Child Health In South Africa Research Articles

A comparative study of pregnancy complications and outcomes for the years 1999 and 2004 at a rural hospital in South Africa: Implications for antenatal care

ABSTRACTBackgroundDetection and management of high-risk pregnancies, all the way through antenatal care, have been advocated as a high-quality mean of reducing maternal and perinatal morbidity and mortality.ObjectivesThis study reviewed the demographic variables, pregnancy and obstetric complications and perinatal outcomes for the years 1999 and 2004 in a rural hospital in KwaZulu-Natal Province, South Africa, with the aim of evaluating trends and gaps that may enhance appropriate strategies for improvement of antenatal care.MethodA retrospective comparative study, with representative samples of pregnant women, were randomly selected for the respective years 1999 and 2004. Descriptive statistics were calculated depending on measurement scale. A Z-test was carried out to assess the significant difference (p < 0.05) in proportions between pregnancy complications and outcomes of the groups. Multivariate logistic regression analysis was undertaken to determine the significant predictors for outcome variables.ResultsThe numbers of pregnancies among young women (< 25 years) increased significantly by 8% (p < 0.05) in the year 2004. Compared with 1999, the reduction in the numbers of pregnancies (1%) among higher parity (parity 5 or more) women in 2004 was remarkable. There were significant reductions of eclampsia, anaemia and post partum haemorrhage. Women with breech presentation were 3.75 times more likely to deliver preterm, and 5.45 times more likely to deliver low birth-weight babies. Similarly, women with pregnancy-induced hypertension were more likely to have preterm (OR = 3.50, 95% CI 2.83; 4.35) and low birth-weight babies (OR = 2.09, 95% CI 1.62; 2.71). Eclampsia was also a risk factor associated with preterm deliveries (OR = 6.14, 95% CI 3.74; 10.09) and low birth-weight babies (OR = 3.40, 95% CI 1.83; 6.28).ConclusionThis study suggests that further research is needed to find the causes of higher rate of teenage pregnancies and an increase in quality of antenatal care is more important in improving maternal and perinatal health. Training of staff to standard protocol and guidelines on antenatal care and care during delivery, and adherence to it, should be encouraged to improve maternal and child health in South Africa.

Dynamic Health Care Decisions and Child Health in South Africa

A large number of child deaths in developing countries could be averted if ill children received care sooner rather than later or not at all. This article analyses the health care treatment pathway that is followed for children under the age of six. The majority of these children receive treatment within 24 hours. We find, however, that income affects the probability of any treatment, despite freely available public health care, and that delayed treatment of severely ill children is more likely to occur in more expensive private facilities. Our results suggest that free public health care is not enough to mitigate health inequality amongst young children and that delayed health care could lead to adverse household expenditure shocks.

Marian Jacobs: pioneer of child health in South Africa

Marian Jacobs: pioneer of child health in South Africa

International child health: 10 years of democracy in South Africa; the challenges facing children today

<h2>Summary</h2> Decades of discriminatory apartheid policies resulted in marked racial disparity in children's health in South Africa. In 1994, the country's first democratically elected government prioritised maternal and child health. Ten years of democracy have yielded varied success for child health and well-being. Although excellent policies now exist, there has been less success in transforming these into measurable actions and outcomes. The devastating effects of the acquired immunodeficiency syndrome (AIDS) pandemic have rapidly reversed hard-earned child mortality gains. There have been notable successes in improving access to health care, reducing communicable diseases, implementing new programmes such as the Integrated Management of Childhood Illness (IMCI) strategy and increasing access to child social support grants. In contrast, other priorities such as neonatal, adolescent, and disability-related health services remain relatively neglected. Arguably, the greatest challenge facing child health in South Africa in the next decade is the orphan crisis as a result of AIDS.

Birth to ten: child health in South Africa in the 1990s. Rationale and methods of a birth cohort study

Birth to ten: child health in South Africa in the 1990s. Rationale and methods of a birth cohort study

Birth to ten: child health in South Africa in the 1990s. Rationale and methods of a birth cohort study

Birth to Ten is a longitudinal birth cohort study which began in April 1990 in the Johannesburg/Soweto area of Transvaal, South Africa. In this paper, the reason for the initiation of the study and its location in the current sociopolitical context is discussed. The health status of South Africa children in terms of infant mortality, morbidity (notifiable diseases) and nutritional status is described and mention is made of measures of psychological health and the importance of environmental pollution on health. The existing health service infrastructure in the study area is described and the fragmentation of health services between races, between preventive and curative services and on a geographical basis is highlighted. The study objectives, design, population, inclusion and exclusion criteria, methods of measurement and logistics are described.