CLEVER Maternity Care

Improvement of the quality of obstetric care in midwife-led obstetric units, and in their referral district hospitals, using a geographical catchment area approach within the health districts. 

A CLEVER way to reduce maternal and perinatal mortality and morbidity: essential respectful high quality obstetric care to birthing mothers is presented innovatively to address the local barriers in the health system, the blind spots in critical thinking during obstetric care and the preferences of the individual clients and their cultures. The package called ‘Working CLEVER’ in delivery units provides a framework for a turn-around within individual labour ward units that reinforces needed routines (including pre-referral care and referrals) and improves practical health worker skills levels through local monitoring and coaching. The package can be disseminated during master training workshops and implemented by district clinical specialist teams and other relevant local clinicians in South Africa.


linical care

abour ward management

liminate barriers

erify care

(mergency) O(bstetric) S(imulation) T(raining) on autopilot

espectful care




MSD for Mothers Global Giving

MSD for Mothers has established a 10-year, $500m global initiative to create a world where no woman dies giving birth.

Oosthuizen, S.J., Bergh, A.-M., Grimbeek, J., and Pattinson, R.C., 2020. CLEVER maternity care: A before-and-after study of women’s experience of childbirth in Tshwane, South Africa. African Journal of Primary Health Care & Family Medicine, 12 (1). DOI: 10.4102/phcfm.v12i1.2560
Oosthuizen, S.J., Bergh, A.-M., Grimbeek, J., and Pattinson, R.C., 2019. Midwife-led obstetric units working ‘CLEVER’: Improving perinatal outcome indicators in a South African health district. South African Medical Journal, 109 (2), 95. DOI: 10.7196/SAMJ.2019.v109i2.13429
Oosthuizen, S.J., Bergh, A.-M., and Pattinson, R.C., 2018. Systems thinking: A turning point for improving respectful obstetric care in South African health districts. South African Medical Journal, 108 (11), 910. DOI: 10.7196/SAMJ.2018.v108i11.13312
Oosthuizen, S.J., Bergh, A.-M., Pattinson, R.C., and Grimbeek, J., 2017. It does matter where you come from: mothers’ experiences of childbirth in midwife obstetric units, Tshwane, South Africa. Reproductive Health, 14 (1). DOI: 10.1186/s12978-017-0411-5
Pattinson, R.C., Bergh, A.M., Ameh, C., Makin, J., Pillay, Y., van den Broek, N. and Moodley, J., 2019. Reducing maternal deaths by skills-and-drills training in managing obstetric emergencies: A before-and-after observational study. South African Medical Journal, 109(4), pp.241-5. DOI:10.7196/SAMJ.2019.v109i4.13578
Media articles



- Author Sarie Oosthuizen
Published by Johan Pretorius

Copyright © University of Pretoria 2021. All rights reserved.

FAQ's Email Us Virtual Campus Share Cookie Preferences