Transcript DSAD nodal baseline results: Sekhukhune

1
Department of Social Development
nodal baseline survey:
Sekhukhune results
2
Objectives of overall project
• Conduct socio-economic and demographic baseline study and situational
analyses of DSD services across the 14 ISRDP and 8 URP Nodes
• Integrate existing provincial research activities in the 10 ISRDP nodes of
the UNFPA’s 2nd Country Programme
• Monitor and evaluate local projects, provide SLA support
• Identify and describe types of services being delivered (including Sexual
Reproductive Health Services)
• Establish the challenges encountered in terms of delivery & make
recommendations regarding service delivery gaps and ultimately overall
improvement in service delivery
• Provide an overall assessment of impact of these services
• Project began with baseline & situational analysis; then on-going nodal
support; and will end in 2008 with second qualitative evaluation and a
second survey, a measurement survey that looks for change over time.
3
Methodology for generating these results
• First-ever integrated nodal baseline survey in all nodes,
urban and rural
• All results presented here based on original, primary data
• Sample based on census 2001; stratified by municipality in
ISRDP and wards in URP; then probability proportional to
size (PPS) sampling used in both urban and rural,
randomness via selection of starting point and respondent;
external back-checks to ensure fieldwork quality
• 8387 interviews completed in 22 nodes
• Sample error margin: 1.1% - nodal error margin: 4.9%
• This presentation is only Sekhukhune data: national report
and results available from DSD.
4
How to read these findings
• Baseline survey on 5 major areas of DSD/government work:
– Poverty
– Development
– Social Capital
– Health Status
– Service Delivery
• Indices created to track strengths and challenges in each area;
and combined to create a global nodal index. Allows
comparison within and across node, overall and by sector.
• Using this index, high index score = bad news
• Nodes colour-coded on basis of ranking relative to other nodes
– Red:
Really bad compared to others
– Yellow: OK
– Green: Better than others
5
Findings
•
Detailed baseline report available
– Published November 2006
– Detailed findings across all nodes
– Statistical tables available for all nodes
– Background chapter of secondary data available for each node
– Qualitative situation analysis available per node
•
This presentation
– High level Sekhukhune-specific findings
– Sekhukhune scorecard on key indicators
– Identify key strengths/weakness for the node and target areas for
interventions
•
What next?
– 2008 will see qualitative evaluation and second quantitative survey to
measure change over time
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Sekhukhune Scorecard
Index
Rating
Poverty

Social Capital Deficit
J
Development Deficit

Service Delivery Deficit
L
Health Deficit
J
Global
J
Compared with other nodes, Sekhukhune has predominantly mid-range
(yellow) and positive (green) scores, suggesting that in comparison with other
ISRDP nodes, it is performing well - though with room to improve, and
warning red lights flashing where service delivery is concerned.
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Poverty index
Kgalagadi
Sekhukhune
Chris Hani
Ukhahlamba
Ugu
Zululand
58%
Umkhanyakude
Maruleng
57%
Umzinyathi
50%
56%
Alfred Nzo
46%
47%
41%
46%
50%
43%
55%
18%
Thabo
Mofutsanyane
10%
0%
36%
Central Karoo
50%
40%
30%
20%
52%
Bushbuckridge
70%
60%
O.R. Tambo
Poverty Index - ISRDP Nodes
The poverty deficit index is based on 10 indicators (see table below), given equal weighting.
Sekhukhune is towards the middle of the 14 nodes, as the 9th poorest node.
Female headed households
Overcrowding
Unemployment
No refuse removal
No income
No RDP standard water
Informal housing
No RDP standard sanitation
Functional illiteracy
No electricity for lighting
8
Poverty deficit
96%
75%
97%
77%
65%
38%
36%
20%
22%
No refuse
removal
No RDP
sanitation
ISRDP Avg
No RDP
water
Unemployed
2%
Illiterate
Female
headed hh
No income
2%
4%
3%
30%
12%
Sekhukune
Crowding
0%
No
electricity 4
lighting
20%
Informal
dwelling
40%
17%
60%
43%
51%
80%
53%
78%
100%
78%
120%
80%
Pov erty Measures: Sekhukhune v s. ISRDP Av g
Priority Areas
Difference v s ISRDP Av g
Difference v s ISRDP Av g
40%
20%
-40%
-39%
-80%
-67%
-61%
Note the positives where the node scores above the ISRDP average
No refuse
removal
No refuse
removal
No RDP
sanitation
No RDP
water
-60%
No RDP
sanitation
-14%
Unemployed
Illiterate
No income
Female
headed hh
Crowding
-19%
-1%
No RDP
water
-61%
Illiterate
-67%
-5%
Unemployed
-80%
-39%
-1%
-5%
-14%
-19%
No income
-60%
22%
20%
Female
headed hh
-20%
-40%
Informal
dwelling
0%
No
electricity 4
Crowding
lighting
-20%
Informal
dwelling
0%
20%
28%
No
electricity 4
lighting
40%
28%
For example, read
as: Sekhukhune
respondents 28%
more likely to have
no refuse removal;
22% more likely to
have no RDP
sanitation; and so on.
