1

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

survey:survey:Alfred Nzo resultsAlfred Nzo 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 Alfred Nzo data: national

report and results are 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 Alfred Nzo-specific findings– Alfred Nzo 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

Alfred Nzo scorecardIndex RatingPoverty Social Capital Health Service Delivery Development Global

Compared with other nodes, Alfred Nzo is a mixed bag: it has red (warning) lights flashing in the

poverty and development awareness indexes; but scores better than the ISRDP average in the areas of

social capital, service delivery, health and the overall global index.

7

PovertyPoverty Index - ISRDP Nodes

18%

36%41% 43% 46% 46% 47% 50% 50% 52%

55% 56% 57% 58%

0%

10%

20%

30%

40%

50%

60%

70%

14 13 12 11 10 9 8 7 6 5 4

Alfre

d Nz

o 2 1

Female headed households OvercrowdingUnemployment No refuse removalNo income No RDP standard waterInformal housing No RDP standard sanitationFunctional illiteracy No electricity for lighting

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

weighting. Alfred Nzo in the 3rd poorest of all 14 ISRDP nodes..

8

Poverty deficitPoverty Measures: Alfred Nzo vs. ISRDP Avg

1% 2%

32%

82%

57%

93%

36%

93%

90%

77%

2% 4%

38%

78%

53%

80%

30%

75%

65%

51%

0%20%40%60%80%

100%

No

inco

me

Ove

r-cr

owdi

ng

Illite

rate

Une

mpl

oyed

Fem

ale

head

edho

useh

old

No

RD

Psa

nita

tion No

elec

trici

ty 4

light

s

No

refu

sere

mov

al

No

RD

Pw

ater

Info

rmal

dwel

ling

Alfred Nzo ISRDP Avg

Difference vs ISRDP Avg

-50% -46%

-16%

5% 9%17% 21% 23%

39%50%

-60%

-40%

-20%

0%

20%

40%

60%

No

inco

me

Ove

r-cr

owdi

ng

Illite

rate

Une

mpl

oyed

Fem

ale

head

edho

useh

old

No

RD

Psa

nita

tion No

elec

trici

ty 4

light

s

No

refu

sere

mov

al

No

RD

Pw

ater

Info

rmal

dwel

ling

Priority areas

For example, read For example, read

as: respondents in as: respondents in

Alfred Nzo 50% Alfred Nzo 50%

more likely than more likely than

ISRDP average to ISRDP average to

live in informal live in informal

dwellings; 39% dwellings; 39%

more likely not to more likely not to

have water to RDP have water to RDP

standards; 23% standards; 23%

more likely to have more likely to have

no refuse removal; no refuse removal;

etc.etc.

Note the positives: lower than average incidence of Note the positives: lower than average incidence of

no income etc.no income etc.

9

Poverty analysis• We have seen that Alfred Nzo is amongst the poorest

ISRDP nodes, measured using these poverty indicators. Among the key challenges are the following, any of which are service delivery issues:– 93% of respondents lacked RDP-level sanitation– 93% did not have their refuse removed– 90% lacked RDP-standard water– The rate of unemployment was 82%– 77% of respondents lived in informal dwellings– 57% of households sampled were headed by women

• It is difficult to identify positives in such a challenging environment, but the data do suggest that functional illiteracy was lower (at 32%) than the ISRDP average, and just 1% of respondents said they had no regular income source.

• Poverty remains an overriding challenge for the node.

10

Development deficitDevelopment Index - ISRDP Nodes

23%27% 30% 31%

34% 34% 35% 36%38% 40%

44% 46%49%

57%

0%

10%

20%

30%

40%

50%

60%

14 13 12 11 10 9 8 7 6 5

Alfre

d Nz

o 3 2 1

• 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.

• Alfred Nzo rates as the 4th worst ISRDP node on development awareness, a negative finding and somewhat counter-intuitive given the robust social capital (including social networks and CSO membership) in the node.

