Department of Social Development nodal baseline survey: O R Tambo results

1. Department of Social Development nodal baseline survey: O R Tambo 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 O R Tambo data: national report and results are 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 O R Tambo-specific findings • O R Tambo 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. OR Tambo scorecard Compared with other nodes, O R Tambo does not fare well. It has red warning lights flashing in the areas of poverty and development awareness, and the global composite index is also flashing warning signs. This should be a priority node within the ISRDP.

7. Poverty index The poverty deficit index is based on 10 indicators (see table below), given equal weighting. OR Tambo has the 4th highest level of poverty in the ISRDP.

8. Poverty deficit Priority areas include above average incidence of no RDP-level water, no regular income, informal dwellings, etc. The positives - below average incidence of illiteracy & over-crowding

9. Poverty analysis • Poverty is one of the key challenges facing O R Tambo, which has the 4th worst poverty levels among the 14 ISRDP nodes. • Challenges range across the following: • 95% of O R Tambo respondents had no refuse removal • 94% had no RDP-level sanitation provision • 92% had no RDP-level water provision • The rate of unemployment was 84% (the ISRDP average was 78%) • 66% were living in informal dwellings • 55% of households were female-headed (the ISRDP average was 53%) • Illiteracy was at 28%, but better than the ISRDP average of 38%

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. • O R Tambo has the 4th best score on the social capital index. That said, over half (55%) of respondents belonged to no CSO, although church membership was high at 91%.

11. Social capital deficit Incidence of anomie and mistrust were higher in O R Tambo than the ISRDP average.Other items (in green) were better than the ISRDP average.

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. • O R Tambo has the 2nd worst level of development awareness among the ISRDP nodes. This is a negative finding, particularly given the high levels of social capital in the node.

13. Development deficit Respondents were less aware than the ISRDP average of development activities across the board, including whether government or CSOs were involved.

14. Service delivery deficit OR Tambo ranks ninth (from best to worst) on service delivery out of the 14 ISRDP nodes

15. Service Delivery – Weaknesses Weaknessesinclude most aspects of basic service delivery, e.g. respondents were 43% more likely in this node to rate the quality of water as poor than the ISRDP average, 30% more likely to rate quality of refuse removal as poor, and so on

16. Service Delivery – Strengths Strengths: Include some aspects of basic service delivery (e.g. respondents are 29% less likely to rate quality of transport as poor than ISRDP average) and aspects of DSD service delivery (e.g. respondents are 15% less likely to report that they did not have access to a pension point than the ISRDP average)

17. Service Delivery: Main Features • Other important services provided by DSD such as Children Homes, Rehabilitation Centres and Drop-In Centres worryingly received almost 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 greater penetration of DSD services as well as grants in the node even though the node is doing better than the ISRDP average

18. Health Deficit OR Tambo is rated the seventh best of the 14 ISRDP nodes in respect to health measures

19. Health Deficit Priority Areas: Respondents are 24% more likely to report that their poor health limits their social activities than the ISRDP average, and 5% more likely to report that poor health prevents them from working than the ISRDP average

20. Health • HIV and AIDS was reported as the major health problem in OR Tambo by 42% of respondents (higher than the average of 30% across all nodes) • Alcohol Abuse was also reported as a major health problem in OR Tambo by 22% of respondents, lower than the average of 28% across all nodes), as was TB (18% of respondents mentioned this vs. an ISRDP average of 16%) • 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, perceived to be slightly better than the IRDP average, nevertheless • 41% of respondents reported distance to health facility as being a problem • 38% 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 focusses on the issues of HIV and AIDS, alcohol abuse and TB • Poverty and the health challenges of HIV and AIDS TB and, alcohol abuse cannot be separated and whatever intervention is decided upon should be in the form of an integrated response to the challenges facing OR Tambo residents

21. Proportion who agree that both parties in a relationship should share decision - making Read as: Many in the node do not support the view that most decisions in the household require joint decision-making by both partners

22. Proportion supporting statements about female contraception Read as: Node is still deeply conservative as myths about contraception are widely held

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 much higher in this node than the ISRDP average and points to a high proportion of very negative attitudes about Gender Based Violence in the node. Encouraging 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 positive attitudes have been absorbed by all within the node

24. Attitudes towards abortion Read as: More than half the respondents (58%) do not support abortion in any situation in this node, much higher than the ISRDP average (42%)

25. Sexual Reproductive Health & GBV • Findings point to the need for nuanced campaigns around contraception and their very close link with conflicting attitudes towards women in OR Tambo • Disturbing to note the the very negative attitudes towards Gender Based Violence and abortions, not to mention the widespread belief in certain 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 • Limited support for joint decision-making by both partners on matters of importance has been taken further as many actually endorse physically abusing their female partner. This is a very worrying finding. • 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 relatively high and secrecy is relatively low (albeit higher than ISRDP average), suggesting stigmatization is gradually dropping in face of unavoidability of the epidemic

27. HIV & AIDS: Proportion who accept the following statements Read as: Good awareness of how HIV is transmitted, although gaps in respondents’ knowledge can be observed (e.g. Mosquitoes)

28. HIV and AIDS • Evidence suggests that previous campaigns (and the high incidence of the pandemic in the node) have led to a high awareness of impact of HIV and AIDS. • Very encouraging to see how many in the node have correct knowledge about the transmission of the disease, 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 awareness of AIDS sufferers in their communities few respondents can actively assist • Less than 5% in the node reported on providing support to orphans or providing Home Based Care • Despite high incidence of HIV across OR Tambo, 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, in particular to providing targeted support to increase the numbers of households providing HBC and/or supporting orphans

29. Conclusions • OR Tambo has a poor Global Development Rating • Key Priorities and Strengths:

30. Conclusions OR Tambo has a poor L Global Development Rating. Key challenges and strengths, emerging from the statistical analysis, appear below.