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Poverty analysis
• Relative to other nodes in the ISRDP, Sekhukhune has the 6th lowest
level of poverty as measured by this index.
• Key challenges in the node revolve around service delivery:
– 77% of Sekhukhune respondents did not have water to RDP
standards, 20% higher than the ISRDP average
– 97% did not have RDP sanitation, 22% higher than the average
– 96% did not have refuse removal, 28% higher than the average
• Unemployment is endemic to ISRDP nodes, and with a rate of
unemployment of 78%, Sekhukhune had the same as the average for
the ISRDP nodes as a while
• On the more positive side, Sekhukhune residents were 67% less likely
to be living in shacks (17% did so), illiteracy was lower than the
programme average, as was incidence of no regular income
• Female-headed households were also less common than the average:
43% of Sekhukhune households were headed by women, compared
with a programme average of 53%
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Social capital deficit
Social Capital Deficit Index - ISRDP Nodes
60%
45%
45%
Ugu
Ukhahlamba
Thabo
Mofutsanyane
49%
Maruleng
44%
48%
Umkhanyakude
43%
Zululand
41%
Central Karoo
27%
39%
41%
Chris Hani
30%
38%
O.R. Tambo
40%
Sekhukhune
50%
Umzinyathi
52%
47%
29%
20%
•
•
Kgalagadi
•
•
Alfred Nzo
0%
Bushbuckridge
10%
This graph measures the social capital deficit - so high scores are bad news.
Social capital includes networks of reciprocation, trust, alienation and anomie,
membership of civil society organisations, and so on.
Sekhukhune has the 3rd best score on the social capital index, suggesting there
is a strong foundation on which to build partnerships and livelihoods.
Just 4 in 10 respondents do not belong to a CSO, suggesting that outreach and
partnerships should be a key area of focus by building on an existing strength.
0%
-50%
-100%
-58%
-34%
-16%
People in
c'ty only
care 4
selves
-5%
Politics is
waste of
time
-2%
150%
No
Religion
50%
Alienation
Anomie
No
Reli gi on
Ali enation
Anomie
Poli tics is
waste of
ti me
Peopl e i n
c'ty onl y
care 4
selves
Must be
careful of
people
100%
30%
2%
9%
22%
70%
59%
58%
50%
49%
50%
56%
55%
38%
20%
19%
38%
80%
Must be
careful of
people
Sekhukune
No CSO
mmbrshi p
31%
60%
No CSO
mmbrship
0%
13%
20%
C'ty can't
solve own
probl ems
40%
C'ty can't
solve own
problems
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Social capital deficit
Social Capital Measures: Sekhukhune vs. ISRDP Avg
ISRDP Av g
Difference vs ISRDP Avg
133%
Priority Areas
For example, read as:
Sekhukhune
respondents were more
likely than ISRDP
average to show
incidence of anomie
and alienation, and
not to have a religion.
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Development deficit
Development Deficit Index - ISRDP Nodes
57%
60%
34%
34%
35%
36%
Sekhukhune
Thabo
Mofutsanyane
Central Karoo
27%
31%
Bushbuckridge
30%
30%
Chris Hani
40%
Umzinyathi
50%
38%
40%
44%
46%
49%
23%
20%
•
Maruleng
O.R. Tambo
Ugu
Alfred Nzo
Zululand
Umkhanyakude
•
Ukhahlamba
0%
Kgalagadi
10%
This index measures respondents’ awareness of development projects, of all
types, carried out by government and/or CSOs. It is a perception measure not an objective indication of what is actually happening on the ground.
Sekhukhune rates 6th of the 14 ISRDP nodes, suggesting that development
activities are happening on the ground and that people are aware of them.
This is presumably enhanced by the high levels of social capital seen earlier.
