A recent report by Human Rights Watch, “Stop Making Excuses’: Accountability for Maternal Health Care in South Africa,” documents maternity care failures that include the abuse of maternity patients by health workers and substandard care in Eastern Cape Province, putting women and their newborns at high risk of death or injury.
The report examines shortcomings in the tools used by health authorities to identify and correct health system failures that contribute to poor maternal health. Eastern Cape has some of the worst health indicators in South Africa, including high infant, child, and maternal mortality rates. But analyses by government and other public health experts show that other regions experience the same problems, including negative attitudes by health workers, poor quality care, administrative and financial management inefficiencies, and lack of accountability for health system failures.
A lack of oversight and accountability for recurrent problems in the health system and abuses committed by health personnel contributes to South Africa’s substandard maternity care and undermines one of its top health goals: to reduce its high maternal death rate. South Africa’s maternal mortality ratio has more than quadrupled over the past decade, making accountability structures to improve oversight and correct health system deficiencies all the more critical, according to Human Rights Watch.
South Africa is unlikely to meet its commitment under the United Nations Millennium Development Goals to reduce maternal deaths by 75 percent between 1990 and 2015. Its maternal mortality ratio increased from 150 deaths per 100,000 live births in 1998 to 625 in 2007, with HIV playing a role in many of the deaths, according to government reports. The UN estimates that 4,500 women die each year in South Africa due to preventable and treatable pregnancy- and childbirth-related causes. Human Rights Watch believes South Africa can reverse this trend.
Human Rights Watch calls on the national and Eastern Cape provincial governments to do more to identify barriers to quality health care and to use that information to strengthen the health system. Human Rights Watch calls on the South African national and Eastern Cape provincial governments to condemn physical, verbal, and other abuse of women seeking maternity care, and to take immediate steps to strengthen accountability to ensure women’s right to safe and dignified maternity care. It urges both national and provincial governments to improve complaint procedures to solicit needed information and provide remedies; ensure that health workers are involved in devising strategies to address systemic problems that lead to complaints, and develop systems to assess patterns of complaints and address systemic problems.
The report is based on field research between August 2010 and April 2011 with maternity patients, families, community caregivers, health and human rights experts, health workers, government officials, and representatives of donor and international agencies.
READ the full report here.
LEARN more about the report here.
VISIT the Human Rights Watch website here.