1

Department of Social Department of Social Development nodal baseline Development nodal baseline

survey:survey:

Alexandra resultsAlexandra 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 Alexandra 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 Alexandra-specific findings

– Alexandra 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

Alexandra scorecardIndex Rating

Poverty

Social Capital Deficit

Development Deficit

Service Delivery Deficit

Health Deficit

Global

Compared with other nodes, Alexandra scores positively (above average)

on health, below average on service delivery, and all other areas are within

the URP average. The red warning light for service delivery highlights

Alexandra’s weak point compared with other URP nodes.

7

Poverty deficitPoverty Index - URP Nodes

11%

14%16% 17% 17%

19%

26%27%

0%

5%

10%

15%

20%

25%

30%M

itchells

Pla

in

Kw

aM

ashu

Mdants

ane

Moth

erw

ell

Ale

xandra

Gale

shew

e

Inanda

Khayelitsha

The poverty deficit index is based on 10 indicators (see table below), given equal

weighting. Alexandra is the 4th poorest urban node (alongside Motherwell). In

other words, poverty is clearly an issue within Alexandra, but is lower than in

other URP nodes.

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

Electricity for Electricity for

lighting is a key lighting is a key

priority in priority in

Alexandra, coming Alexandra, coming

in 79% above the in 79% above the

URP average. URP average. In In

green are the green are the

positive scorespositive scores - -

where incidence where incidence

were lower than the were lower than the

URP average, and URP average, and

give positive results give positive results

for water provision, for water provision,

refuse removal, and refuse removal, and

so on.so on.

Poverty Measures: Alexendra vs. URP Avg3% 3% 2% 2%

10% 15

%

12%

47%

63%

9%7% 8%

3% 3%

13% 19

%

14%

47%

63%

5%

0%

20%

40%

60%

80%

No

RD

Pw

ater

No

refu

sere

mov

al

Ove

r-cr

owdi

ng

No

inco

me

No

RD

Psa

nita

tion

Info

rmal

dwel

ling

Fun

ctio

nal

illite

racy

Fem

ale

head

ed H

H

Une

mpl

oyed No

elec

tric

ity(l

ight

s)

Alexandra URPAvg

Difference vs URP Avg

-66% -62%

-32% -27% -22% -20% -19%

1% 1%

79%

-80%

-60%

-40%

-20%

0%

20%

40%

60%

80%

100%

No

RD

Pw

ater

No

refu

sere

mov

al

Ove

r-cr

owdi

ng

No

inco

me

No

RD

Psa

nita

tion

Info

rmal

dwel

ling

Func

tiona

lill

itera

cy

Fem

ale

head

ed H

H

Une

mpl

oyed N

oel

ectr

icity

(ligh

ts)

9

Poverty analysis• Poverty scores in urban nodes are generally

better than those in rural nodes, for obvious reasons - greater connectivity to services, more economic opportunity, and so on. That said, the key challenges facing Alexandra include:– A rate of unemployment of 63% (the same as the URP

average, compared with an ISRDP average of 78%)– 47% of households sampled were female-headed– 15% of respondents lived in shacks– 12% of respondents were functionally illiterate– 19% of respondents were without RDP-level

sanitation (below the URP average of 13%)– 9% of respondents lacked electricity for lighting (URP

average is 5%)

10

Social capital deficitSocial Capital Deficit Index - URP Nodes

42% 44% 46% 46% 48% 49%52%

59%

0%

10%

20%

30%

40%

50%

60%

70%

Gal

eshe

we

Mda

ntsa

ne

Mot

herw

ell

Alex

andr

a

Khay

elits

ha

Mitc

hells

Pla

in

Inan

da

KwaM

ashu

• 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.

• Alexandra lies in the middle range of URP nodes on the social capital index; but it is important to note that poor social capital is a feature of all urban nodes, which are generally worse in this area than ISRDP nodes.

