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Health Minister Aaron Motsoaledi

"With regards to curbing child and maternal mortality, and improving maternal health we are in deep trouble," Motsoaledi said on Tuesday during a parliamentary committee briefing on South Africa's progress on the Millennium Development Goals (MDGs).

The eight goals were adopted in 2000 by members of the United Nations, and intend to tackle pressing issues including poverty, disease, hunger, and gender inequality by 2015.

While MDG4 aims to reduce child mortality by two-thirds, MDG5 is about improving maternal health care and reducing the number of women who die as a result of pregnancy or childbirth by 75%.

"The entire continent is in trouble in this regard. I am not suggesting South Africa will not meet those goals in particular, but the situation has reached crisis levels," he added.

South Africa's maternal mortality rate is high and increasing, and stood at 625 per 100,000 live births in 2007. That is almost double from the situation in 2001, when an average of 369 pregnant South African women died per 100,000 live births.

By signing the MDGs, South Africa pledged to reduce this rate to 38 per 100,000 live births.

"Infant or under-one mortality rates have remained stable over the past years, but under-five mortality in South Africa has risen from 97 per 1,000 live births in 1998 to 104 in 2007," Motsoaledi noted. "The target set by the MDGs is 20."

"Members of Parliament should not see these numbers as statistics. To help children survive we have to improve our women's health. We cannot reach MDG4 without meeting MDG5."

"We need to urgently re-engineer our health system, which is characterised by four negatives," he continued. "It is unsustainable, it is destructive, it is costly, and does not put the emphasis on preventing."

"At the moment most attention goes to the quaternary and curative health care, which aims to cure instead to prevent and is therefore more expensive."

"More should be done to strengthen our country's primary health care, which operates at community level and where more people's problems can be solved. This level aims at prevention of certain diseases."

According to Motsoaledi the government has become more proactive on maternal and child health, especially with regards to the issue of HIV.

"Our new universal HIV approach states that all pregnant women living with HIV are treated with anti-retrovirals when their CD4-count drops below 350. Prevention of mother to child transmission now starts at 14 weeks instead of 28 weeks."