We are proud to announce that we have launched the South African Early Childhood Review 2017 – our annual statistical review of more than 40 carefully selected data points measuring early childhood service delivery in South Africa across the five essential package components:

1. maternal and child health
2. nutrition
3. support for primary caregivers
4. social services and income support
5. early learning

The 2017 review assesses indicators down to district level, and not only shows the shocking inequalities throughout South Africa as it had in 2016, but also within its provinces.

Another new feature is data from South Africa’s first population level pre-school child assessment tool – ELOM. ELOM measures whether ECD programmes are effective in preparing children for Grade R and identifies areas for programmatic improvement. ELOM’s data from testing 1 300 children across the five income quintiles acts is assessed as a baseline for the Review’s early learning coverage.

The review includes data on several carefully selected indicators that reveal the following:

Children under 6 years

  • there are between six and seven million living in South Africa
  • nearly two thirds (about four million) live in the poorest 40% of households
  • who live in the rural districts, are receiving disproportionately poorer services
  • the provinces with the highest proportion of those living in rural areas are the Eastern Cape, 60%; Limpopo, 83%; KwaZulu-Natal, 61%, and Mpumalanga, 65%.
  • about a third (32%) live in households without piped water
  • in 19 out of the 52 districts in South Africa, more than half live in households without piped water
  • more than 1.5 million live in a household without a toilet or ventilated improved pit latrine
  • the majority (62%) live in households that fall below the upper food poverty line of R965 per person per month
  • of R415 per person per month
  • 29% live in workless households (more than 1.8 million)

Primary maternal and child health

  • early antenatal bookings, before 20 weeks into pregnancy, have increased to 61%. This is important as protecting the health of a mother and her child starts with antenatal care, which is an important gateway to primary health and nutrition services. Receiving proper antenatal care reduces poor pregnancy outcomes and can help prevent stunting and HIV in young children
  • despite being recorded as among the districts with the highest number of households with children under 6, Johannesburg, Ekurhuleni and Tshwane have the lowest rates of antenatal visits: 52%, 55% and 55% respectively
  • at least 400,000 pregnant women each year only visit the clinic after their 20th week into pregnancy
  • South Africa’s infant mortality rate of 27 deaths per 1,000 live births is relatively high
  • the under-5 mortality rate is 40 per 1,000
  • 89% of children under 1 complete the primary immunisation course. This coverage level is an indicator that the health system is functioning well
  • More than a fifth (1.4 million) of children under 6 have poor access to clinics as they live more than 30 minutes away from the nearest health facility. The highest rates are in Eastern Cape (33%) and KwaZulu-Natal (30%)
  • The national delivery in facility birth rate is 85%, with highest in Gauteng and Limpopo (97% and 91% respectively)

Nutritional support

  • more than a fifth of children suffer from stunting – a condition where children are too short for their age
  • 13% of children under 5 years are overweight
  • prevalence of anaemia in women of reproductive age higher than 30% in some provinces
  • 32% of infants under 6 are exclusively breastfed while one in four children under 6 are not breastfed at all
  • Only 23% of children between 6-23 months are fed a minimum acceptable diet
  • 44% of children under 5 suffer from Vitamin A deficiency while 57% of children between 12-59 months received a Vitamin A dose at a public facility
  • Some districts like Amthole and Xhariep have above 90% vitamin A supplementation coverage rates while others like Pixley ka Seme and Waterberg have coverage rates lower than 40%
  • Approximately 11% of children under 5 are anaemic

Support for primary caregivers

  • majority of children under 6 (85%) live with their biological mother
  • 76% of women attended antenatal visits four or more times during their last pregnancy, making this an opportunity to extend other services to them in this space
  • 94% of HIV-positive mothers received information during antenatal visits
  • 69% of women who gave birth in public facilities received follow-up care within six days of giving birth, but this rate was as low as 53% and 58% in the Northern and Eastern Cape respectively
  • antenatal and postnatal depression and anxiety are prevalent and affects approximately one third of mothers

Social services and income support

  • the uptake rate of the Child Support Grant among poor children under 6 years is 81%. 4 254 186 children under 6 receive the CSG
  • Uptake rates are highest in Eastern Cape (86%), Limpopo (84%) and North West (79%), and lowest in Western Cape (70%) and Gauteng (67%)
  • only 64% of poor infants under 1 receive the CSG, with rates lowest in Gauteng (49%) and Western Cape (55%) and highest uptake in Eastern Cape (75%). The CSG is an important social assistance programme that provides income support for children living in poverty

Stimulation for early learning

  • 63% of 3-5 year olds are enrolled in an early learning group programme. Access for 3-5 year olds is lowest in KwaZulu-Natal (49%) and over a million still do not have access to early learning programmes. This means that many poor children enter school already disadvantaged by not having had access to quality early learning programmes that were available to their wealthier peers. Receiving high quality early learning is directly linked to greater cognitive gains, especially for children from low-income communities. At this point there is no reliable data that allows national monitoring of the quality of the early learning programmes children do receive.
  • more than 83% of 3-5 year olds in the richest 20% of households attend a group learning programme while only 58% in the poorest 20% of households are enrolled in a programme

Click here to read the full South African Early Childhood Review 2017.

The South African Early Childhood Review 2017 is a joint venture between Ilifa Labantwana, the Children’s Institute at the University of Cape Town, the Department of Planning, Monitoring and Evaluation, and Innovation Edge.

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