MDG 4 Target: Reduce by two-thirds, between 1990 & 2015, themortality rate of children underfive years.
MDG 4 Target: Reduce by two-thirds, between 1990 & 2015, themortality rate of children underfive years.
At the close of the MDG period South Africa had madesubstantial progress, but not sufficient to achieve itsMDG 4 target based on the set indicators
WHERE ARE WE AS A COUNTRY?WHERE ARE WE AS A COUNTRY?
WHERE ARE WE AS A COUNTRY?WHERE ARE WE AS A COUNTRY?
Goal indicators
1994 baseline (ornearest year)
2010Status(ornearestyear)
2013Status(ornearestyear)2015
Currentstatus(2014 ornearestyear)2015
2015Target
Targetachievability
Indicator
Under-five mortalityrate (per 1,000 livebirths)
38
(1998)
38.7
(2011)
37.5
(2012)
34.3
(2013)
20
Not Achieved
Infant mortality rate(per 1,000 live births)
54 (1998)
26.5
(2011)
24.9(2012)
23.6
(2013)
18
Not Achieved
Proportion of 1 year-old childrenimmunised againstmeasles
68.5 (2001)
84.8
87.3
91.2
> 95
Not Achieved
Under five & Infant mortality ratesince 1998 and the 2015 MDG target
Under five & Infant mortality ratesince 1998 and the 2015 MDG target
Neonatal mortality rate
Neonatal mortality rate
Proportion of under-one year oldchildren who received all primaryvaccinations
Proportion of under-one year oldchildren who received all primaryvaccinations
Measles immunisation of childrenunder the age of 1 year
Measles immunisation of childrenunder the age of 1 year
Life expectancy at birth
Life expectancy at birth
Goal indicators
1994 baseline(or nearestyear)
2010Status (ornearestyear)
2013Status(ornearestyear)2015
Currentstatus(2014 ornearestyear) 2015
(RMS)
2015Target
Life expectancyat birth
53.4
(2002)
60.4(2007)
60.2
62.2
Notarget
Key drivers of progress in thereduction of child mortality rates
Key drivers of progress in thereduction of child mortality rates
•Access to clean water and sanitation for manyhouseholds and
•Introduction of child support grants played an importantrole in improving nutritional, educational and healthoutcomes among children.
•Key child survival strategies such as immunisations,breastfeeding promotion, PMTCT, anti-retroviral therapy(ART) and treatment of common childhood illnesses(such as diarrhoea and pneumonia) using the IntegratedManagement of Childhood Illness (IMCI) approach, havecontributed to the decline in child mortality noted above.
TOWARDS SUSTAINABLEDEVELOPMENT GOALS (SDGS)
TOWARDS SUSTAINABLEDEVELOPMENT GOALS (SDGS)
Related Sustainable Development Goal (SDG)
•Goal 3: Ensure healthy lives and promote well-being forall at all ages.
Related cross cutting goals:
•Goal 1: End poverty in all its forms everywhere.
•Goal 2: End hunger, achieve food security and improvednutrition, and promote sustainable agriculture.
•Goal 6: Ensure availability and sustainable managementof water and sanitation for all.
MDG 5 TARGETSMDG 5 TARGETS
MDG 5 TARGETSMDG 5 TARGETS
•To reduce by three quarters, between1990 and 2015, the maternal mortalityratio.
•To achieve by 2015, universal accessto reproductive health
WHERE ARE WE AT THE CLOSE OF THEMDG ERA?WHERE ARE WE AT THE CLOSE OF THEMDG ERA?
WHERE ARE WE AT THE CLOSE OF THEMDG ERA?WHERE ARE WE AT THE CLOSE OF THEMDG ERA?
•South Africa has made significantprogress with regard to theimprovement of maternal health andthe reduction of maternal mortalityrate but could not achieve all the goalindicators.
WHERE ARE WE AS A COUNTRY INRELATION TO THE SET INDICATORS?WHERE ARE WE AS A COUNTRY INRELATION TO THE SET INDICATORS?
