Strengthening anaesthesia support for the National Committee for the Confidential Enquiry into Maternal Deaths

Abstract

Anaesthesia plays a critical role in maternal care. In approximately 30% of maternal death cases in South Africa, an anaesthetic is given. As the country enters a new triennium of the Confidential Enquiry into Maternal Deaths (CEMD), strengthening anaesthesia representation and reporting is essential to support national efforts to reduce maternal mortality in line with the Sustainable Development Goals. Emerging data from the National Committee for the Confidential Enquiry into Maternal Deaths (NCCEMD) highlight significant gaps in anaesthesia reporting, with incomplete provincial participation and substantial underreporting in the Database for the Retrospective Analysis of Maternal Anaesthesia (DRAMA). These deficiencies limit the accuracy of national audits and hinder the identification of avoidable factors and system failures. Challenges are compounded by a workforce largely consisting of non-specialist providers with variable levels of experience and support. This article argues for strengthened anaesthesia involvement in the CEMD through formalised provincial assessor roles, improved data alignment, and structured feedback mechanisms. Enhanced anaesthesia support is essential to improve clinical governance and reduce preventable maternal morbidity and mortality.