South Africa’s Response to Children and HIV and AIDS

iMEDIATE continues focusing on children’s rights and participation. We are busy with a regional study for Save the Children Sweden to identify opportunities and challenges related to creating spaces for children to be meaningfully involved in decisions and processes that affect them.

One thing that has long been apparent is that, in South Africa at least, there is a legal and policy framework that guarantees children the opportunity to be heard and to participate in all spheres of life. However, the gulf between rights on paper and rights in practice continues.

Millions of children are still without adequate nutrition, health services, education, family care and housing and their experiences and ideas about what needs to be done are sorely neglected in most planning, budgeting and programming.

The Children’s Institute in Cape Town has an initiative called Children Count – Abantwana Babalulekile – through which is presents child-centered data on many aspects of socio-economic rights. This is a very useful tool for those who want up-to-date statistics and a sound evidence base for advocacy on children’s rights.

Scorecard 2009:Weighing Up

The Children’s Rights Centre, in Durban, has just published a very accessible booklet titled Scorecard 2009: WEIGHING UP South African’s Response to Children and HIV and AIDS, with support from the Children’s Institute, the University of Cape Town, the Medical Research Council and Irish Aid.

The Scorecard measures how South Africa is doing in implementing HIV and AIDS and STI National Strategic Plan 2007-2011 (NSP) for children and families. The NSP is South Africa’s plan for working together as a country to address the problem of HIV and AIDS. It describes the actions that need to be taken to prevent further HIV infections and to make sure there is access to treatment, care and support for people living with HIV and their families.

The 2009 Scorecard highlights the need for more and better information on service delivery and child outcomes relating to HIV and AIDS in South Africa, and reflects keenly on the necessity to set bold targets based on actual need.
The booklet focuses on ten indicators that are broken down as below:

On target
• HIV Prevention – The proportion of adolescent girls aged 15 to 19 years visiting antenatal clinics, who test HIV-negative, the indicator is on target;
• Access to PMTCT – the proportion of HIV-positive pregnant women who receive PMTCT prophylaxis;
• ARV treatment for Children – The proportion of children under 15 years old starting antiretroviral treatment as a proportion of the number of new HIV infections in children;
• Maternal Health – The proportion of women progressing to AIDS who start antiretroviral treatment.

Below target
• Infant mortality – the number of children under one year of age who die in a year, per 1000 live births in the same year. Alarmingly, there are no reliable statistics on this since 1998;
• Social Services – The proportion of registered social workers compared to the number of social workers needed to deliver services to children in terms of the Children’s Act;
• Income Support – The proportion of children under one year who receive the Child Support Grant.

Don’t know
• PMTCT child outcomes – the proportion of babies born to HIV-infected mothers, who are HIV-negative at three months;
• Child protection – The proportion of eligible children who are given post-exposure prophylaxis after rape;
• Cooperative governance – the proportion of civil society sectors represented at SANAC Programme Implementation Committee meetings.

Looking at these indicators, it is good to notice that the number of HIV infected people on treatment has increased and there has been a reduction in new infections. Women taking a stand and moving forward in accessing treatment is an achievement, compared to women who could not or did not want to take treatment for themselves or their children because they were scared of their partners, or due to stigma.

However, the challenges both for service delivery and for monitoring are immense. Apart from indicators that are below target lack of information is a serious obstacle. Some Provinces do not roll out data in time. Who is responsible for this and where is the accountability? An ongoing challenge is the human resource shortage. Without adequate recruitment, training, remuneration and support of social workers and health professionals across the spectrum, it is hard to see how targets can be met.

For more information visit:
http://www.childrencount.ci.org.za/
http://www.crc-sa.co.za/catchnetwork