For the Portfolio Committee on Women, Children, Youth and Persons with Disabilities

1
Evidence on the challenges facing children in
South Africa

• For the Portfolio Committee on Women, Children,
  Youth and Persons with Disabilities
• 11 August 2010

2
Contents

• SAs progress in realising childrens rights
• Non-submission of country reports to the UN and
  AU for over a decade
• Childrens rights to health, survival and
  development
• SA Child Gauge 2009/2010
• Childrens rights to social services, protection
  from abuse and neglect, family and alternative
  care
• Childrens Act implementation problems
• Childrens rights to special protection within
  the criminal justice system
• Child Justice Act implementation problems

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SAs progress in realising childrens rights

• SA ratified the UNCRC in 1996 and the ACRWChild.
• Our first obligation under these treaties is to
  regularly submit our country reports to
• show our progress,
• admit challenges and ask for international help,
• publicly debate the progress and challenges, and
• plan for improvements
• SA submitted first country report to UN in 1997
  but has subsequently failed to submit the 2nd and
  3rd reports which were due in 2002 and 2007.
• We have never submitted a report to the AU
• The report is now finalised by the ORC/Minister
  for Children and is now with Cabinet awaiting
  approval.
• There has been no public debate about the
  contents of the report.
• The report can be used as the evidence base for
  progress made and areas in need of improvement.
  Ie no need to re-create the evidence base
• The report should track progress on each of the
  rights and show a plan for addressing areas where
  rights violations remain

4
SA Child Gauge 2009/10 Tracking SAs progress
on child health

• Key legislative developments in 2009/10
• Childrens right to health
• Status of child health in SA
• HIV and TB
• Child malnutrition
• Mental health and risk behaviour
• Basic health care services for children
• Managing resources and building capacity
• Community based child health services
• Child and family friendly child health services
• Social determinants of health
• Ministers vision for child health in SA
• Children Count the numbers

5
Under 5 child death rate

• U5MR is a key indicator of a countrys progress
  in realising childrens rights
• In 1990, estimated at 60 per 1000 live births
• In 2000 estimated at 73 per 1000 live births
• In 2008 estimated at 67 per 1000 live births
• 2015 Ito MDG 4 we need to reduce our U5MR by two
  thirds to 20 per 1000 live births

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Data problems

• Since 1998 we have not had reliable data on child
  mortality rates
• Without reliable data we cannot measure our
  progress in giving effect to childrens rights to
  survival and development
• Data collection in this area needs to be
  prioritised. Who is responsible? Department of
  Health, Statistics SA, Minister of Monitoring and
  Evaluation in the Presidency.

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What we do know

• Main causes of death
• Contributory factors
• What to do to save more babies

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Interventions to address the main causes of under
5 child deaths

• HIV/AIDS (35)
• Neonatal complications/infections (30)
• Diarrhoea (11)

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HIV/AIDS (35)

• Increase coverage of PMTCT
• Improve HIV prevention awareness programmes
• Increase coverage of ARVs for HIV positive adults
  and children
• Integrate HIV and TB treatment
• Improve child nutrition
• Improve child immunity (eg. Vitamin A
  supplementation)
• Ensure health care services for women and
  children are accessible, good quality and caring

12
Neonatal complications/infections(30)

• Improve mothers health and nutrition
• Improve access to and quality of health care for
  pregnant women
• Create a caring health sector for pregnant women
• Improve hygiene practices in neonatal wards to
  prevent spread of infections
• Hold managers and staff accountable for
  negligence
• NB Community health workers to support pregnant
  women, newborn babies and nurses

13
Diarrhoea (11)

• Improve access to clean water on site for
  children
• 7 million children do not have access to clean
  water
• Improve basic sanitation facilities
• 7 million children do not have access to adequate
  toilets
• Educate caregivers on importance of oral
  rehydration therapy (ORT)
• Better infection control in hospitals
• Improve young child nutrition
• Improve young child immunity (eg. Vitamin A
  supplementation)

14
Budgets to look at for these service areas

• Provincial Departments of Health
• Local Government (water and sanitation)
• Provincial Departments of Social Development
  (home and community based care, early child hood
  development, social assistance grants)

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Contributory factors

• Poverty
• Under- nutrition
• Low immunity
• Lack of access to services
• Inequality
• Human resource shortages in the public health
  sector (37 of posts are vacant)

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New child legislation implementation challenges

• Childrens Act and Child Justice Act both came
  into effect on 1 April 2010
• Both have not received a quarter of the budget
  that they need for implementation in year one.
• (See Summary of Childrens Act Budget Analysis
  2010/11)
• If effectively implemented they can reduce child
  abuse, neglect and exploitation and give effect
  to a number of constitutional rights in section
  28 of the Bill of Rights

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Together they provide the primary legislative
framework for a range of social welfare services
for vulnerable children including

• Partial care and ECD
• Prevention and early intervention services
• including home and community based care, child
  and family counselling
• Probation assessments and diversion programmes
  for children in trouble with the law
• Protection services
• reporting child abuse, social work
  investigations, childrens court inquiries
• Child and youth care centres
• shelters, childrens homes, places of safety,
  reform schools, schools of industry, secure care
  centres
• Foster care and cluster foster care
• Adoption

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The workforce

• The provincial departments of social development
  rely heavily on NPOs to provide the majority of
  the services under these two Acts
• But NPOs are only partially subsidised by
  government
• They have to raise the rest of their budgets from
  donors and corporates the recession has reduced
  this source of income

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NPO subsidies

• Example Child and Youth Care Centres
• Government run centres R6000/child/month
• NPO run centres R2000/child/month
• - no subsidies for staff salaries therefore they
  have R11.84 per child per day
• for childs food
• - Majority of child and youth care centres are
  run by NPOs on behalf of the
• State
• Similar situation in old age homes, child
  protection services, ECD
• centres and centres for children and people with
  disabilities
• Free State High Court has recently ruled that
  this funding policy is
• unconstitutional and unreasonable and must be
  reviewed by the
• end of 2010 (Nawongo court case)

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How to improve services for vulnerable groups?

• NPOs deliver the majority of services to
  vulnerable groups
• Elderly
• People with disabilities
• Children
• Victims of crime (especially sexual offences)
• These are services that the State is obliged to
  provide in terms of
• the Constitution and a range of social welfare
  laws
• Childrens Act
• Older Persons Act
• Child Justice Act
• Increasing the budgets of the provincial
  departments of social
• development and increasing the share of these
  budgets that is transferred to
• NPOs will make a major impact on improving
  essential services for all vulnerable
• groups.