University of South Africa, South Africa
Rose Mmusi-Phetoe is a qualified Community Health Nurse, Demographer and Sociologist. Her career started in the eighties when she qualified and worked as a professional nurse and midwife. She moved from bed-side nursing to community health and development field, having realized that health issues are fundamentally social issues. Her career spans more than 20 years in which she continuously engaged with communities on health promotion and development interventions to create a livelihood. Her efforts are characterized by reaching out to the socially excluded and hard to reach populations in SA while working as a Maternal and Child Survival Specialist at UNICEF and as a researcher, planner and policy analyst in the Departments of Health and Population Development. She is currently working as a senior lecturer, Community Health at the University of South Africa.
The maternal mortality ratio and neonatal mortality rate have been persistently high in South Africa. The Maternal and Neonatal Mortality are indicative of the health of the population and reflect deeper issues such as inequitable distribution of the country’s resources, social exclusion, deprivation, and lack of access to quality public services. The purpose of this paper is to illustrate the process of developing a model that meet the overall health needs of the socially excluded, the deprived and the vulnerable women by listing those factors that influence maternal and child health outcomes. From the point of view that individual reproduction and health decision-making take place in a milieu comprising multiple socio-economic and cultural factors, this research further
intended adding to the body of knowledge on maternal and child health in order to influence policies and interventions. Data was collected through a multi-staged, qualitative research design. The results show how structural factors result in high risk for poor maternal and child health outcomes, suggesting that the high rates of poor health outcomes are evidence of deprivation of women’s needs due to poverty leading to an inability to cope with pregnancy and childbirth. The results were used to develop a model that proposes pathways for policy action to confront both the structural and intermediary determinants of maternal and child ill health and mortality. The pathways operate through integrative and inter-sectoral mechanisms intended at empowering women and
enhancing female reproductive health care activities.