NATIONAL ASSEMBLY
FOR WRITTEN REPLY
QUESTION NO. 640
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 07 March 2011
(INTERNAL QUESTION PAPER NO. 4)
Mrs H Lamoela (DA) to ask the Minister of Health:
(1) Whether he has any strategy in place to ensure that the Government
meets its Millennium Development Goals (MDG) with regard to (a) child
and (b) maternal mortality; if not, why not; if so, in each case, (i)
what strategy (ii) when was it first implemented and (iii) who is
responsible for the (aa) implementation and (bb) monitoring of the
strategy;
(2) whether the Government is meeting its MDG targets in each case; if
not, why not; if so, what are the relevant details?
NW685E
REPLY:
1) South Africa does have a number of interventions in place to address
the key causes of maternal and child mortality. These include â
a) intervention packages aimed at improving child survival,
articulated in the Integrated Management of Childhood Illnesses
(IMCI) strategy. IMCIS focuses on the well-being of the whole
child aiming to reduce death, illness and disability, and to
promote improved growth and development among children under
five years of age. IMCI includes both preventive and curative
elements that are implemented by families and communities as
well as by health facilities. The strategy includes three main
components, namely, improving case management skills of health-
care staff, improving overall health systems and improving
family and community health practices, including infant and
young child nutrition, immunisation and HIV prevention (PMTCT)
and care.
i) and (ii) an over-arching Strategic Plan for
Maternal, Neonatal, Child and Womenâs Health (MNCWH)
and Nutrition in South Africa â 2009 to 2014 with
eight (8) strategies, namely â
- addressing inequity through targeting of under-
served areas;
- development of a comprehensive and coordinated
framework for provision of MNCWH & Nutrition
services;
- strengthening community-based MNCWH and
Nutrition interventions;
- strengthening provision of key MNCWH and
Nutrition interventions at Primary Health Care
and district levels;
- strengthening provision of key MNCWH and
Nutrition interventions at district hospital
level;
- strengthening the capacity of the health system
to support the provision of MNCWH and Nutrition
services;
- strengthening human resource capacity for
delivery of MNCWH and Nutrition services; and
- strengthening systems for monitoring and
evaluation of MNCWH and Nutrition interventions
and outcomes.
b) Maternal deaths were made notifiable in October 1997 by the
Minister of Health, and a National Committee on Confidential
Enquiries into Maternal Deaths (NCCEMD) was appointed to look
into all causes of maternal death.
i) and (ii) The recommendations that have been made
by the NCCEMD in their triennial reports have
afforded the Department the opportunity to focus on
four (4) main areas, namely, improving health care
provider knowledge and skills in providing emergency
care and ensuring adequate screening and treatment of
the major causes of maternal death; improving quality
and coverage of reproductive health services
especially contraception and termination of pregnancy
services; improving management provision of staffing
and equipment norms in the different levels of care
and improving transport services and the availability
of blood for transfusion; and community involvement
and empowerment regarding maternal, neonatal and
reproductive health in general.
Two other Committees were appointed in 2008 to
independently look at trends in perinatal and Under-5
morbidity and mortality and to recommend strategies
to reduce the morbidity and mortality within the
resources of the country.
HIV/AIDS has contributed to the high maternal and
child mortality in the country with indication that a
pregnant woman who is HIV positive has a ten-fold
chance of dying as compared to an HIV negative
pregnant woman.
On World AIDS Day 2009, the President directed that:
1. all pregnant mothers who are HIV positive be
treated when the CD-4 count is 350 or less,
instead of the then 200;
2. PMTCT be started at 14 weeks instead of the then
28 weeks;
3. all children born HIV positive be treated
immediately on diagnosis regardless of their CD-4
count.
All the above are being implemented since April 2010.
ii) (a) and (b) All Provincial
Departments of Health with support from the
National Department of Health are responsible
for implementing and monitoring these
strategies.
2) The MDG targets are supposed to be met by 2015.
END.