{"id":41424,"date":"2020-01-29T09:04:16","date_gmt":"2020-01-29T14:04:16","guid":{"rendered":"https:\/\/www.healthynewbornnetwork.org\/?post_type=news-item&p=41424"},"modified":"2023-11-21T12:35:09","modified_gmt":"2023-11-21T17:35:09","slug":"south-africa-steps-up-its-game-to-end-mother-to-child-transmission-of-hiv","status":"publish","type":"news-item","link":"https:\/\/www.healthynewbornnetwork.org\/news-item\/south-africa-steps-up-its-game-to-end-mother-to-child-transmission-of-hiv\/","title":{"rendered":"South Africa steps up its game to end mother-to-child transmission of HIV"},"content":{"rendered":"

This article was originally published on <\/em>The Conversation<\/em><\/a><\/p>\n

South Africa\u2019s prevention of mother-to-child transmission programme has achieved remarkable successes in recent years. It has improved the health and life expectancy for pregnant women living with HIV, and it has reduced the risk of transmission of the virus to their offspring.<\/p>\n

HIV can be transmitted during pregnancy, at the time of delivery, and through breastfeeding. The most critical intervention to prevent transmission is to ensure that the mother has undetectable HIV viral load levels in her bloodstream. This is done by providing her with effective antiretroviral treatment (ART).<\/p>\n

Access to ART for pregnant women was first introduced in 2004 and has evolved over the years. In 2015, antenatal services for pregnant women were further improved by providing access to lifelong ART, irrespective of CD4 count or clinical disease severity.<\/p>\n

As a result, South Africa\u2019s programme is a global leader with more than 95%<\/a> of women being tested for HIV during antenatal care. More than 90% of HIV-positive women are now being initiated on ART, a huge improvement from only 57% accessing ART in 2007<\/a>. Mother-to-child transmission rates have dropped dramatically. Without any intervention, the HIV-infection rate was around 40%<\/a>. With these interventions the HIV-infection rate at birth is currently around 1%<\/a>.<\/p>\n

The aim now is to eliminate mother to child transmission completely. But realising this ambitious target will require innovative strategies and continuous quality improvement. Maternal viral suppression rates need to be improved, particularly in the period after the mother gives birth. In turn, this would lead to reduced HIV transmission during breastfeeding, improved maternal health, viral suppression in future pregnancies and reduced HIV transmission to sexual partners.<\/p>\n

To achieve these outcomes the South African Department of Health has revised<\/a> the guidelines for the prevention of mother to child transmission. It now includes a strong focus on maternal viral suppression during antenatal care, at delivery, and in the period after birth.<\/p>\n

If implemented effectively, the approach set out in the guidelines, would put South Africa within reach of eliminating mother to child transmission.<\/p>\n

What\u2019s being done<\/h2>\n

A significant strategy to achieve and sustain maternal viral suppression is the new drug dolutegravir<\/a>. This \u201cgame-changer\u201d is now available in the arsenal of first-line ARTs in South Africa. The drug has a number of features that make it particularly attractive and therefore the preferred first-line option in people starting ART. Most importantly, it rapidly suppresses the viral load, and has few side-effects. This makes it easier for people to continue taking their treatment as their medication doesn\u2019t make them feel ill.<\/p>\n

Dolutgravir also has few interactions with other drugs, especially certain family planning methods, and the virus doesn\u2019t easily develop drug resistance against it.<\/p>\n

But there is a potential safety concern. Recent data from Botswana suggest that there may be a risk of neural tube defects in the babies of women falling pregnant while on the drug. As a result, the recommendation is that the drug is used with caution around the time of conception.<\/p>\n

This highlights the need for all women to be appropriately counselled on contraceptive options and the risks and benefits of dolutegravir. They must be allowed to make an informed choice.<\/p>\n

Potent ART regimens are most effective when coupled with viral load monitoring which provides a way of confirming good adherence and viral suppression. It also enables timeous detection of factors that may be negatively affecting viral load suppression such as depression, non-disclosure, or drug-interactions.<\/p>\n

New to the programme is that all women will have a viral load test at the time of delivery. This will determine the response to ART received during antenatal care and facilitate an appropriate response to ensure viral suppression into the breastfeeding period.<\/p>\n

A viral load has also been introduced at six months after delivery for all women on ART, and an HIV test at 6 months for all HIV negative but exposed infants.<\/p>\n

Finally, the breastfeeding period is now widely considered to be the \u201cnew frontier\u201d for preventing mother to child transmission. More than half of the transmission now occurs in the first 6 months after delivery.<\/p>\n

