1 Department of Social Development nodal baseline survey: Mdantsane 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 Mdantsane 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 Mdantsane-specific findings – Mdantsane 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 Mdantsane scorecard Index Rating Poverty K Social Capital Deficit J Development Deficit L Service Delivery Deficit K Health Deficit K Global K A brief glance at the scorecard shows that Mdantsane is a place of contrasts - scoring positively (above the URP average) on social capital; below average on development awareness; and within the URP average on all other items including the composite ‘global’ index. 7 Poverty deficit Poverty Index - URP Nodes 30% 26% 27% 25% 17% 17% Motherwell Alexandra 15% 16% Mdantsane 19% 20% 14% 11% 10% Khayelitsha Inanda Galeshewe KwaMashu 0% Mitchells Plain 5% The poverty deficit index is based on 10 indicators (see table below), given equal weighting. Mdantsane is the 3rd best performing node in this respect. 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 Poverty Measures: Mdantsane vs. URP Avg 80% 100% 48% 47% Mdantsane 6% 3% No income Functional illiteracy URPAvg Unemployed 4% 5% No electricity (lights) Informal dwelling 0% Female headed HH 2% 3% Overcrowding 11% 14% 4% 7% 3% 8% No refuse removal No water 4% 13% 3% 19% 40% No sanitation 60% 20% 63% 80% Difference vs URP Avg 150% 127% 100% 50% 28% No income The positives, in green, where Mdantsane scored lower -24% than the URP -26% (better) -42% -49% - 84% below the URP average - RDP average, include informal dwellings -62% -67% sanitation, and so on. -100% -84% -50% Unemployed Functional illiteracy No electricity (lights) Overcrowding No water No refuse removal No sanitation Informal dwelling Female headed HH 2% 0% Priority areas - where Mdantsane scored above the URP average - a negative result - include incidence of no regular income and the rate of unemployment. 9 Poverty analysis • In comparison with other URP nodes, poverty may seem to be less acute in Mdantsane. But the node faces key challenges in this regard: – The rate of unemployment was 80%, compared with a URP – – – – average of 63% 48% of households were female-headed At 11%, functional illiteracy was lower than the URP average (14%) 6% of respondents had no regular income But many other indicators were positive, with just 3% of shack dwellers, 4% without RDP sanitation, 4% without RDP water, and 3% without refuse removal 10 Social capital deficit Social Capital Deficit Index - URP Nodes 70% 59% 46% 48% 49% Alexandra Khayelitsha Mitchells Plain 44% 46% Motherwell 42% Mdantsane 50% Galeshewe 60% 52% 40% 30% 20% • • • KwaMashu 0% Inanda 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. By comparison with other URP nodes, Mdantsane scores well on social capital, with the 2nd highest level of social capital among the urban nodes. 11 Social capital deficit Mdantsane Be careful with people 42% C'ty can't solve problems 40% 57% 55% 51% Anomie Politics a waste of time Alienation 46% 48% 41% 30% C'ty mmbrs only care 4 themselves No Religion 0% No CSO mmbrship 11% 20% 6% 40% 24% 60% 50% 80% 58% 100% 84% 94% Social Capital Measures: Mdantsane vs. URP Avg URPAvg The only area scoring negatively was mistrust Difference vs URP Avg 20% 12% -18% -16% -6% -30% -40% -50% All other measures were positive: for example, Mdantsane respondents were 43% more-43% likely to have a religious affiliation, 19% less likely to agree people only care for themselves, and so on. Be careful with people No CSO mmbrship -18% -11% C'ty can't solve problems Politics a waste of time -19% Alienation -20% C'ty mmbrs only care 4 themselves -10% No Religion 0% Anomie 10% 12 Development deficit Development Deficit Index - URP Nodes 60% 56% 47% Mitchells Plain 38% 39% Motherwell 33% 38% Alexandra 31% Khayelitsha 40% Inanda 50% 43% 30% 20% • • KwaMashu Mdantsane 0% Galeshewe 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. Mdantsane had the 2nd best level of social capital but has the 2nd worst level of development awareness. 