Publications
HST provides free electronic access to over 500 health systems research related reports, publications and papers. Close to 300 of these are publications that have been commissioned and funded by the Trust. Topics include among others district systems development, drug supply management, human resource development, informatics, legislation, finance, environmental health, mental health, lessons learnt, nutrition and sexually transmitted diseases / HIV/AIDS. The main publication of the HST is the annual South African Health Review. From 2005 all HST publications will be available in low resolution only. To explore the range of publications HST offers use the Advanced search to search using a variety of criteria.

In some parts of the country most pregnant women make some use of the services provided, but in other, especially rural, areas little use is made of them despite an increase following the introduction of a free maternity service. Of great concern is the standard of care provided and the large percentage of women who attend for antenatal care (ANC) and then deliver at home. In some cases this latter is at least 50%. Most women who attend book late and miss some of the benefits of antenatal care. Even when women do book the care is often sub-optimal with overcrowded clinics precluding adequate health education, and basic investigations such as syphilis serology, haemoglobin estimations, and fundal height measurements being omitted. The picture in the labour wards of many hospitals is even bleaker. The basic tool for monitoring labour, the composite labour graph, is often not used or used incorrectly. Anecdotal reports from widespread areas suggest that there are many avoidable maternal and perinatal deaths. Such reports have been substantiated by the Confidential Enquiries into Maternal Deaths and by the reductions in avoidable perinatal deaths which follow the introduction of the Perinatal Problem Identification Programme (PPIP).

However there are many pockets of excellence in South Africa where reproducible strategies are used so the resources required to improve care are already available.