AN ANALYSIS OF THE 2010

STATE OF THE NATION

ADDRESS

Presentation to the Portfolio &

Select Committees on Women, Youth,

Children and Persons with Disabilities

23 February 2010

KEY PRIORITIES OUTLINED IN 2010

The President outlined five strategic priorities for 2010, namely:

•Education and skills development•Ensuring a long and healthy life for all South Africans•Rural development and land reform•Creating decent work •Fighting crime

2009 vs 2010

Priorities 2010

• Education and skills development• Ensuring a long and healthy life for

all South Africans• Rural development and land reform• Creating decent work • Fighting crime

Particular emphasis on Youth and Youth development

Priorities 2009

• Speeding up economic growth, transformation of the economy and the creation of decent work;

• Building economic and social infrastructure;

• Development and implementation of a comprehensive rural development strategy;

• Strengthening the skills and human resource base;

• Improving the health profile of all South Africans;

• Intensification of the fight against crime and corruption;

• Building cohesive, caring and sustainable communities;

• Pursuing African advancement and enhanced international co-operation;

• Ensuring sustainable resource management; and

• Improving public services and strengthen democratic institutions.

In keeping with the Committees’ theme for 2010, namely “Maternal and Woman’s Health, Child Survival and Development”, this presentation will focus primarily on the impact of the 2010 State of the Nation Address on the health, development and survival of:

Women

Youth

Children

Persons with Disabilities

Focus for SONA 2010 analysis

SONA 2010 HEALTH COMMITMENTS

• A continued focus on the improvement of the healthcare system – this will be achieved through the building and upgrading of hospitals and clinics, as well as through collaboration with and financial support from role-players in the private sector and development institutions,

•The working conditions of healthcare workers will be improved,

•Interventions to lower maternal mortality rates will be introduced,

•Measures/ interventions to reduce new HIV infections as well as treat HIV and tuberculosis will be intensified,

•Infant mortality will be reduced through an immunisation programme

•Health programmes in schools will be reinstated

•Preparations for the introduction of the National Health Insurance scheme will continue.

WOMEN & THE 2010 STATE OF THE NATION ADDRESS:

WOMEN’S HEALTH

•Improvement of the Healthcare System

- important priority for many women across the country who make use of primary healthcare facilities and who are often subjected to inefficient service delivery at these facilities

•Interventions to lower Maternal Mortality Rates-reduction of maternal mortality rates is one of the MDGs which South Africa has committed to attaining by 2015 – very little progress.

-development indicators released by Presidency in 2009 indicate that in 1997 the maternal mortality ratio was approximately 81 deaths per 100 000 live births – by 2005 this figure had increased to 400 deaths per 100 000 live births.

-number of maternal deaths is compounded by the impact of HIV and AIDS, 4th “Saving the Mothers” report by the National Committee on Enquiries into Maternal Deaths indicates that

almost 60% of maternal deaths were avoidable.

-largest contributing factors to maternal deaths was a lack of blood transfusions (19%), followed by a lack of ICU facilities (9.2%) and a lack of appropriately trained staff (8.9%).

•Measures to reduce and treat HIV and AIDS The President highlights that the undertakings made on World Aids Day will be implemented. These include:

-Access to anti-retroviral treatment for all pregnant HIV positive women with a CD4 count of 350 or those presenting symptoms of HIV regardless of their CD4 count-The provision of treatment to all pregnant HIV positive women – all women infected with HIV will be put on treatment at fourteen weeks of pregnancy to protect the baby.-Positive benefit for many HIV positive women in terms of increased accessibility and earlier intervention provision

•The National Health Insurance Scheme-Particularly important priority for women in South Africa, especially those from rural and impoverished communities as it could result in improved and equitable access to healthcare services, granted that the scheme is thoroughly conceptualised and managed effectively.

•Infrastructural Development and the Provision of Basic Services- People living in rural areas, as well as those residing in informal settlements often do not have access to safe water or sanitation services, which increases their vulnerability to infectious diseases. - President has emphasised the provision of housing, water, sanitation, electricity, waste management and roads, with a total of R846 billion to be spent on public infrastructure over the next three years.

WOMEN & THE 2010 STATE OF THE NATION ADDRESS:

WOMEN’S HEALTH

Implications for Committees

National Health Insurance Scheme: Monitor, from a gender perspective, progress on the implementation of the NHI scheme, particularly as it relates to women as beneficiaries

Reducing maternal mortality:•Track progress made with regard to achieving the health-related MDGs, particularly MDG 5 (Improving maternal health) and MDG 6 (Combating HIV/AIDS).•Track budgetary allocations with regard to measures to improve maternal health. In a presentation by National Treasury on the 2010 budget, it was indicated that an additional R12.4 billion rand would be allocated towards treatment for HIV, AIDS, TB and infant mortality, however no mention is made of maternal mortality, despite it being identified as a specific priority by the President in the SONA.

