National Youth Risk
Behaviour Survey
2008
KwaZulu-Natal Province
17 and 18 February 2011
1
ACKNOWLEDGEMENT
Principle Investigator:
- Prof SP Reddy (MRC)
Co-Investigators:
- Dr S James (MRC)
- Dr I Funani (MRC)
- Dr S Sifunda (MRC)
Statisticians:
- Mr R Omardien (ARCH Actuarial Consulting)
- Mr N Kambaran (ARCH Actuarial Consulting)
Funders:
- Centre for Disease Control (CDC)
2
BACKGROUND
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South Africa is experiencing a multiple burden of disease:
¾
Communicable diseases
¾ Non-communicable diseases
¾ Intentional and Unintentional Injuries
ƒ
Traditionally, focus has been mortality:
Now: shift focus to behaviors and determinants
ƒ
Since 1994, a number of policies were introduced by all
government departments
ƒ
The objectives of this study were developed in the context of
these policies
3
OBJECTIVES OF THE STUDY
ƒ
To obtain nationally and provincially
representative data on the prevalence of
behaviours that place South African
learners at risk
ƒ
Track changes in the prevalence of these
behaviours over time
4
DEPARTMENT MANDATE
ƒ
ƒ
ƒ
Minister signed NSDA with the President on vision
no. 2 of government “ a long and Health life for all
South African
Minister of health signed with eight other
Department and 9 MEC’s for Health
Priorities
9 Transit from curative to primary prevention
9 Primary prevention, educating individuals,
households and communities on benefit of
healthy life style
9 Behavior change program primary focus
5
NDOH: Youth and Adolescent
Outcome-based Priorities 2010 -14
Increase Life Expectancy amongst Y&A
through promotion of healthy life-style and
reducing risky behaviours
„ Reduce Y&A Morbidity and Mortality Rate
„ Combat HIV and AIDS and decrease the
burden of disease from tuberculosis
„ Improve health services for youth: Youth
Friendly Services (YFS) in all PHC facilities
„
6
METHODOLOGY
ƒ
Study Area: All nine provinces in SA
ƒ
Study Setting: government schools
ƒ
Study Population: Grade 8-11 learners (3.1 million
learners) – All racial groups
ƒ
Sampling frame: NDOE 2007 school data base
ƒ
Average of 2 grade 8-11 classes per school
selected at random
7
METHODOLOGY
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Study Instrument: Self-administered questionnaire
ƒ
Sample Selection: Stratified two stage cluster sample
Stratum = Province
Clusters = School (Primary Sampling Unit), Class
23 Schools selected in each province
8
BEHAVIOURS INVESTIGATED
‰
•
•
‰
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INFECTIOUS DISEASE:
Sexual behaviour
Hygiene
‰
INJURY AND TRAUMA
Traffic Safety
Violence
‰
ƒ
ƒ
ƒ
•
CHRONIC DISEASE:
Dietary Behaviour
Physical Inactivity
MENTAL HEALTH
Substance Use
Suicide-related behaviour
‰ ADDITIONALLY:
• Height & Weight measures were taken
9
SELECTED RESULTS FROM
EACH BEHAVIOUR STUDIED
10
Behaviours related to
Infectious Disease
11
SEXUAL BEHAVIOUR
NATIONAL
KZN
Ever have sex:
37,5% 37,5%
Age at Initiation < 14 years:
12,6% 13,7%
Two or more partners in Lifetime :
41,1% 38,2%
Sex in the past 3 months:
52,3% 49,8%
Always use condom:
30,7% 27,3%
Used alcohol before sex:
16,2% 12,5%
Used drugs before sex:
14,3%
9,0%
12
SEXUAL BEHAVIOUR (CONT)
METHODS OF CONTRACEPTION USED
NATIONAL
No of Methods:
Birth Control Pill:
Condom:
KZN
17,9% 18,1%
4,7%
5,0%
45,1% 44,2%
Injection:
7,0%
3,3%
With Drawl
3,3%
3,7%
Morning after pill:
1,4%
1,1%
Some other Methods:
2,6%
2,5%
Have been pregnant and made someone pregnant:
19.0% 19,4%
Have a child/children of his/her own:
17,7% 18,3%
13
SEXUAL BEHAVIOUR:TOP (CONT)
Had an abortion/or partner had a abortion:
NATIONAL
KZN
8,2%
6,3%
Hospital/Clinic:
51,2% 46,3%
Traditional Doctor / Healer:
20,5% 28,3%
Another Place:
10,2%
