Publics, technologies and interventions in reproduction and early life in South Africa

Despite successful clinical interventions and maternal and child health monitoring for over a century, low and middle-income countries, including South Africa, continue to experience the quadruple burden of disease of high maternal mortality rates and poor infant and child health, non-communicable diseases, infectious diseases, and violence and injury. In this article, we focus on how different kinds of technologies in South Africa are implemented in the 'first 1000 days' from conception to early childhood. Some of these interventions, as we discuss, are lifesaving; others are conceptualised as preventing early and longer-term health problems, including cardiometabolic conditions into adulthood and in future generations. Here, we consider the use of routine and specialist technologies in reproduction and early life: scanning and monitoring in pregnancy, caesarean section, extracorporeal membrane oxygenation (ECMO) for very low birth weight infants, and the Road to Health Booklet. Through this focus, we illustrate how 'publics' are constituted such that foetal and infant health outcomes are privileged over women's health, reproductive rights, and public health safety.

Lenore Manderson, Fiona C. Ross