Late antenatal care attendance in metropolitan Cape Town

Late antenatal care attendance in metropolitan Cape Town

Status: Completed

In 2010 South Africa had a maternal mortality rate of 300 per 100,00 live births (WHO, 2013). At the time, this made South Africa an extreme outlier relative to its peer countries as defined by per capita GDP and per capita public healthcare expenditure. Although maternal mortality has since started to decrease with much of the decrease attributed to the large-scale roll-out of antiretroviral treatment for HIV positive mothers, it remains higher than what it should be, given the level of the country’s development and levels of public healthcare expenditure.

While the majority of South African women give birth in healthcare facilities, attend antenatal care and the country is even almost achieving the minimum number of antenatal care visits recommended by the WHO, many women attend antenatal care late in their pregnancies. The National Department of Health monitors antenatal care attendance before 20 weeks of pregnancy, but this definition is already too late in terms of the optimal time in a pregnancy to initiate antiretroviral treatment for HIV-positive women.  HIV is a large driver of South Africa’s high maternal mortality and it is therefore important to get women into the health system as early as possible during pregnancy so they can be tested and treated for HIV.

Using a similar methodology to that first used by Ijeoma Solarin and Vivian Black (2013) in the inner-city of Johannesburg, Anja Smith, a PhD student at ReSEP, and her fieldwork team interviewed 221 women in birth facilities (district hospitals and maternity obstetric units) in metropolitan Cape Town shortly after giving birth during October 2014. The purpose of the cross-sectional survey was to establish timing of antenatal care attendance, as well as reasons for late antenatal care attendance. Data on the socio-demographic characteristics, health behaviour and even self-reported pregnancy outcomes was also collected.

Here Anja is pictured with her fieldwork team after the completion of the project in November 2014. The fieldwork team (from left to right): In front: Nomfezeko Sikota, Christine Abrahams. Behind: Didi Gobile, Lucy Luphondo, Anja Smith, Didi Gobile, Lucy Luphondo, Nomfuzeka Sikota, Christine Abrahams, Mpumi Ketelo.

The findings of the study have been written up as a chapter in Anja’s PhD which was submitted in October 2015. Anja is currently drafting journal articles from the results in her PhD chapter. The first publications from the study will be posted on ReSEP’s website.


ReSEP members involved: Anja Smith, Ronelle Burger

Collaborators: Vivian Black