9,5%
Don’t know where abortion took place
5,4%
4,8%
Ever had sexual transmitted infection:
4,4%
5,2%
Treatment for Sexual transmitted infection:
55,0% 73,3%
14
SEXUAL BEHAVIOUR (CONT)
NATIONAL
KZN
Think they could get HIV in life-time:
11,7%
12,0%
Able to protect themselves from getting HIV:
63,5%
62,9%
Ever received HIV/AIDS education in school:
65,4%
66,8%
Ever had HIV Test:
21,5%
23,7%
15
HYGIENE
NATIONAL
KZN
Always wash hands before eating:
63,3% 63,2%
Always wash hands after going to toilet:
70,1% 73,0%
16
Behaviours related to Chronic
Disease
17
NUTRITION (cont)
Measure height, weight, gender and age used to calculate actual
physiological level of malnutrition
NATIONAL
KZN
UNDER NUTRITION
Under weight for age
Stunting – height for age
Wasting – weight for height
8,4%
5,0%
13,1% 11,7%
4,4%
1,9%
OVERWEIGHT
Overweight
Obesity
19,7% 25,5%
5,3%
5,4%
SELF-PERCEPTION OF NUTRITION LEVEL
Underweight
24,7% 23,7%
Overweight
12,1% 13,2%
18
NUTRITION (cont)
NATIONAL
KZN
Fast Food
39,2%
43,3%
Cakes and Biscuit
42,6%
46,0%
Cool drink Frequently
50,3%
51,0%
Often bought at school tuck shop
44,6%
47,3%
19
NUTRITION (cont)
Diet includes frequent consumption
NATIONAL
KZN
Milk
44,0% 46,4%
Maize
63,0% 60,9%
Meat
52,2% 56,1%
Fresh Fruits
58,4% 62,6%
Uncooked vegetables frequent
38,8% 44,0%
Cooked vegetables frequent
50,3% 53,9%
20
PHYSICAL ACTIVITY
NATIONAL
KZN
Participated in sufficient vigorous physical
activity:
43,2% 39,6%
Participated in sufficient moderate physical
activity:
29,3% 28,0%
Participate in insufficient or no physical activity:
41,1% 43,6%
Physical education classes on timetable:
65,6% 55,4%
21
PHYSICAL ACTIVITY (cont)
NATIONAL
Did not want to take part in physical activity:
KZN
28,8% 29,8%
Reasons for inactivity:
Was ill:
17,8% 16,7%
Felt unsafe:
10,0% 12,2%
No access to equipment:
13,3% 12,5%
Don’t know the reasons for inactivity:
30,1% 28,8%
Watch TV for more than 3 hours per day:
29,3% 29,2%
22
Behaviours related to Injury
and Trauma
23
VIOLENCE IN SCHOOLS
NATIONAL
Carried a weapon:
Carried a gun:
KZN
15,1% 14,1%
8,2%
7,7%
Carried a knife:
16,4% 13,7%
Was bullied:
36,3% 34,2%
Was involved in physical fight:
31,3% 31,1%
Was injured in the physical fight:
34,0% 34,4%
Was approached to join gangs:
21.2% 21,7%
Member of the gangs:
19,4% 21,3%
24
VIOLENCE /ASSAULT/SAFETY ON
SCHOOL PROPERTY
Was assaulted by boyfriend/girlfriend:
NATIONA
KZN
L
15,1% 12,9%
Assaulted boyfriend/girlfriend:
13,5% 12,2%
Was ever forced to have sex:
10,0%
8,9%
Ever forced someone else to have sex:
9,0%
9,2%
Carried any weapon at school:
9,0%
8,7%
Was threatened / Injured by someone with
weapon:
15,7% 15,3%
25
VIOLENCE AND SAFETY ON THE
SCHOOL PROPERTY (CON)
NATIONAL
KZN
Felt unsafe on way to and from school:
22,9% 25,1%
Felt unsafe at school:
27,0% 26,7%
Engaged in physical fight at school:
21,0% 20,2%
Watched a fight at school:
58,7% 60,2%
Attempted to stop a fight at school
36,3% 38,0%
26
TRAFFIC SAFETY
Always wear a seat belt when driven by someone
else:
NATIONA
KZN
L
15,5% 13,6%
Driven by someone who had been drinking
alcohol:
37,6% 36,0%
Walked alongside road after drinking alcohol:
18,1% 15,3%
Walk alongside of road after taking drugs:
Ever gamble:
7,6%
7,2%
29,0% 26,4%
27
Behaviours related to
Mental Health
28
BEHAVIOURS RELATED TO
MENTAL HEALTH 2008
NATIONAL
KZN
SUIDICE RELATED BEHAVIOUR:
Had sad or hopeless feelings:
23,6% 24,6%
Require to see doctor or counselor for sad or
hopeless feeling:
38,3% 32,0%
Ever considered attempting suicide:
20,7% 20,2%
Made a plan to commit suicide:
16,8% 16,9%
Made more attempts to commit suicide:
21,4% 21,9%
Made a suicide attempt require medical treatment:
29,1% 30,9%
29
USE OF TABACCO
NATIONAL
Ever smoke:
