CHILD SURVIVAL

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CHILD SURVIVAL

• Kashifa Abrahams - Senior Researcher
• Child Health Service Programme

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Purpose

• Childrens Institute
• Background - Why child survival?
• Child survival in Rights framework
• Way forward

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Mission of CI

• The Childrens Institute, University of Cape
  Town, aims to contribute to policies, laws and
  interventions that promote equity and realize the
  rights and improve the conditions of all children
  in South Africa, through research, advocacy,
  education and technical support.

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Current status of Child Survival in SA

• IMR 60/1000 live births
• U5MR 95/1000 live births
• 10 deaths of children under 5 yrs every hour

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TRENDS IN CHILD MORTALITY ESAR, 1990-2004 TRENDS IN CHILD MORTALITY ESAR, 1990-2004 TRENDS IN CHILD MORTALITY ESAR, 1990-2004 TRENDS IN CHILD MORTALITY ESAR, 1990-2004 TRENDS IN CHILD MORTALITY ESAR, 1990-2004
COUNTRY U5MR, 1990 U5MR, 2004 CHANGE EPI COV.
Botswana 58 116 -58 97
Zimbabwe 80 129 -49 85
Kenya 97 120 -33 73
Rwanda 173 203 -30 89
Swaziland 110 156 -16 83
South Africa 60 67 -7 93
Zambia 180 182 -2 80
Angola 260 260 0 59
Burundi 190 190 0 74
Somalia 225 225 0 30
Uganda 160 138 22 87
Namibia 86 63 23 81
Tanzania (Dar) 161 126 35 95
Ethiopia 204 166 38 80
Lesotho 120 82 38 78
Madagascar 168 123/94 45 OR 72 61
Comoros 120 70 50 76
Eritrea 147 82 65 83
Malawi 241 175 66 89
Mozambique 235 152 83 72
AVE, WEIGHTED 167 149 18 78 (unweighted)
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Main causes of child deaths

• Largely preventable
• HIV/AIDS
• Diseases of poverty (e.g. diarhoeal disease,
  malnutrition, pneumonia)
• Trauma (Road traffic accidents violence, which
  include homicide and suicide etc.)
• Age 0 to 4 years - burns
• Age 5 to 14 years - MV pedestrian
• Age 15 to 64 years - firearms
• Other neonatal sepsis, preterm births

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Out- patient Density
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Why work from a rights perspective?

• What are human rights?
• Human rights are about legal rights and legal
  duties
• Rights holders all children under 18
• Duty bearers all government departments
• Legal instruments
• Constitution of South Africa Act 108 of 1996
• International law United Nations Convention on
  the Rights of the Child and African Charter on
  the Rights and Welfare of the Child
• Non-binding agreements Millennium Development
  Goals
• Analyze child survival in terms of rights
  holders and duty bearers

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Relationship between international
constitutional law

• The right to survival exists only in
  international law. It is incorporated to South
  African law through the right to life and through
  the socio-economic rights and through the duty to
  respect protect and promote.
• Also international law must be considered

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Constitution Everyone has the right to life International law Duty State Duty Bearers
Duty to Respect the right to life Universal Declaration of Human Rights art 3 Everyone has the right to life. Covenant on Civil Political Rights art 6 Every human being has the inherent right to life. ACRWC art 5 (1) UNCRC art 6 (1) Every child has the inherent right to life. The State may not take someones life. The right is inherent and non derogable. It is the basis of all other human rights because all the other rights depend on the right to life. (Bueren, 1995, Detrick, 1999) Legislature Must draft laws that prevent and punish State actors who kill people. For example the prohibition of the death penalty is a way in which the legislature gives effect to the right to life. Department of Safety Security Police officers or army are not allowed to arbitrarily/ unlawfully kill people. Department of Correctional Services People may not be killed in detention. J
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Duty to Protect and Promote the right to life UNCRC 6(2) ACRWC 5(2) States must ensure to the maximum extent possible the survival and development of the child. The State must take positive measures to avoid preventable deaths. (Hodgson, 1994) State must ensure that people dont take other peoples lives. Dept. of Agriculture ensure food production to avoid starvation. Dept Health measures to avoid death, remediate/cure illness/ disease/injury. Post Mortem and follow up on child deaths Dept of Home Affairs Registration of Births and deaths. Police Services Prevent crime (especially child abuse and domestic violence). Stats SA collect disaggregate data on child deaths Dept of Soc Dev payment of grants and delivery of social services Dept Transport prevent road accidents Presidency ORC Coordinate activities of departments. Dept Water Affairs Forestry and Local Government Ensure access to clean water and sanitation.
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Duty to fulfil the right to life UNCRC 6(2) ACRWC 5(2) States must ensure to the maximum extent possible the survival and development of the child. Parents are primarily responsible for ensuring their childrens development State must assist parents esp. i.r.t. housing, nutrition health, clothing and education. Dept of Housing healthy and safe living conditions. Dept of Education provide syllables for child and adult education teaching people to ensure survival and development Dept of Environmental Affairs ensure environment for healthy development Dept of Health provide PHC and access to the full range of health services to ensure survival and development, provide assistive devices for children with disabilities Dept of Soc Dev payment of grants and delivery of social services Local Government provision of basic services (water, sanitation, refuse removal, electricity)
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What does this mean in practice?

• All persons under 18 have the right to max.
  survival and development
• Binds all government departments and other bodies
• Analyse the hazards for different age groups to
  formulate responses

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Way forward

• Acknowledgement Awareness
• Mainstreaming Child Rights-Child Survival
  Development
• Integrated Plan
• Multi-level, co-ordinated responses
• Parliamentary Inquiry into Child Survival

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Take Home Message

• Child Survival warrants URGENT attention in South
  Africa
• JMC has KEY ROLE to play to enhancing prospects
  for survival for the nations children