August 25, 2011
Poor governance, corruption, and abuse in South Africa's health care system contribute to its high maternal death total of some 4,500 women annually, according to Human Rights Watch. A new HRW report documents care failures, abuse of maternity patients by health workers, and inferior services in Eastern Cape Province that put lives at risk.
South Africa's maternal death rate more than quadrupled over the past decade, from 150 deaths per 100,000 live births in 1998 to 650 deaths per 100,000 in 2007, putting the UN Millennium Development Goal of no more than 38 maternal deaths per 100,000 by 2015 completely out of reach.
Better reporting and the country's 18 percent HIV infection rate could both be factors in the increase, HRW said. The government claims nearly half of maternal deaths between 2005 and 2007 were related to HIV/AIDS. However, just 9 percent of maternal deaths in sub-Saharan Africa overall are HIV/AIDS-related. The report quotes witnesses who say HIV-positive women in South Africa are denied care or given it too late.
"The basic issue is lack of oversight and accountability in terms of monitoring what is happening, and acting on it," said Agnes Odhiambo, the HRW project's lead researcher. "If nurses are abusive, they need to be accountable; if people are corrupt, they need to be made accountable."
Most of the witnesses interviewed, who were not identified for fear of repercussions, did not file complaints. There were no responses in the few cases where complaints were lodged, HRW said. Several women said they avoided government facilities because of widely known stories of patient abuse.
"We are very, very much aware ... painfully aware," said Aaron Motsoaledi, South Africa's health minister. He agreed with "some" of the findings, but added that he has been working several years to reduce the maternal death rate.
To download the report, "'Stop Making Excuses': Accountability for Maternal Health Care in South Africa," visit: www.hrw.org/reports/2011/08/08/stop-making-excuses-0.