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Development deficit
80%
29%
31%
31%
33%
No
Farming
29%
32%
No
Gardens
No Food
31%
34%
No
HIV/Aids
32%
34%
32%
36%
No Sport
No Com
Halls
30%
34%
No
Creches
24%
26%
30%
35%
26%
31%
No Water
No Health
Facilities
28%
35%
24%
31%
No
Schools
No Other
Dev
24%
32%
40%
No
Houses
60%
65%
54%
75%
67%
Development Measures: Sekhukhune vs. ISRD Avg
Sekhukune
No DevtGovt
No DevtNPOs
0%
No Roads
20%
ISRDP Avg
Difference vs ISRD Avg
20%
-25%
-22%
No Devt-Govt
-5%
No Devt-NPOs
-6%
No Farming
-7%
No Food
-9%
No Com Halls
-9%
No Roads
No Sport
-11%
-11%
No Gardens
-13%
No HIV/Aids
-13%
No Creches
-15%
No Health Facilities
-18%
No Water
No Other Dev
No Schools
11%
No Houses
25%
20%
15%
10%
5%
0%
-5%
-10%
-15%
-20%
-25%
-30%
Two weakest areas are
lack of awareness of
who is providing government or CSOs rather than lack of
knowledge of types of
development activity.
Everything else is a
positive, scoring better
than the ISRDP
average.
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Service delivery deficit
51%
51%
53%
54%
Umkhanyakude
Kgalagadi
Ukhahlamba
Ugu
O.R. Tambo
57%
61%
61%
62%
Bushbuckridge
50%
57%
Sekhukhune
50%
Alfred Nzo
40%
48%
Umzinyathi
50%
47%
Zululand
60%
Chris Hani
70%
Maruleng
Service Delivery Deficit Index - ISRDP Nodes
Thabo
Mofutsanyane
Sekhukhune has the fourth worst rating
on service delivery amongst the 14 ISRDP
nodes, i.e. it was rated 7% worst in terms
of service delivery.
39%
30%
20%
10%
Central Karoo
0%
Service Delivery Index
• Average proportion receiving DSD Grants
• Average proportion making use of DSD Services
• Average proportion rating government services
as poor quality
• Proportion who rarely have clean water
• Proportion with no/limited phone access
• Proportion who believe there is no coordination
in government
• Proportion who believe local council has
performed badly/terribly
• Proportion who have not heard of IDPs
15
Service delivery – weaknesses
40%
63%
34%
60%
42%
67%
47%
No Pension
point
Qualitywater poor
55%
44%
DSD
Cleanliness
Poor
55%
57%
46%
DSD Staff
knowledge
poor
Quality-roads
poor
59%
48%
DSD Staff
unhelpfull
57%
47%
60%
59%
48%
80%
59%
49%
100%
79%
Service Delivery Measures: Sekhukhune vs. ISRDP Avg
Sekhukune
Govt Dept
Co-ordination
poor
Poor DSD
Services
DSD Staff no
comparssion
0%
No DSD
office
20%
ISRDP Avg
Weaknesses
Difference vs ISRDP Avg
100%
85%
Access to DSD offices was
also perceived to be poor,
20% worse than the ISRDP
average.
80%
60%
40%
42%
20%
21%
22%
23%
25%
42%
44%
26%
Govt Dept
Co-ordination
poor
Qualitywater poor
Quality-roads
poor
No Pension
point
DSD
Cleanliness
Poor
DSD Staff
knowledge
poor
DSD Staff
unhelpfull
Poor DSD
Services
DSD Staff no
comparssion
No DSD
office
20%
0%
Read as: Quality of DSD
service delivery is worse in
Sekhukhune than the average
for all ISRDP nodes, e.g. staff
compassion is perceived to
be a fifth (21%) worse than
across all ISRDP nodes.
Basic service delivery was
rated as inadequate, e.g.
quality of roads were seen to
be 42% worse than the
average for ISRDP nodes
16
Service delivery – strengths
80%
58%
67%
69%
Service Delivery Measures: Sekhukhune vs. ISRDP Avg
11%
4%
4%
3%
20%
15%
40%
24%
34%
60%
Sekhukune
Qualitysecurity
poor
Qualityelectricity
poor
Qualityeducation
poor
Qualitysewerage
poor
Qualityrefuse
poor
0%
Strengths
ISRDP Avg
-60%
-58%
-67%
-80%
-100%
-120%
-76%
-95%
-95%
-36%
Qualityhealth poor
Qualitysecurity
poor
Qualityelectricity
poor
Qualityeducation
poor
-43%
Poor Quality
of Services
-40%
Qualitysewerage
poor
-20%
Qualityrefuse poor
0%
No
Participation
in IDPs
Difference vs ISRDP Avg
-33%
Read as: Nevertheless,
strengths with service
delivery in Sekhukhune can
be found, e.g. households in
the node are a third (33%)
less likely to rate the quality
of health delivery as poor
compared with the ISRDP
average
17
Service delivery: main features
Sekhukhune
ISRDP
• Of the households receiving grants six out of ten (63%)
are receiving Child Support Grants
• ISRDP average for households receiving Child Support
Grants is half (50%)
• Three out of ten (34%) households receiving grants are
receiving Pensions
• ISRDP average for households receiving pensions is a
third (31%)
• Four of ten of the Households (41%) encounter DSD
services at a DSD office
• Half of households across all nodes (50%) experience
DSD services at a DSD office
• A third of households (33.4%) interact with the DSD at
a Pension Pay Out point
• A further third of households (31%) across all nodes
will receive DSD services at a Pension Pay Out point
•
•
Other important services provided by DSD such as Children Homes,
Rehabilitation Centres and Drop-In Centres worryingly received no mention by
respondents and signals very low awareness of these critical services.
