Johannesburg — Mothers and children have frequent access to healthcare facilities, but the poor quality of care they receive is leading to unnecessary deaths, a new report from the Human Sciences Research Council (HSRC) shows.

The findings, which are in line with the conclusions of the Lancet special report on SA published last year, add to pressure on Health Minister Aaron Motsoaledi to improve public health services.

The HSRC report, released yesterday, shows that almost all women (97%) use antenatal care services, and most babies (95%) are born in hospitals or clinics with a doctor or nurse present at delivery. Yet SA has one of the highest maternal and infant mortality rates in the world.

Maternal mortality stands at 240-400 in 100000, and infant mortality is 21 in 1000 live births.

"It is encouraging that many women deliver at hospitals, and home deliveries are rare. But what worries us is what happens when they get to facilities," said HSRC CEO Olive Shisana. "The healthcare system is not delivering good services" she said.

The HSRC report was based on a household survey conducted in 2008, which included 8966 children up to the age of 18 from all nine provinces.

Researchers used questionnaires and conducted HIV tests among willing participants. It was found that the proportion of children getting immunised against potentially deadly diseases was well below levels recommended by the World Health Organisations. There was good coverage for BCG, which is administered at birth for protection against tuberculosis, but there were much lower rates for vaccinations needed by older babies and children.

Only 62% of children had been vaccinated against measles and 65% against polio. The WHO recommends 90% coverage.

The health minister conceded the shortcomings in SA's health system, saying many deaths among women and children were preventable.

Staff often failed to follow protocols and adhere to infection control measures, he said.

Motsoaledi said he had twice met hospital CEOs in the past year to discuss improving quality, and planned to establish an independent office of standards compliance to improve the services at public health services.

He also decried the small proportion (25%) of babies who were exclusively breast-fed, saying he would support a ban on the infant formula advertisement.

The survey found HIV prevalence of 2,1% among babies under the age of two, below the 3,3% average for children under the age of four. Shisana said the relatively low rate among infants suggested that the government's programme to prevent mother-to- child transmission of HIV was beginning to bear fruit.

One in five children under the age of two had spent more than six days in hospital in the past 12 months. HIV-positive children were being admitted more frequently than other children (17% compared with 4,7%).