60% 50% 40% 30% 20% 10% 0% -10% -20% -16% No Houses No water No Schools No Health Facilities 19% No C'ty halls No HIV/AIDS project 18% 19% No Devt-Govt 14% 19% No Other Dev 12% 18% No Devt-NPOs 11% 18% No Sport 9% No Roads 3% No Farming Mdantsane No Creches 1% No Gardens 48% 40% No Sport 48% 40% 47% 39% 46% 36% 46% 30% No Schools No water No Houses 59% 50% 49% 41% No C'ty halls No Devt-Govt No Other Dev 81% 68% 48% 42% No Health Facilities No Devt-NPOs 42% 37% No HIV/AIDS project 31% 27% 46% 42% No Creches No Roads 42% 40% 36% 36% No Gardens No Farming 32% 38% No food project 100% 80% 60% 40% 20% 0% No food project 13 Development deficit Development Measures: Mdantsane vs. URP Avg URPAvg Difference vs URP Avg 50% 27% Mdantsane respondents had lower than average awareness of all types of development (and who was providing development) barring food-growing projects. 14 Service delivery deficit 45% 49% 50% Khayelitsha 50% 48% Motherwell 60% 52% 53% KwaMashu Service Delivery Deficit Index - URP Nodes Mdantsane Mdantsane ranks 5th out of the 8 URP nodes on service delivery 70% 56% 60% 40% 30% 20% 10% • 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 Mitchells Plain Service Delivery Index Alexandra Inanda Galeshewe 0% • 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 13% 24% 45% 49% Poor Quality of Services 122% Qualitytransport poor Qualityroads poor 72% Qualityeducation poor Qualityhealth poor 40% Qualitysecurity poor 31% Qualitytransport poor Qualityroads poor Qualityeducation poor Qualityhealth poor Poor Quality of Services Qualitysecurity poor Qualityrefuse poor Qualityelectricity poor 22% 52% 55% 30% 56% 13% 30% 25% 12% 21% 23% 39% 20% 68% 52% 36% 11% 16% 17% 20% Qualityrefuse poor Mdantsane No Access to DSD facility 40% Qualityelectricity poor 140% 120% 100% 80% 60% 40% 20% 0% 59% 60% No Access to DSD facility Poor DSD Services 80% Poor DSD Services 15 Service delivery – weaknesses Service Delivery Measures: Mdantsane vs. URP Avg 0% URPAvg Difference vs URP Avg 129% 82% Weaknesses, i.e. where doing worse than URP average, include respondents are 129% more likely to rate the quality of transport as poor than the URP average, and 122% more likely than the URP average to report the quality of roads as poor, and so on. 16 Service delivery – strengths Mdantsane 78% 66% No Old age pension Govt Dept Co-ordination poor Local Govt Performance poor Qualitywater poor No Phone 0% Strengths: Respondents 12% 7% 20% 5% 40% 10% 60% 44% 51% 80% 34% 100% 70% Service Delivery Measures: Mdantsane vs. URP Avg URPAvg -24% -30% -28% -40% -46% -50% -60% -56% -2% No Foster child grant -5% No DSD grant -16% No DSD office No Old age pension Govt Dept Co-ordination poor -20% Local Govt Performance poor -10% Qualitywater poor 0% No Phone Difference vs URP Avg -2% 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 56% less likely to rate the quality of/ access to water as poor than the URP average and 46% less likely than the URP average to report that that quality of/ access to phone communication was poor and so on. 17 Service Delivery: Main Features Mdantsane URP • Of the households receiving grants a third (36%) are receiving Child Support Grants • Average for households receiving Child Support Grants is a third (37%) • A third (35%) receiving grants are receiving Pensions • Average for households receiving pensions is two out of ten (22%) •Nearly half (47%) encounter DSD services at a DSD office • Four out of ten (44%) experience DSD services at a DSD office • A third (35%) of the respondents interact with the DSD at a Pension Pay Out point • A third (35%) 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 Mdantsane is ranked as the 5th best of the 8 URP nodes in respect to health measures Health Deficit Index - URP Nodes 40% 30% 34% 54% Inanda 42% 53% Motherwell 50% 53% KwaMashu 60% 45% 37% 29% 20% 10% Mdantsane Khayelitsha Galeshewe Alexandra Mitchells Plain 0% Health Index • 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 39% 42% 41% 42% 33% 40% 29% 60% 44% 56% Health Measures: Mdantsane vs. URP Avg 1% 1% 20% Mdantsane Difficulty accessing health care Malaria incidence Cannot work Ltd Social Activities Poor Health 0% URPAvg Difference vs URP Avg 50% 42% 40% 30% 20% 10% -1% Difficulty accessing health care Cannot work -12% -5% Malaria incidence -20% Ltd Social Activities -10% Poor Health 0% 0% Priority areas: Respondents in this node are 42% more likely to report difficulty accessing health care compared with the URP average. 