Health Minister Joe Phaahla has reported that 1824 infants died at the Chris Hani Baragwanath Hospital between 2020 and 2022. The hospital recorded 564 infant deaths in 2020, 660 in 2021, and 600 in 2022.
The health minister wrote a report speaking on the negligence at Chris Hani Baragwanath as it is one of the biggest and busiest hospitals in the country. The report was a response to parliament, with specific questions below from EFF MP Naledi Chirwa;
- What was the infant mortality rate at Chris Hani Baragwanath in each of the past three years?
- The number of healthcare workers in the same department that has since been employed at the hospital
- How many obstetrics ambulances had been procured to date for the hospital?
- What plans were in place to ensure that infant mortality due to negligence and lack of healthcare professional personnel was avoided and reduced?
- Targets the Department of Health had set regarding the infant deaths in 2023.
- The number of the specified targets that had been achieved.
The questions above shine a light on why the World Health Organization would place Sub-Saharan Africa at the highest percentage of neonatal mortality rate in the world, at 43%. This statistic confirms that medical negligence and avoidable deaths are part of a failing public health system in need of rectification.
What is the Department of Health doing to fix the issues?
The guarantee of an infant’s survival begins with the care the mother receives at the beginning of the pregnancy through prenatal care, constant appointments and finally, delivery. However, according to Phaahla’s report, all this cannot be achieved if separate departments do not work together for the greater good. Hospitals do not have dedicated obstetrics ambulances, meaning that some expectant mothers will not make it on time to the hospital to give birth safely.
Phaahla further asserted that the provision of ambulances is the responsibility of Gauteng EMS and not of the hospital. However, Gauteng EMS is starting the Gauteng Scheduled Emergency Transport (G-SET) which is a scheduled transport system at high-call volume facilities like Chris Hani Hospital. The minister maintained that G-SET would be implemented in the new financial year, encouraged by improved response times, and increased opportunities to recruit more staff.
Plus, according to Phaahla, Baragwanath Hospital has an action plan which includes having monitoring and evaluation teams that monitor perinatal mortality data. The teams use the Perinatal Problem Identification Program (PPIP) to eliminate avoidable deaths.
Facility management must ensure that all delivery institutions discuss every death within seven days, report on PPIP, develop and follow up on implementation of Quality Improvement Plans (QIP). Junior staff must also be provided with technical support and onsite corrective measures.
What were the main causes of deaths?
Medical negligence has been attributed to overcrowding, understaffing, and poor hospital administration. Most Gauteng hospitals are experiencing overcrowding, but Baragwanath experiences disproportionate numbers of overcrowding because it caters to more than Gauteng residents due to size and expertise. These issues result in the mismatch between service demand and supply, and inefficient patient flow through hospital beds.
With limited resources, the minister believes that many public health facilities could perform better if it weren’t for inefficiency, poor management, neglect of duty due to poor supervision, and corruption.
While considering all the managerial and administrative failures, a study involving newborn babies also revealed a prevalence of infections caused by multi-drug resistant bacteria in South African hospitals. The study led by experts from the National Institute for Communicable Diseases (NICD), observed that most infections occurred after day three of life and thus were probably acquired in hospital.
The study was conducted over six years to estimate the burden of culture confirmed neonatal bloodstream infections and meningitis in South Africa. It involved an analysis of blood and cerebrospinal fluid culture pathology records from newborn babies at 256 public-sector hospitals.
The study was the first national population level analysis of invasive newborn infections in the local public health sector involving babies younger than twenty-eight days admitted between January 2014 and December 2019. The study discovered that around 70% of cases were caused by three bacterial pathogens, Klebsiella pneumoniae, Acinetobacter baumannii, and Staphylococcus aureus, none of which can be prevented by vaccines and a large proportion of which were resistant to antibiotics usually used to treat neonatal infections.
The issues at Baragwanath hospital are caused by systemic issues that need to be rectified at a national administrative level and should involve all departments to ensure compliance. The minister has maintained that the Department of Health is implementing the new regulations to reduce infant deaths at Chris Hani Hospital. Let us hope that this stops happening altogether.