Over the past ten years, South Africa’s institutional maternal mortality ratio (IMMR) has declined.

Maternal mortality is an important issue that requires our attention. Defined as death occurring during pregnancy, childbirth, or the postpartum period, it is a dark reflection of the safety and well-being of women during the crucial stages of motherhood. While South Africa has made significant progress in lowering its institutional maternal mortality ratio (IMMR) over the past decade, there are still challenges that need to be addressed in order to further improve outcomes for women and their babies.

According to data from the Department of Health, South Africa’s IMMR fell from 144.9 deaths per 100,000 live births in 2011 to 120.9 deaths per 100,000 live births in 2021, marking a commendable reduction of 16.6%. Notably, some provinces experienced significant declines in IMMR during this period, including KwaZulu-Natal (35.5%), Limpopo (34.9%), and the Northern Cape (57.5%). However, the Eastern Cape and Western Cape provinces saw an increase in IMMR by 27.2% and 193.4%, respectively.

It is important to interpret these figures in the right context. The Eastern Cape and Western Cape provinces had the lowest IMMR figures in year 2011, making it challenging to maintain such low rates over time. In fact, in year 2021, the Western Cape outperformed the rest of the provinces, achieving the lowest IMMR. Thus, while the increase in IMMR may seem alarming, it does not necessarily imply poor performance. Instead, it underlines the need for sustained efforts to improve maternal healthcare in all provinces.

Key contributing factors

A key factor contributing to the overall decline in IMMR is improved access to prenatal care. The percentage of pregnant women visiting antenatal clinics before 20 weeks of pregnancy increased significantly from 31.3% in 2006 to 67.9% in 2021. These early visits make it possible to detect any potential complications and promote the safety of both mother and baby. The availability of contraception and safe abortion services, along with high-quality post-abortion care, has played a vital role in preventing unintended pregnancies and reducing maternal mortality.

Room for improvement

While progress has been made, South Africa still lags behind developed countries and other emerging markets in terms of IMMR. In 2020, South Africa’s IMMR was at 127 deaths per 100,000 live births, while countries like Australia and China reported much lower rates of 2.9 and 23 deaths per 100,000 live births, respectively. This difference indicates the need for continued efforts to further reduce maternal mortality and bridge the gap with global standards.

Addressing maternal mortality requires a comprehensive approach. Firstly, respectful and dignified maternity care must be prioritized, with efficient transportation and emergency medical services to ensure timely prompt access to adequate care. The majority of maternal deaths are preventable with timely interventions, making the availability of skilled healthcare providers and well-equipped facilities important.

Also, education plays an important role in promoting reproductive health and empowering women and girls. Comprehensive knowledge about STD and HIV prevention, cervical cancer, and other reproductive tract diseases is very important. Encouraging regular visits at antenatal clinics and highlighting the significance of giving birth in a health facility under the supervision of skilled attendants is crucial for detecting and managing complications effectively.

Lastly, a rights-based approach to women’s health is critical in fighting maternal mortality. This involves working towards raising the social and economic status of women and girls within our societies, making sure that there is equitable access to healthcare services, and improving the overall quality of maternity and reproductive healthcare.

Group effort

While South Africa’s progress in reducing IMMR is laudable, there is still work to be done. It requires a group effort from healthcare providers, policymakers in government, communities and individuals to address the remaining challenges and build a future where no woman dies due to pregnancy or childbirth-related complications.

By continuing to prioritise maternal health, invest in healthcare infrastructure, and empower women, we can create a society that values the well-being of our mothers and children.

[Image: jas from Pixabay]

If you like what you have just read, support the Daily Friend

Click here for a free 30-day trial with the CRA


Tawanda is a research analyst for the Centre For Risk Analysis (CRA). He is primarily involved in writing chapters for the Socio-Economic Survey of South Africa, a reference guide on major trends in various social and economic fields. Tawanda’s other responsibilities include writing opinion pieces, assisting in research projects and reports and liaising with the media. Tawanda holds an Honours in Business Management from the University of Limpopo and is currently studying towards his Masters in Business Management.