision taken by our government immediately after the attainment of democracy was free health care for pregnant and lactating women as well as children under five years.
In addition to the policy of free healthcare, we have built more than 1600 clinics which has increased access to health services for majority of particularly historically disadvantaged people.
Now, more than 94% of mothers attend antenatal care at least once during pregnancy and over 84% deliver in health care facilities. The 1998 SA Demographic and Health Survey found that the maternal mortality ratio (MMR) was 150/100 000. In 2002, Statistics SA reviewed all registered deaths and estimated MMR to be at 124/100 000.
Family planning package is available in all our facilities and women no longer have to suffer complication or even die as result of illegal abortion as the implementation of the Choice of Termination of Pregnancy has made this service available to those who need them.
The programme for prevention of mother to child transmission of HIV has been expanded to 90% of facilities with an uptake of 60%. Treatment protocol has been improved to include dual therapy and this intervention is being expanded.
PMTCT also serves as an entry-point for women to access comprehensive package of care for HIV and AIDS including nutrition, treatment of opportunistic infections and antiretroviral therapy.
As part of efforts to improve the health of children, many facilities have been designated as Baby-Friendly. Currently 100% of infants between 6 and 11 months of age receive vitamin A supplementation and the implementation of the community and household component of the Integrated Management of Childhood Illnesses strategy is expanding.
The overall immunisation coverage has been increased to 83% by 2006 and, in the same year, the country was declared Polio Free by the Africa Regional Certification Commission.
These are just some of the programmes that demonstrate our commitment as the Department of Health to improve the health of women and children. We chose to focus on this group because maternal and child health are the best indicators of the performance of the health system.
It is within this context that we are today launching the three committees: one on Maternal Mortality, Perinatal Mortality and Infant Mortality.
Perinatal and Infant Mortality committees are new committees while on Maternal Mortality, we are appointing new members since the three year term of office of the previous committee expired.
Each committee is made up of 15 members and they have been chosen to reflect the demographics of our country and various expertise in the health sector including doctors, nurses, academics and in-service health care professionals.
We request that each Committee has its first meeting within the next three weeks. The Cluster: Maternal, Child, Women's Health and Nutrition of the National Department of Health will provide the support and logistics needed for the successful work of the committees.
Programme Director, while significant progress has been made in addressing the challenges of maternal and infant mortality in the country, we believe there is still more that needs to be done. These committees are going to assist in collating and interpreting data that should assist us in making further advances in these areas.
Every maternal, perinatal and under five death will be recorded by these committees. They are going to record cause of death, the contributing factors and classify that death incident accordingly. They will thereafter make recommendations of the measures that need to be taken to address preventable causes and factors.
We expect these recommendations to include identification of improvements in the delivery of health services and protocols or guidelines to better manage cases within the health system. In cases where contributing factors are outside of the health system, we will have to engage with responsible sectors to ensure that such challenges are addressed.
This is an enormous task which requires dedication on the part of the committee members and cooperation from various roleplayers within the national health system. We need information to filter through from facilities where incidents are first reported up to the national level to enable these committees to have most accurate information that they can work on.
This approach should have an effect in improving the quality of health care. It is a strong tool for identification of problem areas and it serves as source of important data for further policy development and other remedial actions.
The confidential enquiries into maternal deaths was started in England and Wales in 1952 and extended to cover the United Kingdom in 1985. This effort contributed to the significant improvement of the healthcare of pregnant women and decrease in maternal mortality in the United Kingdom. South Africa is the only other country in the world that has instituted and sustained confidential enquiries into maternal deaths.
Considerable progress has already been done over the past ten years in determining the causes of Maternal Mortality through the work of the National Committee on Confidential Enquiry into Maternal Deaths. The work of this committee which is published every three years in the Saving Mothers Report has enriched the process of assessing deaths in an effort to improve the quality of care.
The work of this committee has enabled the Department to identify the causes of Maternal Deaths, the trends over the years and take remedial action necessary to strengthen the health systems, improve the quality of healthcare and prevent further deaths.
The Committees on Perinatal Mortality and Infant Mortality will build on the work done on Saving Babies and Saving Children which are important initiative but had limited coverage.
I urge you as new members of these Committees to facilitate the institutionalisation of recording of all deaths in the country both within facilities and in the community, in public as well as private sectors.
You should be able to report within the next six months. Further reports that you will deliver at the end of each year and at the end of your three year term should provide a more in-depth picture that identify trends and common factors that have to be addressed to reduce deaths.
We are determined as government to improve the health of women and children as part of the mandate given to us by the people of South Africa. Moreover, we have made committed in the Millennium Development Goals to, amongst other things:
So let us work together to ensure that we deliver on these goals. I wish to thank all the members of these Committees for rising up to the challenge by accepting the invitation to serve on their respective committees. Your attendance today is a further indication of your commitment.
It is now a great pleasure for me to officially launch the three Committees on Maternal Mortality, Perinatal Mortality and Infant Mortality
I thank you all.