Evidence on the challenges facing children in South Africa

1. For the Portfolio Committee on Women, Children, Youth and Persons with Disabilities 11 August 2010 Evidence on the challenges facing children in South Africa

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

3. SA’s progress in realising children’s 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 SA’s progress on child health • Key legislative developments in 2009/10 • Children’s 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 • Minister’s vision for child health in SA • Children Count – the numbers

5. Under 5 child death rate U5MR is a key indicator of a country’s progress in realising children’s 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

7. 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 children’s 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.

8. What we do know: • Main causes of death • Contributory factors • What to do to save more babies

10. Interventions to address the main causes of under 5 child deaths • HIV/AIDS (35%) • Neonatal complications/infections (30%) • Diarrhoea (11%)

11. 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)

15. 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)

19. New child legislation implementation challenges • Children’s 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 Children’s 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

20. 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, children’s court inquiries • Child and youth care centres • shelters, children’s homes, places of safety, reform schools, schools of industry, secure care centres • Foster care and cluster foster care • Adoption

21. 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

22. 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 child’s 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)

23. 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 • Children’s 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.