Abstract
This chapter presents a synthesis of the progress on key health-related MDGs in two South African provinces of KwaZulu-Natal (KZN) and the Eastern Cape (EC) focusing on sexual reproductive health and rights (SRHR) indicators. Utilizing a mixed method approach that included a desk review of policy directives on SRHR, secondary quantitative analysis of key epidemiological indicators, and a qualitative component that included focus group discussions in both urban and rural contexts; we offer evidence about how demographic and socioeconomic conditions explain trends in SRHR and show the complexity, interaction, and intersection of SRHR and all its determinants. The chapter concludes by discussing challenges [including (infra)structural, service delivery, access] in addressing specific SRHR goals and offers evidence of progress and prospects for a post 2015 agenda in addressing health-related MDGs in South Africa.
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Notes
- 1.
The “youth bulge” is a result of the cohort of young people and prime-aged adults increasing at an alarming rate. Demographic dividend is reaped when there is a large economically active population, supporting a relatively small dependent population. In many countries undergoing demographic transition, youth bulge has been associated with growing unrest, due to the resultant high youth unemployment. For instance, in South Africa, many young adults continue to stay in their childhood households and together with their offspring depend on the support from their ageing generation; which comes with its own unique set of challenges as well as potential opportunities. Demographics show the typical population pyramid of a developing state, with the majority of South Africans younger than 24 years of age.
- 2.
The demographic dividend is ideally a window of opportunity in the development of a society or nation which opens up as fertility rates decline when faster rates of economic growth and human development are possible when combined with effective policies and markets.
- 3.
Important to note in the analysis of the maternal deaths is that for KZN and to some extent EC, the primary cause of maternal mortality is the non-pregnancy related infections whilst hypertension was the main cause of maternal mortality under the direct causes of maternal mortality in EC.
- 4.
Couple-years of protection (CYP) (Contraceptive prevalence) rate estimates protection provided by family planning (FP) services during a 1-year period, based upon the volume of all contraceptives sold or distributed free of charge to clients during that period. CYP measures the volume of program activity from data routinely collected through programs, projects or service delivery mechanisms (clinics, community-based distributors, social/commercial marketing).
- 5.
The male condom distribution rate measures the number of condoms that are distributed by the Department of Health via public health facilities and other outlets in a year to males 15 years and older in the districts.
- 6.
Statistics South Africa’ General Household Survey 2012 indicates that 4.5 % of girls 13–19 years old had been pregnant in 2011 a slight decrease from 2010 (4.9 %) and 2009 (4.6 %).
- 7.
Measuring poverty in South Africa is a contested practice. A variety of indexes are often utilized to indicate levels and severity of poverty. In this report we approach the issue of poverty utilizing the poverty indicators framework that namely assesses the poverty headcount, poverty gap, and severity of poverty by various national and international poverty lines. The poverty headcount refers to the proportion of the population living below a poverty line, while the poverty gap refers to a mean distance of the poor from the poverty line. The severity of poverty is an indicator that takes account of extreme poverty by giving greater weight to those further from the poverty line. We also present qualitative data on poverty to indicate the lived experience of participants about how they experience and manage poverty.
References
Adams, A. (2008). Skills development in the informal sector of sub-Saharan Africa. Washington, DC: World Bank.
Africa Commission. (2009). Realising the potential of Africa’s youth. Copenhagen: Africa Commission.
Arthur, J. L. (2006). Implications of family size on the quality of life of people in the Sunyani Municipality. A Master of Arts (Environmental Management and Policy) dissertation submitted to the Centre For Development Studies of The Faculty of Social Sciences, University of Cape Coast, Ghana.
Bhana, K., Lopes, C., & Massawe, D. (2013). Shelters housing women who have experienced abuse: Policy, funding and practice—profiling three shelters in the Western Cape. Cape Town: Heinrich Boll Stiftung.
Bjåstad, E. (2008).Gender-based violence and development: Knowing and attitudes among student teachers. School of Development Studies Research Report No. 81. University of Kwazulu-Natal, Durban: Development Studies.
Bradshaw, D., & Dorrington, R. E. (2011a). Maternal mortality ratio – trends in the vital registration data. South African Journal of Geography, 18(2), 38–42.
