Social factors determining maternal and neonatal mortality in South Africa: A qualitative study

Abstract

BackgroundSouth Africa’s maternal mortality ratio has increased from 150/100 000 in 1990 to 269/100 000 live births in 2015 against the Millennium Development Goals 5 (MDG5) target of 38/100 000, indicating slow progress in improving maternal health. The neonatal mortality rate was 14/1000 live births against the MDG4 target of 7/1000. The purpose of the article was to outline the socio-economic factors that determine maternal and neonatal mortality in South African communities.ObjectivesTo identify and describe the social determinants of maternal and neonatal mortality in South Africa.MethodA qualitative study using audio-taped individual interviews was conducted. The interviews included 10 pregnant women who were purposefully recruited from the antenatal clinic attendees in a public hospital. The interviews were conducted in isiZulu and later translated into English by the researcher who is fluent in both. Data were analysed using the World Health Organization’s (WHO) Commission on Social Determinants of Health framework.ResultsFindings revealed that poverty was an underlying factor to the vulnerability to illness and death of the mothers and their neonates. Other determinants were found to be the nutritional inadequacies, neglect and abuse by male partners, HIV or AIDS, inattention to reproductive health and violation of reproductive rights, and powerlessness of women and health system issues such as poor quality and incompetent health care.ConclusionIt is apparent that poverty plays a major role in determining the health of mothers and neonates. This requires more coordinated multi-sectorial interventions to address both the social determinants and direct causes of maternal and neonatal deaths.

Perinatal Mortality in Sub-Saharan Africa: A Meta-Analysis of Demographic and Health Surveys

“…With 68% of the population living on less than $1.25 per day and 86.9 million of its 180 million inhabitants living in extreme poverty [3132], the high level of perinatal mortality in Nigeria could be a result of poverty in the country. Poverty remains an underlying factor associated with poor birth outcomes, and studies have shown a significant association between poverty and perinatal mortality [3334]. Poverty is multidimensional, with economic, political, social, governance, health and environmental components that influence child survival at the individual, household and societal level [3536].…”

Institutional violence during the parturition process in Brazil: integrative review

“…Mistreatment and disrespect reports to women during the parturition process in health institutions are not recent, although their elimination is a claim of social movements for human rights, which in recent years have gained visibility because of the scientific evidence on the low quality impact of care during the pregnancy-puerperal period for women and children (1)(2) . These events have promoted conceptual advances on violence in institutionalized childbirth in the legal, political, and welfare practices, shaking government agendas (3)(4) .…”

Access and utilisation of reproductive, maternal, neonatal and child health services among women who inject drugs in coastal Kenya: Findings from a qualitative study

“…Other barriers operate to reduce supply, affordability and availability of these services. These include out-of-pocket health expenditures [33], inattention to reproductive health and rights [37], poor quality of health care [37], inadequate staffing [38], and lack of training of health providers [36], fear of being neglected or maltreated by health workers [34,36]. Our study adds onto existing literature showing that women who inject drugs may particularly be affected by these barriers [23,26,39].…”