The impact of free maternal health care in South Africa.

Although free care is one of several measures which may help to increase access to and quality of maternal care services these findings suggest that free MCH alone cannot suffice for the reduction of the large burden of avoidable maternal and perinatal mortality in the country.

Abstract

This article reviews the South African experience of free maternal health care (MCH) and its possible impact on maternal health. In 1994 the South African government announced the policy of free care supporting the development of accessible good quality and efficient primary health care. Included in the free MCH policy were all public services (hospital and primary health care) to pregnant women from point of confirmation of pregnancy until 42 days after delivery and children under the age of 6 years. A national evaluation of the free MCH policy was conducted in 1995 by an independent agency. Assessments found an increased utilization of existing antenatal services increased drug costs by 1% of recurrent health sector expenditure and a perception that the free care policy is being achieved at the expense of service providers hence little support is given by those most directly involved in its implementation. Although free care is one of several measures which may help to increase access to and quality of maternal care services these findings suggest that free MCH alone cannot suffice for the reduction of the large burden of avoidable maternal and perinatal mortality in the country.