1

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

survey:survey:

KwaMashu resultsKwaMashu 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 KwaMashu 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 KwaMashu-specific findings

– KwaMashu 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

KwaMashu scorecard

Index Rating

Poverty Social Capital Deficit Development Deficit Service Delivery Deficit Health Deficit Global

A brief glance at the scorecard shows that KwaMashu is among the poorer

urban nodes, with red warning lights flashing in the areas of social capital,

development awareness and as the overall, composite score for the node.

Poverty is not as acute as in other urban nodes, while service delivery and

health are on average for the URP.

7

Poverty deficitPoverty Index - URP Nodes

11%

14%16% 17% 17%

19%

26%27%

0%

5%

10%

15%

20%

25%

30%

MitchellsPlain

KwaMashu Mdantsane Motherwell AlexandraGaleshewe

Inanda

Khayelitsha

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

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

weighting. KwaMashu is the second least poor urban node.

8

Poverty deficit

The two areas The two areas

scoring above the scoring above the

URP average are URP average are

illiteracy and illiteracy and

over-crowding; over-crowding;

on all other on all other

poverty poverty

indicators, indicators, in in

green,green,

KwaMashu did KwaMashu did

better or as well better or as well

as the URP as the URP

average.average.

Poverty Measures: KwaMashu vs. URP Avg

3% 1%9%

3% 6%

49%43%

8%16%

4%13%

3%

19%

5% 7%

63%

47%

8%14%

3%0%

20%

40%

60%

80%

No RDPsanitation No income

Informaldwelling

No

electricity(lights)

No RDPwater

Unemployed

Female

headed HHNo refuse

removalFunctional

illiteracyOver-

crowding

KwaMashu URPAvg

Difference vs URP Avg

-79%-73%

-51%-45%

-22% -21%

-9%

0%

14% 16%

-100%

-80%

-60%

-40%

-20%

0%

20%

40%

No RDPsanitation No income

Informaldwelling

No

electricity(lights)

No RDPwater

Unemployed

Female

headed HHNo refuse

removalFunctional

illiteracyOver-

crowding

9

Social capital deficitSocial Capital Deficit Index - URP Nodes

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

52%

59%

0%

10%

20%

30%

40%

50%

60%

70%

Galeshewe Mdantsane Motherwell AlexandraKhayelitsha

Mitchells Plain

Inanda

KwaMashu

• 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, social capital is in real trouble in KwaMashu, which has the worst score in this area, suggesting that building social capital must be a nodal priority.

10

Social Capital Measures: KwaMashu vs. URP Avg

29%

57%

96%

69% 73% 71%61%

18%30%

57%

84%

58% 55%50%

42%

11%

0%

20%

40%

60%

80%

100%

120%

C'ty mmbrsonly care 4themselves

Anomie

Be carefulwith peoplePolitics awaste of

timeNo CSOmmbrship Alienation C'ty can't

solveproblems

No Religion KwaMashu URPAvg

Difference vs URP Avg

-2%

0%

14%20%

33%

41% 44%

72%

-10%

0%

10%

20%

30%

40%

50%

60%

70%

80%

C'ty mmbrsonly care 4themselves

Anomie

Be carefulwith peoplePolitics awaste of

timeNo CSOmmbrship Alienation C'ty can't

solveproblems

No Religion

Social capital deficit

Priority areas - Priority areas -

where the nodal where the nodal

average was average was

higher than the higher than the

URP average - URP average -

include mistrust include mistrust

(14% higher (14% higher

than the than the

average), lack of average), lack of

faith in politics, faith in politics,

low CSO low CSO

membership, membership,

high alienation high alienation

and so on.and so on.

11

Development deficitDevelopment Deficit Index - URP Nodes

31% 33%

38% 38% 39%43%

47%

56%

0%

10%

20%

30%

40%

50%

60%

KhayelitshaMitchells Plain

Inanda

Alexandra Motherwell Galeshewe Mdantsane KwaMashu

• 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.

• KwaMashu has the worst level of development awareness, reflecting its poor social capital score.