11

Social Capital Measures: Alexendra vs. URP Avg

37% 42

% 48%

40% 52

%

88%

41%

23%

50% 57

%

58%

42% 55

%

84%

30%

11%

0%

20%

40%

60%

80%

100%

Alie

natio

n

Ano

mie

Pol

itics

aw

aste

of

time

C'ty

can

'tso

lve

prob

lem

s

No

CSO

mm

brsh

ip

Be

care

ful

with

peo

ple

C'ty

mm

brs

only

car

e 4

them

selv

es

No

Rel

igio

n

Alexandra URPAvg

Difference vs URP Avg

-27% -25%-17%

-7% -5%

5%

40%

117%

-40%

-20%

0%

20%

40%

60%

80%

100%

120%

140%

Alie

natio

n

Ano

mie

Pol

itics

aw

aste

of

time

C'ty

can

'tso

lve

prob

lem

s

No

CSO

mm

brsh

ip

Be

care

ful

with

peo

ple

C'ty

mm

brs

only

car

e 4

them

selv

es

No

Rel

igio

n

Social capital deficit

Priority areas Priority areas

(where Alexandra is (where Alexandra is

above the URP above the URP

average) include average) include

mistrust and a mistrust and a

sense that sense that

community community

members only care members only care

for themselves; as for themselves; as

well as non-well as non-

membership of a membership of a

faith-based faith-based

organisation. But organisation. But

alienation and alienation and

anomie were better anomie were better

than in the URP than in the URP

generally, generally, as were as were

other items in other items in

green.green.

12

Development deficitDevelopment Deficit Index - URP Nodes

31% 33%38% 38% 39%

43%47%

56%

0%

10%

20%

30%

40%

50%

60%Kh

ayeli

tsha

Mitc

hells

Plai

n

Inan

da

Alex

andr

a

Mot

herw

ell

Gale

shew

e

Mda

ntsa

ne

KwaM

ashu

• 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.

• Development awareness is in the mid-URP range in Alexandra.

13

Development Measures: Alexendra vs. URP Avg28

%

21%

41%

35%

60%

37%

40%

29% 41

%

36% 42%

42%

39%

42%

43%

39%

27%

50%

40%

68%

41%

42%

30% 42

%

36%

40%

40%

37%

38%

36%

0%

20%

40%

60%

80%

No

Sch

ools

No

Roa

ds

No

Dev

t-G

ovt

No

Spo

rt

No

Dev

t-N

PO

s

No

Oth

er D

ev

No

Cre

ches

No

Hou

ses

No

Hea

lth F

acilit

ies

No

wat

er

No

Far

min

g

No

C'ty

hal

ls

No

HIV

/AID

S p

roje

ct

No

food

pro

ject

No

Gar

dens

Alexandra URPAvg

Difference vs URP Avg

-29%-23%

-18%-13% -13% -11%

-6%-4% -2%

1%3% 3% 6%

11%

20%

-40%

-30%

-20%

-10%

0%

10%

20%

30%

No

Sch

ools

No

Roa

ds

No

Dev

t-G

ovt

No

Spo

rt

No

Dev

t-N

PO

s

No

Oth

er D

ev

No

Cre

ches

No

Hou

ses

No

Hea

lth F

acilit

ies

No

wat

er

No

Far

min

g

No

C'ty

hal

ls

No

HIV

/AID

S p

roje

ct

No

food

pro

ject

No

Gar

dens

Development deficit

Priorities in red Priorities in red

show areas where show areas where

scores for scores for

Alexandra were Alexandra were

above the URP above the URP

average. These average. These

include low include low

awareness of a awareness of a

range of range of

development types development types

- though there are - though there are

more positives (in more positives (in

greengreen, where , where

awareness is higher awareness is higher

than the URP than the URP

average) - across average) - across

types of project and types of project and

who is providing who is providing

themthem.

14

Service delivery deficitService Delivery Deficit Index - URP Nodes

45%48% 49% 50% 52% 53%

56%60%

0%

10%

20%

30%

40%

50%

60%

70%G

ales

hew

e

Inan

da

Mot

herw

ell

Kha

yelit

sha

Mda

ntsa

ne

Kw

aMas

hu

Ale

xand

ra

Mitc

hells

Pla

in

Alexandra ranks 7th worst out of the 8 URP nodes on service delivery

Alexandra ranks 7th worst out of the 8 URP nodes on service delivery

Service Delivery Index• 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

• 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

15

Service Delivery Measures: Alexandra vs. URP Avg

62%

62%

59%

62%

15%

45%

32%

66%

49%

31%

53%

53%

51%

52%

12%

36%

24% 44

%

30%

17%

0%

20%

40%60%

80%

DS

D S

taff

know

ledg

epo

or

DS

D S

taff

unhe

lpfu

ll

DS

DC

lean

lines

sP

oor

Poo

r DS

DS

ervi

ces

No

Pho

ne

Qua

lity-

secu

rity

poor

Qua

lity-

sew

erag

epo

or

Gov

t Dep

tC

o-or

dina

tion

poor

Qua

lity-

hous

ing

poor

Qua

lity-

elec

trici

typo

or

Alexandra URPAvg

Difference vs URP Avg

15% 17% 17% 18% 21% 26% 33%49%

63%84%

0%20%40%60%80%

100%

DSD

Staff

know

ledge po

or

DSD

Staff

unhe

lpfull

DSD

Clea

nline

ss Poor

Poor

DSD

Serv

ices

No P

hone

Quali

ty-se

curity po

or

Quali

ty-se

wera

ge poor

Govt

Dept Co

-or

dinati

on poor

Quali

ty-ho

using po

or

Quali

ty-ele

ctrici

ty poor

Service delivery – weaknesses

WeaknessesWeaknesses, i.e. , i.e.