To improve viral suppression rates in the period after birth, the new guidelines outline mechanisms for linking mothers back into care post-delivery, for integrating care for the mother-infant-pair to ensure drug regimens are adhered to, and for promoting and protecting breastfeeding as a major child survival strategy. To reduce the risk of transmission through breast milk, greater efforts are being made to promote optimal feeding practices and to provide babies with infant prophylaxis until maternal viral suppression is achieved.<\/p>\n

The whole new approach is designed to be practical and user-friendly so that health care workers can provide the necessary care to mothers and their babies.<\/p>\n

Creating an environment that enables rigorous implementation of this guideline will move South Africa closer to the goal of eliminating mother to child transmission of HIV and making an HIV-free generation a reality.<\/p>\n","protected":false},"author":7211,"featured_media":41425,"template":"","acf":[],"yoast_head":"\nHealthy Newborn Network<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.healthynewbornnetwork.org\/news-item\/south-africa-steps-up-its-game-to-end-mother-to-child-transmission-of-hiv\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"South Africa steps up its game to end mother-to-child transmission of HIV - Healthy Newborn Network\" \/>\n<meta property=\"og:description\" content=\"This article was originally published on The Conversation South Africa\u2019s prevention of mother-to-child transmission programme has achieved remarkable successes in recent years. 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Africa steps up its game to end mother-to-child transmission of HIV"}]},{"@type":"WebSite","@id":"https:\/\/www.healthynewbornnetwork.org\/#website","url":"https:\/\/www.healthynewbornnetwork.org\/","name":"Healthy Newborn Network","description":"Addressing critical knowledge gaps in newborn health.","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.healthynewbornnetwork.org\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"}]}},"featured_image":"<img width=\"768\" height=\"376\" src=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/South-Africa-steps-up-its-game-768x376.jpg\" class=\"attachment-medium_large size-medium_large\" alt=\"\" decoding=\"async\" srcset=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/South-Africa-steps-up-its-game-768x376.jpg 768w, https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/South-Africa-steps-up-its-game-300x147.jpg 300w, https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/South-Africa-steps-up-its-game-1024x501.jpg 1024w, https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/South-Africa-steps-up-its-game-1536x751.jpg 1536w, https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/South-Africa-steps-up-its-game.jpg 1904w\" sizes=\"(max-width: 768px) 100vw, 768px\" \/>","author_name":"HNN Team","author_image":"<img src=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/themes\/hnn\/dist\/images\/member-default.jpg\" alt=\"\" class=\"avatar avatar-32 photo\" height=\"32\" width=\"32\"\/>","acf_custom_fields":{"external_link":"https:\/\/theconversation.com\/south-africa-steps-up-its-game-to-end-mother-to-child-transmission-of-hiv-128439","publication_date":"20200106","publication":"The Conversation","partners":[],"issues":[{"ID":123,"post_author":"7211","post_date":"2015-10-21 15:18:46","post_date_gmt":"2015-10-21 15:18:46","post_content":"[vc_row full_width=\"stretch_row\" css=\".vc_custom_1453403441710{margin-top: -60px !important;padding-top: 30px !important;padding-bottom: 30px !important;background-color: #ffffff !important;}\"][vc_column width=\"1\/2\"][vc_column_text]\r\n<h2>Preventing mother-to-child HIV transmission is crucial to achieving an HIV-free generation and ending the global inequities in HIV diagnosis, treatment, and care.<\/h2>\r\nEarly HIV diagnosis, paired with treatment and care, allows people to live long, healthy lives and reduces the likelihood of their transmitting the virus to others. Vertical transmission, or mother-to-child transmission, of HIV is the leading cause of infection among children under 15. Globally, nearly\u00a0<a href=\"https:\/\/data.unicef.org\/topic\/hivaids\/emtct\/\">1.5 million deaths and 2.9 million<\/a> new HIV infections have been averted since 2000 as a result of the scale-up of programs to prevent mother-to-child-transmission of HIV. In 2021, <a href=\"https:\/\/www.unaids.org\/en\/resources\/fact-sheet\">81 percent of pregnant women<\/a> living with HIV had access to antiretroviral medication. While mother-to-child transmission of HIV has been nearly eliminated from high-income countries, progress has been slower in low- and middle-income countries. In sub-Saharan Africa, women and girls accounted for 63 percent of all new HIV infections in 2021, increasing the risk of transmission to their newborns. More work needs to be done to prevent HIV among women, girls, and children and close the gaps to achieve the global targets of <a href=\"https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/201506_JC2743_Understanding_FastTrack_en.pdf\">95-95-95 by 2025;<\/a> 95 percent of people living with HIV know their HIV status, 95 percent of people who know their status are on antiretroviral treatment, and 95 percent of people on HIV treatment have a suppressed viral load, reducing the risk of transmission.