12

Development Measures: KwaMashu vs. URP Avg

19%

55%

30%

48%57%

51%60%

55%

42%

69% 67%74%

66%72% 75%

50%

68%

30%36%

40%36%

40% 37%27%

42% 39% 42%38% 40% 41%

0%

20%

40%

60%

80%

No Devt-GovtNo Devt-NPOs

No HousesNo water

No C'ty hallsNo GardensNo Farming

No HIV/AIDS project

No Roads

No Health Facilities

No SchoolsNo Creches

No food project

No Sport

No Other Dev

KwaMashu URPAvg

Difference vs URP Avg

-62%

-20%

-2%

34%41% 44%

49% 50% 52%

63%71% 73% 74% 77% 82%

-80%

-60%

-40%

-20%

0%

20%

40%

60%

80%

100%

No Devt-GovtNo Devt-NPOs

No HousesNo water

No C'ty hallsNo GardensNo Farming

No HIV/AIDS project

No Roads

No Health Facilities

No SchoolsNo Creches

No food project

No Sport

No Other Dev

Development deficit

Awareness is lower Awareness is lower

than the URP than the URP

average across average across

board - the only board - the only

less gloomy scores less gloomy scores

relate to whether relate to whether

civil society or civil society or

government is government is

providing providing

development development

services. But services. But

across all types of across all types of

development development

activity, awareness activity, awareness

in KwaMashu was in KwaMashu was

lower than the lower than the

URP average.URP average.

13

Service delivery deficitService Delivery Deficit Index - URP Nodes

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

56%60%

0%

10%

20%

30%

40%

50%

60%

70%

Galeshewe

Inanda

Motherwell Khayelitsha Mdantsane KwaMashu Alexandra MitchellsPlain

KwaMashu ranks 6th worst out of the 8 URP nodes on service delivery

KwaMashu ranks 6th 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

14

Service Delivery Measures: KwaMashu vs. URP Avg

21%

48%

19%29%

89%

15%

49%

32%21% 24%20%

44%

17%24%

70%

12%

36%

23%12% 10%

0%

20%

40%

60%

80%

100%

Poor Qualityof ServicesGovt DeptCo-ordination

poor Water notclean

Quality-sewerage

poor

Local GovtPerformance

poor Quality-education

poor

Quality-

security poor

Quality-health poor

No PhoneNot

participated

in IDP

Kw aMashu URPAvg

Difference vs URP Avg

2% 9% 9%18% 26% 32% 36% 42%

74%

131%

0%

20%

40%

60%

80%

100%

120%

140%

Poor Qualityof ServicesGovt DeptCo-ordination

poor Water notclean

Quality-sewerage

poor

Local GovtPerformance

poor Quality-educationpoor

Quality-

security poor

Quality-health poor

No PhoneNot

participated

in IDP

Service delivery – weaknesses

WeaknessesWeaknesses, i.e. , i.e.

where doing worse where doing worse

than URP average, than URP average,

include issues such include issues such

as respondents are as respondents are

42% more likely to 42% more likely to

rate the quality of rate the quality of

access to health access to health

services as poor than services as poor than

the URP average, and the URP average, and

32% more likely than 32% more likely than

the URP average to the URP average to

report the quality of/ report the quality of/

access to education access to education

as poor, and so on.as poor, and so on.

15

Service Delivery Measures: KwaMashu vs. URP Avg

7% 7%

19%

68%

26%17% 13%

25%

78%

30%

0%

20%

40%

60%

80%

100%

Quality-electricitypoor

Quality-transportpoor Quality-

roadspoorNo Old

agepension Quality-housing

poor

KwaMashu URPAvg

Difference vs URP Avg

-60%

-44%

-23%

-13% -12%-9% -8% -7%

-70%

-60%

-50%

-40%

-30%

-20%

-10%

0%

Quality-electricitypoor

Quality-transportpoor

Quality-roads

poorNo Old age

pension Quality-

housing poor

Poor DSDServices DSD Staffunhelpfull DSD Staff nocomparssion

Service delivery – strengths

Strengths: Strengths:

Respondents are Respondents are

less likely to less likely to

complain about a complain about a

range of different range of different

services delivered in services delivered in

this node when this node when

compared with the compared with the

URP average. For URP average. For

instance, instance,

respondents in this respondents in this

node are 60% less node are 60% less

likely to rate the likely to rate the

quality of/ access to quality of/ access to

the electricity the electricity

supply poor than the supply poor than the

URP average, and URP average, and

44% less likely than 44% less likely than

the URP average to the URP average to

report that that report that that

quality of transport quality of transport

is poor and so on.is poor and so on.

16

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.

KwaMashu URP

• Of the households receiving grants a third (37%) are receiving Child Support Grants

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

• A third (33%) receiving grants are receiving Pensions

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

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

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

• A third (37%) 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

17

Health DeficitHealth Deficit Index - URP Nodes

29%34%

37%

42%45%

53% 53% 54%

0%

10%

20%

30%

40%

50%

60%

MitchellsPlain

Alexandra Galeshewe Khayelitsha Mdantsane KwaMashu Motherwell

Inanda

Mdantsane is ranked as the

6th best of the 8 URP nodes

in respect to health measures

Mdantsane is ranked as the

6th best of the 8 URP nodes

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

18

Health Measures: KwaMashu vs. URP Avg

0%

44%

53%

62%66%

1%

33%39% 42% 44%

0%

20%

40%

60%

80%

Malariaincidence

PoorHealth

Difficultyaccessinghealthcare Cannotwork

Ltd SocialActivities

KwaMashu URPAvg

Difference vs URP Avg

-75%

33% 36%

49% 51%

-100%

-80%

-60%

-40%

-20%

0%

20%

40%

60%

Malariaincidence

PoorHealth

Difficultyaccessinghealthcare Cannotwork

Ltd SocialActivities

Health deficit

Priority areas: Priority areas:

