A re-examination of estimates and causes of maternal mortality for South Africa with particular focus on provincial levels

One of the problems in monitoring maternal mortality is lack of reliable estimates. Several studies have provided estimates of maternal mortality from pregnancy related deaths on South Africa utilizing Census and survey data but these estimates have have methodological weaknesses. This study re-examines maternal mortality from pregnancy related deaths at national and provincial levels in South Africa and provides insight into the causes of the maternal mortality deaths.

Data from the 2001 census, 2007 Community survey and death registrations were utilised. Information on household deaths including pregnancy related deaths were collected. Direct and indirect methods were utilised to estimate maternal mortality ratio.
The results indicate that maternal mortality ratio increased from around 150 per 100,000 live births in 1992-1998 to about 764 per 100,000 live births in 2007 and ranged from 102 per 100,000 live births in the Western Cape Province to 1,639 in the Eastern Cape Province in 2007. Maternal infections and parasitic diseases as well as other maternal diseases complicating pregnancy, childbirth and the peurperium are the major causes.
Despite strategies to improve maternal and child health, maternal mortality is increasing and remains a public health challenge in South Africa.