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Child survival warrants urgent attention
Kashifa Abrahams, Child Health Services Programme |
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Current prospects for child survival in South Africa are dismal: The South African Medical Research Council’s Burden of Disease Study estimated in the year 2000 that, every hour, 10 children under the age of five years die from a preventable cause.
The topic of child survival was put firmly on the public agenda by the Children’s Institute in the run-up to Child Protection Month in June by hosting a roundtable discussion on child survival. The two-day discussions were aimed at:
- generating a collective dialogue among experts to examine the current status of child survival in the country and what is currently being done to address the situation,
- identifying the knowledge gaps in relation to child survival, particularly data gaps due to the lack of a co-ordinated information system, and
- discussing what further measures could be introduced to enhance survival prospects for the nation’s children in a comprehensive and sustained manner.
The roundtable was attended by a mixture of academics, child health experts and practitioners and non-governmental and human rights organisations, and it generated a considerable amount of debate in the media.
A human rights issue
The survival status of the nation’s children (all persons under the age of 18 years) has been a key focus in work undertaken by the Children’s Institute and the roundtable was an initiative of the Child Survival Project of the Child Health Services Programme. The project’s direction, as is the case with all the work of the Children’s Institute, has been informed by a rights framework – in this case children’s right to survival and development.
Leading experts from a range of disciplines and sectors who attended the roundtable discussed the country’s regressive performance related to this crucial human right. They reviewed existing research findings and key interventions required to ensure that South Africa meets its commitments on the survival and development of every child.
Numerous preventable deaths
Although all children in South Africa have the right to survival and development, more than 100,000 children die annually according to the Medical Research Council’s Burden of Disease Study 2000. National estimates indicate that childhood deaths are likely to continue to rise as a consequence of HIV/AIDS; diseases of poverty, such as diarrhoeal disease and pneumonia; and trauma.
In addition, neonatal sepsis and pre-term birth are the causes of numerous deaths of very young babies, all of which could easily be prevented through antenatal care interventions delivered at public health facilities.
Data shows increasing child death rate
To reach Millennium Development Goal 4, South Africa must reduce its infant and child mortality rates by two-thirds by 2015. But child survival outcomes in the country have regressed – the infant mortality and under-five mortality rates have increased between 1990 and 2004, according to UNICEF and the World Health Organisation.
Delegates heard that South Africa was one of seven countries in Africa with increasing numbers of children under five years that have died during this period. Yet, according to the Child Survival Series published in The Lancet, 10 other countries in Africa, such as Uganda and Ethiopia, have made positive strides in this regard.
Need for integrated response
The key message that emerged from the meeting of experts was unanimous – child survival warrants urgent attention in South Africa. A vertical, one-track programme approach will not turn around the surge in child death rates. The call for a parliamentary inquiry into child survival was but one of many recommendations that were put forward by delegates, along with the need to develop an integrated plan with targeted interventions to decrease the large amounts of avoidable child deaths in South Africa, particularly in the current era of HIV/AIDS.
An integrated response of this nature would have to cut through all government departments that have an impact on child well-being, directly or indirectly, and would have to involve the expertise of civil society and the international community.
A commitment to develop an integrated plan to enhance child survival prospects in South Africa would reaffirm the State’s commitment to further child survival and development as stipulated in the:
- Constitution of South Africa Act 108 of 1996;
- South African National Programme of Action for Children;
- United Nations Convention on the Rights of the Child;
- African Charter on the Rights and Welfare of the Child;
- NEPAD agreement; and
- Millennium Development Declaration (Goal 4, Target 5).
Roundtable outcomes
Media advocacy was instrumental in raising the profile of child survival in the public arena during the week of the roundtable, and the event received extensive coverage from the print and electronic news media. During the following week, which was Child Protection Week, several Children’s Institute researchers contributed to a series of opinion-editorials on the various preventable causes of child deaths in South Africa, and which were published in a number of newspapers nationally. These articles, together with the coverage on the roundtable the previous week, created further exposure to the issue, with particularly requests for interviews received from radio news desks.
Generating this kind of public debate paid off, as soon after the roundtable discussion a delegation of the Child Survival Project was invited by the parliamentary Joint Monitoring Committee on the Improvement of Quality of Life and Status of Children, Youth and Disabled Persons to make a presentation on child survival. The presentation was well received by the committee members who welcomed the input while requesting more information to engage and follow up on issues raised.
The European Union’s Cultural Workshop Conference Initiative (CWCI) was a key funder of the roundtable discussion and the related communication products (see New CI publications for details).
For more information on this project, contact Kashifa Abrahams or on +27 21 685 7441 x 102.
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