Saving the lives of South Africa's mothers, babies, and children: can the health system deliver?

Chopra, Mickey; Daviaud, Emmanuelle; Pattinson, Robert Clive; Fonn, Sharon; Lawn, Joy E

doi:10.1016/s0140-6736(09)61123-5

Cited by 178 publications

(193 citation statements)

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“…However, these need to be matched by improvements in quality of services. There is growing evidence from community groups working on the ground in a number of countries that weaknesses in the availability of beds and personnel combined with insufficient training in the face of growing demand leads to a number of questionable practices: women are discharged from the labour wards too soon after delivery; practices during delivery include routine episiotomies, application of excessive fundal pressure, unecessary oxytocin injections and other practices meant to speed up the delivery; unnecessary caesarean sections become the norm; and poorly trained personnel are unable to recognise or manage obstetric emergencies before it becomes too late to save the life of the woman (Chopra et al, 2009;Limwattananon et al, 2011;Oladapo, Daniel, & Olatunji, 2006;Rashid et al, 2011;Wahed, Moran, & Iqbal, 2010). This has led to a growing discussion in Latin America of the incidence of the phenomenon of so-called 'obstetric violence' as a characterisation of the serious quality failures that may result.…”

Section: Uhc -The Challenge Of Path Dependencementioning

confidence: 99%

“…Snow et al (2014) documents persistent inequalities in access to SRHR causing harm especially to women in the lowest two wealth quintiles, with 'key services … in shockingly short supply'. Furthermore, indirect evidence on HIV-and abortion-related and maternal deaths of adolescents suggests widespread gaps in access to health care (Chopra, Daviaud, Pattinson, Fonn, & Lawn, 2009;Houweling, Ronsmans, Campbell, & Kunst, 2007;Rashid, Akram, & Standing, 2011;Tilahun, Mengistie, Egata, & Reda, 2012). Santhya and Jejeebhoy (2014) provide evidence on the persistence of inequalities and gaps in SRHR among adolescents, especially girls.…”

Section: Introductionmentioning

confidence: 99%

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Sexual and reproductive health and rights in changing health systems

2015

Reproductive Health Matters

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Sexual and reproductive health and rights (SRHR) are centrally important to health. However, there have been significant shortcomings in implementing SRHR to date. In the context of health systems reform and universal health coverage/care (UHC), this paper explores the following questions. What do these changes in health systems thinking mean for SRHR and gender equity in health in the context of renewed calls for increased investments in the health of women and girls? Can SRHR be integrated usefully into the call for UHC, and if so how? Can health systems reforms address the continuing sexual and reproductive ill health and violations of sexual and reproductive rights (SRR)? Conversely, can the attention to individual human rights that is intrinsic to the SRHR agenda and its continuing concerns about equality, quality and accountability provide impetus for strengthening the health system? The paper argues that achieving equity on the UHC path will require a combination of system improvements and services that benefit all, together with special attention to those whose needs are great and who are likely to fall behind in the politics of choice and voice (i.e., progressive universalism paying particular attention to gender inequalities).Keywords: sexual and reproductive health and rights; universal health coverage/care; quality of care; accountability; equity Introduction Sexual and reproductive health and rights (SRHR) are centrally important to health outcomes in all countries. Sex and reproduction define unique and specific health needs for girls and women over the entire life course. Whether, how and to what extent these health needs are met by the health system depends on the extent to which girls' and women's human rights are respected, protected and fulfilled. Throughout the life course, the sexual and reproductive rights (SRR) of girls and women -to bodily autonomy and integrity, to choice in relation to sexuality and reproduction, to freedom from coercion, discrimination and violence or fear of violence, to safety, satisfaction and pleasureprofoundly shape their physical and mental health and well-being.

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Section: Uhc -The Challenge Of Path Dependencementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sexual and reproductive health and rights in changing health systems

2015

Reproductive Health Matters

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“…South Africa is a developing nation with a limited budget for treating non-communicable diseases such as cancer, not least because a large proportion of the country's healthcare budget is understandably spent on addressing the concurrent HIV/AIDS and TB epidemics (see for example the Lancet series on "Health in South Africa" published in 2009, with particular emphasis on the following publications: Abdool et al [158]; Chopra et al [159]; Coovadia et al [160]; and Mayosi et al [161]). Considering these financial constraints, two possible situations can be envisaged in which a patient treated in the public sector (i.e.…”

Section: Prospects Of 'Omics Based Molecular Approaches In Colorectalmentioning

confidence: 99%

Prospects of ‘Omics Based Molecular Approaches in Colorectal Cancer Diagnosis and Treatment in the Developing World: A Case Study in Cape Town, South Africa

Adeola¹,

Goosen²,

Goldberg³

et al. 2014

Colorectal Cancer - Surgery, Diagnostics and Treatment

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“…The under-5 mortality rate rose from 59 per 1,000 live births in 2007 (WHO 2010a) to 67 per 1,000 in 2008 (WB World Health Organization 2010a). South Africa is one of only 12 countries in which mortality rates for children under 5 years of age have increased since the MDGs were adopted in 1990 (Chopra et al 2009).…”

Section: Demography and Health Indicatorsmentioning

confidence: 99%

“…Moreover, many neonatal, child and maternal deaths could be avoided, particularly if HIV/AIDS-related deaths could be reduced (Chopra et al 2009). According to Coovadia et al (2009), South Africa has good policies in place to improve health care in South Africa.…”

Section: Demography and Health Indicatorsmentioning

confidence: 99%

Genetic services and testing in South Africa

2012

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South Africa is a developing middle-income country with a population of over 49 million people. It has a health system, based on national, provincial and private health programmes, which is in transition. There are well organised but small genetic services, based mostly in academic centres, provincial health departments and the National Health Laboratory Service. Trained medical geneticists, genetic counsellors and medical scientists are available to deliver the service. Funding for this service is limited, due partly to the extensive demands made by the rampant HIV/AIDS epidemic (which has lead to a falling life expectancy, and increasing maternal, child and infant mortality rates) and partly due to some ignorance, among both health professionals and the public, concerning the benefits of genetic counselling and testing in affected families. There are four academic human genetics departments across the country providing counselling (7,313 cases were counselled in 2008), testing services (16,073 genetic tests were performed in 2008) and professional training. They also undertake research. Only one tenth of the required staff, according to the WHO recommendations, is available at present to provide these services, and further employment opportunities are urgently required. However, training of professionals continues, comprehensive genetic testing facilities are available, research on many of the genetic conditions of specific concern to the country has been and is being undertaken, and patients from all over Southern and Central Africa make use of these services.

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Saving the lives of South Africa's mothers, babies, and children: can the health system deliver?

Cited by 178 publications

References 37 publications

Sexual and reproductive health and rights in changing health systems

Sexual and reproductive health and rights in changing health systems

Prospects of ‘Omics Based Molecular Approaches in Colorectal Cancer Diagnosis and Treatment in the Developing World: A Case Study in Cape Town, South Africa

Genetic services and testing in South Africa

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