Abstract

PIP: This article recommends restructuring maternal and child health services in Guateng in Johannesburg, South Africa. A review was conducted by the Strategic Management Team of Guateng Services. It was recommended that health personnel identify priority service requirements in order to improve coverage and include needs at all levels of care. Secondary level hospitals in the region need better trained medical staff. Training could be conducted by interning staff in academic hospitals before placement in secondary hospitals. Service sites should be increased to 1 prenatal-postnatal clinic per 5000 population, 1 primary health center (PHC) with delivery facilities per 40,000 population, and 1 PHC for 90,000-110,000 population in densely populated areas. The maximum distance to a clinic should be 2 km in densely populated areas and 7 km in other areas. Quality of care should be addressed at weekly meetings in hospitals with obstetric, neonatal, and midwife staff. Meetings should provide in-service training. A data management system is needed to assess coverage and quality of care. Uniform systems should be adopted. Data collection personnel should be trained. Eight priorities are identified as urgent and possible steps in improving maternal and child health services. A public health-oriented perinatal priorities association is needed to lobby, assist with the development of new strategies, and set service goals. This association should review national statistics, quality of care, and upgrades; and perform research on prenatal visits, genetic screening, and WR testing.