[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-red\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">54<\/span><\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1666047176103{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percent of children in need <a href=\"https:\/\/www.theglobalfund.org\/media\/11304\/corporate_2021resultsreport_report_en.pdf\" target=\"_blank\" rel=\"noopener\">who receive life-saving treatment<\/a> for HIV<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-yellow\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><b><span class=\"ticker\">63<\/span><\/b><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1652993131651{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percent of infants exposed to HIV <a href=\"https:\/\/www.childrenandaids.org\/sites\/default\/files\/2022-01\/2021%20WAD%20Report-sm.pdf\" target=\"_blank\" rel=\"noopener\">tested within<\/a> two months of birth<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-blue\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><b><span class=\"ticker\">2<\/span><\/b><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1652992737559{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percentage point increase in ART coverage for pregnant women living with HIV from 2016 to 2020; this <a href=\"https:\/\/www.childrenandaids.org\/sites\/default\/files\/2022-01\/2021%20WAD%20Report-sm.pdf\" target=\"_blank\" rel=\"noopener\">rate has stalled<\/a> compared to the 38-percentage point increase in coverage from 2010-2015.<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner][vc_column_text]\r\n<h6 style=\"text-align: center;\"><span style=\"font-style: italic;\">All data on this page represents the most recent data available, unless otherwise noted. Please visit our\u00a0<\/span><a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\"><span style=\"font-style: italic;\">Newborn Numbers<\/span><\/a><span style=\"font-style: italic;\">\u00a0page and download the Excel spreadsheet to explore the data further.<\/span><\/h6>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" css=\".vc_custom_1452696349804{margin-top: 30px !important;margin-bottom: 30px !important;background-color: #f6f6f4 !important;}\"][vc_column][vc_text_separator title=\"HIV Transmission\" color=\"custom\" accent_color=\"#cccccc\"][vc_row_inner equal_height=\"yes\"][vc_column_inner][vc_column_text]Newborns can be infected with HIV by their mothers in a few ways, requiring a comprehensive, multi-level preventative approach. An HIV-positive mother can transmit HIV to her child during pregnancy, childbirth, or breastfeeding. Between 15 and 45 percent of infants born to HIV-positive women will become infected, if no preventative action is taken. Antiretroviral therapy (ART) can significantly reduce the risk of vertical transmission, as it decreases viral levels and makes it less transmittable. All pregnant women should be tested for HIV at their first antenatal visit, especially those in HIV-endemic regions, and all pregnant women living with HIV should be supported to initiate or continue ART during pregnancy. All children born to HIV-positive mothers should receive preventative antiretroviral drugs, with regular testing at two months and after the cessation of breastfeeding.\r\n\r\nMajor strides have been made to reduce the risk of mother-to-child transmission of HIV through global prioritization and commitments. A global multi-partner effort has decreased the rate of transmission in children by\u00a0<a href=\"https:\/\/www.unaids.org\/en\/resources\/fact-sheet\">53 percent since 2010<\/a>.\u00a0However, the COVID-19 pandemic led to noticeable declines in ART coverage among pregnant and breastfeeding women. Approximately <a href=\"https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/global-alliance-end-AIDS-in-children_en.pdf\">800,000 children under 15 years<\/a> of age are not on treatment, and the majority of global childhood infections, 4 out of 5, occurred in sub-Saharan Africa in 2021. With the launch of the new <a href=\"https:\/\/www.unaids.org\/en\/resources\/documents\/2021\/2021-2026-global-AIDS-strategy\" target=\"_blank\" rel=\"noopener\">Global AIDS Strategy<\/a> in 2021 came an increased commitment to achieving the 2025 target of 95 percent coverage of services for eliminating mother-to-child transmission. The <a href=\"https:\/\/www.unaids.org\/en\/resources\/documents\/2021\/2021-2026-global-AIDS-strategy\">Global Alliance to End AIDS