Chair ... [Applause.] Thank you very much, colleagues! South Africa has made great strides in ensuring access to health care for women and children. We have free primary health care for all children under the age of six, to mention just one example. The number of health care facilities has, over the past 17 years, increased from approximately just over 3 600 to 4 200. So, much has been achieved with regard to access.
Why is it then that our child and maternal mortality rates keep increasing? In fact, we are only one of a handful of countries that are failing to reduce the rate at which mothers and children are dying.
As far as our Millennium Development Goals are concerned, our infant mortality target is to reduce to 18 the number of deaths per 1 000 live births. Our current rate is 53. That is nearly 200% higher than the 2015 target.
The under-5 child mortality rate is even worse, with our current levels hovering around 104 deaths per 1 000 live births, while our target is 20. That means our child mortality rate is thus 420% higher than our MDG target.
When we look at the maternal mortality rate, the situation is far worse. The 2015 target is to reduce maternal mortality to 38 out of each 100 000 live births. However, our current level is 625 per 100 000 live births. That is a staggering 1 500% higher than our target.
I know the Department of Health is about to publish the official maternal mortality rates based on confidential death inquiries. However, these inquiries understate the true maternal mortality rate as they only focus on facility-based deaths and exclude those who die at home. In this regard, South Africa is notorious worldwide for its poor quality in reporting.
Why then are we failing our women and children so spectacularly? Is it money? The simple answer is no. Even Minister Manuel alluded to this last week during the MDG workshop. Evidence shows, time and time again, that countries with lower or similar GDPs to ours are actually reducing child and maternal mortality rates. Some examples are Brazil, Vietnam, Algeria, Peru and Namibia, to mention a few who are all out-performing us.
So, is it HIV/Aids? Increasingly, the government is blaming HIV for the high rate of child deaths. It is ironic that the party that allowed Aids to obtain such a powerful iron grip across our country through their decade of denialism is now using this as an excuse.
Although baby deaths may, in some instances, be related to HIV and Aids, these and other causal factors are preventable. The main reason for babies and mothers dying in hospitals or during the postpartum period are largely attributable to the poor quality of health care provided in our hospitals.
Despite the availability of antenatal care, despite the availability of skilled birth attendants, and despite the hospital referral system, mothers and children continue to die. The main reasons for babies and mothers dying in our health care facilities are attributable to broken accountability structures resulting from the politicisation of service delivery in health care.
Another reason for the high mortality rate is corruption. An International Monetary Fund paper, titled Corruption and the Provision of Health Care and Education Services, directly links the increasing child and maternal mortality rates in a country to that of the levels of corruption. I quote from the report:
The empirical analysis shows that a high level of corruption has adverse consequences for a country's child and infant mortality rates, percentage of low birth-weight babies in total births, and dropout rates in primary school. In particular, child mortality rates in countries with high corruption are about one third higher than in countries with low corruption, and infant mortality rates are almost twice as high.
The report highlights important policy implications in the light of the role played by governments in the provision of health care. I am going to mention one due to time constraints. It says:
Improvements in indicators of health care and education services do not necessarily require higher public spending. It is equally, if not more, important to institute transparent procurement procedures and enhance financial accountability of public spending.
Evidence from across the globe proves that we can reduce infant, child and maternal mortality rates, but we just need the political will to fix the accountability structures within the health system, depoliticise the delivery of services and combat corruption. I thank you very much. [Applause.]