- Pregnant women in rural NW village advised to buy supplements.
- Ramatlabama clinic has not had stock for months.
- Clinic staff fear health complications for mothers and unborn babies.
MAHIKENG – Pregnant women using Ramatlabama Health Centre outside Mahikeng in the North West Province, say they have been unable to get antenatal supplements from the clinic for months and instead have been advised to buy supplements privately from pharmacies.
The healthcare facility serves more than 2,000 residents in the surrounding rural community.
One expectant mother, Dimakatso* had her pregnancy confirmed at the clinic in June and when she returned in July, was given one pack of folic acid and ARVs. When she went back in August she was told there were no supplements available.
“They wrote it on a maternity book and said to me I must go buy pills at Clicks or a pharmacy.”
“Where will I get the money? Those things are expensive.”
Community healthcare workers in the area are concerned that the stockout could lead to health complications for both mothers and their unborn babies if not addressed urgently.
“I didn’t buy them the first month after booking at the facility. I am waiting for next month when they say maybe stock will come,” said another pregnant woman in her first trimester.
“I am scared for my baby. What will happen if the pills are not supplied again?”
Why antenatal supplements matter
South Africa’s primary healthcare guidelines recommend iron, calcium and folic acid supplements as part of antenatal care.
The guidelines state that iron can help prevent anaemia — low levels of healthy red blood cells. Calcium can help prevent pre-eclampsia — a pregnancy complication involving high blood pressure — while folic acid taken before conception and during early pregnancy can help prevent neural tube defects affecting the development of the baby’s brain and spinal cord.
A 2021 review of South African research found that anaemia affected between 29% and 42.7% of pregnant women in the studies examined.
Health-e News found that at private pharmacies, a month’s supply of iron supplements costs about R160, while 30 calcium tablets cost around R120. Several unemployed mothers in Ramatlabama village told Health-e News they cannot afford these prices.
Worry about potential health risks
For pregnant women like Lebogang Mosiane, a 32-year-old in her first trimester, the wait for supplements is not just inconvenient — it causes worry about potential health risks. Healthcare workers at the clinic say without daily iron and calcium, the women face a higher chance of complications for themselves and their unborn children.
“Most of us are not working. We are depending on either a child support grant which is R580 or the SDR [Social Distress Relief grant] of R370. That R580 is for child food and needs, not for pills that I should get free at the clinic. Some are first time mothers like me. Why should I buy something which I should be getting for free,” said Mosiane.
Ramatlabama clinic staff, speaking on condition of anonymity, confirmed they have been experiencing antenatal supplements stockouts for months since May this year. “The issue has been reported to the sub-district,” said one healthcare worker.
Department acknowledges supply problems
When asked for comment, North West Department of Health spokesperson, Tebogo Lekgethwane, acknowledged that the province was experiencing intermittent supply constraints affecting certain medicines and facilities.
“The department is closely monitoring the situation and implementing interventions at both provincial and national level to minimise disruptions to patient care. The department has also sought to reassure patients, healthcare workers and communities that efforts are underway to address the shortages and improve medicine availability,” Lekgethwane said.
Lekgethwane says the shortages cannot be attributed to a single factor or solely to the operations of the North West Department of Health. According to Lekgethwane, wider disruptions affect parts of South Africa’s pharmaceutical supply chain.
NW pharmaceutical services under internal intervention
Last year the North West Department of Health issued a media statement assuring patients and communities of a stable supply of medicines. It noted that pharmaceutical services in the province were placed under internal intervention in November 2023 following a system crash of the stock inventory management system at the provincial medicines depot.
Since then, changes have been made in the Provincial Pharmaceutical Management system with the aim of improving pharmaceutical service delivery and overall medicine availability.
Community health workers in Ramatlabama who spoke to Health-e News said government must urgently address supply chain issues at primary healthcare level, where most women access antenatal care.
They say many women are now going months without supplements because they cannot afford them.
“If we are serious about reducing maternal deaths and giving babies a healthy start, clinics cannot run out of basic, life-saving supplements like iron,” said one community health worker in the area.
*Not her real name.