in Children<\/a>, launched in 2022, will support these efforts through four pillars:\r\n<ul>\r\n \t<li>Early testing and optimized comprehensive, high-quality treatment and care for infants, children, and adolescents living with and exposed to HIV<\/li>\r\n \t<li>Closing the treatment gap for pregnant women living with HIV and optimizing continuity of treatment towards the goal of elimination of mother-to-child transmission<\/li>\r\n \t<li>Preventing and detecting new HIV infections among pregnant and breastfeeding adolescents and women<\/li>\r\n \t<li>Addressing rights, gender equality, and the social and structural barriers that hinder access to services<\/li>\r\n<\/ul>\r\n[\/vc_column_text][vc_text_separator title=\"Key resources\"][vc_column_text]\r\n<ul>\r\n \t<li><a href=\"https:\/\/www.childrenandaids.org\/vertical_transmission\" target=\"_blank\" rel=\"noopener\">Prevention of Vertical Transmission<\/a>, Children and AIDS Unicef (2022)<\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/updated-recommendations-on-hiv-prevention-infant-diagnosis-antiretroviral-initiation-and-monitoring\/\" target=\"_blank\" rel=\"noopener\">WHO updated clinical and service delivery recommendations for HIV prevention, treatment and care<\/a> (2021)<\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/global-aids-strategy-2021-2026\/\" target=\"_blank\" rel=\"noopener\">Global AIDS Strategy 2021\u20132026: End Inequalities, End AIDS<\/a> (2021)<\/li>\r\n \t<li><a href=\"https:\/\/www.theglobalfund.org\/en\/blog\/2021-11-03-20-years-of-progress-to-protect-mothers-and-babies-from-hiv\/\" target=\"_blank\" rel=\"noopener\">20 Years of Progress to Protect Mothers and Babies From HIV<\/a> (2021)<\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/start-free-stay-free-aids-free\/\" target=\"_blank\" rel=\"noopener\">Final report from the Start Free, Stay Free, AIDS Free initiative<\/a> (2021)<\/li>\r\n \t<li><a href=\"https:\/\/www.unaids.org\/en\/resources\/documents\/2020\/2020_women-adolescent-girls-and-hiv\" target=\"_blank\" rel=\"noopener\">We\u2019ve got the power \u2014 Women, adolescent girls and the HIV response<\/a> (2020)<\/li>\r\n \t<li><a href=\"https:\/\/www.unaids.org\/en\/resources\/documents\/2020\/prevailing-against-pandemics\" target=\"_blank\" rel=\"noopener\">Prevailing against pandemics by putting people at the centre \u2014 World AIDS Day report<\/a> (2020)<\/li>\r\n \t<li><a href=\"https:\/\/www.childrenandaids.org\/sites\/default\/files\/2017-04\/IATT_Part-1-PMTCT-in-Humanitarian-Settings_2015.pdf\" target=\"_blank\" rel=\"noopener\">PMTCT in Humanitarian Settings Part I: Lessons Learned and Recommendations<\/a> (2015)<\/li>\r\n \t<li><a href=\"https:\/\/www.childrenandaids.org\/sites\/default\/files\/2017-04\/IATT_Part-2-PMTCT-in-Humanitarian-Settings_2015_0.pdf\" target=\"_blank\" rel=\"noopener\">PMTCT in Humanitarian Settings: Part II Implementation Guide<\/a> (2015)<\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row]","post_title":"Prevention of mother-to-child transmission of HIV (PMTCT)","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"hiv-aids-prevention-mother-child-transmission","to_ping":"","pinged":"","post_modified":"2022-12-01 11:02:13","post_modified_gmt":"2022-12-01 16:02:13","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=123","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"}],"regions":[{"ID":247,"post_author":"7211","post_date":"2015-11-22 21:37:22","post_date_gmt":"2015-11-22 21:37:22","post_content":"","post_title":"Africa","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"africa","to_ping":"","pinged":"","post_modified":"2016-02-11 21:42:43","post_modified_gmt":"2016-02-11 21:42:43","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=region&p=247","menu_order":0,"post_type":"region","post_mime_type":"","comment_count":"0","filter":"raw"}],"countries":[{"ID":223,"post_author":"7211","post_date":"2015-10-21 22:04:20","post_date_gmt":"2015-10-21 22:04:20","post_content":"[vc_row][vc_column css=\".vc_custom_1453305596740{padding-top: 30px !important;padding-bottom: 30px !important;}\"][vc_text_separator title=\"Leading causes of neonatal deaths in South Africa (2020)\" el_class=\"transform:upperclass\"][vc_row_inner][vc_column_inner][vc_round_chart type=\"doughnut\" stroke_width=\"1\" stroke_color=\"custom\" values=\"%5B%7B%22title%22%3A%220%25%20Diarrhoea%22%2C%22value%22%3A%220%25%22%2C%22color%22%3A%22vista-blue%22%7D%2C%7B%22title%22%3A%220%25%20Tetanus%22%2C%22value%22%3A%220%25%22%2C%22color%22%3A%22mulled-wine%22%2C%22custom_color%22%3A%22%238d6dc4%22%7D%2C%7B%22title%22%3A%225%25%20Pneumonia%22%2C%22value%22%3A%225%25%22%2C%22color%22%3A%22peacoc%22%7D%2C%7B%22title%22%3A%2236%25%20Preterm%20birth%20complications%22%2C%22value%22%3A%2236%25%22%2C%22color%22%3A%22blue%22%7D%2C%7B%22title%22%3A%2220%25%20Intrapartum%20related%20events%22%2C%22value%22%3A%2220%25%22%2C%22color%22%3A%22turquoise%22%7D%2C%7B%22title%22%3A%2214%25%20Sepsis%20and%20other%20infectious%20conditions%20of%20the%20newborn%22%2C%22value%22%3A%2214%25%22%2C%22color%22%3A%22pink%22%7D%2C%7B%22title%22%3A%2210%25%20Congenital%20abnormalities%5Ct%22%2C%22value%22%3A%2210%25%22%2C%22color%22%3A%22violet%22%7D%2C%7B%22title%22%3A%2215%25%20Other%20conditions%22%2C%22value%22%3A%2215%25%22%2C%22color%22%3A%22chino%22%7D%5D\" custom_stroke_color=\"#f6f6f4\" css=\".vc_custom_1686335375365{padding-right: 