HEALTH: Focus on health, systems
by Greg Nicolson,
2014-11-20 07:01:48.0
FOUR months into her pregnancy, Eve Morodo*, a 29-year-old waitress from Thembisa, started antenatal treatment, returning once a month to the Emkesiyi public clinic until the birth of her second child, a healthy boy, earlier this year.
Her experience shows that while SA’s public antenatal care services are functioning, there is much room for improvement. Antenatal care is a significant part of the NDP’s aim to achieve “a long and healthy life for all South Africans”. The plan says by 2030 life expectancy should increase to 70 years and under-five child mortality should drop from 56 per 1,000 lives to below 30. Infant mortality should fall below 20 per 1,000 births while the burden of disease is reduced and universal coverage achieved.
The rate of pregnant women interacting with the health system is high — about 97% attend an antenatal clinic at least once. In the antenatal sessions there is a particular focus on preventing mother-to-child transmission of HIV.
Morodo says the nurses — she only saw nurses, no doctor — took blood and urine samples, but she couldn’t say what all the tests were for. She was tested for HIV/AIDS and felt the staff respected her privacy. While the nurses were helpful and polite, the service upset her.
Arriving at the clinic at 8am she would wait until 3pm. “Each and every single time I am not going to work.” Each time she had to get a doctor’s note to show her employer. “It’s bad service ... I was not feeling good. Public clinics are not like private,” she said, reflecting a common perception. “For us, it’s mahala.”
Morodo went to the clinic after going into labour and within 15 minutes was taken by ambulance to Thembisa Hospital where doctors performed a caesarean after they told her the baby was too large for a natural birth. Her only gripe at the hospital was the nurses screaming at her to push before doctors decided to operate. After the birth, she got a pap smear test for cervical cancer and has taken her child to the clinic for immunisations.
A recent study by Amnesty International, however, criticises the antenatal care system. The organisation says the maternal mortality rate of 269 per 100,000 live births falls far short of SA’s Millennium Development Goal target of 38 by 2015. While most pregnant women access antenatal care, they do so late in their pregnancy. Amnesty says its research has shown that late and irregular clinic visits are due to three factors: lack of privacy; lack of information and knowledge about sexual and reproductive health rights; and problems related to the costs and availability of transport.
* Name changed to protect privacy
Picture: THINKSTOCK
FOUR months into her pregnancy, Eve Morodo*, a 29-year-old waitress from Thembisa, started antenatal treatment, returning once a month to the Emkesiyi public clinic until the birth of her second child, a healthy boy, earlier this year.
Her experience shows that while SA’s public antenatal care services are functioning, there is much room for improvement. Antenatal care is a significant part of the NDP’s aim to achieve “a long and healthy life for all South Africans”. The plan says by 2030 life expectancy should increase to 70 years and under-five child mortality should drop from 56 per 1,000 lives to below 30. Infant mortality should fall below 20 per 1,000 births while the burden of disease is reduced and universal coverage achieved.
The rate of pregnant women interacting with the health system is high — about 97% attend an antenatal clinic at least once. In the antenatal sessions there is a particular focus on preventing mother-to-child transmission of HIV.
Morodo says the nurses — she only saw nurses, no doctor — took blood and urine samples, but she couldn’t say what all the tests were for. She was tested for HIV/AIDS and felt the staff respected her privacy. While the nurses were helpful and polite, the service upset her.
Arriving at the clinic at 8am she would wait until 3pm. “Each and every single time I am not going to work.” Each time she had to get a doctor’s note to show her employer. “It’s bad service ... I was not feeling good. Public clinics are not like private,” she said, reflecting a common perception. “For us, it’s mahala.”
Morodo went to the clinic after going into labour and within 15 minutes was taken by ambulance to Thembisa Hospital where doctors performed a caesarean after they told her the baby was too large for a natural birth. Her only gripe at the hospital was the nurses screaming at her to push before doctors decided to operate. After the birth, she got a pap smear test for cervical cancer and has taken her child to the clinic for immunisations.
A recent study by Amnesty International, however, criticises the antenatal care system. The organisation says the maternal mortality rate of 269 per 100,000 live births falls far short of SA’s Millennium Development Goal target of 38 by 2015. While most pregnant women access antenatal care, they do so late in their pregnancy. Amnesty says its research has shown that late and irregular clinic visits are due to three factors: lack of privacy; lack of information and knowledge about sexual and reproductive health rights; and problems related to the costs and availability of transport.
* Name changed to protect privacy
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