Every Death Counts: South Africa's Mothers, Babies, And Children

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Main Category: Public Health
Also Included In: Nursing / Midwifery;  Pregnancy / Obstetrics;  Pediatrics / Children's Health
Article Date: 10 Apr 2008 - 16:00 PDT

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The combined authors of three health reports on South African maternal, neonatal, and child deaths have come together to launch a new report, entitled Every Death Counts, which analyzed the combined data and proposed key strategies to reduce this horrible mortality burden in this country. This was published in a Public Health Paper in the Countdown Special Issue of The Lancet, put out on April 12, 2007.

In this study, Joy Lawn, Saving Newborn Lives/Save the Children-US, and colleagues from the South Africa of the Every Death Counts Writing Group say: "All indications are that maternal and child mortality has increased since the baseline for Millennium Development Goals in 1990." Every year in South Africa, at least 1,600 mothers die to pregnancy and childbirth complications. Approximately 20,000 babies are stillborn while 22,000 die before reaching the age of one month. In total, 75,000 children die before turning five.

Five major health challenges contribute to this toll: pregnancy and childbirth complications, newborn illness, childhood illness, HIV and AIDS, and malnutrition. South Africa is one of twelve countries globally in which child mortality rates have increased since 1990. As a result, the country must now achieve a yearly rate of 15% reduction to meet the Millennium Development Goal 4 by 2015. According to the authors, "This toll is too high in view of South Africa's status as a middle-income country and capacity to provide services...The existing high coverage of many key interventions presents an opportunity to save lives by focusing on high-quality services and integration of HIV/AIDS care, while addressing inequity by reach the poorest and marginalized populations."

Some of these lives could be spared: over 40,000 babies and children each year could be saved if high-impact interventions reached all families in South Africa. With more investments in the solutions that save babies and children, more women's lives could be saved. There are many success stories, of individual clinicians and hospitals that have made an impact in a short time, but national progress, they point out, will require national leadership.

The authors conclude that this new data must be used to shape future policy. "National mortality audits for mothers, babies, and children are an achievement and present recommendations and strategies to save lives. The new Every Death Counts report brings these aims together as one harmonised set of recommendations. However, if South Africa is to see a reduction in maternal, neonatal, and child mortality, these recommendations need to be fully implemented to turn mortality data into action. This goal needs accountability at all levels. Then every death will truly count."

Every death counts: use of mortality audit data for decision making to save the lives of mothers, babies, and children in South Africa
Every Death Counts Writing Group
The Lancet, Vol 371, April 12, 2008, 1294-1304
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South Africa in the spotlight
Editorial
The Lancet, Vol 371, April 12, 2008, 1215
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Written by Anna Sophia McKenney
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