20 Health • • • • • • Alcohol Abuse is perceived to the major health problem in Mdantsane, with three out of ten respondents (30%) reporting this, higher than the average of 24% across all URP nodes HIV and AIDS was also seen to be a major health problem in the node (28% mentioned this, lower than the URP average of 42%), as was TB (mentioned by 24% respondents, slightly higher than the URP average of 23%) 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 – – • • • 45% of respondents reported distance to health facility as being a problem 36% 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 alcohol and drug abuse, 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 identified 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 Mdantsane residents 21 Proportion who agree that both parties in a relationship should share decision - making URP Average Mdantsane 79 Ag ree whe ther to u se famil y pl anni ng 68 95 Ag ree o n when to have chil dren Read as: 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 Ag ree o n us ing income to p ay fo r hea lth care or m edicine s 84 84 77 75 Ag ree o n whether to ta ke a si ck child to the cli nic 67 0 10 20 30 40 50 60 70 80 90 10 0 22 Proportion supporting statements about female contraception URP Average Mdantsane 22 Agree that contraception leads to promiscuity Read as: Node is relatively progressive as all myths about contraception are not as widely held as the URP average - though still widely shared 30 Agree that women who use contraception risks being sterile 41 46 Agree that female contraception is a women's business and nothing to do with men 46 49 Agree that women get pregnant so women must worry about contraception 63 71 0 10 20 30 40 50 60 70 80 23 Proportion who agreed that a man is justified in hitting or beating his partner in the following situations URP Average Mdantsane Is unfaithful 16 14 Does not look after the children 12 9 Goes out without telling him 7 5 Argues with him 7 4 Refuses to have sex with him 4 3 Burns the food 4 2 Read as: Support for violence against women in all situations is 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 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 Mdantsane 73 Total Read as: Abortion is NOT supported by two out of ten respondents (22%), far 0%lower 10% than the average (42%) 22 49 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 the node Encouraging to note the positive attitudes towards Gender Based Violence, coupled to qualified support for abortions. Moreover, the node is relatively progressive when compared to other nodes with regards to most 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 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 decisionmaking 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 nongovernmental agencies - integration and co-ordination remain the core challenges in the ISRDP and URP nodes. 26 HIV & AIDS: Awareness levels URP Average If household member was infected would want to keep it secret? Read as: Prevalence rates are high and secrecy is very low, suggesting stigmatization may be dropping in face of unavoidability of the epidemic Mdantsane 5 19 Heard about those who have died of AIDS in community? 89 67 88 Heard about those in community with AIDS? 66 0 10 20 30 40 50 % Yes 60 70 80 90 10 0 27 HIV & AIDS: Proportion who accept the following statements URP Average Mdantsane 89 Cond oms prevent tran smis sion of HIV 85 One can get AIDS from s harin g razors 94 Read as: Very high awareness of how HIV is transmitted, except in the case of Mosquitoes Heal thy lo oki ng p erson ca n ha ve AIDS 85 92 88 78 In fected moth ers can pass on virus thro ugh breas tfee ding 80 38 Mosq uito es p ass on HIV 19 0 10 20 30 40 50 % wh o ag ree 60 70 80 90 10 0 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 – 8% are providing Home Based Care (HBC) – 8% 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 • Mdantsane has an average K Global Development Rating. Key challenges and existing strengths, emerging from the statistical analysis, are below. Challenges Strengths Poverty K • Higher than average incidence of no regular income and high rate of unemployment • Low incidence of shacks, positive on sanitation and refuse removal Development L • Low awareness across the board • Only above average on food project awareness Service Delivery K • Concerns re transport, roads, education • Positive scores re water, phone access, local government performance Health K • Low scores re access to health facilities • Increasing support to HBC initiatives and orphans • Positive scores on health generally Social Capital J • Above average incidence of mistrust • Generally positive scores
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