WeeklySA_AdminESSENTIAL: Pregnant women at a rural North West clinic say months of supplement shortages have forced them to choose between buying essential pills and meeting basic household needs…
By Bakang Ditibane
MAHIKENG – Pregnant women using Ramatlabama Health Centre outside Mahikeng in North West say they have gone months without antenatal supplements and have been advised to buy them from private pharmacies instead.
The facility serves more than 2 000 residents in the surrounding rural community, where unemployed mothers say they cannot afford supplements that should be available through public healthcare.
One expectant mother, Dimakatso*, had her pregnancy confirmed at the clinic in June. When she returned in July, she received one pack of folic acid and antiretroviral medication. In August, she was told no supplements were available.
“They wrote it on a maternity book and said to me I must go buy pills at Clicks or a pharmacy,” she said.
“Where will I get the money? Those things are expensive.”
Community health workers fear prolonged shortages could put mothers and their unborn babies at risk.
Another woman, in her first trimester, said she had been unable to buy the supplements after her first antenatal appointment.
“I didn’t buy them the first month after booking at the facility. I am waiting for next month when they say maybe stock will come,” she said.
“I am scared for my baby. What will happen if the pills are not supplied again?”
Why antenatal supplements matter
South Africa’s primary healthcare guidelines recommend iron, calcium and folic acid supplements as part of antenatal care.
Iron helps prevent anaemia, a condition in which the blood has too few healthy red blood cells or insufficient haemoglobin to carry oxygen effectively. Calcium supplementation can help prevent pre-eclampsia, a pregnancy complication involving high blood pressure.
Folic acid taken before conception and during early pregnancy helps prevent neural tube defects affecting the development of a baby’s brain and spinal cord.
A 2021 review of South African research found that anaemia affected between 29% and 42.7% of pregnant women in the studies examined.
Health-e News found that a month’s supply of iron supplements at private pharmacies costs about R160, while 30 calcium tablets cost around R120. Several unemployed mothers in Ramatlabama village said these prices were beyond their means.
For Lebogang Mosiane (32), who is in her first trimester, the shortage has brought both financial pressure and anxiety about her pregnancy.
“Most of us are not working. We are depending on either a child support grant which is R580 or the SDR [Social Distress Relief grant] of R370,” she said.
“That R580 is for child food and needs, not for pills that I should get free at the clinic.”
Clinic staff, speaking anonymously, said antenatal supplement shortages had persisted since May.
“The issue has been reported to the sub-district,” one healthcare worker said.
State acknowledges problems
North West Department of Health spokesperson Tebogo Lekgethwane acknowledged intermittent supply constraints affecting certain medicines and facilities.
“The department is closely monitoring the situation and implementing interventions at both provincial and national level to minimise disruptions to patient care,” he said.
“The department has also sought to reassure patients, healthcare workers and communities that efforts are underway to address the shortages and improve medicine availability.”
Lekgethwane said the shortages could not be attributed to a single factor or solely to the provincial department’s operations. Wider disruptions were affecting parts of South Africa’s pharmaceutical supply chain, he said.
Supply system under ‘intervention’
In a media statement issued last year, the department assured patients and communities of a stable medicine supply. It said provincial pharmaceutical services had been placed under internal intervention in November 2023 after the stock inventory management system at the provincial medicines depot crashed.
Changes had since been made to pharmaceutical management to improve service delivery and medicine availability.
However, community health workers in Ramatlabama said urgent action was needed at primary healthcare facilities, where many women receive antenatal care.
They said some pregnant women were going months without supplements because they could not afford to buy them.
“If we are serious about reducing maternal deaths and giving babies a healthy start, clinics cannot run out of basic, life-saving supplements like iron,” one community health worker said.
Dimakatso is not her real name*
