The Nelson Mandela Academic hospital echoed the challenges as presented by the Provincial Department of Health. The challenges experienced on a macro provincial level were the same as those experienced on a micro community level. As an institution, the hospital struggled with the same challenges, and as the only such facility within a 250km radius, excessive pressure is put on the hospital to provide high risk and emergency care. Though the hospital is able to meet this challenge, it struggles particularly with overcrowding as mothers who have been discharged to their local and district hospitals often wait for days to be transported. This exacerbates an existing challenge of overcrowding within the hospital.