At the 2000 Millennium Summit 189 global leaders agreed upon achieving

eight Millennium Development Goals (MDGs) by 2015. This paper focuses on

MDG 4 and 5: MDG 4 aims to reduce under-five deaths by two-thirds by 2015

in each country, and MDG 5 aims to improve maternal health by 2015. The

right to survive pregnancy has been highlighted by the United Nations as

an issue bearing not only on development, but also on human rights.The

leading cause of maternal deaths worldwide is obstetric haemorrhage,

mostly during or just after delivery, which is largely preventable through

skilled care during childbirth; followed by sepsis; complications of unsafe

abortion and eclampsia. Although globally there has been a decline in

maternal deaths, inadequate gains have been made in developing

countries. In 2008, 8.8 million under-five deaths were reported worldwide,

of which 40% had occurred during the neonatal period. The main causes

were pneumonia, diarrhoea, pre-term birth defects and birth asphyxia,

with malnutrition as the underlying cause. The World Health Organization

(WHO) further identified the principal determinants that lead to maternal

and child deaths as the environmental, socio-economic and behavioural

factors. It was found that mothers and children from poor households of

low income and literacy levels and those who lived in the most remote

areas were mostly denied their rights of regular access to quality health

care. Moreover children whose mothers lacked basic education were less

likely to reach the age of five than those whose mothers had basic

education. Another challenge faced by global leaders is that one billion

children worldwide do not have regular access to essential medicines. In

sub-Saharan Africa 1 in 6 children die before they reach the age of five, and

in South Asia where 1 in 7 children die before they reach the age of five.

South Africa has not made progress in attaining itsMDG 4 and 5 goals by

2015. Some developing countries have adopted a community-based

approach to increase and expand health coverage in their attempt to

address MDG 4 and 5 goals. It is also recommended that stake holders in

developing countries take it upon themselves to empower all women,

to ultimately improve maternal health and child survival.


Millennium Development Goal, Infant mortality, Maternal health, Essential

medicines, Determinants of Health, South Africa


In 1959 the United Nations General Assembly adopted the Declaration of the Rights of the Child, which stood to protect children’s rights to health care, education and protec - tion from discrimination. 1 Moreover accor - ding to the United Nations Convention on the Rights of the Child, each child also has the right to safe drinking water, nutritious food and a clean, safe living environment . 2 Additionally, women in maternity are entit - led to special care and assistance. 3 In an effort to endorse the right of every human to attain the highest possible quality of health, global leaders expressed the need to rein - force the Right to Health Care at the Interna - tional Conference on Primary Health Care, where the Alma Ata Declaration took place. The objective of the Declaration was to implement Primary Health Care (PHC) by 2000, which was recognized as the essential element to obtain “Health for All”. All govern - ments were to ensure that every person of state continuously obtains a means to health, and to guarantee availability, acces - sibility, safety and quality of health care services. 4 At the turn of the millennium, it was evident that most governments would not achieve this goal. Consequently, global leaders agreed upon achieving eight Millen - nium Development Goals (MDGs) that aim to reduce or eliminate target global concerns by 2015. 5 2

Faith Kuzeeko, Amanda Siruma, Diana Hornby, Sunitha Srinivas