UNICEF South Africa Country Programme 2007

1. UNICEF South Africa Country Programme 2007

2. Introductory Remarks • Achievements of Parliament • Promulgation of various pieces of legislation that will impact on children including the Children’s Act no 38 of 2005 • The challenges to deal with Poverty, AIDS and Crime • Importance of Parliament’s oversight role • UNICEFs commitment to provide ongoing support and intention to have a full time presence at Parliament COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

3. Access to social services is increasing, child survival is deteriorating MMR figures are for 2000, 2001 & 2002 COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

4. Programme Structure 2007 - 2010 • Social Transformation and Strategic Leveraging • Child Survival and Development • Education and Adolescent Development • Protection for Orphans and Vulnerable Children • Programme Planning, Monitoring and Evaluation, Communication and External Relations COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

5. ORPHANS AND VULNERABLE CHILDREN Social Transformation and Strategic Leveraging Child Survival and Development Education and Adolescent Development Protection for Orphans and Vulnerable Children Social Protection of OVCs Child Friendly Schools Plus Social Policy ChildSurvival Children’s Budgets Protecting children and women from Violence Adolescent Development Nutrition Programmes of Action for OVCs Programme Planning, Monitoring & Evaluation Child Participation Communication and External Relations COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

6. Child Survival and Nutrition COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

7. Morbidity and Mortality Profile of Children in South Africa COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

8. Morbidity and Mortality Profile of Children in South Africa 60% of all under five deaths are caused by preventable diseases namely: • diarrhoeal disease (10-15%), • respiratory infections (7%), • low birth weight (6%) and • protein energy malnutrition (5 to 10%). • 40% of all illnesses and death are attributable to HIV and AIDS. COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

9. Our response to address this: • Accelerated implementation of community IMCI, • Support health workers to identify and provide care for vulnerable babies and support family care of these children post-discharge, • Early detection and management of growth faltering at community level, • Implementation and scaling up of the Basic Antenatal Care Package including neonatal care COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

10. Impact of HIV and AIDS in South Africa • Approximately 5,7 million people infected • 3.3 million women and 104,863 babies infected • 29,5% infection rate among women visiting antenatal clinics • Greatest killer of under 5 children = AIDS (40%) • Almost 300,000 babies born to HIV+ mothers a year • More than 55,000 children in need of ARV, only 13,000 receiving ARV COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

11. 5 Key Strategies • Early diagnosis and testing of infants • Streamlining health systems to maximise staff capacity to treat HIV+ infants • Scaling up PMTCT+ to prevent children from contracting HIV • Targeted neonatal and infant care • Supporting Safety Net Systems for Orphans and Vulnerable Children (OVCs) COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

12. Early diagnosis and testing • Capacity of NHLS to test has increased over time. To date about 6000 babies are tested using PCR every month. Maximum testing capacity is about 15000 babies per month • Coverage of testing still low especially, in rural areas • There is a need to optimize IMCI services in identifying the HIV infected infants and fast track them onto long term HIV treatment • Select provinces are initiating early testing at 6 weeks though currently there is no national policy COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

13. Plans for 2006 • Increase the number of infants tested for HIV from 30,000 to at least 120,000. • Review national Policy on PMTCT, including ARV in PMTCT and service delivery intensified in 2-3 districts in KZN • Complete review of national C-IMCI and national plan to accelerate implementation • Develop capacity of 4000 health workers to implement BFHI, IYCFP, C-IMCI, KMC & GMPM COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

14. Expanding access to ARVs for children • ART accredited treatment sites in all 53 health districts of South Africa, relatively few of these provide care for infants and children • Theoretical and practical training insufficient • Human resource constraints • Plans for 2006 • Double number of children receiving ARVs from 8,500 to 17,000 COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

15. Suggested areas for oversight: Health • Staff shortages – need to oversee implementation of National Human Resources Plan for Health • Child Survival – oversee provincial allocations and spending of the Integrated Nutrition and Community and Home Based Care Services (CHBCS) grants • HIV & AIDS – of great concern is the marginalization of children who are HIV positive in accessing comprehensive Anti-Retroviral Treatment COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

16. Child Protection COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

17. Mortality is increasing & spending on child support grant is expected to increase tremendously COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

18. Care and support for OVC We have to ensure that OVC have access to: • Education • Health services • Social Grants • Care and support COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

19. National: Policies & legislation Provincial: Budget allocations and services Municipalities: Plans and programmes for Children Communities: Child Care Forums Families: Training and Care Children – orphaned and vulnerable

20. Plans for 2006 • Support implementation of National Action Plan • Complete establishment of OVC database • Complete pilot study of ECD sites as nodes of care and support • Scaling up of child care forums and safety networks • Develop and finalise national primary caregiver training programme COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

