The Health and Wellness Portfolio Committee remains committed to ensuring that maternal health is a top priority in Gauteng’s healthcare system. While progress has been made in reducing maternal mortality rates, serious challenges remain, particularly in the accurate reporting of maternal deaths, staff shortages, and delays in expectant mothers accessing care.

Through its oversight role, the committee has identified inconsistencies in maternal mortality reporting across multiple health information systems, which obscure the true scale of the crisis. In response, the committee recently convened a stakeholder engagement session in Mogale City on 28 February 2025, bringing together maternal health experts, healthcare professionals, and community representatives.

The session aimed to assess whether the Gauteng Department of Health is effectively implementing national recommendations to improve maternal care and reduce preventable deaths amongst other issues.

Gains and Challenges in Maternal Healthcare

The provincial department reports a decline in maternal deaths from 122 in 2021 to 107.6 in 2023, according to the latest triennial report — a positive step. However, every maternal death remains a tragedy, and urgent action is needed to sustain and accelerate this progress.

Key concerns raised by stakeholders include:

  • Late booking for antenatal care: Many pregnant women only seek medical care after 20 weeks, increasing risks for both mother and child. More targeted community health education is needed to encourage earlier antenatal visits.
  • Midwifery skills shortage: The current midwife-to-patient ratio is inadequate, putting expectant mothers at greater risk. The department should explore the possibilities in lifting the moratorium on midwifery posts and explore public-private partnerships to train more nurses in maternal care.
  • Support for healthcare workers: Medical staff need structured debriefing and emotional support following maternal deaths, as well as continuous learning from critical incidents.
  • Strengthening emergency care: More Essential Steps for Maternity and Obstetric Emergencies (ESMOE) training for ambulance personnel is crucial to improving outcomes for women in transit to healthcare facilities.
  • Community partnerships: Faith-based and community organisations should play a greater role in providing post-discharge counselling and mental health support for new mothers.
  • Addressing unsafe terminations: The department must intensify efforts to curb illegal terminations, which contribute to maternal deaths. More accessible, safe, and legal termination of pregnancy services must be strengthened in line with public health policies.

Holding the Department Accountable

Committee Chairperson Adv. Ezra Letsoalo reaffirmed the committee’s commitment to holding the department accountable for implementing the national maternal health recommendations. This includes ensuring evidence-based interventions and workforce development remain a priority.

Beyond official reporting, the committee will establish a structured framework that categorises stakeholder recommendations into immediate, short-term, and long-term actions. The department will be required to report on progress in addressing these recommendations.

A Call for Collective Action

Public healthcare governance thrives on accountability and citizen participation. The concerns raised by healthcare workers, educators and communities must be acted upon. By aligning efforts between government, healthcare professionals, and civil society, Gauteng can strengthen maternal healthcare, reduce preventable deaths, and ensure that every mother receives the care she deserves.