Bradshaw, D., & Dorrington, R. E. (2011b). Maternal mortality in South Africa: Lessons from a case study in the use of deaths reported by households in censuses and surveys. Journal of Population Research, 28, 49–73. doi:10.1007/s12546-011-9050-9.
Caraël, M., & Glynn, J. R. (2011). HIV infection in young adults in Africa: Context, risks, and opportunities for prevention. In C. Michel & J. R. Glynn (Eds.), HIV, resurgent infections and population change in Africa (International studies in population, Vol. 6). New York: Springer.
Chimbwete, C., Ndhlovu, C., Mothiba, T., & Ndhlovu, L. (2012). Evaluation of the UNFPA 3rd country programme of assistance to the Government of the Republic of South Africa (2007–2012). UNFPA. Pretoria: Masazi Development Associates, CC.
Coen, A., Gupta, G. R., & Bogecho, D. (2004). Are we there yet? Ten years down, ten years to go in achieving reproductive rights and equality for women. Countdown2015: ICPD at 10, Fall, 12–17.
Commonwealth Secretariat. (2007). Plan of action for youth empowerment 2007–2015. London: Department of Health 2011. Sexual Reproductive Health and Rights: Reviewing the Evidence, 42–45.
Department of Health. (2011a). Health Data Advisory and Coordination Committee (HDACC) report, Department of Health, Pretoria.
Department of Health. (2011b). The 2010 national antenatal sentinel HIV & syphilis prevalence survey in South Africa, Department of Health, Pretoria.
DHIS. (2014). District health information system database. National Department of Health. http://indicators.hst.org.za/healthstats/231/data#sthash.s6muyitQ.dpuf. Accessed 5 July 2014.
Dorrington, R., et al. (2012). Rapid mortality surveillance report 2012. Burden of Disease Research Unit, Medical Research Council. http://www.mrc.ac.za/bod/RapidMortalitySurveillanceReport 2012.pdf. Accessed 26 July 2014.
Eastern Cape Department of Health (EC DoH). (2010). Province of the Eastern Cape Five Year Strategic Plan 2009/10–2014/15.
Flanagan, A., Lince, N., Durao de Menezes, I., & Mdlopane, L. (2013). Teen pregnancy in South Africa: A literature review examining contributing factors and unique interventions. Ibis Reproductive Health.
Fraser-Hurt, N., Zuma, K., Njuho, P., Chikwava, F., Slaymaker, E., Hosegood, V., et al. (2011). The HIV epidemic in South Africa: What do we know and how has it changed? Pretoria: South African National AIDS Council.
Garenne, M., McCaa, R., & Nacro, K. (2011). Maternal mortality in south Africa: An update from the 2007 community survey. Journal of Population Research, 28(1), 89–101.
Government of South Africa. (2010). Millennium development goals. Country report 2010. Pretoria.
Health Systems Trust. (2013). District health barometer-2012/2013. Durban, South Africa: Health System Trust. Available at http://www.hst.org.za.
Holt, K., Lince, N., Hargey, A., Struthers, H., Nkala, B., McIntyre, J., Gray, G., Mnyani, C., & Blanchard, K. (2012). Assessment of service available and healthcare workers’ opinion about young women’s sexual and reproductive health in Soweto, South Africa. Journal of African Reproductive Health (special edition) 16(2), 283.
Jewkes, R., Abrahams, N., Mathews, S., Seedat, M., Van Niekerk, A., Suffla, S., & Ratele, K. (2009a). Preventing rape and violence in South Africa: Call for leadership in a new agenda for action. Pretoria: Medical Research Council.
Jewkes, R., Sikweyiya, S., Morrell, R., & Dunkle, K. (2009b). Understanding men’s health and use of violence: Interface of rape and HIV in South Africa. Parowvallei: Medical Research Council.
Jewkes, R., Morrell, R., & Christofides, N. (2009c). Empowering teenagers to prevent pregnancy: Lessons from South Africa. Culture, Health & Sexuality, 11, 675–688.
