REPUBLIC OF SOUTH AFRICA COMBINED SECOND PERIODIC REPORT UNDER THE AFRICAN CHARTER ON HUMAN AND PEOPLE`S RIGHTS and INITIAL REPORT UNDER THE PROTOCOL TO THE AFRICAN CHARTER ON THE RIGHTS OF WOMEN IN AFRICA 42 deaths per 1,000 live births in 2011. The Infant Mortality Rate (IMR) has decreased from 40 deaths per 1,000 live births in 2009, to 30 deaths per 1,000 live births in 2011.178 294. Under the national prevention of mother-to-child (PMTCT) programme, every pregnant woman is offered HIV testing and counselling. If a woman tests positive for HIV, she is put on to a regime of anti-retroviral therapy to avoid transmitting the virus to her baby, and is offered a continuum of treatment, care and support for herself and her infant. The Department of Health has a strategic plan in place which identifies "priority interventions" that will have the greatest influence on reducing mortality rates, as well as enhancing gender equity and reproductive health. The campaign on Accelerated Reduction of Maternal Mortality in Africa (CARMMA), an African Union initiative, was launched in May 2012 and aims to reduce maternal and infant mortality rates. 295. Immunisation is a significant barrier against disease and death, and the rates of children receiving their primary vaccines have steadily been increasing under immunisation programmes. These aim to protect children against vaccine-preventable diseases, such as measles, TB, cholera and pertussis. Measures to improve child health also include the expansion and strengthening of school health services and the establishment of district clinical specialist teams. Other prevention services, such as regular deworming and growth monitoring, help protect children's health. 296. The Health of our Children report in 2010, which surveyed 8 966 children, found that HIV prevalence among infants (age 0 to 2 years) was 2.1%, lower than the 3.3% average in the age 0 to 4 years, suggesting a positive impact of the national Prevention of Motherto-Child Transmission programme, begun in 2006. The right to water and sanitation 297. 178 179 Significant progress has been made in the area of water and sanitation. Some 89,9% of South African households had access to piped water in 2013. Table 7 below shows the percentage of households that have access to improved sanitation facilities (e.g. flush toilets or pit toilets with ventilation pipes) increased from 62,3% in 2002 to 77,9% in 2013. The percentage of households who had no access to toilet facilities or who used bucket toilets decreased from 12,3% in 2002 to 5,3% in 2013.179 Department of Health, Annual Performance Plan, 2013/14 – 2015/16 General Household Survey, 2013 85