Urgent thought should be given as to how best to raise awareness across the
node with respect to these under utilised services - and how to increase
penetration of DSD services as well as grants in the node.
18
Health deficit
Sekhukhune is rated the
second best ISRDP node
with respect to health
measures, with less than
half of all households (46%)
perceiving their health
status as poor.
Health Deficit Index - ISRDP Nodes
70%
58%
Bushbuckridge
Chris Hani
Zululand
Kgalagadi
58%
Thabo
Mofutsanyane
Alfred Nzo
56%
58%
Umzinyathi
47%
55%
57%
Ukhahlamba
46%
54%
O.R. Tambo
46%
53%
Maruleng
45%
Sekhukhune
50%
Central Karoo
60%
Ugu
63%
56%
40%
30%
20%
10%
Health Index
Umkhanyakude
0%
• Proportion of household infected by malaria
• Proportion who had difficulty in doing daily
past 12 months
• Proportion who experience difficulty
accessing health care
• Proportion who rated their health
poor/terrible during past 4 weeks
work
• Proportion whose usual social activities were
limited by physical/emotional problems
19
Health deficit
Sekhukune
64%
33%
Difficulty
accessing
health
care
Ltd Social
Activities
Poor
Health
Cannot
work
Malaria
incidence
0%
3%
20%
0%
40%
21%
27%
60%
39%
54%
80%
61%
100%
77%
Health Measures: Sekhukhune vs. ISRDP Avg
ISRDP Avg
Priority Areas
Difference vs ISRDP Avg
40%
21%
-60%
-80%
-100%
-100%
-120%
-49%
-48%
-47%
Difficulty
accessing
health
care
Ltd Social
Activities
-40%
Poor
Health
-20%
Malaria
incidence
0%
Cannot
work
20%
Despite high health status
rating in this node,
households reported that
they were 21% more likely to
have difficulty accessing
health care than the ISRDP
average.
20
Health
•
•
•
•
•
•
•
•
TB was seen as the major health problem in Sekhukhune by a third of respondents (33%) (the
average was 22% across all nodes).
HIV and AIDS was also reported to be a significant health problem in the node (28% reported
this, slightly lower than an average of 30% across all nodes)
Men were as likely as women to rate their health as poor
Youth were as likely as older adults to rate their health as poor
Access to services also impacts the health of those in the node, with respondents in the node
21% more likely than the ISRDP average to report access to health services as a problem, in
particular
– 62% of households reported distance to health facility as being a problem
– 60% of households reported paying for health services as being a problem
These findings highlight the key health issues facing those in the node and point to the need for
an integrated approach that focusses on the issues of HIV and AIDS, and TB and also takes
into account the challenges respondents face in accessing health care
Difficult to see how a sectoral or targetted approach would work to improve access to health,
rather it requires a provincial or even national intervention to remove this obstacle
Poverty and the dual health challenge of HIV and AIDS and access to health cannot be
separated and whatever intervention is decided upon should be in the form of an integrated
response to the challenges facing Maruleng residents
21
Proportion who agree that both parties in a relationship should share
decision - making
Ave rage
Se k huk hune
73
Agree w hether to use
family planning
65
Read as: Majority in
the node support the
view that most
decisions in the
household require
joint decision-making
by both partners
Agree on w hen to hav e
children
Agree on using income to
pay for health care or
medicines
84
78
77
68
84
Agree on w hether to take
a sick child to the clinic
0
57
10
20
30
40
50
60
70
80
90
22
Proportion supporting statements about female contraception
Ave rage
Se k huk hune
35
Agree that contraception
leads to promiscuity
30
Agree that w omen w ho
use contraception risks
being sterile
Agree that female
contraception is a
w omen's business and
nothing to do w ith men
57
Read as: Node is still
deeply conservative
as myths about
contraception are
widely held.