where doing worse where doing worse

than URP average, than URP average,

are largely to do are largely to do

with delivery of with delivery of

basic services. For basic services. For

instance, instance,

respondents are respondents are

84% more likely to 84% more likely to

rate the electricity rate the electricity

supply as poor than supply as poor than

the URP averagethe URP average

16

Service Delivery Measures: Alexandra vs. URP Avg

7% 6%

12%

6% 7%

17%

13%

25%

12%

10%

0%

20%

40%

Wat

er n

otcl

ean

Qua

lity-

tran

spor

tpo

or

Qua

lity-

road

s po

or

Qua

lity-

educ

atio

npo

or

Not

part

icip

ated

in ID

P

Alexandra URPAvgDifference vs URP Avg

-58% -57%-54%

-50%

-36%

-19%

-9%

0%

-70%

-60%

-50%

-40%

-30%

-20%

-10%

0%

Wa

ter

no

tcl

ea

n

Qu

alit

y-tr

an

spo

rt p

oo

r

Qu

alit

y-ro

ad

sp

oo

r

Qu

alit

y-e

du

catio

np

oo

r

No

tp

art

icip

ate

d in

IDP

Qu

alit

y-re

fuse

po

or

Qu

alit

y-w

ate

rp

oo

r

No

Ho

me

ba

sed

ca

re

Service delivery – strengths

Strengths: Strengths:

Respondents are less Respondents are less

likely to complain likely to complain

about access to/ about access to/

quality of certain quality of certain

aspects the delivery of aspects the delivery of

basic services when basic services when

compared with the compared with the

URP average. For URP average. For

instance, respondents instance, respondents

in this node are 58% in this node are 58%

less likely to rate the less likely to rate the

quality of water as not quality of water as not

clean than the URP clean than the URP

averageaverage

17

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.

Alexandra URP

• Of the households receiving grants a third (31%) are receiving Child Support Grants

• Average for households receiving Child Support Grants is a third (37%)

• One out of ten (13%) receiving grants are receiving Pensions

• Average for households receiving pensions is two out of ten (22%)

• Four out of ten (43%) encounter DSD services at a DSD office

• Four out of ten (44%) experience DSD services at a DSD office

• Three out of ten (28%) 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

18

Health deficitHealth Deficit Index - URP Nodes

29%34%

37%

42%45%

53% 53% 54%

0%

10%

20%

30%

40%

50%

60%M

itche

llsP

lain

Ale

xand

ra

Gal

eshe

we

Kha

yelit

sha

Mda

ntsa

ne

Kw

aMas

hu

Mot

herw

ell

Inan

da

Alexandra is ranked as the

2nd best URP node in respect

to health measures

Alexandra is ranked as the

2nd best URP node in respect

to health measures

Health Index• Proportion of household infected by malaria past 12 months• Proportion who experience difficulty accessing health care • Proportion who rated their health poor/terrible during past 4 weeks

• Proportion who had difficulty in doing daily work • Proportion whose usual social activities were limited by physical/emotional problems

19

Health Measures: Alexandra vs. URP Avg15

% 24%

22% 30

%

1%

39%

42%

33% 44

%

1%

0%

20%

40%

60%

Diff

icul

tyac

cess

ing

heal

thca

re

Can

not

wor

k

Poo

rH

ealth

Ltd

Soc

ial

Act

iviti

es

Mal

aria

inci

denc

e

Alexandra URPAvg

Difference vs URP Avg

-61%

-42%

-32% -31%

0%

-70%

-60%

-50%

-40%

-30%

-20%

-10%

0%

Difficu

lty

acce

ssin

gh

ea

lth

ca

re

Ca

nn

ot

wo

rk

Po

or

He

alth

Ltd

So

cia

lA

ctivitie

s

Ma

lari

ain

cid

en

ce

Health deficit

Strengths: Strengths:

Alexandra, because of its Alexandra, because of its

high health rating when high health rating when

compared with other compared with other

URP nodes, is better on URP nodes, is better on

many of the key health many of the key health

variables. For instance, variables. For instance,

respondents are 61% respondents are 61%

less likely to report less likely to report

difficulty accessing difficulty accessing

health care when health care when

compared with the URP compared with the URP

average, and 42% less average, and 42% less

likely to report that poor likely to report that poor

health prevented them health prevented them

from working when from working when

compared with the URP compared with the URP

average average

20

Health

• HIV and AIDS was seen by the vast majority in the node (60%) as the major health problem facing Alexandra (much higher than the average of 42% across all URP nodes)

