Johannesburg - DA spokesperson for health in Gauteng, Jack Bloom, has raised concerns about the shortage of 90 neonatal Intensive Care Units (NICUs) that could save the lives of premature and sickly babies in the province.
Bloom said that the information was revealed by Gauteng Health and Wellness MEC Nomantu Nkomo-Ralehoko in a written reply to his questions in the Gauteng Legislature.
“Worst affected is the Chris Hani Baragwanath Academic Hospital, which has 18 neonatal ICUs but should have 17 more NICUs to meet international standards of care. This shortage is a major factor in the 909 baby deaths that could have been avoided in the past three years.”
The Pholosong Hospital in the far East Rand also requires 17 more NICU beds for its busy neonatal ward, said Bloom.
He said that Charlotte Maxeke Johannesburg Academic Hospital has 14 functioning ICU beds for children, but they need 20 beds to provide a proper service.
“Unfortunately, they have four NICU beds they cannot use because of a shortage of staff and equipment. Kalafong Hospital is short of 13 NICU beds, and Tambo Memorial Hospital is short of eight NICU beds,” added Bloom.
Bloom also highlighted that the George Mukhari, Edenvale, and Mamelodi hospitals each need six more NICUs, while Tembisa and Far East Rand should each have an additional four NICUs, and Leratong Hospital needs three more NICUs.
“When NICU beds are short, the hospitals try to place them at other hospitals, but they admit this is not always possible, and their survival rate decreases. Often, the only option is to ventilate babies in ordinary wards.”
According to Chris Hani Baragwanath Hospital, “transporting sick babies is risky, so survival can be affected negatively”.
Edenvale Hospital has no neonatal ICUs, and they say “babies mostly die awaiting tertiary care”. Despite claiming they have adequate ICU beds, the Thelle Mogoerane Hospital also says babies die waiting for tertiary care, said Bloom.
He said that plans to expand NICU beds are inadequate. Renovations are taking place at Chris Hani Baragwanath Hospital to get NICU beds up from 18 to 23, but this still leaves a shortage of 12 NICU beds in a busy unit with high medical negligence claims.
Bloom further pointed out that Charlotte Maxeke Hospital is looking to employ more multidisciplinary staff to care for babies, while George Mukhari Hospital has no plan to increase beds except to get a new hospital.
“Tembisa Hospital is asking to build a mother-and-child unit with 10 ICU beds and has also asked for another nearby hospital to be built to serve the local population.
“Another constraint is the shortage of NICU nurses, with much blame placed on the delay in accrediting nurse training courses,” said Bloom.
Department spokesperson Motalatale Modiba told The Star that it is striving to meet international standards in its neonatal intensive care units (NICU) across all service centres in the province.
Modiba said that according to international standards, a hospital requires four neonatal beds per 1000 annual deliveries.
However, the number of deliveries in the catchment areas of our hospitals determines the projected size of the neonatal unit.
"Even though some hospitals in the province can use additional NICU beds due to population growth, these hospitals continue to effectively provide intensive and high-quality care to neonates as per the deliveries in the catchment areas."
"Overall, central, tertiary, and regional hospitals have a total of 180 NICU and neonatal high care beds. There is a shortfall of 90 beds as per international standards; however, our facilities are able to accommodate neonates in the available NICU and high-care beds. Where there is a need for additional beds at a particular institution, cluster hospitals refer amongst themselves," said Modiba.
He said that the availability of beds is always monitored across facilities. In some facilities, such as Chris Hani Baragwanath Academic Hospital, renovations are taking place to create more bed capacity, and in others, such as Charlotte Maxeke Johannesburg Academic Hospital, plans to employ more staff are underway.
"In others, like Tembisa Hospital, there are plans subject to approval to build a mother-and-child unit that will bring in additional beds.
An impression must not be created that the only factors that lead to neonatal mortality are bed capacity. Neonatal mortality still happens due to various medical factors," he said.