Aged of initiation <10 years:
Current smokers:
Current frequent smokers:
Tried to quit cigarettes:
Used smokeless tobacco:
KZN
29,5% 24,5%
6,8% 7,0%
21,0% 18,2%
5,8% 4,1%
45,4% 36,6%
12,1% 11,8%
Current smokers exposed to environmental
tobacco smoke:
74,5% 69,6%
Never smokers exposed to environmental
tobacco smoke:
44,1% 43,6%
Parent/Guardian smokers:
42,5% 39,8%
52,8% 53,0%
Driven by somebody smoking in a car:
30
USE OF ILLEGAL AND OTHER
DRUGS
NATIONAL
KZN
Ever used dagga:
12,7%
10,7%
Ever used inhalants:
12.2%
14,8%
Ever use Mandrax:
7,4%
6,2%
Ever used cocaine:
6,7%
5,8%
Ever used heroin:
6,2%
4,7%
Ever used club drugs:
6,8%
5,6%
12,0%
15,8%
Ever taken drugs, TIK:
6,6%
5,7%
Age of Initiation < 13 years
5,2%
5,7%
Ever used over-counter or prescription drugs:
31
ALCOHOL USE
NATIONAL
KZN
Ever use alcohol:
49,6% 46,4%
Aged of initiation <13 years:
11,9% 13,6%
Used alcohol in the past month:
34,9% 30,6%
Past month binge drinking:
28,5% 25,6%
Use of alcohol on School property:
12,7% 11,1%
Attend school after taken alcohol:
8,3% 6,5%
32
PROVINCIAL FIGURES
COMPARED WITH NATIONAL
AND OTHER PROVINCIAL
FIGURES
33
34
35
36
37
38
39
40
41
42
43
44
45
USED ALCOHOL IN THE PAST MONTH
46
PAST MONTH BINGE DRINKING
47
GENERAL RECOMMENDATIONS
„
The YRBS be repeated on a triennial basis to:
•
•
•
•
•
Monitor and track the prevalence of youth
behaviours over time
Monitor youth responses to the socio-demographic
transition
Identify groups of youth who need targeted
interventions
Optimize utilization of resources allocated to youth,
by all sectors
Serve as model of other African Countries to
conduct similar research
48
RECOMMENDATIONS CONT.
•
•
•
•
Well resourced and planned strategy for the
dissemination of YRBS 2008 results across
provinces
Engage with the National Youth Development
Agency (NYDA) to use the findings to initiate
relevant programme development
Develop an Expanded Youth Risk Behaviour
Surveillance System
Development of comprehensive interventions
based on inter-sectoral solutions
49
SPECIFIC RECOMMENDATIONS
„
„
„
„
Conduct in-depth social, psychosocial, economic and ethnic
identify determinants studies
Develop, implement and evaluate targeted, comprehensive
interventions
Develop the capacity of health promoters and educators to
address the behaviours from a risk cluster perspective,
aimed at building resilience and addressing risk behaviours
Creation of an Evidence based for youth health
management through NEPAD
…
Expand YRBS to neighbouring countries
… Development of an African survey instrument
„
Build capacity and create awareness by involving the youth
in this continuous research process. Adapt YRBS to be
implemented at district level throughout the country
50
ADDRESSING YOUTH RISK BEHAVIOUR
BASED ON INTERVENTIONS
•
All relevant sectors : Government, civil society and private
•
Creating synergies with government youth initiatives such as the
Youth Indaba and the National Youth Plan
•
On-going management of behavioural surveillance
•
Development of specific strategies focussing on the specific
levels of impact.
•
Application of comprehensive models such as the health
Promotion Matrix
51
CONCLUSION
„
Youth health and development is a key
priority that feeds into the MDGs
„
The observed increase in risky behaviours
calls for a concerted national effort in dealing
with youth issues
52
CONCLUSION (CONT)
„
Strengthen implementation of programmes at
different levels: Mental health and Substance
abuse, Health promotion and sexual and
reproductive health services
„
Creative partnership models need to be
explored that involve government, researchers,
communities, traditional leadership, NGO’s,
Faith Organisations and other civil society
members.
53
Thank you!!
54