39
36
43
Agree that w omen get
pregnant so w omen m ust
w orry about
contraception
55
60
0
10
20
30
40
50
60
70
23
Proportion who agreed that a man is justified in hitting or
beating his partner in the following situations
Average
Sekhukhune
Is unfaithful
23
46
Does not look after the children
21
40
Goes out without telling him
16
16
Argues with him
15
22
Refuses to have sex with him
9
14
Burns the food
7
9
Read as: Support for violence against women in all situations is higher in this
node than the ISRDP average and points to catastrophic attitudes about
Gender Based Violence in the node.
Disturbing to note that the differences between males and females, and young
and old, in terms of attitudes towards Gender Based Violence are not large these negative attitudes have been absorbed by men and women, young and
old, and interventions are needed to break this cycle
24
Attitudes towards abortion
Agree that abortion should only be allowed if mother's life in danger
Agree that abortion is morally wrong and should never be allowed
Agree that abortion on request should be the right of every women
Sekhukhune
32
63
Total
Read as: Abortion is
NOT supported by two
out of three
respondents (63%) in
this node, far higher
than the ISRDP
average (42%)
49
0%
10%
20%
5
42
30%
40%
50%
60%
70%
9
80%
90%
100%
25
Sexual Reproductive Health & GBV
•
•
•
•
•
•
Findings point to the need for nuanced campaigns around contraception and
their very close link with inappropriate attitudes to women in Sekhukhune
Disturbing to note the high levels of support for Gender Based Violence, coupled
to very limited support for abortions and widespread belief in a range of
different myths about contraception. Hence the need for a campaign that is
based on a solid understanding of local attitudes towards both sexual
reproductive health and GBV as opposed to the interests of a national campaign
In theory, at least, majority support the idea that many decisions in the household
require joint decision-making by both partners
But many across the nodes not only do not support joint decision-making but go
further and endorse physically abusing women
Need to develop an integrated approach that takes poverty and the health
challenges facing nodal residents into account and also integrate critical aspects
of GBV and Sexual Reproductive Health
Challenge is to integrate Sexual Reproductive Health and GBV issues with other
related services being provided by a range of governmental and nongovernmental agencies - integration and co-ordination remain the core
challenges in the ISRDP and URP nodes.
26
HIV & AIDS: Awareness levels
Ave rage
If household m em ber
w as infected w ould w ant
to keep it secret?
Read as: Prevalence
rates are high and
secrecy is relatively low,
suggesting
stigmatization may be
dropping in face of
unavoidability of the
epidemic
Sek huk hune
14
18
Heard about those w ho
hav e died of AIDS in
community?
50
64
46
Heard about those in
community w ith AIDS?
63
0
10
20
30
40
% Yes
50
60
70
27
HIV & AIDS: Proportion who accept the following
statements
Ave rage
Se k huk hune
91
Condoms prev ent
transm ission of HIV
83
95
One can get AIDS from
sharing razors
85
Healthy looking person
can hav e AIDS
74
82
Infected mothers can
pass on v irus through
breastfeeding
92
80
36
Mosquitoes pass on HIV
33
0
10
20
30
40
50
60
% who agree
70
Read as: High
awareness of how HIV
is transmitted
80
90
100
28
HIV and AIDS
•
•
•
•
•
Evidence suggests that previous campaigns (and the high incidence of the
pandemic in the node) have led to high awareness of impact of HIV and
AIDS.
Encouraging to see how many in the node have correct knowledge about
the transmission of the disease (node better than average scores for ISRDP)
Despite high levels of awareness of AIDS sufferers in their communities few
respondents can actively assist
– Less than 1% of households in the node reported on providing support
to orphans or providing Home Based Care
Despite high incidence of HIV across Sekhukhune, levels of poverty are so
crippling few can do much to assist those who are infected and suffering
These findings support the need for an urgent integrated intervention in the
node that incorporates health, poverty, GBV, HIV and AIDS
29
Conclusions
Sekhukhune has a positive J Global Development Rating compared with other
ISRDP nodes. Key challenges and existing strengths as they emerged from
the statistical analysis are summarised below.
Challenges
Strengths
Poverty 
• Refuse removal, sanitation,
RDP water
• Low level of informal housing,
electricity for lighting
Development

• No awareness of who provides
• Houses, schools
Service
Delivery L
• DSD service delivery (access
and quality), water, roads
• (For those who get it), refuse
collection, sewerage, education
Social Capital
J
• Alienation
• Belief that own community can
solve problems, CSO membership
Health J
• Access to services; Gender
Based Violence and Sexual
Reproductive Health
• Positive perceptions of health