The conditions in Eastern Cape maternity wards are so dire that they are contributing to patients’ and infants’ deaths, says a report from the Commission for Gender Equality (CGE).
These main “interdependent challenges… that worsen overflowing, infections and maternal mortality” relate to infrastructure maintenance and “a deficiency in psychosocial support for patients and staff”.
The State of Maternity and Neonatal Healthcare in the Eastern Cape Province (2023/2024), which focused on six hospitals: Cecilia Makiwane, Dora Nginza, Bhisho, Frere, Livingstone and St Elizabeth, was released last week, reports TimesLIVE.
“Delays in equipment procurement … potentially contributing to the elevated rates of neonatal and maternal mortality …and the process of decompleting both Dora Nginza Hospital and Livingstone Hospital appears to present its own set of challenges,” found the report.
Out of 776 facilities, only 143 were compliant with health standards for accommodating patients with disabilities, while mass failure to meet the reports and ground-level recommendations outlined in the Saving Mothers Annual Report highlight the urgent need for corrective action.
Major performance discrepancies were identified, and the leadership vacuum was a concerning factor affecting performance and the filling of critical clinical vacancies.
Cecilia Makiwane Hospital (CMH), the regional teaching hospital in Mdantsane township, cited a number of challenges related to overflow in maternity services.
“According to its report submitted to the commission in the fiscal year 2020/21, CMH recorded 17 maternal deaths per perennial problem identification project (PPIP) and 15 per District Health Information System (DHIS),” read the report.
Notably, the maternal mortality ratio was reported as 249.6 per PPIP and 344 per DHIS. In the subsequent fiscal year 2021/2022, CMH reported 11 maternal deaths per PPIP (including one home death) and eight per DHIS, corresponding to maternal mortality ratios of 249.6 per PPIP and 186.2 per DHIS
From April 2020 to March 2021, a mortality rate of 14.3% was recorded. Between April 2021 and March 2022, the rate was 11%, and from April 2022 to March 2023, it stood at 13.9%.
These deaths were attributed to various causes, including maternal hypertension, spontaneous preterm births, infections and overcrowding in neonatal units.
“CMH did not provide a report indicating or illustrating any interventions to prevent potential future occurrences, nor did it indicate any interventions taken within the reported years,” said the report.
The commission’s investigation into Dora Nginza unveiled significant concerns regarding inadequate bed capacity and the resulting strain on staff.
Problems included some patients sleeping on floors or benches, and “while the hospital has addressed concerns regarding the backlog of C-sections, the absence of a current waiting list poses challenges in assessing backlog reduction efforts”, reads the report.
And with Bhisho Hospital, “there were instances where the data provided to the commission did not provide a clear picture, preventing the commission from conducting a measurable assessment of the rise or decline in the variables to be analysed and concluded”.
Bhisho’s deficiencies in these systems led to discrepancies in reporting accuracy, “impeding effective performance monitoring at the hospital”.
Commission report (Open access)
TimesLIVE article – Eastern Cape hospitals 'compromise women in maternity wards' (Restricted access)
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