South African infants are among the worst off in the world and have one of the lowest chances of survival.

A damning report, the "South African Child Gauge for 2009/2010", released by the University of Cape Town's Children's Institute, blames the crumbling public health system for much of our children's woes.

South Africa holds the dishonorable distinction of being one of only 12 countries - including war-torn Afghanistan - to have failed to reduce child mortality since 1990.

It ranks in the company of the Democratic Republic of Congo and Burundi.

South African child deaths have risen from 56 deaths per 1000 births in 1990 to 67 deaths per 1000 births in 2008, according to Unicef.

This is despite South Africa's high GDP and the billions of rands pumped into providing public health services.

Unicef's deputy representative in South Africa, Malathi Pillai, said the recent spate of infant deaths at the Charlotte Maxeke Academic Hospital, in Johannesburg, was shocking.

"It is important that we recognise that, in many of our communities, the poor quality of other basic services, such as water, sanitation, electricity and dwellings, along with health services, has a profound impact on child mortality and paediatric health.

"For example, a majority of neonatal deaths in South Africa could be averted by improving the quality of care at district hospitals," said Pillai.

The report said that most 2007 child deaths, 81%, were of infants younger than five.

Experts from the Children's Institute lambasted the government and its health department.

But Dr Nathaniel Khaole, the department's acting cluster manager for maternal, child and women's health, denied that the institute's findings were shocking.

"We know what has been happening, we know what to do," he said

He said his department will study the report.