Department of Social Development nodal baseline survey: Khayelitsha results

1. Department of Social Development nodal baseline survey: Khayelitsha 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 Khayelitsha 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 Khayelitsha-specific findings • Khayelitsha 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

6. Khayelitsha scorecard A brief glance at the scorecard shows that Khayelitsha is a place of contrasts - scoring positively (above the URP average) on development awareness; below average on poverty; and on average for social capital, service delivery, health and overall.

7. Poverty deficit The poverty deficit index is based on 10 indicators (see table below), given equal weighting. Khayelitsha is the poorest urban node in this respect.

8. Poverty deficit Most items score negatively (higher than the URP average) including no RDP water (312% above the average), shack dwelling, lack of electricity, and so on. The only positive was slightly better than average incidence of regular income.

9. Poverty analysis • In comparison with other URP nodes, Khayelitsha is the poorest - though poverty is still not at the levels seen in many ISRDP nodes. Among the key poverty-related challenges facing Khayelitsha include: • The rate of unemployment was 67% (above the URP average of 63% but below the ISRDP average of 78%) • 51% of households were female-headed • 51% of respondents lived in shacks • 30% had no RDP-level water • 23% had no RDP-level sanitation • 15% were functionally illiterate

10. Social capital deficit • 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. • By comparison with other URP nodes, social capital is relatively low in Khayelitsha, which rates in the middle of the 8 URP nodes. Building partnerships may be a challenge in this node, though no less important.

11. Social capital deficit Alienation and mistrust are above the URP average in Khayelitsha The node scored below average - a positive result - in some areas including the community solving its own problems, CSO membership, faith in politics, and so on.

12. Development deficit • 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. • Khayelitsha had the best level of development awareness in the URP.

13. Development deficit Respondents from Khayelitsha were more aware than the URP average of virtually all types of development, as well as who was providing it - govt. or civil society. Road-building was the only exception.

14. Service delivery deficit Khayelitsha ranks 4th out of the 8 URP nodes on service delivery

15. Service delivery – weaknesses Weaknesses, i.e. where doing worse than URP average, include respondents are 99% more likely to rate the quality of/ access to the electricity supply as poor than the URP average, and 62% more likely than the URP average to report that access to/ quality of the water supply as poor, and so on.

16. Service delivery – strengths Strengths: Respondents are less likely to complain about a range of different services delivered in this node when compared with the URP average. For instance, respondents in this node are 53% less likely to rate the quality of/ access to safety and security as poor than the URP average and 45% less likely than the URP average to report that that water they receive is not clean and so on.

17. Service Delivery: Main Features • 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. Khayelitsha is ranked as the 4th best of the 8 URP nodes in respect to health measures Health deficit

19. Health deficit Priority areas: Respondents in this node are 4% more likely to report difficulty accessing health care compared with the URP average, and 2% more likely to report that poor health limited their social activities than the URP average

20. Health • HIV and AIDS was seen to be the major health problem in the node (39% mentioned this, lower than the URP average of 42%), • Alcohol Abuse and TB werealso perceived to be a major health problem in Khayelitsha, • TB was mentioned by 22% of respondents, slightly lower than the URP average of 23% • Alcohol abuse was mentioned by 21% of respondents, lower than the average of 24% across all URP nodes • Drug abuse also received mentioned, albeit by far fewer respondents (10%, lower than the URP average of 14%) • 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 health services was perceived to be worse than the IRDP average, in particular • 18% of respondents reported distance to health facility as being a problem • 28% of respondents 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 focuses on the issues of HIV and AIDS, the other identified diseases and improving access to health facilities • A sectoral or targeted approach is need to focus on these health challenges in this node • Poverty and the health challenges cannot be separated and whatever intervention is decided upon should be in the form of an integrated response to the challenges facing Khayelitsha residents

21. Proportion who agree that both parties in a relationship should share decision - making Read as: Vast majority in the node support the view that most decisions in the household require joint decision-making by both partners, higher than the URP average

22. Proportion supporting statements about female contraception Read as: Node is relatively progressive as all myths about contraception are not as widely held as the URP average in all but one instance.

23. Proportion who agreed that a man is justified in hitting or beating his partner in the following situations Read as: Support for violence against women in all situations is far lower in this node than the URP average and points to a high proportion of positive 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 Read as: Abortion is NOT supported by four out of ten respondents (43%), slightly higher than the average (42%)

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 the node • Encouraging to note the positive attitudes towards Gender Based Violence. Moreover, the node is relatively progressive when compared to other nodes with regards to most myths about contraception. However, the node is below average in terms of qualified support for abortions. 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 • Whilst many in the node support the idea that decisions in the household require joint decision-making by both partners, those who do not support joint decision-making have taken it further and endorsed 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 non-governmental agencies - integration and co-ordination remain the core challenges in the ISRDP and URP nodes.

26. HIV & AIDS: Awareness levels Read as: Prevalence rates are high and secrecy is relatively low, suggesting stigmatization may be dropping in face of unavoidability of the epidemic

27. HIV & AIDS: Proportion who accept the following statements Read as: Very high awareness of how HIV is transmitted, except in the case of mosquitoes

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 (the node compares favourably with the URP average on most of the items except in the case of Mosquitoes). • This is however, not a surprising response in an area which is NOT affected by mosquito-borne diseases such as Malaria • Despite high levels of poverty in this node, there is some evidence that respondents are trying to actively assist those community members who are infected and suffering • 5% are providing Home Based Care (HBC) • 3% providing direct support to orphans • These findings support the need for an urgent integrated intervention in the node that incorporates health, poverty, GBV, HIV and AIDS

29. Conclusions Khayelitsha has an average KGlobal Development Rating. Key challenges and existing strengths, emerging from the statistical analysis, are below.