South Africa’s worst places to be a woman, mother

Black women hardest hit by lockdown
Women putting braids (File Image)

The annual District Health Barometer (DNB) provides district-level data on everything from maternal mortality and cervical cancer screenings to childhood immunisation and teen pregnancy rates.

The top ten worst districts to be a motherTop ten districts in which women are least likely to be screened for cervical cancer
HIV, haemorrhages and hypertension account for almost 70 percent of all maternal deaths in South Africa, according to the government’s latest Report on Confidentifal Enquires into Maternal Deaths.While the main causes underlying the deaths of new mothers have been identified in successive reports, the latest DHB argues that South Africa has yet to effectively implement many measures to prevent such deaths.

The DHB does show about an eight percent decrease in maternal deaths in public facilities since its last annual report.

While maternal mortality rates continue to vary largely between provinces, only Mpumalanga showed an increase in maternal deaths. The province also shows an HIV prevalence rate of about 40 percent among expecting mothers, according to the DHB.

1. Capricorn District, Limpopo (292 maternal deaths
per 100,00 live births)
2. uMgungundlovu, KwaZulu-Natal (279 / 100,000)
3. Uthungulu, KwaZulu-Natal (267 / 100,000)
4. John Taolo Gaetsewe, N. Cape (261 / 100,000)
5. Dr Kenneth Kaunda, North West (222 / 100,000)
6. Uthukela, KwaZulu-Natal (222 / 100,000)
7. Ekurhuleni, Gauteng (218 / 100,000)
8. Frances Baard, Northern Cape (204 / 100,000)
9. Buffalo City, Eastern Cape (197 / 100,000)
10. Sedibeng, Gauteng (195 / 100,000)

Cervical cancer is the second most common form of cancer among South African women after breast cancer. South Africa’s rates of cervical cancer are almost twice as high as the global average.Currently, women older than 30 years old who are HIV-negative are only offered three free pap smears – or one pap smear every ten years – in the public sector.

Most private medical aids will cover annual pap smears for women above the age of 16 years who are sexually active.

In 2010, South Africa introduced a policy to allow women living with HIV, who are a higher risk of developing cervical cancer, to access pap smears every three years. Despite this new policy, national pap smear coverage has increased less than one percent since 2011.

In an effort to prevent cervical cancer, girls in the poorest 80 percent of public schools will be vaccinated against the human papillomavirus (HPV), which can cause cervical cancer, beginning in February 2014.

  1. John Taolo Gaetsewe, Northern Cape (24% of women screened)
  2. OR Tambo, Eastern Cape (24%)
  3. Namakwa, Northern Cape (25%)
  4. Pixley ka Seme, Northern Cape (30%)
  5. Alfred Nzo, Eastern Cape (30%)
  6. Buffalo City, Eastern Cape (31%)
  7. Cacadu, Eastern Cape (31%)
  8. Siyanda, Northern Cape (31%)
  9. Sedibeng, Gauteng (34%)
  10. Amathole, Eastern Cape (37%)


Top ten districts home to the highest rates of teenage deliveriesTop ten districts in which children are least likely to be fully immunised by the age of one
Overall, the proportion of teen moms delivering in facilities has dropped by about 16 percent since 2007.Teen deliveries in Gauteng are steadily dropping.In Johannesburg, only percent of babies born in state clinics and hospitals are born to teen moms, however rates in some Eastern Cape districts are more than three times higher.

In July, Health Minister Dr Aaron Motsoaledi announced that sexual and reproductive services would be included as part of the Integrated School Health Programme in order to reduce teen pregnancies. This package will include contraception services for learners in grades 7 through 12.

  1. Alfred Nzo, Eastern Cape (13 % of all deliveries)
  2. OR Tambo, Eastern Cape (13%)
  3. Siyanda, Northern Cape (12%)
  4. Amathole, Eastern Cape (12%)
  5. John Taolo Gaetsewe, Northern Cape (12%)
  6. Umkhanyakude, KwaZulu-Natal (11%)
  7. Joe Gqabi, Eastern Cape (11%)
  8. Zululand, KwaZulu-Natal (11%)
  9. Sisonke, KwaZulu-Natal (11%)
  10. Ugu, KwaZulu-Natal (11%)



By one year of age, children in South Africa should have received at least 12 vaccinations ranging from those to prevent tuberculosis to measles.According to the DHB, South Africa maintains a national vaccination coverage rate of 94 percent, however these figures have been disputed in the past.Both the World Health Organisation and UNICEF have argued that actual vaccination rates are much lower at about 80 percent.

The DHB, which does not yet track new vaccines to combat rotavirus or pneumococcal disease, cautions that vaccination figures depending greatly on the accuracy of population estimates.

  1. Dr Kenneth Kaunda, North West (70% coverage)
  2. Alfred Nzo, Eastern Cape (70%)
  3. Central Karoo, Western Cape (72%)
  4. OR Tambo, Eastern Cape (74%)
  5. Pixley ka Seme, Northern Cape (79%)
  6. Zululand, KwaZulu-Natal (80%)
  7. Xhariep, Free State (80%)
  8. Amathole, Eastern Cape (80%)
  9. Greater Sekhukhune, Limpopo (81%)
  10. Amajuba, KwaZulu-Natal (81%)


*All figures have been rounded to the nearest whole number


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