Khalema, N. E., Ndinda, C., Bhembe, L., Makiwane, M., Vawda, M., Mahapa, N., & Mgcina, N. (2014). Situation analysis of population and development in eight priority districts of KZN and EC: Analysing the determinants of sexual reproductive Health and rights. Research report developed for UNFPA, Pretoria, January, 2013, p. 11.
KwaZulu Natal Department of Health. (2010). KwaZulu Natal strategic plan 2010–2014.
Machisa, M., Jewkes, R., Lowe, M. C., & Rama, K. (2011). The war at home: Gender based violence indicators project, Gauteng research report. Johannesburg: Medical Research Council & Genderlinks.
Macleod-Downes, L., Albertynm, R., & Mayers, P. (2008). Factors determining the vulnerability of women to sexually transmitted HIV: A literature review. Health SA Gesondedheid, 13, 69–72.
Memela, L., & Ayogu, C. (2011). Progress and challenges in the gender-based violence sector. Agenda: Empowering Women for Gender Equity, 19(66), 98–101.
Mngoma, S. (2010, May 26). The teen pregnancy epidemic. The Natal Witness, p. 11.
National Department of Health. (2001). National contraception policy guidelines. Pretoria: National Department of Health.
National Department of Health. (2007). South Africa demographic and health survey 2003.Pretoria: National Department of Health.
National Department of Health. (2010). National Department of health strategic plan 2010/11-2012/13. Pretoria.
National Department of Health. (2011). South Africa’s national strategic plan for a Campaign on Accelerated Reduction of Maternal and Child Mortality in Africa (CARMMA). Pretoria: Department of Health.
National Department of Health. (2013). The national strategic plan for nurse education, training and practice 2012/13-2016/17.
National Planning Commission. (2012). National development plan. http://www.npconline.co.za/medialib/downloads/home/NPC%20National%20Development%20Plan%20Vision%202030%20-lores.pdf. Accessed 23 July 2014.
Ntuli, N. (2014, August 18). KZN children lead in abuse complaints against teachers. The Mercury, 3
OECD (Organisation for Economic Co-operation and Development). (2013). OECD economic surveys: South Africa 2013. OECD Publishing. http://dx.doi.org/10.1787/eco_surveys-zaf-2013-en. Accessed Feb 2014.
Panday, S., Makiwane, M., Ranchod, C., & Lestoala, T. (2009). Teenage pregnancy in South Africa with a specific focus on school-going learners. Child, Youth, Family and Social Development, Human Sciences Research Council. Pretoria: Department of Basic Education.
Ramkissoon, A., Searle, C., Burns, C., & Beksinska, M. (2010). Sexual and reproductive rights. South African Health Review, 33–48.
Republic of South Africa. (1996). Civil Union Act 106 of 2006. Pretoria: Government Printer.
Republic of South Africa. (1998). Domestic Violence Act 116 of 1998. Pretoria: Government Printer.
Republic of South Africa. (2010). Millennium development goals: Country report 2010. http://www.statssa.gov.za/news_archive/Docs/MDGR_2010.pdf. Accessed 19 Mar 2014.
Rumbold, V. (2008). Sexual violence and gender based violence in Africa: Literature review. Population Culture.
SADC. (2008). Sexual and reproductive health strategy for the SADC region 2006–2015.
Sen, G. (2010). Integrating family planning with sexual and reproductive health and rights: The past as prologue? Studies in Family Planning, 41(2), 143–146.
Shisana, O., Rehle, T., Simbayi, L. C., Labadarios, D., Zuma, K., Jooste, S., Van Zyl, J., & SABSSM IV Implementation Team. (2013). South African national HIV prevalence, incidence and behaviour survey 2012. Cape Town: HSRC SABSSM preliminary report
Shisana, O., Rehle, T., Simbayi, L. C., Zuma, K., Jooste, S., Zungu, N., Labadarios, D., Onoya, D., et al. (2014). South African national HIV prevalence, incidence and behaviour survey, 2012. Cape Town: HSRC Press.
South African Police Service. (2011/2012). Annual report 2011/2012, 84–85. Available at http://www.saps.gov.za/saps_profile/strategic_framework/annual_report/index.htm. Accessed 20 Apr 2015.
