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South Africa
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Issues affecting children

HIV and AIDS
South Africa has a generalised, hyperendemic HIV epidemic, and is home to the largest number of people living with HIV (6.4 million). Trends show a growing HIV epidemic among the general population in South Africa, with prevalence rising from 10.6% in 2008 to 12.2% in 2012.1 Prevalence is presumed to have risen as a result of the effects of increased ART coverage and subsequent decrease in mortality. Evidence shows a decrease in the total number of people dying from AIDS from 300 000 in 2010 to 270 000 in 2011, to 136 000 in 2014.2 Despite this progress, HIV burden for the general population remains high. There are great variations by province, from 5% in the Western Cape to 17% in KwaZulu-Natal, though there are hot spots within lower prevalence provinces. There are more PLHIV in the City of Durban that in the whole of Brazil.3 There is also a wide variation of disease burden across age, race, gender, socio-economic status. Further, according to SANAC HIV prevalence also varies greatly by age and sex, with women age 30-34 having the highest burden, at 36%, and young men age 15-19 having the lowest, at 0.7% (Figure 1.1.2). Importantly, this age disaggregated data highlights the disproportionately elevated vulnerability of young women and girls compared to their male peers; adolescent girls 15-19 are eight times more likely to be living with HIV than boys in the same age group, and young women (20-24) are 3.4 times more likely. These data point to a dire need to address the socio-structural factors which place young women and girls at higher HIV risk.

Adolescent Sexual and Reproductive Health and Rights
Data from South Africa shows a national HIV prevalence rate of 5.6% among adolescent girls (aged 15–19 years), rising to 17.4% for young women (aged 20–24 years). Some of the reasons cited for this high HIV prevalence rate among adolescent girls and young women include lack of hope for the future, extreme pressures to have sex for money or favours, poor risk perception and lack of knowledge of individual HIV status. Girls and young women face obstacles to accessing contraceptives and health services, increasing the risk of unintended pregnancy, unsafe abortion and unattended deliveries.

Orphans and Vulnerable Children and Youth
Mid 2013 General Household Survey estimated South Africa’s total population to be 53 million people, of whom 18.6 million were children (under 18 years). Children therefore constitute 35% of the total population. HIV and TB epidemics are the major causes of deaths, thus contributing to increased number of orphans and other children and youth who are made vulnerable (OVCY). In 2013, there were approximately 3.37 million orphans in South Africa. This includes children without a living biological mother, father or both parents, and is equivalent to 18% of all children in South Africa. The total number of orphans has increased by 13% since 2002, with 380,000 more orphaned children in 2013 than in 2002. Almost half of all orphans in South Africa have been located in KwaZulu-Natal and the Eastern Cape. The lowest orphaning rates are in the Western Cape (8% of children have lost at least one parent) and Gauteng (13%). Close to half (46%) of all orphans are resident in the poorest 20% of households. Around a quarter of children in the poorest 20% of households are orphans, compared with the richest 20% where total orphaning rates are around 3%. Some in depth studies also reveal the vulnerabilities and risks orphans and children made vulnerable by HIV face. A national longitudinal study with 730 adolescents found that Youth affected simultaneously by AIDS-orphanhood and having an AIDS-sick caregiver (dual-affected) are three times more exposed to emotional and physical abuse and six times more likely to experience transactional sex than in healthy families. The combination of familial AIDS, food insecurity and abuse raise transactional sex risk amongst girls from 1% to 57% 7. In addition, it was found that mental health problems, such as depression, anxiety and post-traumatic stress disorder persist over a four-year period amongst children orphaned by AIDS.8

Gender Based Violence
Gender-based violence (GBV) is a major structural element that increases vulnerability to HIV and STIs in South Africa. It is estimated that 20–25% of new HIV infections in young women in South Africa are attributable to GBV.59 It has also been (conservatively) estimated that sexual and gender-based violence costs South Africa between R28.4 billion and R42.4 billion per year, which is between 0.9% to 3% of GDP annually.60 Violence in schools is one of the scourges that continue relentlessly in South Africa. Everyday reports are published on newspapers and electronic media about the increasing levels of violence that includes physical, sexual and psychological in our schools. The second South African National School Violence Study report states that one in five learners had experienced some form of violence while at school. Survivors of gender-based violence (GBV) often experience life-long emotional distress, mental health problems and poor reproductive health. The levels of violence in schools often reflect the levels and patterns of violence in the countries, communities and families.

Education
The social and economic realities of South Africa merit schools as valuable centres of support for communities, and demands more from its educators than ever before. Socio-economic factors found in the South African context include high rates of HIV infection and tuberculosis, orphans and vulnerable children, child-headed households, crime, violence, abuse and high rates of unemployment and poverty. The combination of factors play a significant role in the physical and mental health and wellbeing of the population, especially among children. This context can have a particularly debilitating impact on learner academic capacity and progress. South Africa has improved access to education with a gross attendance rate of 97% in 2013, and an increase in access in the preschool years, with 91% of 5 to 6-year-olds attending some kind of educational institution or care facility . However, the challenges within education remain enormous. Reported attendance rates drop off sharply as children get older and over 400,000 children of school-going age do not attend school While there is no significant difference in drop-out rates between boys and girls, pregnancy accounts for between 11% and 20% of drop-out amongst teenage girls not attending school . Problems related to education access are most pronounced in rural areas, home to two thirds of children living in poverty . Care and Support efforts are needed to address these barriers to education, ultimately increasing our return on this significant investment.

Number of children reached by the country in 2016

64 394 children, as reported in annual report

Policy and frameworks supporting children
  1. National Policy Framework on OVC
  2. National Action Plan for OVCY
  3. Programme of Action for Orphans, Vulnerable Children and Youth
  4. PSS Conceptual Framework for OVCY
  5. PSS Intervention Guidelines for OVCY
In-country HR capacity
Country Director 1
Programme Manager 1
Technical Advisor 1
Monitoring and Evaluation
Training Team
Finance and Administration Director 1
Human Resources
Administration
Finance 1
Associates