11

Development Measures: Alfred Nzo vs. ISRD Avg

31% 42

%

37% 44

%

44%

35% 43

%

45% 47%

43% 51

%

49%

51%

49%

51%54%

67%

31% 35

%

35%

26% 32

%

33%

34%

31% 36

%

34%

34%

31%

32%

0%

20%

40%

60%

80%

Devt

-G

ovt

Devt

-NP

Os

Scho

ols

Oth

erDe

v

Healt

h

Road

s

Gar

dens

Farm

ing

Crec

hes

Wat

er

Spor

t

Com

Hall

s

HIV/

Aids

Food

Hous

es

Alfred Nzo ISRDP Avg

Difference vs ISRD Avg

-42%-37%

19%27% 27% 32% 34% 37% 39% 39% 43% 45% 48%

58% 60%

-60%

-40%

-20%

0%

20%

40%

60%

80%

Devt

-Gov

t

Devt

-NPO

s

Scho

ols

Oth

er D

ev

Healt

h

Road

s

Gar

dens

Farm

ing

Crec

hes

Wat

er

Spor

t

Com

Hall

s

HIV/

Aids

Food

Hous

es

Development deficit

Target areas

There are few There are few

positives: respondents positives: respondents

were only were only above the above the

averageaverage in awareness in awareness

of who was providing of who was providing

development - development -

government or CSOs - government or CSOs -

but not on any type of but not on any type of

development activitydevelopment activity

12

Social capital deficitSocial Capital Index - ISRDP Nodes

27% 29%

38% 39% 41% 41% 43% 44% 45% 45% 47% 48% 49%52%

0%

10%

20%

30%

40%

50%

60%

Alfre

d Nz

o

13 12 11 10 9 8 7 6 5 4 3 2 1

• 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.

• But for Alfred Nzo this area is good news: it enjoys the best levels of social capital of all 14 ISRDP nodes. Just 30% of respondents belong to no CSO, and there is a very strong basis for partnerships, networking and outreach.

13

Social Capital Measures: Alfred Nzo vs. ISRDP Avg

0 4%

30%

16% 22

% 28%

12%

37%

66%

0

9%

58%

31% 38

% 49%

20%

56%

70%

0

0.2

0.4

0.6

0.8

Socia

lCa

pital

Inde

x

Relig

ion

Nom

embe

rship

Able

toso

lvepr

oblem

s

No-o

neca

res

Cant

influe

nce

com

dev

t

Who

peo

pleca

re fo

r

Politi

cs is

wast

e

Deali

ng w

ithpe

ople

Alfred Nzo ISRDP Avg

Difference vs ISRDP Avg

-57%

-48% -48%-44% -43%

-39%-35%

-6%

-70%

-60%

-50%

-40%

-30%

-20%

-10%

0%

Relig

ion

Nom

embe

rshi

p

Able

to s

olve

prob

lems

No-o

neca

res

Cant

influ

ence

com

dev

t

Who

peo

ple

care

for

Politi

cs is

wast

e

Deali

ng w

ithpe

ople

Social capital deficit

Strengths

For example, read as: For example, read as:

Alfred Nzo respondents Alfred Nzo respondents

were 57% less likely than were 57% less likely than

ISRDP average to ISRDP average to

believe you need to be believe you need to be

careful dealing with careful dealing with

people, 35% less likely to people, 35% less likely to

think politics is a waste think politics is a waste

of time, etc.of time, etc.

14

Service DeliveryService Delivery Index - ISRDP Nodes

39%

47% 48% 50% 50% 51% 51% 53% 54% 57% 57% 61% 61% 62%

0%

10%

20%

30%

40%

50%

60%

70%

14 13 12

Alfre

d Nz

o

10 9 8 7 6 5 4 3 2 1

Alfred Nzo has the fourth best rating on

service delivery amongst the 14 ISRDP

nodes.

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: Alfred Nzo vs. ISRDP Avg

5%

31%

26%

42%

27%

24% 32

%

59%

44%

38%

15%

55%

44%

67%

42%

34% 47

%

64%

48%

41%

0%

20%

40%

60%

80%

Qua

lity-

educ

ation

Qua

lity-ro

ads

Qua

lity-

trans

port

Loca

l Gov

tPe

rform

ance

Qua

lity-

wate

r

Gov

t Dep

tCo

-ord

inatio

n

Clea

n wa

ter

Old

age

pens

ion

Mea

n Q

uality

Qua

lity-

healt

h

Alfred Nzo ISRDP Avg

Difference vs ISRDP Avg

-65%

-44%-40% -37% -35%

-31% -30%

-8% -8% -7%

-70%

-60%

-50%

-40%

-30%

-20%

-10%

0%

Qua

lity-

educ

ation

Qua

lity-ro

ads

Qua

lity-

trans

port

Loca

l Gov

tPe

rform

ance

Qua

lity-

wate

r

Gov

t Dep

tCo

-ord

inatio

n

Clea

n wa

ter

Old

age

pens

ion

Mea

n Q

uality

Qua

lity-

healt

h

Service delivery – strengths

Strengths

Read as: With the quality of

service delivery relatively high

in this node a number of

positive findings can be

reported upon including the

finding that respondents

perceive the quality of

education in the node to be

65% better than the ISRDP

average and local government

performance to be 37% better

than the ISRDP average

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.

