From the Editor

Reducing neonatal deaths in South Africa: Progress and challenges

N Rhoda, S Velaphi, G S Gebhardt, S Kauchali, P Barron


Although current levels of the neonatal mortality rate (NMR) are within reach of the Sustainable Development Goal (SDG) target of 12 per 1 000 live births, the absolute number of deaths is unacceptably high for a lower-middle-income country such as South Africa (SA). Neonatal mortality over the last decade has declined very slowly, and is not commensurate with the level of government investment in healthcare. The recent neonatal mortality rate of 21 per 1 000 live births reported by the SA Demographic Health Survey is of major concern. This paper reviews recent efforts to reduce the neonatal mortality rate, including support for the implementation of neonatal policies and plans, and strengthening programmes to deliver low-cost, high-impact interventions. We review recent estimates of the NMR and causes of neonatal deaths, and discuss how the mortality from preventable causes of death could be reduced. If SA is to meet the SDG target, special attention should be given to the availability of high-impact interventions, providing an adequate number of appropriately trained healthcare providers and a more active role played by ward-based community health workers and district clinical specialist teams.

Authors' affiliations

N Rhoda, Department of Neonatology and Paediatrics, Faculty of Health Sciences, University of Cape Town, South Africa

S Velaphi, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

G S Gebhardt, Department of Obstetrics and Gynaecology, Faculty of Health Sciences, Stellenbosch University, Stellenbosch, and Tygerberg Hospital, South Africa

S Kauchali, National Department of Health, South Africa, and Department of Paediatrics and Child Health, University of KwaZulu-Natal, Durban, South Africa

P Barron, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa

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Cite this article

South African Medical Journal 2018;108(3a):s9-s16. DOI:10.7196/SAMJ.2017.v108i3b.12804

Article History

Date submitted: 2018-03-02
Date published: 2018-03-02

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