Revitalisation and upgrading of healthcare facilities:Request briefings and progress updates from the relevant Departments responsible for these programmes i.t.o. timeframes and targets

Ensuring gendered considerations and prioritisation:Monitoring of departmental budgets to ensure gendered considerations & targeted expenditure in relation to women’s health and survival

Infrastructural development and the provision of basic servicesThere is a link between health status and access to basic services, therefore it is imperative that the Committee continues to engage the Departments of Transport, Local Govt and Human Settlements in terms of their prioritisation of women in their service delivery targets.

YOUTH PRIORITIES IN THE 2010 STATE OF THE NATION ADDRESS

• The creation of jobs for youth – encouraging private sector companies to employ inexperienced young workers, expansion of the public employment programme (local infrastructure, literacy projects, home-based care, school maintenance and early childhood development initiatives).

• Setting up provincial structures of the National Youth Development Agency – speed up establishment of structures nationally so as to mainstream youth development programmes within Government.

YOUTH & 2010 STATE OF THE NATION ADDRESS:JOB CREATION

Implications for the Committee:• Monitoring exactly how many sustainable work opportunities are afforded to youth in Government’s priority programmes such as the EPWP; • Data on youth unemployment and employment should be disaggregated by sex, age, disability, province, industry;• The Departments of Health, Social Development, Basic and Higher Education should brief the Committee on measures to address the country’s brain-drain of skilled professionals.

Initiatives:

• Private sector – employment of inexperienced youth

• Learnerships

• EPWP (ECD, CDW ), NYS

(labour brokering, contract work, exploitation, sustainability)

YOUTH & 2010 STATE OF THE NATION ADDRESS:YOUTH MACHINERY

Implications for the Committee• Monitor, evaluate and oversee performance (strategic plan, budget, annual report)

YOUTH & 2010 STATE OF THE NATION ADDRESS:EDUCATION

BASIC EDUCATION• Attendance and punctuality: Youth must be in school, on time 7 hours a day. •Quality assessments: Grade nines to write independently moderated literacy and numeracy tests.•Aim of increasing pass rates from between 35 and 40% to at least 60% by 2014. •Improving teacher effectiveness: Teachers will be provided with daily lesson plans.•Improved education outcomes: Aim to increase the number of grade 12 learners that are eligible for university admission to 175 000 by 2014.(violence in schools, safe reliable transport, poverty, HIV/AIDS, teacher morale)

HIGHER EDUCATION• Increase entrants – FET colleges• University students - National Student Financial Aid Scheme • Engineers, science and mathematics teachers(access to funding, brain-drain, skills match to labour market)

YOUTH & 2010 STATE OF THE NATION ADDRESS:HEALTH CARE

Priority & Challenges Implications for the Committee

• Maternal Mortality• HIV prevalence• ART provision• Maternal health• Sexual & Reproductive Health• Gender Based Violence• Mental health

• MDG monitoring• PMTCT, ART roll-out, NSP• Access to adolescent health care• Psycho-social services

YOUTH & 2010 STATE OF THE NATION ADDRESS :ACCESS TO BASIC SERVICES

Priority & Challenges Implications for the Committee

• Water, sanitation, electricity – linked to housing• Service delivery protests – unemployment, poverty• Health status of morale of youth

•Disaggregated data•Assessing IDP•A demographic profile. •Number of youth per household with access to water, sanitation, electricity.•Unemployment rate. •Health profile.

YOUTH & 2010 STATE OF THE NATION ADDRESS:RURAL DEVELOPMENT & LAND REFORM,

FIGHTING CRIME

Rural Development & Land Reform• Proper services and land tenure - 500 000 households (6 000 hectares of well-located public land for low income and affordable housing )• Comprehensive Rural Development Programme, P• Provision of infrastructure to support agricultural development • Training for community members • 160 wards - least 60% of households in these sites meeting their food requirements from their own production by 2014 (migration, unemployment, poverty, HIV/AIDS)

Fighting Crime• Reducing - serious and violent crimes, • Increasing the number of police officials by 10% 3 yrs, • Reducing hijacking, business and house robberies and • Reducing contact crimes such as murder, rape and assault.(gender-based violence and violence perpetrated against and by youth, AWT, rehabilitation of offenders, lack of disaggregated data to monitor youth in conflict with the law)

CHILDREN & THE 2010 STATE OF THE NATION ADDRESS:

CHILD SURVIVAL AND DEVELOPMENT

This year President Jacob Zuma re-emphasised the key priorities mentioned from his first 2009 State of The Nation Address. The President mentioned 5 key priorities all of which impact directly on the survival and development of children that Government is committed to; these priorities are as follows:

Health Crime Rural Development and Land Reform Employment Education

CHILDREN & THE 2010 STATE OF THE NATION ADDRESS:

CHILD HEALTH

• Implementation of School health Programmes. – Should focus on a drive toward provide psycho-

social services.– School as nodes of intervention.

