Abstract:
The Confidential Enquiry into Maternal Deaths (CEMD) in South
Africa has been operational for 15 years. This case study describes
the process of notification and independent assessment of
maternal deaths, predominantly in facilities. In the earlier years of
the Enquiry, institutional maternal mortality ratio increased and
was 176.2 per 100 000 live births in the 2008–10 triennium;
thereafter it decreased to 146.7 in the 2011/12 period. The slow
progress was due to the significant contribution of HIV/AIDs to
maternal mortality and challenges in implementing the
recommendations that were devised from the findings of the
Enquiry. Nevertheless, the CEMD process has been maintained
and strengthened so it is currently able to perform routine
maternal death surveillance at both national and district levels,
identify deficiencies within the health system, generate reports and
also provide early warning about alarming trends such as the
increasing numbers of deaths due to caesarean-section-associated
haemorrhage.
