KHOPOTSO: The report reveals that about 75 000 children die before they reach the age of five in South Africa every year. HIV/AIDS is one of the main causes of death. Professor Mickey Chopra is from the Medical Research Council and is one of the authors of the report.

Prof. MICKEY CHOPRA: The report highlights HIV/AIDS and neo-natal causes as the most important ones. The neo-natal causes are broken up into the both asphyxia, infections, and so forth. Those two cause two-thirds of all child deaths.      

KHOPOTSO: The lives of new mothers are also at risk. This study, looking specifically at pregnant women and those who have just given birth, estimates that about 1 600 new mothers die in South Africa every year.

Prof. MICKEY CHOPRA: Why do mothers die? The biggest cause(s) are non-pregnancy related infections such as TB, HIV/AIDS and pneumonia. Sepsis and hyper-tension during pregnancy is another big important cause.

KHOPOTSO: ‘€œEvery Death Counts’€ is a synthesis of three reports that look into the causes of death of South African newborns, children under the age of five and their mothers. Combined they show that HIV ranks among the ‘€œBig Five’€ causes of child and maternal mortality.

Prof. MICKEY CHOPRA: Between them they cause about 260 deaths per day. Pregnancy and childbirth complications, newborn illness, childhood illness, HIV/AIDS and malnutrition are the sort of ‘€œBig Five’€, if you like, of causes of deaths in South Africa of mothers, children and infants.

KHOPOTSO: Chopra says the reach of the country’€™s health care system has improved over the years. But he says several critical gaps remain in the system. These continue to cause increased child and maternal mortality.        

Prof. MICKEY CHOPRA: One important gap is that just over a quarter of mothers come early in their pregnancy, before 20 weeks. So, we’€™re missing opportunities to give interventions such as folates, nutrition education, prevention education early in pregnancy. Only 11% of mothers have the full package of ante-natal services that they should be getting, whether it’€™s in terms of HIV/AIDS education or PMTCT or HIV testing, and so forth.

So, even though three quarters of mothers come to the ante-natal clinic four times or more, only 1 in 10 of them is actually getting the full package of services and care that they should be getting in those four visits’€¦ And finally, there are the HIV/AIDS gaps. Not enough mothers are receiving the full package of PMTCT and not enough children, who need it, are getting simple interventions such as Bactrim and getting on to treatment as well. It’€™s around 25% and below. Those are critical interventions which we need to scale up.                      

KHOPOTSO: The report was launched at the opening of a major scientific conference focusing on child and maternal mortality. In accepting it, the Minister of Health, Dr Manto Tshabalala-Msimang, had this to say.

Dr MANTO TSHABALALA-MSIMANG: The mortality assessment is a key tool for identifying issues that need attention in order to improve quality of care at the policy, management and patient-provider interfaces. The data analysis and recommendations that result from such assessments should help strengthen strategies.

KHOPOTSO: Reducing HIV is one of the health-related MDGs or Millenium Development Goals adopted by the United Nations in the year 2000 and South Africa is a signatory to the goals. When it signed the declaration, South Africa committed itself to MDGs 4, 5 and 6, among others. In that particular order, the goals aim to reduce child deaths by two thirds, reduce maternal deaths by three quarters and to halt and begin to reverse the spread of HIV and AIDS between 1990 and the year 2015. But with the release of the ‘€œEvery Death Counts’€ report there are concerns that South Africa and many countries on the continent will not reach the targets that they agreed to. The Minister of Health defended South Africa and its neighbours.

Dr MANTO TSHABALALA-MSIMANG: Even though there are, indeed, concerns that we may not be able to meet these MDGs, I am convinced that Africa is trying its best and working very hard – even if we don’€™t meet the MDGs to have improved the quality of services that are provided to the women and children on our continent.