UNICEF South Africa Country Programme and Advocacy processes

COUNTRY PROGRAMME: UNICEF SOUTH AFRICA Introductory Remarks Achievements of Social Development sector Promulgation of Children’s Act no 38 of 2005 More than 7 million CSG recipients Establishment of SASSA 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

COUNTRY PROGRAMME: UNICEF SOUTH AFRICA SA economy is booming, wellbeing indicators are not MMR U5MR e0 U5MR increased from 60 in 1990 to 67 in 2004. 40% due to AIDS; 60% due to non-AIDS-related causes 29.5% HIV prevalence among pregnant women at ANC HIV prevalence among teenage girls 4x higher than boys Over 1,000,000 children not in school Approximately 2.5 million orphans 40% of reported rapes are against children (55,000 total annually) Source: MDG Report for South Africa, Stats SA: Gross Domestic Product (P0441); Mid-Year Population Estimates 2005 COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

COUNTRY PROGRAMME: UNICEF SOUTH AFRICA Programme Structure 2002-2006 Basic Social Services HIV and AIDS Social Policy and Local Governance Communication, External Relations, and Partnerships Basic Social Services – NGOs and Government have taken up the work in this area but the focus now needs to be on service delivery that is effective and efficient – not just on getting services moving. HIV/AIDS – the Government’s Comprehensive Plan now assures ARV treatment and the GOSA has asked UNICEF to help create an Accelerated Action Plan for Pediatric AIDS. SPLG – this programme has been revamped to focus on budget analysis, parliamentary advocacy and social policy and delivery systems. Communications – a new aspect of this programme addresses private sector fundraising. COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

ORPHANS AND VULNERABLE CHILDREN Education & Adolescent Development Health & Nutrition Child Protection Advocacy & Strategic Leveraging Advocacy for Children’s Rights Protection against violence Basic Education Child Survival Social Protection / Safety Nets Adolescent development Nutrition Leveraging Funds Early Childhood Development Monitoring for Impact Programme Communication Environment for full realisation of OVC rights: Leveraging resources for first call for children Partnerships for realization of child rights Four programmes: Social Transformation and Strategic Leveraging Health and nutrition Education Child protection Strategic Approach: National advocacy campaign for first call for children though social mobilisation and communication Leverage national resources to deliver scaled-up, evidence-based services Identification of multiplier-effect interventions Identification of bottlenecks to implementation of legislation and service delivery Recruit high-caliber staff who can galvanize thinking and scale-up for children. Planning, Monitoring & Evaluation External Relations COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

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

Morbidity and Mortality Profile of Children in South Africa 60% of all children are ill or are dying from preventable causes 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

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

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 Between 55,000 and 82,000 children in need of ARV, only 5,000 receiving ARV 1 million births per year →29% infection rate amongst women attending antenatal clinics →290,000 HIV+ mothers →30% of babies born to HIV+ mothers will contract HI virus →50% of HIV+ babies will die before 2 years of age SOURCES Approximately 6.29 million people infected (2004 DoH Antenatal survey) 3.3 million women and 104,863 babies infected (2004 DoH Antenatal survey) 29,5% infection rate among women visiting antenatal clinics (2004 DoH Antenatal survey) Greatest killer of under 5 children = AIDS (40%) (MRC) Almost 300,000 babies born to HIV+ mothers a year (Health Systems Trust) Between 55,000 and 82,000 children in need of ARV, only 5,000 receiving ARV (MRC) COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

COUNTRY PROGRAMME: UNICEF SOUTH AFRICA 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 infant care Supporting Safety Net Systems for Orphans and Vulnerable Children (OVCs) COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

COUNTRY PROGRAMME: UNICEF SOUTH AFRICA Early diagnosis & testing Few newborn & older babies are being tested resulting in poor early diagnosis. Laboratory tests during first 12-18 months of life are expensive, involve complex technology. Plans for 2006: Increase the number of infants tested for HIV from 30,000 to at least 120,000. UNICEF Action Purchase additional laboratory instruments, staff and building space to dramatically scale up the number of children tested for HIV in the short term. Automate current PCR technology Train personnel in10 hospital and 40 primary health care clinics to utilize new methods of testing infants using a mobile clinical team Commission study to explore pyscho-social and community aspects of diagnosis of HIV in children on program staff, mothers and children. Help simplify testing and diagnostic technology Roll out the new technology as rapidly as possible in South Africa and other countries COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

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 UNICEF Action: Form national network of experienced paediatric HIV sites/units to provide clinical & systems support to less capacitated areas; Define geographical areas of responsibility in which sites/units will provide support to avoid duplication & areas unsupported by any unit/site; Employ, train, supervise & coordinate multi-disciplinary mobile outreach teams that provide on the job training to secondary and primary health centers providing ART Develop district based learning collaboration to improve referral networks and to co-ordinate paediatric HIV care & prevention within health districts. COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

COUNTRY PROGRAMME: UNICEF SOUTH AFRICA Child protection COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

