Mothers and babies pay heavy price for xenophobia in healthcare services

At Section27, we often engage with pregnant women and young children being denied access to healthcare services at hospitals in Gauteng. This is despite that providing free health services to vulnerable categories of persons, like pregnant women and young children, is one of the key tenets of equitable access to healthcare services. In fact, it is a core determinant of priority health outcomes, such as reducing maternal and child disease and death.

Pregnant women and young children have special health needs.

During pregnancy, the physiological changes in a woman’s body can be monitored at clinics and community health centres for low to medium-risk antenatal care. Pregnant women can be referred to hospitals for antenatal care when their pregnancies are high risk. For instance, when they are living with unmanaged HIV or when they have high blood pressure. When women with high-risk pregnancies are unable to access the necessary advanced healthcare at the hospital level, they are unable to monitor the progress of their pregnancy and identify and manage harmful risk factors. For pregnant women, HIV, in the absence of treatment and management, can lead to maternal death and disease, and there is an increased risk of transmitting HIV to an infant.

Inconsistent access to antenatal care can result in the loss of an opportunity to make early critical interventions for managing or treating underlying conditions. By the time pregnant women do present to hospitals, they are in labour and cannot be denied access to emergency healthcare services in terms of section 27(3) of the Constitution. With many of the risk factors being either unknown or unmanaged, the birthing process can lead to additional complications that could put both the pregnant woman and the foetus or infant in grave danger.

The first few years of a child’s life include critical stages of development. In the neonatal period (0 – 28 days), an infant with perinatal exposure to HIV requires the administration of Nevirapine within the first few hours of birth to prevent transmission. During childhood, illnesses like cerebral palsy require treatment involving allied medical disciplines, which, if lacking, can lead to developmental challenges for such a child. Often, these services can only be found in a hospital setting, so a failure to grant access to a hospital would be tantamount to a denial of the necessary care.

A nurse looks on as a newborn rests in an intensive care ward. (Photo: Denvor de Wee / Spotlight)

A new mother with her child. (Photo: Denvor de Wee / Spotlight)

The neonatal unit at Leratong Hospital. (Photo: Denvor de Wee / Spotlight)

The effect of the laws and policies

A departure from the maternal and child health goals

Asylum seekers waiting at the revamped Desmond Tutu Refugee Reception Centre in Marabastad. (Photo: GCIS / Spotlight)

Health Minister Dr Joe Phaahla. (Photo: Gallo Images / Daily Maverick / Leila Dougan)

Reasons for free healthcare services