• Close monitoring of the Expanded Programme on Immunization

• Implementation of the HIV and AIDS and STI National Strategic Plan 2007-2011, concentrating:

– provider-initiated testing, – dual therapy in PMTCT – universal coverage of antiretroviral therapy

• Engaging with empirical research.• Ensuring that the respective Government

Departments have the requisite information (data and statistics) to be able to monitor and evaluate trends.

• Assessing whether appropriate resources have been allocated to programmes earmarked to address child survival.

• Monitoring whether the programmes aimed at improving child survival outcomes are effective.

• Building and upgrading hospitals and clinics and so in doing, further improve the working conditions of healthcare workers.

• Provide interventions to lower maternal mortality rates, to reduce new HIV infections and to effectively treat HIV and tuberculosis.

• Reduce infant mortality through a massive immunisation programme.

• Reinstate health programmes in schools.

• Implement all the undertakings made on World Aids Day relating to new HIV prevention and treatment measures.

Listed Priorities Implications

CHILDREN & THE 2010 STATE OF THE NATION ADDRESS:

CHILD & BASIC SERVICES

Water is vital for health, hygiene and sanitation. Water is essentially a tool to transform society

towards social and environmental justice and poverty eradication.• Lack of basic services such as clean running water leaves children more

vulnerable in terms of achieving their full potential. Children are particularly vulnerable to illnesses associated with poor water, such as diarrhoea and cholera.

• The use of the bucket system exposes children to unsanitary and unhygienic circumstances leaving them vulnerable to diseases and infection.

• Provinces with the highest percentage of no toilet facilities or bucket users include: Eastern Cape (19.5%), Limpopo (11.6%), and Free State (10.6%) and Northern Cape (10.5%).Thirty-eight per cent of the child population live in the above-mentioned areas.

• While roll-out of toilets and water pipes has begun, it needs to be done faster. • Oversight at the above-mentioned areas should be conducted to ensure that the

most poorly equipped provinces are dealt with urgently. • Hence the Integrated Development Plans are another key tool to assess if and how

municipalities have linked that allocation of basic services to child health needs.

Implications

CHILDREN & THE 2010 STATE OF THE NATION ADDRESS:

CHILD PROTECTION

• A need for well-resourced detective and forensic laboratory services.

• Ongoing training is also required to equip personnel within the criminal justice system to keep abreast of legislative developments.

• A 10% increase is not sufficient when dealing with complex social issues such as violence against children.

– training to equip police men and women to deal with victims of violence, specifically children.

– Police will have to be adequately trained in basic counselling and referral methodologies in order to assist with psycho-social issues which are bound to arise when dealing with youth and children.

– reactive crime prevention measures. Such measures would specifically target children and youth –for e.g. programmes at schools to encourage a crime-free society.

• To consider: reinstate Child Protection Units

• A reduction of serious and violent crimes.

• Ensuring that the justice system works efficiently.

• Implementing plans to increase the number of police men and women by 10% over the next three years.

• Participation in community safety forums.

Listed Priorities Implications

A Disability Perspective of the 2010 State of the Nation Address

• Highlighted the need for increased social spending – CDG needs to be extended to include more children with varying disabilities.

•Expansion of the road network: critical to people with disabilities given the barriers to accessing services (e.g. Long travelling distances and lack of efficient public transport)

• Implications for the introduction of performance monitoring system for persons with disabilities: service delivery.

•Upgrading of public health care system: what does this entail and how does it affect persons with disabilities: assistive devices and services

•Basic services: Turnaround Strategy – how does this speak to the needs of persons with disabilities?

Impact of the SONA on Persons with Disabilities

•Provision of Social Assistance to vulnerable was central: what about Persons with Disabilities. CDG does not cover: deafness, blindness, albinism, epilepsy, autism and progressively disabling life threatening inherited diseases.

•Basic Services to the most vulnerable: IDC would take the lead in the development of basic services – progress up till 2010 has not been on basic service: Problematic.

•Health Care Provision: so far improvement of the health care system has not focussed sufficiently on the needs of Persons with Disabilities (e.g. assistive devices, attitudinal barriers, etc.)

Implications for Parliament for 2010

The Committees need to establish:

• How the CDG will be extended to suit the needs of Persons with Disabilities?

• How will the shift in focus impact on the basic services needs of Persons with Disabilities?

• How does the improvement of the Health Care System impact on the Persons with Disabilities?

• How will Persons with Disabilities be covered by the NHI?

Thank you