Programme director, the MEC for Health of KZN, Dr Dhlomo
The Minister of Women, Children and People with Disabilities, Ms Xingwana
The Premier of KZN, Dr Mkhize
The AU Commissioner for Social Affairs, Advocate Gawanas
The UNICEF Goodwill Ambassador, Ms Chaka Chaka
Members of the national and provincial legislatures present
Traditional leaders
Representatives of bi-lateral and multi-lateral agencies
Members of the health profession
Representatives of business and organised labour
Members of non governmental organisations
Members of the media
Ladies and gentlemen
Programme Director, it is indeed an honour and singular privilege to participate in this special event of launching the Campaign to Accelerate the Reduction of Maternal Mortality in Africa (CARMMA) and to align ourselves to our fellow Africans that have already done so as a result of decisions taken by our Heads of State of the African Union Commission. Let me, on behalf of the South African government join the growing continental voice that has adopted the theme for CARMMA:
"South Africa cares: No woman should die while giving life".
Ladies and gentlemen, CARMMA is an African Union Commission (AUC) initiative to call all Africans to intensify the implementation of a commitment made in Maputo underpinned by a Programme of Action to reduce maternal mortality in the African region. The African Union stands for a united and strong Africa and South Africa as a proud and committed member will do everything we can to meet our commitment.
South Africa accepts the challenge to meet the Millennium Development Goals 4, 5 and 6 and I quote from my appeal to the Parliament during my department's budget vote speech a week ago:
"It is important to note that Maternal Mortality is not just the death of a women – it is death of a woman because she dared fall pregnant! She becomes vulnerable to death because she is trying to bring new life into this World! We know that even mortality brought by HIV and AIDS as well as malaria is disproportionally affecting young woman of childbearing age more than men. This disproportionate assault on woman of childbearing age is happening more on the continent of Africa than on any part of the World.
Hence the African Union came up with a programme called CARMMA i.e. Campaign on Accelerated Reduction of Maternal and Child Mortality in Africa.
We will now outline concrete steps to reduce Maternal and Child Mortality during this event, as promised to the Parliament during the Budget Vote speech. We shall further elaborate on how we shall roll-out the strategy called ESMOE i.e. Essential Steps in Managing Obstetric Emergencies and the strategy called Emergency Obstetric Simulation Training EOST), in order to pledge publicly our commitment to South Africans especially our mothers, mothers-to-be, their children and children-to-be."
The reason is said this is that our mortality data are frankly not acceptable. The Director-General at my request, appointed a Health Data Advisory and Coordination Committee (HDACC) to review the proposed indicators in the Negotiated Service Delivery Agreement (NSDA) entered into by myself and other Cabinet colleagues and Provincial colleagues. The HDACC considered data sources and advised on practical and achievable targets.
The recommended indicator values are:
- Maternal Mortality ratio: 310 per 100 000 live births to be reduced to 270 per 100 000 live births in 2014.
- Neonatal Mortality rate of 14 per 1 000 live births to be reduced to 12 per 1 000 live births by 2014.
- Infant Mortality Rate of 40 per 1 000 live births to be reduced to 36 per 1 000 live births by 2014.
- Under-5 Mortality Rate of 56 per 1 000 live births to be reduced to 50 per 1 000 live births by 2014.
I do think that with concerted action we can do better and I am sure that you will agree with me. It is against this background that this event was planned. CARMMA aims to ensure coordinated effort and effective implementation of existing plans and strategies through positive messaging; encouraging achievements and achievements made in other countries in reducing maternal mortality and seeking to replicate them with special focus on intensifying actions aimed at reducing maternal, newborn and child mortality.
We have a package of strategies and activities that will be used to meet the objectives of CARMMA thereby reducing maternal, neonatal and child health. I would like to thank the AU Commissioner for Social Affairs, Adv Gawanas for accepting out invitation to official launch South Africa's CARMMA strategy.
The CARMMA strategy is nested within the Strategic Plan for Maternal, Neonatal, Child and Women’s Health (MNCWH) and Nutrition in South Africa, 2012 – 2016. This strategy responds to the major causes of morbidity and mortality as it relates to mothers, neonates and children under 5. I will not provide an exhaustive outline of the strategy save to say that it is based on eight key strategies which are:
- Addressing inequity through targeting of under-served areas.
- Development of a comprehensive and coordinated framework for the provision of MNCWH & Nutrition services
- Strengthening community-based MNCWH & Nutrition interventions
- Strengthening provision of key MNCWH & Nutrition interventions at PHC and district levels
- Strengthening provision of key MNCWH & Nutrition interventions at district hospital level
- Strengthening the capacity of the health system to support the provision of MNCWH & Nutrition services
- Strengthening human resource capacity for delivery of MNCWH & Nutrition services
- Strengthening systems for monitoring and evaluation of MNCWH & Nutrition interventions and outcomes.
The following are the key components of the CARMMA strategy:
a) Strengthening access to comprehensive sexual and reproductive health services and rights, with specific focus to family planning services.
b) Advocacy and promotion of early antenatal care attendance/ booking.
c) Allocation of obstetric ambulances to every facility where deliveries are conducted.
c) Establishment of maternity waiting homes, where necessary and facilities for lactating mothers and for Kangaroo Mother Care (KMC).
d) Strengthening Human Resources for Maternal and Child Health through:
- training on Essential Steps in Management of Obstetric Emergencies (ESMOE) for doctors and midwives
- strengthening midwifery education and training.
e) Improve child survival through promotion of breast-feeding, appropriate care and support of pregnant women and lactating mothers in the workplace.
f) Elimination of mother to child transmission of HIV.
Now let me turn to the most pleasant task that I have today. This task is to introduce the keynote speaker, Ms Graca Machel! In 2010 no less than Time Magazine listed Ms Machel as one of the people who 'most affect our world’! I cannot do better than quoting the article in Time Magazine which said this of our keynote speaker:
"Graça Machel is a born freedom fighter. Long before she became one of the world's most effective and joyful advocates for the rights of children, women and refugees, she was a schoolteacher in Mozambique seeking her country's liberation from Portugal. In 1975, when it gained independence, she was named Minister for Education and Culture; she also married Samora Machel, who had become Mozambique's first President. He died in a plane crash 11 years later, and in 1998 she wedded Nelson Mandela. She remains the sturdy shoulder that the South African leans on.
Machel, 64, has a warm smile, a hearty laugh and a way of making everyone feel comfortable. She continues to campaign against pediatric AIDS and the abuse of children and refugees. Along with Mandela, she is a charter member of the Elders an independent group of global leaders but on her own, she remains a potent voice for justice, one that is always listened to.
Ladies and gentlemen, I am sure that you will agree with me that we could not have a more appropriate keynote speaker on this important occasion. Please join me in welcoming Ms Graca Machel.