Stats SA. (2008/09). Poverty profile of South Africa: Application of the poverty lines on the LCS 2008/2009. Report No. 03-10-03 (2008/2009).
Stats SA. (2010). Estimation of fertility from the 2007 community survey of South Africa. Report No. 03-00-04, 1–43.
Stats SA. (2011a). General household survey. Statistical release P0318, 1–160.
Stats SA. (2011b). Mortality and causes of death in South Africa, 2011: Findings from death notification. Statistical release P0302, 1–17. Retrieved on August 12, 2014 at Stats SA 2013a. Mid-year population estimates.
Stats SA. (2011c). Victims of crime survey 2011. Statistical release P0341, 1–62.
Stats SA. (2012). General household surveys. Statistical release P0318, 1–164.
Stats SA. (2013a). General household survey. Statistical release P0318, 1–160.
Stats SA. (2013b). Millennium Development Goals country report. Pretoria: Stats SA.
Stats SA. (2014). Mortality and causes of death in South Africa, 2011: Findings from death notification/statistics South Africa. Pretoria: Statistics South Africa.
Thomson-de Boor, H., Shand, T., Peacock, D., Sanger, C., Herstad, M., & Phillips, L. (2013). Policy report: Engaging men in HIV and GBV prevention, SRHR promotion, parenting and LGBTI rights, South Africa. Sonke Gender Justice Network: Johannesburg, South Africa.
Thorpe, J., Nesbitt, G., Whittle, P., & Mbadlanyana, T. (2014). A four year review of the work of committees of parliament in relation to gender based violence. Cape Town: Research Unit, Parliament of the RSA.
Udjo, E. O., & Lalthapersad-Pillay, P. (2013). Estimating maternal mortality and causes in South Africa: National and provincial levels. Midwifery. http://dx.doi.org/10.1016/j.midw.2013.05.011i.
UN. (2010). World youth report—youth and climate change. New York: UN Commonwealth Secretariat.
UNDP. (2010). South African millennium development goals. Country Report 2010, 1–139.
UNFPA. (2010a). Linking sexual and reproductive health and HIV. New York: UNFPA.
UNFPA. (2010b). Donor support for contraceptives and condoms for family planning and STI/HIV prevention 2010. www.unfpa.org/…/FINAL%20Donor%20Support%202010-2.pdf. Accessed 2 Feb 2014.
UNFPA. (2012). Annual report: Promises to keep. New York: UNFPA.
Urdal, H. (2007). The demographics of political violence: Youth bulges, insecurity, and conflict. In L. Brainard & D. Chollet (Eds.), Too poor for peace? poverty, conflict and security in the 21st century. Washington, DC: Brookings.
Usdin, S., Thekiso, M., Johnston, N., Govender, K., Vetten, L., & Le Roux, G. (1999). Violence against women in South Africa. A resource for journalists. Johannesburg: Soul City Institute for Heal.
Watson, J. (2014). Engaging with the state: Lessons learnt from social advocacy on gender-based violence. Agenda. doi:10.1080/10130950.2014.927626.
Willan, S. (2013). A review of teenage pregnancy in South Africa—Experiences of schooling and knowledge and access to sexual and reproductive health services. Durban: Health Systems Trust.
Willan, S. (2014). A review of teenage pregnancy in South Africa—Experiences of schooling, and knowledge and access to sexual & reproductive health services. Partners in Sexual Health (PSH). http://www.hst.org.za/publications/review-teenage-pregnancy-south-africa-experiences-schooling-and-knowledge-and-access-se. Accessed 30 July 2014.
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Khalema, N.E. et al. (2015). (Ad)dressing Sexual Reproductive Health Issues and Its Determinants in KwaZulu-Natal and Eastern Cape Provinces of South Africa: Evidence from a Situational Analysis of Millennium Development Goals Indicators. In: Andrews, N., Khalema, N., Assié-Lumumba, N. (eds) Millennium Development Goals (MDGs) in Retrospect. Social Indicators Research Series, vol 58. Springer, Cham. https://doi.org/10.1007/978-3-319-16166-2_10
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