Respondents in this Respondents in this

node are 51% more node are 51% more

likely to report that likely to report that

poor health limits poor health limits

their social activities their social activities

than the URP average, than the URP average,

49% more likely than 49% more likely than

the URP average to the URP average to

state that poor health state that poor health

prevented them from prevented them from

working, and 36% working, and 36%

more likely to say that more likely to say that

they had difficulty they had difficulty

accessing health care accessing health care

when compared with when compared with

the URP average. the URP average.

19

Health • HIV and AIDS was seen to be the major health problem in the node (37% mentioned

this, lower than the URP average of 42%),

• Drug and Alcohol Abuse were also perceived as major health problems in KwaMashu

– Drug abuse received mention by a third of all respondents (33%, more than double the URP

average of 14%)

– Alcohol abuse was mentioned by two out of ten respondents (20%, vs. 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 health services was erceived to be worse than the IRDP average, in

particular

– 19% of respondents reported distance to health facility as being a problem

– 45% 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, alcohol

and drug abuse 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 noted 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 KwaMashu residents

20Proportion who agree that both parties in a relationship should share

decision - making

67

77

84

68

34

44

57

29

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 KwaMashu

Read as: Minority in the

node support the view

that most decisions in

the household require

joint decision-making by

both partners, far lower

than the URP average

Read as: Minority in the

node support the view

that most decisions in

the household require

joint decision-making by

both partners, far lower

than the URP average

21

Proportion supporting statements about female contraception

71

49

46

30

81

69

42

27

0 10 20 30 40 50 60 70 80 90

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 KwaMashu

Read as: Node is relatively

progressive on some issues as

these myths about

contraception are not as

widely held as the URP

average, but on other items it

is very conservative when

compared to the URP average.

Read as: Node is relatively

progressive on some issues as

these myths about

contraception are not as

widely held as the URP

average, but on other items it

is very conservative when

compared to the URP average.

22Proportion 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 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 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 KwaMashu

Is unfaithful 16 41

Does not look after the children

12 26

Goes out without telling him

7 15

Argues with him 7 12

Refuses to have sex with him

4 6

Burns the food 4 8

23

Attitudes towards abortion

49

44

42

48

9

8

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

Total

KwaMashu

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 nearly half

the respondents (48%),

higher than the average

(42%)

Read as: Abortion is NOT

supported by nearly half

the respondents (48%),

higher than the average

(42%)

24

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 high levels of support for Gender Based Violence, coupled to very limited support for abortions and widespread belief in a range of different 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

• There are those in the node who support the idea that decisions in the household require joint decision-making by both partners, but there are many who do not support joint decision-making. Moreover, many of these respondents 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.

25

HIV & AIDS: Awareness levels

66

67

19

89

88

43

0 10 20 30 40 50 60 70 80 90 100

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 KwaMashu Read as: Prevalence

rates are high and

secrecy is more than

double the URP average,

suggesting

stigmatization has yet to

drop in the face of the

epidemic.

Read as: Prevalence

rates are high and

secrecy is more than

double the URP average,

suggesting

stigmatization has yet to

drop in the face of the

epidemic.

26

HIV & AIDS: Proportion who accept the following statements

19

80

88

85

85

5

82

98

98

89

0 20 40 60 80 100 120

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 KwaMashu

Read as: Very high

awareness of how HIV is

transmitted

Read as: Very high

awareness of how HIV is

transmitted

27

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.– Worrying that so many in the node would want to keep their

status secret if they were infected. – Further research is urgently needed on this issue in the node

in order to inform a nuanced campaign that takes the fears and concerns of the local communities into account.

• 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 all the items.

• 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.

28

Conclusions• KwaMashu has a below average Global Development Rating. Key challenges and

existing strengths, emerging from the statistical analysis, are below.

Challenges Strengths

Poverty • Illiteracy • Above average scores for sanitation, regular income and incidence of shacks

Development

• Low across the board, worst rate in the URP

Service Delivery

• Low participation in IDPs• Challenges include phone and health services

• Positives include electricity, transport, roads

Health • Poor health impacts on social activities and ability to work; access to health care facilities a challenge, as is GBV, Sexual Reproductive Health, HIV and AIDS (esp. stigmatisation)

• High awareness of HIV/AIDS issues

Social Capital

• Low across the board, worst rate in the URP