Mother and child healthcare
Every year, 4,300 mothers die due to complications of pregnancy and childbirth, 20,000 babies are stillborn and another 23,000 die in their first month of life. In total, 75,000 children do not make it to their fifth birthday.
Despite conducive policies and high coverage of antenatal care and other services, the challenge of HIV and AIDS and the inadequate implementation of existing maternal, neonatal and child healthcare programmes are largely responsible for the loss of lives.
National data show that 61 per cent of under-five deaths are linked to avoidable factors related to failures of the health system. Furthermore, improving the quality of health services at the primary care level, with timely referral of patients to higher levels of the health system when necessary, is a priority. In order to meet this critical need, the Department of Health has started to re-engineer the primary healthcare system, on the basis of a three-pronged model which includes outreach by ward-based teams of community health workers, strengthened school health services and district-based clinical specialist teams, all focused on improving maternal and child health. UNICEF is providing support to all three streams.
In 2011, UNICEF helped to develop a leadership and mentorship package for KwaZulu-Natal’s Department of Health district specialist teams, with a view to rolling out the package to other provinces. The teams, which include a gynaecologist, paediatrician, anaesthetist, family physician, an advanced midwife, an advanced paediatric nurse and a primary healthcare nurse, aim to strengthen clinical governance in health clinics and district hospitals; supervise adherence to treatment guidelines and protocols, mentor clinicians and monitor health outcomes.
To improve the integration of PMTC and maternal, neonatal and child healthcare, a capacity-building programme was also developed and introduced to all districts in KwaZulu-Natal. The training aims to build the skills and competencies of community health workers to deliver home and community-based health services and improve referrals to fixed health facilities.
Also part of primary healthcare reengineering, the Departments of Health, Social Development and Basic Education revised the School Health Policy and implementation guidelines, with support from UNICEF. The poorest schools and a range of services have been chosen for initial implementation. School health services include screening of all grade R and grade 1 pupils for developmental readiness, vision and hearing tests, and making sure that children are fully immunised. Sexual and reproductive health education will be provided to older learners, to complement life skills education.