Department of Social Development nodal baseline survey: KwaMashu results

1. Department of Social Development nodal baseline survey: KwaMashu 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 KwaMashu 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 KwaMashu-specific findings • KwaMashu 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. KwaMashu scorecard A brief glance at the scorecard shows that KwaMashu is among the poorer urban nodes, with red warning lights flashing in the areas of social capital, development awareness and as the overall, composite score for the node. Poverty is not as acute as in other urban nodes, while service delivery and health are on average for the URP.

7. Poverty deficit The poverty deficit index is based on 10 indicators (see table below), given equal weighting. KwaMashu is the second least poor urban node.

8. Poverty deficit The two areas scoring above the URP average are illiteracy and over-crowding; on all other poverty indicators, in green, KwaMashu did better or as well as the URP average.

9. 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 in real trouble in KwaMashu, which has the worst score in this area, suggesting that building social capital must be a nodal priority.

10. Social capital deficit Priority areas - where the nodal average was higher than the URP average - include mistrust (14% higher than the average), lack of faith in politics, low CSO membership, high alienation and so on.

11. 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. • KwaMashu has the worst level of development awareness, reflecting its poor social capital score.

12. Development deficit Awareness is lower than the URP average across board - the only less gloomy scores relate to whether civil society or government is providing development services. But across all types of development activity, awareness in KwaMashu was lower than the URP average.

13. Service delivery deficit KwaMashu ranks 6th worst out of the 8 URP nodes on service delivery

14. Service delivery – weaknesses Weaknesses, i.e. where doing worse than URP average, include issues such as respondents are 42% more likely to rate the quality of access to health services as poor than the URP average, and 32% more likely than the URP average to report the quality of/ access to education as poor, and so on.

15. 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 60% less likely to rate the quality of/ access to the electricity supply poor than the URP average, and 44% less likely than the URP average to report that that quality of transport is poor and so on.

16. 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.

17. Mdantsane is ranked as the 6th best of the 8 URP nodes in respect to health measures Health Deficit

18. Health deficit Priority areas: Respondents in this node are 51% more likely to report that poor health limits their social activities than the URP average, 49% more likely than the URP average to state that poor health prevented them from working, and 36% more likely to say that they had difficulty accessing health care when compared with the URP average.

19. Health • HIV and AIDS was seen to be the major health problem in the node (37% mentioned this, lower than the URP average of 42%), • Drug and Alcohol Abuse were also perceived as major health problems in KwaMashu • Drug abuse received mention by a third of all respondents (33%, more than double the URP average of 14%) • Alcohol abuse was mentioned by two out of ten respondents (20%, vs. URP average of 24%) • 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 erceived to be worse than the IRDP average, in particular • 19% of respondents reported distance to health facility as being a problem • 45% 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, alcohol and drug abuse 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 noted in this node cannot be separated and whatever intervention is decided upon should be in the form of an integrated response to the challenges facing KwaMashu residents

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

21. Proportion supporting statements about female contraception Read as: Node is relatively progressive on some issues as these myths about contraception are not as widely held as the URP average, but on other items it is very conservative when compared to the URP average.

22. 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 much higher in this node than the URP average and points to a high proportion of negative 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

23. Attitudes towards abortion Read as: Abortion is NOT supported by nearly half the respondents (48%), higher than the average (42%)

24. 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 • 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 • There are those in the node who support the idea that decisions in the household require joint decision-making by both partners, but there are many who do not support joint decision-making. Moreover, many of these respondents 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.

25. HIV & AIDS: Awareness levels Read as: Prevalence rates are high and secrecy is more than double the URP average, suggesting stigmatization has yet to drop in the face of the epidemic.

26. HIV & AIDS: Proportion who accept the following statements Read as: Very high awareness of how HIV is transmitted

27. 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. • Worrying that so many in the node would want to keep their status secret if they were infected. • Further research is urgently needed on this issue in the node in order to inform a nuanced campaign that takes the fears and concerns of the local communities into account. • 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 all the items. • 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 • 9% are providing Home Based Care (HBC) • 5% 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.

28. Conclusions • KwaMashu has a below average L Global Development Rating. Key challenges and existing strengths, emerging from the statistical analysis, are below.