• Alcohol Abuse was also reported as the major health problem in the node, by a quarter of the respondents (24%, equivalent to the 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 services which has been perceived as a major issue in other nodes

was not seen to be a major obstacle, with respondents in the node far less less likely than the URP average to report access to health services as a problem, thus we find that only– 8% of respondents reported distance to health facility as being a problem– 8% 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 and alcohol abuse

• A sectoral or targeted approach is need to focus on these disease related issues in this node

• Poverty and the health challenge of HIV and AIDS and cannot be separated and whatever intervention is decided upon should be in the form of an integrated response to the challenges facing Alexandra residents

21Proportion who agree that both parties in a relationship should share

decision - making

67

77

84

68

67

76

80

71

0 10 20 30 40 50 60 70 80 90

Agree on whether to take a sickchild to the clinic

Agree on using income to payfor health care or medicines

Agree on when to have children

Agree whether to use familyplanning

URP Average Alexandra

Read as: Majority in

the node support the

view that most

decisions in the

household require

joint decision-

making by both

partners, albeit that

this node is below

the URP average on

certain issues

Read as: Majority in

the node support the

view that most

decisions in the

household require

joint decision-

making by both

partners, albeit that

this node is below

the URP average on

certain issues

22

Proportion supporting statements about female contraception

71

49

46

30

72

35

37

25

0 10 20 30 40 50 60 70 80

Agree that women getpregnant so women must

worry aboutcontraception

Agree that femalecontraception is a

women's business andnothing to do with men

Agree that women whouse contraception risks

being sterile

Agree that contraceptionleads to promiscuity

URP Average Alexandra

Read as: Node is

relatively

progressive as

most myths about

contraception are

not as widely held

as the average,

except in one

instance

Read as: Node is

relatively

progressive as

most myths about

contraception are

not as widely held

as the average,

except in one

instance

23Proportion 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 very 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

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 very 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

URP Average Alexandra

Is unfaithful 16 23

Does not look after the children

12 15

Goes out without telling him

7 13

Argues with him 7 11

Refuses to have sex with him

4 7

Burns the food 4 10

24

Attitudes towards abortion

49

50

42

32

9

18

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Total

Alexandra

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

Read as: Abortion is NOT

supported by a third of all

respondents (32%) lower

than the average (42%)

Read as: Abortion is NOT

supported by a third of all

respondents (32%) lower

than the average (42%)

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

• Disturbing to note the negative attitudes towards Gender Based Violence, coupled to qualified support for abortions. Nevertheless 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 decision-making 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.

26

HIV & AIDS: Awareness levels

66

67

19

68

67

18

0 10 20 30 40 50 60 70 80

Heard about those incommunity with AIDS?

Heard about those who havedied of AIDS in community?

If household member wasinfected would want to keep it

secret?

% Yes

URP Average Alexandra Read as: Prevalence

rates are high and

secrecy is relatively low,

suggesting

stigmatization may be

dropping in face of

unavoidability of the

epidemic

Read as: Prevalence

rates are high and

secrecy is relatively low,

suggesting

stigmatization may be

dropping in face of

unavoidability of the

epidemic

27

HIV & AIDS: Proportion who accept the following statements

19

80

88

85

85

14

89

88

80

95

0 10 20 30 40 50 60 70 80 90 100

Mosquitoes pass on HIV

Infected mothers can pass onvirus through breastfeeding

Healthy looking person can haveAIDS

One can get AIDS from sharingrazors

Condoms prevent transmissionof HIV

% who agree

URP Average Alexandra

Read as: Very high

awareness of how HIV is

transmitted

Read as: Very high

awareness of how HIV is

transmitted

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 most of the items), nevertheless the previous slide does show areas which should be prioritised in future campaigns

• 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

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Conclusions• Alexandra has an average Global Development Rating , compared with

other URP nodes. Its key challenges and strengths are listed below.

Challenges Strengths

Poverty • Unemployment and electricity for lighting

• Water & refuse removal

Development

• Low awareness of some development esp. HIV/AIDS

• Better awareness of school building, roads, government delivery

Service Delivery

• Poor quality electricity, housing, government co-ordination

• Clean water, transport, roads

Health • HIV and AIDS & alcohol abuse• GBV and Sexual Reproductive Health

• Access to health care • Health status has low impact on work or social activities

Social Capital

• Low religious affiliation; mistrust of neighbours

• Low level alienation and anomie, faith in politics