Overview of maternal, neonatal and child deaths in South Africa: challenges, opportunities, progress and future prospects

The fact that most sub-Saharan Africa countries including South Africa (SA) are not on track to meet the 2015 target of improving maternal, neonate and child health (MNCH) is a major public health concern. The aim of this paper to give an overview of the current state of MNC deaths in SA, their relative causes, highlight challenges, existing opportunities, progress made and future prospects. The overview involved a synthesis and review of recent data and information from key national representative peer reviewed articles and grey literature from the National Department of Health and related stakeholder reports. Since 1990 the situation in SA aroused a lot of research interest in tracing the historical context of the problem, evaluating progress made and actions for improving MNCH. In 2009 the SA government established three national committees for confidential enquiry on MNC deaths. Multifactorial systems' related challenges were identified. Subsequently, the new National Strategic Plan for MNC and Women's Health and Nutrition has, in addition to provision of comprehensive interventions, been linked and aligned with efforts to strengthen the health systems particularly through the re-engineering of the Primary Health Care (PHC) services and district health systems. The overview gives an insight of the process that has influenced MNCH policy and programs in the country. The SA experience and current MNCH situation may be different compared to other African countries, however, the political commitment and government stewardship coupled with critical and yet complimentary research is exemplary, especially, given several global and regional plans and commitments to improve MNCH in the continent.