COMMUNITY BASED SITUATIONAL ANALYSIS Maternal and ...

ealising the seriousness of his condition, planned to take the child to a paediatrician in the
morning. However, the baby died at three o’clock in the morning, before she was able to seek
health care.
It is possible that mothers are not being educated by health care providers attending them
about danger signs to watch for at home. For example, a Rietvlei mother reported that her
infant was treated at a clinic and then referred to hospital for his cough. This baby was admitted
to the hospital for a week after which he was discharged and showed improvement. The next
week, however, the baby started breathing very fast and died after a few days. She reported
that she did not take him back to hospital because she thought the treatment the hospital had
already given him would eventually cure him. Had she been instructed on the steps to take if
the infant’s health deteriorated, it is possible that he would have been taken back to the
hospital for additional care and could have survived this illness.
Poor quality of care: The experiences reported by respondents suggest that the quality of
care received in many instances was sub-standard. For example, some mothers who took their
infants for care reported that they were sent home with paracetamol or electrolyte sachets
when perhaps the infant should have been admitted. A mother in Rietvlei reported that she took
her sick infant to hospital, was given medicine and then sent home. The child died at home
later that day. In other cases, mothers recounted that their infants died on the way home after
having been admitted and discharged from hospital. One Rietvlei mother recounted how her
baby was discharged from hospital while still showing signs of weakness and a sunken
fontanel. The baby fell asleep on the way home and when she arrived at home she realised the
baby had died. Another Rietvlei mother reported that her child was admitted for three weeks
with cough, vomiting and fever. The staff advised the mother to take the child home where she
then died after two days.
Some mothers reported taking their infants to a clinic but that the clinic did not have appropriate
medication. When asked if they have any ideas “for how health care facilities and providers can
better serve families…with sick infants,” several mothers suggested that it is of primary
importance that clinics have enough stocks of medicines. One mother stated:
“It is not nice to go to the clinic seeking help and you end up not getting that help you needed.”
Another mother suggested that the most important thing needed to improve care is:
“[i]f facilities could improve on the long hours people (sick people) endure before being
attended [to].”
One respondent stated that her baby got sick at night but that she could not get transport until
the next morning. When they got to the health facility, they had to wait for several hours to be
seen. By that time, her baby was already gravely ill.
Many respondents reported that they did not know the cause of their infant’s death. This
occurred even among some women whose infants had died in hospital. They reported that staff
did not take the time to explain to them what happened, and they did not feel that they had the
right to ask. These mothers expressed grave disappointment about their experiences with
facility staff. For example, one mother who seemed to have accepted the fate of her baby (she
believed that it was her baby’s death day – "kwase kufike usuku”) became very tearful when
recounting how she had been treated at the facility.
Community Based Situation Analysis: Maternal & Neonatal Follow-up Care 32