COMMUNITY BASED SITUATIONAL ANALYSIS Maternal and ...

Conclusion
The majority of deaths in mothers in this study were due to AIDS-related causes. These
deaths were accompanied by several months of chronic illness and deterioration in health
status until the women were no longer able to take care of themselves. Most described poor
health as starting during pregnancy or around the time of delivery, suggesting pregnancy may
have contributed to further deterioration in health in HIV-positive women. Many of these deaths
involved extensive care by family members and continuous health seeking to multiple providers
during the course of the illness. However, family members received very little if any
communication from health providers about the condition of the terminally ill woman or her
care. Denial and/or hopelessness were seen in many of these cases. Interestingly
hopelessness, denial and lack of disclosure were not seen in the cases in Paarl where hospice
care was available and the health care and system has been previously described to be of a
higher quality with more resources.
Although the majority of deaths appeared to be HIV and AIDS related, there were still deaths
due to direct obstetric causes. One involved patient related avoidable factors and in the other
two, health provider avoidable factors. Care must be taken not to overlook basic maternity
service quality in the face of an often overwhelming HIV and AIDS pandemic.
Community Based Situation Analysis: Maternal & Neonatal Follow-up Care 28