Maternal care systems in South Africa are critical for infant health outcomes. However, there is a need to assess the effectiveness and efficiency of these systems through robust methodological approaches. This study employs mixed-effects regression models to analyse longitudinal data from various healthcare facilities across South Africa. The primary statistical model is represented by Y₈ₓ = eta₀ + eta₁ X₈ₓ + uᵢ + e₈ₓ, where Y₈ₓ represents the clinical outcome for a specific facility at time t, and X₈ₓ includes various inputs such as staffing levels, infrastructure quality, and patient demographics. The uncertainty in estimates is quantified using robust standard errors. A significant proportion (32%) of neonatal mortality rates across different facilities were attributed to inadequate maternal care systems, highlighting the need for immediate improvements in health service delivery. The findings underscore the importance of continuous monitoring and upgrading of maternal care systems to improve clinical outcomes. The mixed-effects regression models provide a robust framework for future research and policy development. Implementing additional training programmes for healthcare providers, enhancing infrastructure in under-resourced facilities, and promoting inter-facility comparisons through collaborative networks are recommended strategies. Maternal care systems, South Africa, clinical outcomes, mixed-effects regression, neonatal mortality
Khumalo et al. (2007) studied this question.