The confidential enquiry into maternal deaths in South Africa: a case study

Abstract

The Confidential Enquiry into Maternal Deaths (CEMD) in South Africa has been operational for 15 years. This case study describes the process of notification and independent assessment of maternal deaths, predominantly in facilities. In the earlier years of the Enquiry, institutional maternal mortality ratio increased and was 176.2 per 100 000 live births in the 2008–10 triennium; thereafter it decreased to 146.7 in the 2011/12 period. The slow progress was due to the significant contribution of HIV/AIDs to maternal mortality and challenges in implementing the recommendations that were devised from the findings of the Enquiry. Nevertheless, the CEMD process has been maintained and strengthened so it is currently able to perform routine maternal death surveillance at both national and district levels, identify deficiencies within the health system, generate reports and also provide early warning about alarming trends such as the increasing numbers of deaths due to caesarean‐section‐associated haemorrhage.

Intention to Use Institutional Delivery and Associated Factors among ANC Attendants in Wollaita Soddo Town, Southern Ethiopia: A Cross-Sectional Community Based Study, Application of Theory of Planned Behavioral Model

“…The majority of maternal health complications and deaths occurred in low and middle income countries where three quarters of the deaths are due to preventable direct obstetric complications [2,3,4,5,6].…”

Maternal death and caesarean section in South Africa: Results from the 2011 - 2013 Saving Mothers Report of the National Committee for Confidential Enquiries into Maternal Deaths

“…The National Committee for Confidential Enquiries into Maternal Deaths in South Africa (SA) (NCCEMD) has published triennial reports of maternal deaths [3] since its inception in 1998. In the previous report, concern was raised about the increasing rate of haemorrhage during and after CS.…”

Avoidable factors associated with pregnant and postpartum patients admitted to two intensive care units in South Africa

“…In an attempt to address the issue of AVFs associated with maternal morbidity and mortality, models for assessing preventability have been reported. [3,4] In SA, the AVFs associated with pregnant and postpartum patients admitted to ICUs are rarely reported separately, despite the contribution of these factors to both maternal mortality and morbidity. Given that ICUs are scarce facilities in SA, [5] the identification of these AVFs may lead to the development of recommendations to address these issues ,with a possible reduction in the number of ICU admissions.…”