Backed by the Discovery Foundation Rural Distinguished Visitor Award, Dr Maria Mmaphefo Maluleka is on a mission to undo the systemic challenges contributing to South Africa’s rate of pregnancy-related deaths, including ectopic pregnancy.
Dr Maria Mmaphefo Maluleka. Image supplied.
Early diagnosis and timely intervention are critical to reducing maternal illness and death linked to early pregnancy complications.
Reserch fuelled by personal experience
The Saving Mothers 2020-2023 report recorded 103 deaths from ectopic pregnancy, with 82% involving suboptimal care and 45% considered clearly avoidable.
These are the systemic challenges that Maluleka’s research seeks to address.
A registrar in Family Medicine and Primary Health Care at Sefako Makgatho Health Sciences University, Maluleka’s journey began in Mmakau village, near Ga-Rankuwa.
Her career path, from radiography to private practice, public service and later the South African Social Security Agency (Sassa) Appeals Tribunal, broadened her understanding of how health systems intersect with social realities.
Reflecting on her work, Maluleka says, “Engaging directly with applicants… deepened my empathy and reinforced the importance of due process in safeguarding human dignity.”
These experiences now inform her research into the management of ectopic pregnancies at a Gauteng district hospital.
Undoing systemic challenges
Maluleka’s work is urgently needed.
Her study audits three years of cases to identify delays in care, documentation gaps, staff shortages and inconsistent adherence to clinical guidelines.
Early pregnancy deaths (including ectopic pregnancy and miscarriage) are now the fifth leading cause of maternal mortality nationally.
The World Health Organisation (WHO) similarly emphasises that early diagnosis and timely intervention are essential to reducing maternal morbidity and mortality.
Ectopic pregnancy often presents with nonspecific symptoms that mimic other conditions.
In resource-limited settings, delayed access to ultrasound or β-hCG testing can be life-threatening.
Maluleka’s research highlights how these systemic barriers unfold in real time for women.
Her work proposes practical interventions: earlier recognition of ectopic pregnancies at primary healthcare level, improved emergency preparedness, strengthened diagnostic pathways, and better adherence to clinical guidelines.
These recommendations align with national priorities to reduce preventable maternal deaths and improve reproductive health outcomes.