21. Violence against women and children • Latest SAPS Crime Statistics 2004/2005: • More than 360,000 women and children murdered, raped, assaulted, sexually molested or abused • 40% of 55,114 rapes were against children • 47.7% (4,829) of all indecent assault cases were children. • 31,607 children victims of common assault • 24,189 children victims of assault to commit grievous bodily harm • Most rapes still go unreported COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

22. Plans for 2006 • Draft legal discussion paper on trafficking in preparation for draft bill • Cost the National Policy Framework and Strategy for the Prevention and Management of Child Abuse and Neglect and use it to advocate for resource allocation • Develop community-based systems to report and monitor child protection abuses • Roll out child protection models in 3 municipalities • Train 3,000 health workers, social workers & police on prevention & management of child abuse • Increase the number of Thuthuzela Care Centres from 12 to 18 nationwide COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

23. Suggested areas for oversight: Child Protection • Advocate • for a national system of identifying and tracking orphans and vulnerable children at local, district and provincial levels • the finalization of the Child Justice Bill and Sexual Offences Bill • the implementation of the National Action Plan to end violence against women and children, specifically the roll out of the Thuthuzela Multi-purpose Centres • monitoring of the large number of children in conflict with the law, especially those awaiting trial in prisons and police cells COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

24. Education and Adolescent Development COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

25. Situation of children • Primary net enrolment ratio (7 – 13 years) increased from 88% in 1996 to 96% in 2004 • Fundamental challenge – provision of quality education • 687,000 children out of school • School retention: only 65% reach Grade 5 • Only 16 % (Birth to 5 years) have access to formal ECD • Violence and insecurity major concern COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

26. Plans for 2006 • Develop a national primary caregiver training programme for babies & young children • Develop models of care for children under 5 and their caregivers • Develop ECD centres as nodes of care and support for OVC COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

27. A Child-Friendly School: • safe and protective environment for children • healthy spaces to learn and grow • access to clean water & sanitation • gender sensitive • strong links to the surrounding communities, and • outreach services for orphans and other vulnerable children. COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

28. A Child-friendly school: • Provision of quality education for all children means: • Quality School buildings, structures and equipment • Quality Teachers and teaching practices • Quality Management and governance practices • Supporting the establishment of an independent national M&E unit COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

29. Plans for 2006 • Strengthen implementation & evaluation of lifeskills programmes for adolescents at national & provincial level • Develop a rights based approach to lifeskills guidelines for school and communities • Accelerate child participation and leadership development in lifeskills programmes • Strengthen educator and community based capacity and support for effective lifeskills implementation • support provincial HIV/AIDS and lifeskills structures for specific targeted interventions • Develop best practices in reducing teenage suicide, teenage pregnancy, drug-abuse and HIV COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

30. Suggested areas for oversight: Education • Fee-free schools - Poor parents are legally entitled not to pay school fees, but this policy is not implemented consistently. • building child-friendly schools • Achieving Education for All in the context of HIV and AIDS • Increase investment in teacher education • Support the implementation of the National Integrated Plan for Early Childhood Development COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

31. Social Policy and Local Governance COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

32. Situation of children • Services to especially vulnerable and poor children remains insufficient • Budgets remain under-spent in the face of poverty and need • Good policies and legislation but implementation remains inadequate COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

33. Plans for 2006 • Develop a National Policy Framework for integrated services for children • Conduct a Situation Analysis of children in receipt and in need of social assistance and a Study on the impact of the Child Support Grant • Develop a toolkit for Municipalities to take action for Children COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

34. Plans for 2006 • Develop a framework to monitor implementation of services to children (Provincial M&E Framework) • Conduct a rapid assessment of the public expenditure towards services contributing to the survival, care, protection and development of children in three (3) local municipalities COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

35. Suggested areas for oversight: SPLG • Extending the child support grant to children aged 14-18 years • Liaising with the Justice Portfolio Committee to fast-track the finalization of the Child Justice Bill and Sexual Offences Bill • Oversee allocations iro services to children and related spending patterns • A national system of identifying and tracking orphans and vulnerable children at local, district and provincial levels • Advocate for the increased of access of children, particularly 3 and 4 year-olds, to formal ECD by targeting for example the EPWP sources • Review of Social Assistance Act COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

36. Plans for 2007 • Plan to establish Office in Cape Town by January 2007 • Want to be of support to SD Portfolio Committee – Members will have to indicate areas where support is required • Analyzing State of Nation and Budget Speeches to advocate for children (will be ongoing process) • Resource leveraging: support study to analyse use of government funds for children at national, provincial & local levels - recommendations for annual budget prioritisation and planning COUNTRY PROGRAMME: UNICEF SOUTH AFRICA