SDG 3: Tip 6 – SA’s stress levels and our moms, babies and reproductive health

TARGET #

DESCRIPTION

SA STATUS

(PER 2019 COUNTRY REPORT)

3.1

By 2030, reduce the global maternal mortality ratio to less than 70 per 100 000 live births

Maternal mortality:

121 per 100 000 live births (2016)

3.2

By 2030, end preventable deaths of new-borns and children under 5 years of age with all countries aiming to reduce neonatal mortality to at least 12 per 1 000 live births and reduce under-5 mortality to at least as low as 25 per 1 000 live births

Neonatal mortality:

21 (2016) per 1 000 live births

Under-5 mortality:

42 (2016) per 1 000 live births

3.3

By 2030, end the epidemics of AIDS (0 per 1 000), tuberculosis (0 per 100 000), malaria (0 per 1 000) and neglected tropical diseases and combat hepatitis (0 per 100 000), water-borne diseases and other communicable diseases

New HIV infections:

1 (2017) new infection per 1 000 uninfected population

TB incidence: 567 (2017)

per 100 000

Malaria incidence:

1,4 per 1 000 (2018)

Hepatitis B mortality:

0,5 per 100 000 (2015)

3.4

By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being

Mortality rates attributed to cardiovascular disease, cancer, diabetes and chronic respiratory diseases have remained relatively stable between 2011 and 2016

For 2016 these rates were:

· Cardiovascular disease: 11%

· Cancer: 7%

· Diabetes: 4%

· Chronic respiratory diseases: 3%

In 2013, the suicide mortality rate was on the increase, but it declined in 2015 when it was 1,3 per 100 000

3.5

Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and the harmful use of alcohol

Harmful use of alcohol:

7,27 litres per capita (2017)

The harmful use of alcohol resulted in 3 million deaths (5,3% of all deaths) worldwide in 2016

3.7

By 2030, ensure universal access to sexual and reproductive healthcare services including family planning, information and education, and integrate reproductive health into national strategies and programmes

Use of modern contraception methods: 75,7% (2016) was the percentage of women of reproductive age (aged 15−49 years) who had their need for family planning satisfied with modern methods

Adolescent birth rate per 1 000 females:

Girls aged 10−14:

0,6 (2017)

Girls aged 15−19:

46,2 (2017)

3.c

Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing states

The 2019 Country Report provides no status for this target but the WHO’s website state that they estimate a projected shortfall of 18 million health workers by 2030, mostly in low- and lower-middle-income countries. They further state that there is a chronic underinvestment in education and training of health workers in some countries and also a mismatch between education and employment strategies in health systems

Clinical psychologist Mandy Rodrigues has two master’s degrees focusing on psychoneuroimmunology in the field of HIV/AIDS, addressing the link between stress and CD4 cell counts. Both studies indicated that decreasing stress and improving social support increased the immune system and the body’s ability to fight the progression of the disease.

Once in private practice, she focused on developing programmes for lifestyle-related diseases such as cardiovascular disease, endometriosis, burnout, infertility, Type-2 diabetes and autoimmune diseases, resulting in her co-authoring the book Faster, better, sicker: time urgency perfectionism stress. This included the development of a dynamic, interactive online CBT stress management course at www.tups.co offering a practical, affordable programme including psychometric measures of stress, physical symptoms / diseases, and the reduction of substance abuse, road rage and burnout. This data was presented in numerous posters internationally and nationally. In developing countries, as individuals become more urbanised, lifestyle diseases are emerging and are not managed effectively.

Through her own journey of miscarriage, infertility and cancer, Mandy became involved in providing educational material across social media platforms on miscarriage, stillbirth and neonatal death with www.houseoffertility.org and their subsidiary emptywombs. This led to the birth of the Bereavement Training Programme, a ground-breaking educational training application (in development) which involves individual and ongoing online training and assessment of all staff from administrators through to nursing sisters and doctors. The programme offers modules supporting healthcare workers and patients and providing accurate data about the preventable causes of such deaths given the high rates of perinatal mortality either during pregnancy or after, indicating where improvements are needed.

Developing countries are in dire need of staff training in rural clinics and public healthcare whereby patient retention and compliance is imperative in the prevention, management and support of these mothers to prevent the high rates of perinatal deaths and maternal deaths. Morbidity is more common than mortality, although the causes are similar. If mortality can be reduced, morbidity will decrease. The literature also suggests that there is a need to support healthcare workers in the field who present with burnout, and a reluctance to enter the field of obstetrics given the complications of non-compliance, lack of resources and inadequate support.

This programme will dovetail with www.healthdocs.co.za, an affordable, user-friendly application to which Mandy has contributed educational material and which helps the medical field to digitise records, improve administration and communication, and manage medico-legal risk. HealthDocs provides innovative solutions for patients to facilitate better outcomes via coordinating care, real-time engagement and bilateral sharing of information with medical practitioners, care teams and industry stakeholders. HealthDocs also provides innovative disease management solutions, ensuring companies are equipped to proactively manage the health of employees including reproductive health and education, antenatal care, and monitored medical visits beyond the birth. HealthDocs can be shared across clinics and the workplace nationwide ensuring that expectant mothers are monitored and their health records captured. With poverty, lack of resources and epidemics like HIV/COVID-19, expectant mothers are inadvertently neglecting antenatal care, resulting in higher infant mortality rates, maternal deaths, and deaths of children under the age of five. These can be monitored and preventable strategies recommended by allowing access to such a portal which can be used across developing countries to ensure compliance and hopefully decrease mortality and morbidity.

Could you or your organisation partner with Mandy to help us achieve these important SDG 3 targets?

Website: mandyrodrigues.com
Chairperson of the Psychology SIG and on the executive board of SASREG: https://sasreg.co.za/executive-committee/.
Ambassador to #STRONGERTOGETHER initiative: https://www.myivfanswers.com/stronger-together/
Regular speaker and contributor to https://www.myivfanswers.com/.
Online stress management course and book: tups.co
Co-author of book Faster better sicker: time urgency perfectionism stress: https://www.tups.co/pdf/fbs_book.pdf
Bereavement Training Programme: https://www.houseoffertility.org/Pregnancyloss.html
HealthDocs: healthdocs.co.za
Chair and organiser of Support Zone at FSA 2020: https://fertilityshowafrica.com/
YouTube channel: https://youtu.be/hkrn456OeWw
Expert talk on grief and loss introducing the Bereavement Training Programme: