occasion of the seventh Annual Congress of Midwives of South Africa,
Durban
11 December 2007
Programme Director
Ladies and Gentlemen
Let me take this opportunity to thank the organisers of this the seventh
Annual Congress of Midwives of South Africa for extending the kind invitation
to me to deliver the keynote address this morning. I would also like to
congratulate you on winning the bid to host the 29th Triennial Congress of the
International Federation of Midwives (ICM) for 2011.
Let me also welcome the delegates from outside South Africa who are
attending this Congress. You will not be disappointed by the friendliness,
hospitality of the people and the beauty of Durban. I hope that you have had or
you will have the opportunity to tour the province of KwaZulu-Natal during your
visit here. I am very excited by the theme you have chosen for this congress
which is midwives accelerating the attainment of the Millennium Development
Goals (MDGs).
This will relate particularly to the Millennium Development Goal number five
which is focuses on improving maternal health. The country's process towards
attaining the MDGs is in motion and midwives are important role-players in this
regard. Healthcare providers in general and midwives in particular, have an
exceptional role to play in the endeavour to attain the MDGs especially:
* MDG four: Reducing child mortality through reducing by two thirds, between
1990 and 2015, the under-five mortality rate
* MDG five: Improving maternal health through reducing by three quarters
between 1990 and 2015, the maternal mortality ratio.
In October this year, I attended the Women's Conference in London which was
aimed at celebrating the 20th anniversary of the Safe Motherhood conference
that was held in Nairobi, Kenya in 1987. The delegates were reminded that:
"More than half a million women die each year during pregnancy and
childbirth. Most of them die because there is not enough skilled, regular and
emergency care. In sub-Saharan Africa, one in 16 women run the risk of dying
during pregnancy or childbirth over a lifetime, compared with about one in 2
800 women in the developed world."
Herein lies the challenge. There is no doubt that there are number of
underlying factors that continue to undermine the health of women in Africa and
limit their ability to have safe pregnancies and delivery. The challenge of
poverty and under development, poor nutrition, lack of access to safe water and
sanitation are some of the social determinants of health that have to be
addressed if we are to significant reduce maternal deaths and under five
mortality.
To achieve these goals, we also need dedicated commitment of each and every
midwife in South Africa that we can hope to assure pregnant women in South
Africa that they will deliver a healthy baby and be in good health to look
after that baby after delivery.
The participants in this Midwives Congress aim to share experiences and
ideas and commit to improving and maintaining high standards of midwifery
practice. Maintaining those standards usually comes with a need to sacrifice.
The women of Southern Africa primarily depend on you and your skills to ensure
that their pregnancies are joyful journeys with happy destinations.
Let me hasten to refer to some of the eight congress themes you have chosen
for this congress:
1. Saving mothers and saving babies: current status in South Africa and
Africa. The confidential enquiry into maternal deaths process, now 10 years in
operation, identifies the numbers, causes and avoidable or remediable factors
associated with maternal deaths. As you discuss these processes during the
congress, please commit to revert to your constituencies with the key messages
that came out of the "Beyond the Numbers" A World Health Organisation (WHO)
document which formed part of the conceptual framework of the South African
National Committee on Confidential Enquiry into Maternal Deaths (NCCEMD).
Stated in this document are the following:
* avoiding maternal deaths is possible, even in resource-poor countries, but
it requires the right kind of information on which to base programmes
* knowing the level of maternal mortality is not enough; we need to understand
the underlying factors that led to the deaths
* each maternal death or case of life-threatening complication has a story to
tell and can provide indications on practical ways of addressing the
problem
* a commitment to act upon the findings of these reviews is a key prerequisite
for success.
These abovementioned four key messages should be your "guiding stars" as you
engage each other in constructive deliberations on saving mothers and saving
children.
2. Empowering midwives: the skilled attendants
To be skilled and to remain skilled involves a conscious effort on the part
of every cadre of healthcare provision in our respective health systems.
Keeping up with the best practices in the profession, demands that all midwives
avail themselves for continuing nursing education, self development and
constant reading.
Nurses including midwives form the backbone of all the skilled birth
attendants (inclusive of doctors and other birth attendant categories) in our
health system. That is the reason for starting with nurses in the Occupation
Specific Dispensation (OSD) initiative of the Department of Health. This will
hopefully address the ever-growing challenge of attracting into and retaining
nurses, in the public service.
3. Protecting the mothers, the neonate and the midwives physically,
emotionally and psycho-socially
While protecting mothers and children, midwives like all other health
workers deserve to feel secure in their working environments. Government is
cognisant of the challenges that have confronted health workers with regard to
security in some of the health facilities. Health facilities are valuable
institutions that should remain accessible to the public at all times. All
communities must therefore assist in protecting these institutions from crime.
Crime is a social challenge which requires an integrated community
response.
The Department of Health is also developing the standards for package of
security services which should guide the provision of security services in
health facilities.
4. Midwives holding hands with women, men, families and communities within
the different cultural settings (Batho Pele). We should all respect the
principle that "The users of our services should enjoy priority attention".
Such principle underpins our African cultural being. It is also in line with
the commitments we made through the Patient Rights Charter and the Batho Pele
service principles. May I wish you insightful and fruitful deliberations in
this regard?
Programme Director; let me reiterate what I said on the occasion of the
Excellence in HealthCare Awards 2007 on 30 November 2007, at Vodaworld in
Midrand. The protracted industrial action by government employees had serious
impact and implications on the health sector. Healthcare providers including
midwives suffered the most and were subjected to various forms of intimidation.
You have to be once again commended for your continued service under those
trying circumstances even though at times, it bordered on exposing yourselves
to personal danger.
These are the challenges that need serious and frank discussion during this
congress and devising possible strategies, geared towards avoiding a repetition
in future. It is your constituencies that need to go back to the founding
principles that guided the profession of nursing and to try to find ways and
means of learning from these unfortunate experiences.
Ethical behaviour should at all times trump any other consideration when
dealing with your clients especially pregnant women. Anything short of ethical
conduct cannot and will not help to attain the MDGs four and five as expressed
in the congress aims for 2007.
2007 is midway to the time-frame set in the United Nations Millennium
Declaration, adopted by the eighth Plenary Session of the General Assembly on 8
September 2000. Let us use this opportunity to recommit ourselves to taking all
measures possible to ensure that we honour our commitment and attain the
MDGs.
Thank you.
Issued by: Department of Health
11 December 2007
Source: Department of Health (http://www.doh.gov.za)
