South Africa has made great progress towards reducing maternal mortality and newborn deaths over the past decade. However, the country still needs to significantly improve the quality of services provided to achieve the relevant Sustainable Development Goal (SDG) 3 to “Ensure healthy lives and promote well-being for all at all ages.” COVID-19 has only exacerbated the situation, putting at risk many of the recent gains made due to disruption in the provision and uptake of routine maternal and neonatal healthcare services.
A recent article published in the Global Health: Science and Practice journal details successful efforts to reduce maternal and neonatal mortality in the country, including adaptations to the program during the first 19 months of the COVID-19 pandemic.
Working with the Department of Health, South Africa, CHAI implemented a Quality Improvement program called Mphatlalatsane (meaning “the bright star before dawn”). The project aims to strengthen the maternal and neonatal health service package across antenatal, labor, and delivery services.
Global evidence suggests that early interventions at facility and community levels can decrease maternal and neonatal deaths and stillbirths. These interventions include birth preparedness and complication readiness programs, community-based campaigns to strengthen preventive services, improved access to contraceptive and family planning services, access to quality facility-based births, improving immunization uptake, improving women’s educational level, and quality improvement initiatives. Quality improvement programs empower healthcare workers to unlock service delivery bottlenecks under their control, rather than focusing on large-scale, resource-intensive changes. However, micro-level successes can only be sustained and successfully taken to scale if embedded in well-functioning, supportive health systems.
This program introduced many of these interventions to reduce the institutional maternal mortality rate across the program geographies by 29 percent; the mother-to-child HIV transmission rate at 10 weeks to less than one percent; and in-patient mortality among severely malnourished children by up to 39 percent.
The approach covered within the Mphatlalatsane program, lessons, and experiences will be crucial to South Africa as the country plans to make further progress toward SDG goals and reducing the number of preventable deaths of mothers and their newborns.