COUNTRY PROGRAMME: UNICEF SOUTH AFRICA Care and support for OVC Deaths in 20-45 age group tripled in 10 years 1.8 million children lost a parent to AIDS, millions more are living in households in which one or more person is ill, dying or deceased. Child support grant up to age 14 anticipated to reach 11 million South Africans Key results in 2005: National Plan of Action for OVC 2006 – 2008 Development of database for OVC -research Training manuals developed to create safety nets and child care forums for OVC ECD sites piloted as nodes of care and support for village workers supporting OVC in Nkandla. Cabinet approved extension of the means tested Child support grant beyond the age of 7 UNICEF ACTION: Support provincial Dept. of Social Development to establish municipal-level OVC registers & maps of services → ensure OVCs receive health & education services, social grants & early childhood development. Commission statistical analysis & map of census & electoral data to portray density of orphans by district. Commission study of data sources → info about OVCs at local level to inform local, provincial or national-level database. Analyse child support grants to identify where efficiency can be improved → reaching more children with existing resources. SOURCES: National Dept of Social Development COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

COUNTRY PROGRAMME: UNICEF SOUTH AFRICA Care and support for OVC We have to ensure that OVC have access to Education Health services Social Grants Care and support Cabinet approved extension of the means tested Child support grant beyond the age of 7 UNICEF ACTION: Support provincial Dept. of Social Development to establish municipal-level OVC registers & maps of services → ensure OVCs receive health & education services, social grants & early childhood development. Commission statistical analysis & map of census & electoral data to portray density of orphans by district. Commission study of data sources → info about OVCs at local level to inform local, provincial or national-level database. Analyse child support grants to identify where efficiency can be improved → reaching more children with existing resources. SOURCES: National Dept of Social Development COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

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

COUNTRY PROGRAMME: UNICEF SOUTH AFRICA 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

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

COUNTRY PROGRAMME: UNICEF SOUTH AFRICA Plans for 2006 Drafting legal discussion paper on trafficking in preparation for draft bill Costing of National Policy Framework and Strategy for the Prevention and Management of Child Abuse and Neglect and use it to advocate for resource allocation Study on violence against children under 12 years Situation analysis of children living in streets, in residential care, without rights and trafficked children. 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 Scale up services through Thuthuzela Care Centres COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

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

COUNTRY PROGRAMME: UNICEF SOUTH AFRICA 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 1 million 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

Early Childhood Development Key results for 2005: Support GoSA in development of operations plan for implementing Integrated Plan on ECD Technical advise on development of paper for operationalisation of Plan to create 15,300 ECD learnerships Planned for 2006: Development & finalisation of national primary caregiver training programme for babies & young children Development of models of care for children under 5 and their caregivers Development of ECD centres as nodes of care and support for OVC COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

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

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

Adolescent Development Key results 2005: Capacity development on youth leadership continued for youth, educators, school governing bodies, traditional leaders & community members Fatherhood project and reduction of gender-based violence 80 Educators in Eastern Cape & KZN trained on creative facilitation & participation for lifeskills education Planned for 2006: Strengthening implementation & evaluation of lifeskills programmes for adolescents – national & provincial COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

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

COUNTRY PROGRAMME: UNICEF SOUTH AFRICA Situation of children More than 11 million children live in poverty – yet annually in some departments millions are returned unspent Comprehensive policies & legislation: weak implementation & management result in poor service delivery SPLG aims to strengthen Government’s ability to plan, budget and put systems in place to provide more equitable, effective and efficient services, with focus on the most vulnerable children and women. COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

Social Policy and Local Governance Key results 2005: Technical support in finalising Children’s Bill and National Child Abuse Strategy Technical support in finalising Support 2 local municipalities to develop and implement Local Plans of Action for Children (LPA) On line birth registration project taken over by GovSA rolled out to 68 hospitals Conceptual framework developed for Stats SA for stronger monitoring systems for birth registration. COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

COUNTRY PROGRAMME: UNICEF SOUTH AFRICA THE CHALLENGE TO PARLIAMENT IN ADVOCACY AND ACTION FOR CHILDREN COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

COUNTRY PROGRAMME: UNICEF SOUTH AFRICA Advocacy and action Liaising with the Justice Portfolio Committee to fast-track the finalization of the Child Justice Bill and Sexual Offences Bill Oversee allocations for 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 Extending the child support grant to children aged 14-18 years COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

Advocacy and action Review Social Assistance Act Finalise Sexual Offences Bill Finalise Child Justice Bill Finalise Children’s Amendment Bill Advocacy for Children in Parliament Advocacy Document to support the oversight responsibilities of parliamentarians Analyzing State of Nation and Budget Speeches to advocate for children COUNTRY PROGRAMME: UNICEF SOUTH AFRICA

COUNTRY PROGRAMME: UNICEF SOUTH AFRICA 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 Resource leveraging: 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

COUNTRY PROGRAMME: UNICEF SOUTH AFRICA Thank you COUNTRY PROGRAMME: UNICEF SOUTH AFRICA