WHERE ARE WE AS A COUNTRY INRELATION TO THE SET INDICATORS?WHERE ARE WE AS A COUNTRY INRELATION TO THE SET INDICATORS?
Goal indicators
1994baseline (ornearestyear)
2010Status(ornearestyear)
2013Status(ornearestyear)2015
Currentstatus(2014 ornearestyear)2015
2015Target
Targetachievability
Maternal mortality ratio (deathsper 100,000 live births)
134
(2002)
270
(2010)
141
(2013)
141(2013)
38
Notachieved
Proportion of births attended byskilled health personnel(percent)
84
(1998)
91
(2003)
100
Notachieved
NA
Delivery rate in health facilities(percent). [Proxy for skilledbirth attendance]
67 (2003)
79.5
(2010)
81.5
(2013)
85.6(2014)
96
Contraceptive prevalence rate(percent)
50.1
(1998)
50.2
(2003)
100
NotAchieved
Antenatal care coverage (atleast one visit and at least fourvisits) (percent)
76.6
(2001)
102.8(2009)
100.6(2011)
92.9
(2014)
100
Notachieved
Maternal mortality ratio
Maternal mortality ratio
Contraceptive prevalence rate
Contraceptive prevalence rate
•Data not available. Proxy used is couple year protection rate
Source: DHIS
Adolescent birth rate
Adolescent birth rate
•Data not available. Proxy used is under 18 facility deliveries
Source: DHIS
Antenatal care coverage (1st visit)
Antenatal care coverage (1st visit)
Source: DHIS
•Population based data unavailable. Facility data are used
Key drivers of progress in thereduction of maternal mortality rate
Key drivers of progress in thereduction of maternal mortality rate
•Progress on improving maternal healthhas occurred due to several policy andprogramme changes that have increasedthe coverage of essential interventions
•The strong PMTCT programme, which hasseen a significant reduction in HIV relateddeaths during pregnancy.
Key drivers of progress cont…
Key drivers of progress cont…
•Contraceptives are freely available inpublic clinics and the 2012 NationalContraception Clinical Guidelines andNational Contraception has seen anexpansion of contraceptive choices.
•The 1996 Choice on Termination ofPregnancy Act has seen an increase inthe uptake of safe and legal pregnancytermination.
Key drivers of progress cont…
Key drivers of progress cont…
• Regular audits of maternal deaths areconducted.
•The National Committee on ConfidentialEnquiries into Maternal Deaths(NCCEMD), which makesrecommendations for the reduction ofmaternal mortality.
TOWARDS SUSTAINABLEDEVELOPMENT GOALS (SDGS)
TOWARDS SUSTAINABLEDEVELOPMENT GOALS (SDGS)
•Goal 3.1: by 2030 reduce the global maternal mortalityratio (MMR) to less than 70 per 100,000 live births.
• Goal 3.7: by 2030 ensure universal access to sexualand reproductive health care services, including forfamily planning, information and education, and theintegration of reproductive health into national strategiesand programmes.
•The question is, What to we need to do to reach thesedevelopment goals?
Conclusion and Recommendation cont…
Conclusion and Recommendation cont…
•There is a need to strengthen the existing surveillancestrategies for monitoring maternal and child morbidityand mortality in South Africa.
• Data based on the current surveillance system do notaccurately reflect maternal and child mortality rates inSouth Africa.
•Improving the maternal and child morbidity and mortalitysurveillance systems would allow a more reliablecomparison of South Africa with other countries andprovide a rational basis for public health preventionstrategies and improvement of health care services.
Behind Every Healthy Child Is aHealthy MotherImprove maternal health & reducechild mortalitiesNo reason for mothers and babies todie of preventable and treatablecauses
Behind Every Healthy Child Is aHealthy MotherImprove maternal health & reducechild mortalitiesNo reason for mothers and babies todie of preventable and treatablecauses
THANK YOU
THANK YOU
