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- Volume 18, Issue 2, 2012
South African Journal of Obstetrics and Gynaecology - Volume 18, Issue 2, 2012
Volume 18, Issue 2, 2012
Author Bob PattinsonSource: South African Journal of Obstetrics and Gynaecology 18, pp 30 –31 (2012)More Less
It is fitting that Professor James Drife has written an opinion piece on the value of confidential enquiries. When the then Minister of Health (Minister Dlamini-Zuma) created the National Committee for the Confidential Enquiries into Maternal Deaths (NCCEMD) in 1997, Professor Drife was asked by the Department of Health to facilitate getting the committee and its subsequent reports established. Subsequently five reports have been written, with Saving Mothers 2008 - 2010: The Fifth Report on Confidential Enquiries into Maternal Deaths in South Africa being recently released.
Author James DrifeSource: South African Journal of Obstetrics and Gynaecology 18, pp 32 –36 (2012)More Less
Any report or scientific study can do nothing by itself. It is a tool to be used by those who have a specific end in view. When it comes to maternal mortality, we all share the same overall aim - to make pregnancy safer - but the task for each of us is to focus on what we can do as individuals. Every confidential enquiry report contains a wide (perhaps too wide) range of recommendations, and all too often the reader nods in agreement with those directed at other people and skips past those that apply nearer home. Civil servants wait for action from clinicians, while clinicians expect leadership from politicians and managers.
Source: South African Journal of Obstetrics and Gynaecology 18, pp 38 –42 (2012)More Less
Background. The paucity of quality data on maternal deaths and possible mis-specification of models have resulted in a range of estimates of the maternal mortality ratio (MMR) for South Africa.
Objectives. This paper contrasts the estimates from multi-country models for estimating the MMR with the South African data from vital registration.
Method. A literature review was undertaken to identify estimates of the MMR for South Africa and methodologies used. In addition, cause of death data from Statistics SA were analysed for trends.
Results. In contrast to prediction models used by international agencies, the Health Data Advisory and Co-ordinating Committee (HDACC) recommended the use of the vital registration data adjusted for under-registration and misclassification of causes to monitor maternal mortality. HDACC also recommended that, as is done by the Maternal Mortality Estimation Interagency Group (MMEIG), the number of maternal deaths identified be scaled up by 50% to account for the general under-reporting of maternal deaths. Based on this approach, the baseline MMR in 2008 was estimated to be 310 per 100 000 live births. From vital statistics, the indications are that by 2009, South Africa had not yet managed to reverse the upward trend in MMR. The increase is largely a result of an increase in the number of maternal deaths from indirect causes, as might be expected in the context of the HIV pandemic. However, the number of indirect maternal deaths increased markedly only since 2003, a few years later than the rapid increase in AIDS mortality.
Conclusions. There are opportunities to improve monitoring maternal mortality, including strengthening the information systems (vital registration, the confidential enquiry and the routine health information system) and exploring opportunities for linking data from different sources. Better data on the role of HIV in maternal mortality are needed.
Contraceptive use and associated factors among South African youth (18 - 24 years) : a population-based survey : original articleSource: South African Journal of Obstetrics and Gynaecology 18, pp 43 –47 (2012)More Less
Background. Despite ongoing campaigns and intervention programmes promoting safe sex, contraceptive use remains a controversial area among South African youth.
Aim. To investigate contraceptive use and associated factors among South African youth aged 18 - 24 years who reported having had sexual intercourse.
Method. Young South Africans (3 123 subjects aged 18 - 24 years) in four provinces responded to a cross-sectional population-based household survey.
Results. Among women who reported to be currently using contraception (89.1%), 9.3% were using the Pill, 5.2% the intra-uterine contraceptive device, 25.6% injectables, 57.6% male condoms, 5.9% female condoms, and 8.9% dual methods; other methods used were the rhythm method (7.0%), withdrawal (11.5%), and emergency contraception (5.5%). In multivariable analysis among women, ease of getting condoms and not having had early sex (below 15 years of age) were associated with contraceptive use. Among men, better knowledge about contraceptives, having talked with the partner about condoms in the past 12 months, loveLife and multimedia programme exposure were associated with contraceptive use in univariate analysis, while none were retained in the multivariable model.
Conclusion. Communicating with the partner about condom use, education and being employed were significantly associated with contraceptive use. However, use of contraceptives is still low, and this is substantiated by the high rate of unwanted pregnancies reported. It is clear that more vigorous, effective and meticulous means of promoting contraceptive use need to be explored, enabling youth to take control of their reproductive health and make informed decisions.
A review of the incidence and survival of childhood and adolescent cancer and the effects of treatment on future fertility and endocrine development : reviewSource: South African Journal of Obstetrics and Gynaecology 18, pp 48 –53 (2012)More Less
Cancer is not uncommon in children. The reproductive system is an important site for late effects of cancer treatment, and normal pubertal development depends on an undamaged hypothalamic-pituitary-gonadal axis. Fertility compromise can occur due to chemotherapy, radiotherapy to the hypothalamic-pituitary-gonadal axis, or surgery. Cryopreservation techniques of germ cells are improving and may offer hope for fertility preservation.
Implementation of an office-based semen preparation method (SEP-D Kit) for intra-uterine insemination (IUI): A controlled randomised study to compare the IUI pregnancy outcome between a routine (swim-up) and the SEP-D Kit method : scientific letterSource: South African Journal of Obstetrics and Gynaecology 18, pp 54 –55 (2012)More Less
35th National Congress of the South African Society of Obstetricians and Gynaecologists : 6 - 10 May 2012, Champagne Sports Resort, Drakensberg, KwaZulu-Natal : abstractsSource: South African Journal of Obstetrics and Gynaecology 18, pp 56 –79 (2012)More Less