Addressing SA’s Foetal Alcohol Problem
Saturday 9 September is World Foetal Alcohol Spectrum Disorders Day. South Africa has a prevalence rate 14 times higher than the global average
South Africa has the highest rate of Foetal Alcohol Spectrum Disorders (FASD) in the world, with a prevalence rate 14 times higher than the global average. Beyond the social and behavioural factors that contribute to this, experts say that early maternity care has an important role to play in tackling the problem.
Expectant mothers may not even be aware of the impact that alcohol, smoking or pre-existing conditions like diabetes have on foetal health and development
“Women who are trying to fall pregnant or who have already conceived are not seeking medical advice early enough, this can have negative consequences. Expectant mothers may not even be aware of the impact that alcohol, smoking or pre-existing conditions like diabetes have on foetal health and development,” says obstetrician and health systems management expert Howard Manyonga.
Foetal exposure to alcohol while the mother is pregnant restricts the baby’s development both physically and mentally. “It’s best to avoid drinking any alcohol during pregnancy, or when trying to conceive, to avoid the risk of adverse consequences for the baby,” warns Manyonga.
Dr Manyonga heads up ‘The Birthing Team’, which offers a complete maternity care programme to lower-income women. Over and above bringing down the high costs associated with private maternity services, the integrated team-based service incentivises early care with the first assessment advised to take place before 12 weeks of pregnancy.
The mandate of The Birthing Team is to make maternity care more affordable by emphasising preventative and proactive care: “Many expectant parents cannot pay the high and often unpredictable fees of private care and cannot take time off to wait for service at overcrowded public clinics and hospitals. We created a cash option with regular check-ups that sets out the total cost of care from beginning to end,” says Manyonga.
The first assessment offered by The Birthing Team costs R1 500. It consists of two visits; the first includes a physical exam, urine test and an ultrasound scan by a foetal sonographer. At the second, the patient sees a doctor, who designs a care plan. Enrolment costs R18 000, which covers the rest of the pregnancy, delivery and three post-delivery visits – managed by a team of midwives and obstetricians.
A greater awareness of preventable diseases such as FAS
“If more women come for pre-conception consultation as well as early scans, there will be greater awareness and intervention around behaviours that could have long term impact on an unborn child, this includes preventable diseases such as FAS,” says Manyonga.