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South Africa: Millennium Development Goals mid-term country report

Government of South Africa

September 2007

SARPN acknowledges the South African Government as a source of this document:
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Executive Summary

The 2005 South Africa’s Millennium Development Goals Country Report indicated that South Africa (SA) had already met some of the MDGs targets and that for those that had not yet been achieved the country was well on course to achieve them. In fact in most cases, SA has set earlier deadlines than those of the MDGs, including close monitoring of progress.

For purposes of continuity and easier comparability of progress over the years, and wherever possible, this updated report has maintained the same sources of data as those used in the 2005 report. Data continues to improve, even though some of the data challenges that were highlighted in the 2005 report remain in the current report.

Goal 1

The first Millennium Development Goal (MDG) has two targets, which are to halve, between 1990 and 2015, the proportion of people whose income is less than one dollar a day; and to halve, between 1990 and 2015, the proportion of people who suffer from hunger. Using national estimates of poverty and inequality in SA, the 2007 report indicates strong overall income growth, especially since 2002, resulting in the rise of the income of the poorest 10 and 20 percent of the population. The depth of income poverty was measured with reference to a poverty line of R3 000 per capita per annum (or just slightly above US$1 per day in 2000 constant Rand). Again, there are strong indications that the incomes and/or expenditures of those in poverty improved, bringing the very poor closer to the poverty line. In addition, the severity of poverty has been reduced, especially since 2002. However, of concern is that income inequality (as measured by Gini-coefficient) seems to have increased over most of the period.

With regard to target two whose progress is measured using severe malnutrition amongst children under-5 years of age, the report observes a decline from 88 971 cases in 2001 to 30 082 in 2005.

Goal 2

For goal two, the target is to ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling. According to the General Household Survey (GHS), conducted by Statistics South Africa (Stats SA), over 98% of seven to 13 year old children attended education institutions in 2006. The same GHS reveals that 98% of 18 year old children had completed Grade 7 and above in 2006. This reflects an increase of close to 2% since 2004. Self-declared literacy rates obtained from the GHS suggest that youth literacy remained above 96% from 2002 to 2006. The functional literacy rate, which is based on educational achievement of up to grade 7, came close to 90% in 2006, increasing by approximately 4% from 2002. Conversely, the number of 15 to 24 year olds that are not functionally literate has been decreasing steadily from 14% in 2002 to 10% in 2006.

Goal 3

The target for goal three is the elimination of gender disparity in primary and secondary education by 2005, and in all levels of education no later than 2015. At primary school level the Gender Parity Index (GPI) has remained consistently close to one from 1999 to 2006. This suggests that more boys than girls are enrolled at this level of the education system.

At secondary school level, the picture is reversed. More girls than boys are enrolled at this level. Throughout the years from 1999 to 2006, the GPI is skewed in favour of girls. At the tertiary level, gender distribution in respect of enrolment is also skewed in favour of female students. The GPI has remained consistently greater from 2001 to 2006, reaching a peak of 1.7 in 2005.

The GPI for illiteracy in the 15 to 24 year old age group has been less than 1 throughout the period 2002 to 2006. This implies that in the 15 to 24 year old population, more females than males have not attended an education institution.

When it comes to the participation of women and empowerment, progress is also noted. About a third of Members of Parliament are women; SA also prides itself with having a Cabinet with 43% of its members being women; five of the nine provinces are led by women Premiers. At local government level, 40% of Councillors are women. Three of the country’s six metros are led by women Mayors. Currently, SA’s Parliament is ranked 10th out of 130 Parliaments in the world in terms of women's advancement in governance.

Goal 4

The focus of goal four is the reduction by two thirds, between 1990 and 2015, of the under-five mortality rate. SA’s MDGs Report of 2005 reflected overall immunisation coverage of 78% based on 2002 estimates. Routine data subsequently indicated that the national immunisation coverage had increased to 83% as at the end of 2006. In October 2006, SA was declared as being Polio-free by the Africa Regional Certification Commission which is a subcommittee of the Global Certification Commission. Preliminary figures from the 2003 SADHS suggest that infant and under-five mortality rates have remained relatively constant since the 1998 estimates, decreasing by 0.5% and 0.3% respectively. Whilst this is still some distance away from the target of 20/1000 live births by 2015, it clearly shows that the movement is in the right direction.

Goal 5

Target six of the MDGs is the reduction by three-quarters, between 1990 and 2015, of the maternal mortality rate. As reflected in the SA MDGs Country Report for 2005, the 1998 SADHS survey found that the maternal mortality ratio (MMR) was 150/100 000. In 2002, Stats SA, the official statistics collecting agency, reviewed all registered deaths and estimated MMR to be at 124/100 000. This figure suggested that the country was on track towards decreasing MMR over time.

Assistance at delivery by a skilled health professional is one of the key indicators for improving maternal health. As reflected in Figure 2 below, the SADHS 1998 and 2003 also showed a major increase in the percentage of women who were attended to by skilled health professionals during labour, especially by a nurse or midwife. Assistance at delivery by a nurse, midwife or a doctor increased from 84.4% in 1998 to 92.0% in 2003.

Goal 6

Goal six has two targets namely, having halted by 2015 and begin to reverse the spread of HIV and AIDS; and halving halted by 2015, and begin to reverse the incidence of malaria and other major diseases.

