The National Department of Health (NDoH) is moving across provinces to centralise obstetric skills to a handful of district hospitals, urgently briefing district healthcare chiefs and ensuring they have sufficient blood supplies in a bid to further lower the 63% rise in caesarean section deaths due to bleeding between 2008 and 2014. This was said by Dr Yogan Pillay, NDoH Deputy Director-General of Strategic Health Programmes, who added that provinces were being told to buy and/or dedicate

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... nces for quicker interfacility transport of pregnant women and sick infants. He was speaking days after the figures, described as 'scandalous and a disgrace' , were published in the SAMJ last month. The report, from the National Committee on Confidential Enquiries into Maternal Deaths (NCCEMD), came soon after the National Committee on Perinatal Mortality (NaPeMMCo) and Committee on Mortality and Morbidity in Children under Five (Child CoMMiC) reports, also completed last year and highlighting high numbers of avoidable deaths. It blames a low skill set among junior and inexperienced doctors, especially in rural under-resourced areas where they perform emer gency or unnecessary caesarean sections, too often without supervision or proper obstetric/anaesthetic care. Findings include delays in calling for help with ongoing bleeding, inappropriate discharges from post-theatre recovery, and poor monitoring in postnatal wards.