CHIVA Africa’s holistic approach to health system strengthening

As we near the end of women’s month – a time when we have reflected again on how we protect the rights and improve the lives of women and girls in South Africa – we face the stark reality that the health system continues to fail many women and girls. Pregnant women, their babies, and young adolescent girls, are subject to a healthcare system that fails to deliver services that meet their needs – and this has only been exacerbated by the COVID-19 pandemic.

Recent studies show that South Africa recorded a 30% rise in maternal deaths during the 2020 COVID-19 lockdown compared with the same period in 2019, and experts do not believe it is due to undiagnosed SARS-CoV-2 infection itself.  Rather, the leading factors include a lack of transport, lack of beds at facilities, human resource factors, lack of expertise, delay in care, intimate-partner violence, and suicide. In addition, there was a sharp decline in the use of contraception and termination of pregnancy services during lockdown – contributing to an extraordinary increase in teenage pregnancies – most worryingly in the 10 – 14 year age group.

Data from the work CHIVA Africa conducts in KwaZulu-Natal echo these studies and has shown a higher-than-normal reporting of sexual assault cases and pre-term deliveries. Further negative effects on HIV rates, prevention, treatment, and care in a province already known to have the highest prevalence of HIV in the world, is of real concern.  Pregnant women, babies, and adolescent girls continue to be subjected to harm but we need to learn from this and help to build a robust health service today and one that is prepared for any future health crises.

HIV infection remains a major public health challenge for South Africa, and the key driving factors including gender inequality, mental health, poverty, TB, and cultural beliefs all need our urgent and committed attention if we are to protect our women and girls.  CHIVA Africa believes that the health system must be strengthened to support not only the prevention, treatment, and care of HIV but address the structural drivers that lead to HIV infection – all of which are embedded in our teaching and mentoring activities.  We are striving for a better future for women and girls in South Africa – please help us to achieve this.

For more information on CHIVA Africa please visit


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