What the study found
South Africa's progress in lowering maternal mortality was interrupted during the COVID-19 pandemic, with a 42% rise in the national institutional Maternal Mortality Ratio (iMMR, a measure of maternal deaths in health facilities per number of live births). A partial decline was seen in 2022, but the rate remained above the 2019 level.
Why the authors say this matters
The authors conclude that South Africa is not yet on track to meet Sustainable Development Goal 3.1, which aims to reduce maternal mortality. They say the findings show that the pandemic exposed and worsened weaknesses in the health system and that provincial inequities still need to be addressed.
What the researchers tested
The researchers carried out a longitudinal trend analysis using secondary data from South Africa's Confidential Enquiry into Maternal Deaths reports from 2017 to 2022. They examined national and provincial institutional maternal mortality ratio trends and compared provinces to identify disparities.
What worked and what didn't
Before the pandemic, maternal mortality trends were improving, but this was abruptly reversed during the pandemic. Only two provinces maintained a downward trend, while most provinces showed no clear improvement and three provinces had consistently very high and fluctuating iMMRs.
What to keep in mind
The summary does not describe detailed study limitations. The analysis is based on reported CEMD data and focuses on institutional maternal mortality trends from 2017 to 2022.
Key points
- The national institutional Maternal Mortality Ratio rose by 42% during the COVID-19 pandemic.
- Maternal mortality improved before the pandemic, then worsened, and did not fully return to the 2019 baseline by 2022.
- Only two provinces showed a sustained downward trend in maternal mortality.
- Three provinces had consistently high and volatile institutional maternal mortality ratios.
- The authors conclude that South Africa is not yet on track for the SDG maternal mortality target.
Disclosure
- Research title:
- COVID-19 reversed South Africa’s maternal mortality gains
- Authors:
- Gomolemo Rakale, Sam Ntuli, Tshepo Ramarumo, Solly M. Seeletse
- Institutions:
- Sefako Makgatho Health Sciences University, Sefako Makgatho Health Sciences University, Sefako Makgatho Health Sciences University, Sefako Makgatho Health Sciences University
- Publication date:
- 2026-04-14
- OpenAlex record:
- View
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