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Purpose -The purpose of this research is to ascertain whether there has been a change in the outcome of critically ill pregnant women from the indigent South African population from a clearly defined region in Pretoria, after the introduction of new management protocols supported by regular audit and feedback. Design/methodology/approach -A comparison of outcome of all women with severe acute maternal morbidity or maternal deaths was made between 1997/1998 (original protocol) and 2002/2004 (new protocol) was performed. Findings -It was found that there was a significant increase in the prevalence of critically ill pregnant women between 1997/1998 (8.40/1,000 births) and 2002/2004 (10.22/1,000 births; p , 0.014), but a reduction in the MMR 133.2/100,000 births to 104.9/100,000 births (Odds Ratio 0.79, 95 Confidence Intervals 0.51 and 1.2) and in the mortality index from 15.9 per cent to 10.3 per cent (Odds Ratio 0.61, 95 per cent Confidence intervals 0.39 and 0.96). The pattern of primary obstetric causes of critically ill pregnant women has remained unchanged during the study period, but the prevalence of each disease category increased. The average number of dysfunctional organ systems per patient declined from 1.41 in 1997/1998 to 1.19 in 2002/2004. There were significant reductions in the number of critically ill pregnant women with renal dysfunction, metabolic dysfunction and cerebral dysfunction. The number of patient related, administrative related and medical personnel avoidable factors all decreased. Originality/value -The new protocols, audit and feedback have been associated with a reduction in the number of preventable and manageable complications experienced by critically ill pregnant women over the past five years.

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With the increasing prevalence of emphasis on lifestyle-related wellness, the focus has been diverted from treatment and cure of disease to prevention and health promotion. Therefore, the area of wellness has received much attention and has been promoted with much enthusiasm, especially in the corporate industry. The present study delved into the area of overall physical wellness and explored its components and the influence of an active work environment on these components. This study adopted a cross-sectional, quantitative experimental design Undergraduate university students (n = 165) and 234 training recruits and law enforcement employees underwent several wellness assessments in a bid to compare overall physical wellness in sedentary and active work environments. The individual results were compared and scored into risk areas that were ultimately compounded to formulate an overall physical wellness indicator. It was found that the students were superior in some areas of wellness; the recruits, however, possessed a more pronounced state of overall physical wellness. This indicates that physical activity does contribute significantly to attaining a state of overall physical wellness and so reduces the risk of developing lifestyle related chronic conditions. The overall findings suggest that maintaining a healthy lifestyle through physical activity and health-promoting behaviour will result in a greater state of wellness. In this area of research a host of possibilities for future research are unfolding especially the overall wellness indicator.