Deputy Speaker, I have already started answering part of this question by mistake. I was saying that in the four negotiated service delivery agreements, this issue of maternal and child mortality is Outcome 2, and a number of measures have already been taken to reduce maternal mortality.
The National Committee on Confidential Enquiries into Maternal Deaths has recently provided the latest triannual report on maternal mortality for the period from 2008 to 2010, which records the number of institutional deaths, causes of mortality, as well as recommendations to reduce mortality in both public and private hospitals in the country. The report found that by far the biggest cause of maternal mortality is HIV/Aids. It is then not by accident that out of the four major announcements made by the President on World Aids Day 2009 on our new approaches to treat HIV/Aids and tuberculosis, three were targeting women and children. This announcement was implemented on 1 April 2010, and we believe that the results will reflect a dramatic change in the number of HIV-positive pregnant women who pass away.
Another major cause of death was found to be obstetric haemorrhage. I am happy to announce that, working with the SA Blood Transfusion Service, all public health facilities that perform Caesarean sections have dedicated fridges for blood installed and managed by the SA Blood Transfusion Service and are now ensuring that blood is easily available when a life-saving transfusion is needed. In addition, working with universities' in-service training programmes, a process called Essential Steps in Managing Obstetric Emergencies, Esmoe, has been initiated. The report further identified 25 districts in the country which carry the highest burden of maternal mortality. The Esmoe process will then be extended to all of these districts in the 2012-13 financial year.
To improve rapid transport of women in labour in emergency situations provinces have purchased and employed obstetric ambulances and to date 105 dedicated obstetric ambulances have been purchased and are in use nationally. In addition, a plan to expand the number of maternity waiting homes has been developed within provinces.
As with interventions to reduce maternal mortality, a number of initiatives have been put in place to reduce infant mortality. The Prevention of Mother- to-Child Transmission programme has already yielded good results, with transmission rates at six weeks post-delivery cut by 50% from 8% to 3,5% nationally. In addition, pneumococcal vaccines and rotavirus vaccines were both introduced in 2008 and accelerated in 2009 as part of our routine immunisation programme. Coverage has improved significantly, and this will reduce deaths in children from pneumonia and diarrhoea.
Research has also found that a large number of children do not survive simply because they are not being breast-fed. This became worse in sub- Saharan Africa because, as part of the fight against HIV and Aids, many women were discouraged from breast-feeding. This was found to have had negative effects on child survival. A national summit on breast-feeding was held last year, and it adopted a declaration on exclusive breast-feeding, at least for the first six months of life. The promotion of exclusive breast-feeding will play a significant role in decreasing infant mortality as well. In this regard, a number of hospitals have already introduced breast milk banks whereby even children whose mothers cannot breast-feed can get breast milk from these banks. Thank you.