The 2006 antenatal survey results show a statistically significant decrease in the national prevalence rates of HIV amongst pregnant women who use public health facilities between 2005 and 2006. It is for the first time after several years of relative stability, that the survey results show evidence of a decline in HIV prevalence. HIV prevalence in the age group less than 20 years old, decreased from 15.9% in 2005 to 13.7% in 2006. This implies a reduction in new infections (incidence) in the population. In addition, HIV prevalence in women in the 20 to 24 year age group also declined from 30.6% in 2005 to 28.0 in 2006. However, HIV prevalence in the older age groups (30-34 years; 35-39 years; 40+) remained at levels similar to 2005, and in some instances reflected some increases, although these were not statistically significant.

In order to strengthen its efforts to combat HIV and AIDS, SA produced a Comprehensive Plan for HIV and AIDS, as well as the intersectoral Strategic Plan for HIV and AIDS for 2007 to 2011, which builds on the gains of the Strategic Plan for 2000 to 2005. The Strategic Plan serves as a framework for the country’s response to the challenge of HIV and AIDS. At present, 90% of public health facilities provide VCT and PMTCT. Furthermore, by April 2007, a cumulative total of 282 200 patients had been put on antiretroviral treatment, in 316 sites of the Comprehensive Programme for HIV and AIDS Management, Care and Treatment (CCMT) across the nine Provinces. Additional sites are found in correctional services facilities as well as in the private for profit and not for profit health sectors.

The management and control of malaria is one of the key areas of success of the public health sector in SA. The number of malaria cases declined over a five year period, from 51 444 cases in 1999 to 12 098 cases in 2006. The malaria case fatality rate fluctuated during this period, from a peak of 0.8 in 1999, to a lowest level of 0.4 in 2001, and to 0.7 at the end of 2006.

Goal 7

Goal seven has, as its targets, (i) the integration of the principles of sustainable development into country policies and programmes, and reverse the loss of environmental resources; (ii) halve, by 2015, the proportion of people without sustainable access to safe drinking water; and (iii) by 2020, to have achieved a significant improvement in the lives of at least 100 million slum dwellers.

Since 1994, environmental issues have moved into the socio-political arena. They bring together human rights, access to natural resources, social justice, equity and sustainability. In the last twelve years, government has focused on prioritising people’s needs while safeguarding the country’s natural assets. The range of legislative, policy and institutional developments that have occurred over this period have brought about a new environmental management approach, based on recognition of the contribution that the country’s biological resources in relation to food security, science, the economy, cultural integrity and well-being make.

To date, government has made good progress in eradicating backlogs and providing adequate housing. Over three million subsidies have been approved, benefiting over 10 million poor people. Cumulatively, government has spent R40 billion on housing development since the inception of the housing programme. This has contributed to the construction of houses and the preparation of sites totalling 2,4 million.

Major progress has been made with regards to provision of basic water and sanitation services as access to basic services increased from 59% of the population in 1994 to 94% of the population in Mach 2007.

Goal 8

Goal eight encompasses targets 12 to 18 which deal with various issues such as the developing of further open, rule-based, predictable, nondiscriminatory trading and financial system; addressing special needs of the least developed countries; addressing the special needs of landlocked countries and small island developing States; addressing debt problems; developing and implementing strategies for decent and productive work for youth; accessing affordable essential drugs; and making available the benefits of new technologies, especially information and communications.

South Africa actively supports a number of advocacy and awareness-raising efforts aimed at promoting the achievement of the MDGs by developing countries, with particular emphasis on the continent of Africa. In the latter regard, SA has played a leading role in championing the New Partnership for Africa’s Development (NEPAD), which is Africa’s primary socio-economic development programme through which most of the MDGs are addressed. In addition, SA is committed to the promotion and strengthening of South-South co-operation and plays a critical role in various global structures for the purposes of promoting equitable global development.

SA has also been at the forefront of international efforts to promote much-needed reform of the international financial architecture. The International Monetary Fund (IMF) and the World Bank have placed an increasing emphasis on the importance of democratic governance and participatory development (the involvement of all stakeholders in the development process), if developing countries want to meet the MDGs.

South Africa actively seeks to deepen and extend the economic linkages among African countries, within the context of ongoing efforts to shape the international development agenda. Regional integration remains a key policy focus area. This includes SA's participation in the SADC and the Southern African Customs Union (SACU).

South Africa has maintained a high profile in international calls for debt relief for developing countries, most notably those on the continent of Africa. South African President Mbeki and other leaders have played a meaningful role in engaging the G-8 leaders on the issue of debt, making specific proposals in respect of increased aid to Africa in this regard. Equally, SA has actively participated in the work of the Commission for Africa, established by former UK Prime Minister Tony Blair, which calls on wealthier nations to double aid to poor African countries to $50 billion by 2015, reduce agricultural subsidies, and cancel the debt owed by impoverished countries.

In this regard, the South African Government has tirelessly engaged the international community and policy makers, researchers and representatives of civil society in Africa to assess the role of the international community in the development of the continent.

With regard to youth and the labour market, this report indicates that young people entering the labour market are struggling to find employment. They form a relatively large proportion of the unemployed, overall, but particularly young economically active women.

Over the last few years, SA has made concerted efforts to ensure access to safe and affordable drugs, dispensed by appropriately trained personnel.

To date the medicine pricing regulations have produced an estimated reduction in excess of 20% at the factory gate level. Medical scheme expenditure has declined from R11 billion (2001) to R8.5 billion (2006/07) despite increased medicine utilisation over the period.

The public health sector has also strengthened its collaboration with the traditional health sector.

The report also reflects a sharp increase in the number of telephone subscribers from 44.4% in 2002 to 70.2% in 2006. The mobile telephone networks have grown their subscribers at a faster rate as compared to the fixed line networks.

In conclusion, as the report shows, SA is well set to accomplish the MDGs in time. This is largely attributed to the hard work by government & all social partners aimed at improving the material conditions of all South Africans.

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