Right to life and basic health
The Government of South Africa’s investment in the health sector is the highest in Africa – at 13 per cent of total expenditure – but its outcomes do not match the investment.
One in 17 children dies before his or her fifth birthday while one out of every 244 women does not survive pregnancy or childbirth (UN estimates).
Most child and maternal deaths can be avoided by preventative measures and timely medical attention. Thirty-five per cent of deaths in children under five are directly caused by AIDS-related diseases while 30 per cent are from neonatal causes such as stillbirths and birth asphyxia.
A high proportion of children who die are malnourished. Forty-four per cent of pregnant women die from AIDS-related causes, pneumonia and tuberculosis. Also worrying is that data from surveys suggests that immunisation coverage has decreased from 1994 to 2008.
The quality of care in hospitals, health centres and communities needs to be significantly improved if the high death rates are to decrease. In fact, the lives of 50,000 babies and children could be saved by 2015 if South Africa expanded coverage of high impact interventions such as Prevention of Mother-to-Child Transmission of HIV and improved neonatal care. With 5.6 million people living with HIV – of which 518,000 are children under the age of 15 – South Africa has the largest burden of the disease in the world. The epidemic has leveled off at the high rate of 17 per cent of the adult population.
South Africa is taking its response to the epidemic seriously by investing significant resources to reverse the spread of the disease. Antiretrovirals are given to HIV-positive pregnant women earlier in their pregnancies to prevent new paediatric infections. The HIV counselling and testing campaign launched in April 2010 is making progress. The national mother-to-child HIV transmission rate fell to 3.5 per cent in 2010, from 8.5 per cent in 2009.
The coverage of nutrition services and related behaviour varies but is generally low. South Africa needs to do more to improve children’s nutrition. An effective nutrition programme, which includes micronutrient supplementation, exclusive breastfeeding, timely complementary feeding and growth monitoring in the critical early years of a child’s life, is essential for achieving gains in child development.