30px !important;padding-left: 30px !important;background-position: center !important;background-repeat: no-repeat !important;background-size: contain !important;}\"][\/vc_column_inner][\/vc_row_inner][vc_column_text]\r\n<h6 style=\"text-align: left;\">Source: Estimates for causes of death 2000-2020 generated by the WHO and Maternal and Child Epidemiology Estimation Group (MCEE) 2023 and downloaded from <a href=\"http:\/\/data.unicef.org\/\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=http:\/\/data.unicef.org&source=gmail&ust=1551964625737000&usg=AFQjCNFsFTtu9FzS8H64YC88NPOzQVbPwQ\">http:\/\/data.unicef.org<\/a><\/h6>\r\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" gap=\"5\" css=\".vc_custom_1453306441839{background-image: url(\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/country-stat-bkgr.jpg?id=389) !important;background-position: center !important;background-repeat: no-repeat !important;background-size: cover !important;}\"][vc_column css=\".vc_custom_1453306493120{margin-top: 30px !important;margin-bottom: 30px !important;}\"][vc_text_separator title=\"key indicators\" el_class=\"transform:uppercase text-white\"][vc_row_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1552412356987{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">11<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Newborn mortality rate (deaths per 1,000 live births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686335292465{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">2.2<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Annual reduction in newborn mortality rate 2000-2021 (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1650980934354{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #41aaab;\"><strong><span class=\"ticker\">33<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Proportion of under-5 child deaths that are newborn (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686335304276{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">16.2<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Stillbirth rate (deaths per 1,000 births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_row_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686335350088{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">96.7<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Skilled birth attendance (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1578918718172{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #41aaab;\"><strong><span class=\"ticker\">67<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Early initiation of breastfeeding (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1698697104922{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">13<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Preterm birth rate (births <37 weeks per 100 live births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686335328630{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">127<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Maternal mortality ratio (deaths per 100,000 live births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_column_text css=\".vc_custom_1456677993474{margin-top: 20px !important;}\"]\r\n<h5 style=\"text-align: center;\"><span style=\"color: #ffffff;\">Visit our<\/span> <a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn numbers<\/a> <span style=\"color: #ffffff;\">page to explore the most recent data further<\/span><\/h5>\r\n[\/vc_column_text][\/vc_column][\/vc_row]","post_title":"South Africa","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"south-africa","to_ping":"","pinged":"","post_modified":"2023-10-30 16:17:00","post_modified_gmt":"2023-10-30 20:17:00","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=country&p=223","menu_order":0,"post_type":"country","post_mime_type":"","comment_count":"0","filter":"raw"}]},"_links":{"self":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/news-item\/41424"}],"collection":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/news-item"}],"about":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/types\/news-item"}],"author":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/users\/7211"}],"version-history":[{"count":0,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/news-item\/41424\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media\/41425"}],"wp:attachment":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media?parent=41424"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}