Alfred Nzo ISRDP• Of the households receiving grants five out of ten (51%) are receiving Child Support Grants

• ISRDP average for households receiving Child Support Grants is half (50%)

• Four out of ten (41%) households receiving grants are receiving Pensions

• ISRDP average for households receiving pensions is a third (31%)

• Half of respondents (50%) encounter DSD services at a DSD office

• Half across all nodes (50%) experience DSD services at a DSD office

• The other half of the respondents (50%) interact with the DSD at a Pension Pay Out point

• A further third (31%) across all nodes will receive DSD services at a Pension Pay Out point

17

Health deficitAlfred Nzo is rated the 3rd

best ISRDP node in respect to

health measures, with less

than half of respondents

(46%) perceiving their health

status as poor.

Health Deficit Index - ISRDP Nodes

45% 46% 46% 47%53% 54% 55% 56% 56% 57% 58% 58% 58%

63%

0%10%20%30%40%50%60%70%

Cen

tral K

aroo

Sekh

ukhu

ne

Alfre

d N

zo

Kgal

agad

i

Ugu

Mar

ulen

g

O.R

. Tam

bo

Ukh

ahla

mba

Um

ziny

athi

Thab

oM

ofut

sany

ane

Bush

buck

ridge

Chr

is H

ani

Zulu

land

Um

khan

yaku

de

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 • HIV and AIDS was also reported to be the significant health problem in the node,

half of all respondents reported this (51%) as opposed to an average of 30% across all nodes.

• Other health problems perceived by respondents included TB (19% of respondents identified this as an issue) and alcohol abuse (16% perceived this as a problem)

• 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

surprisingly not seen to be a major obstacle, with respondents in the node 31% less likely than the ISRDP average to report access to health services as a problem, thus we find that only– 36% of respondents reported distance to health facility as being a problem– 27% 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, TB 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 Alfred Nzo residents

19Proportion who agree that both parties in a relationship should share

decision - making

57

68

78

65

84

77

84

73

0 10 20 30 40 50 60 70 80 90

Agree on whether to takea sick child to the clinic

Agree on using income topay for health care or

medicines

Agree on when to havechildren

Agree whether to usefamily planning

Average Sekhukhune

Read as: Majority in

the node support the

view that most

decisions in the

household require

joint decision-making

by both partners

20

Proportion supporting statements about female contraception

60

43

39

30

58

48

25

20

0 10 20 30 40 50 60 70

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

Average Alfred Nzo

Read as: Node is still

deeply conservative

and myths about

contraception are

widely held.

21Proportion 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 nearly all situations is higher in this node than the ISRDP average and points to deeply negative attitudes towards 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

Average Alfred NzoIs unfaithful 23 19Does not look after the children

21 32

Goes out without telling him

16 26

Argues with him 15 16Refuses to have sex with him

9 14

Burns the food 7 12

22

Attitudes towards abortion

49

35

42

40

9

23

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

Total

Alfred Nzo

Agree that abortion should only be allowed if mother's life in dangerAgree that abortion is morally wrong and should never be allowedAgree that abortion on request should be the right of every women

Read as: Abortion

is NOT supported

by four out of ten

respondents

(40%), slightly

lower than the

ISRDP average

(42%)

23

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 Alfred Nzo

• Disturbing to note the high levels of support for Gender Based Violence, coupled to very limited support for abortions and widespread belief in certain 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

• In theory, at least, majority support the idea that many decisions in the household require joint decision-making by both partners

• But many across the nodes not only do not support joint decision-making but go further and endorse 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.

24

HIV & AIDS: Awareness levels

63

64

18

71

74

11

0 10 20 30 40 50 60 70 80

Heard about those incommunity with AIDS?

Heard about those whohave died of AIDS in

community?

If household memberwas infected would want

to keep it secret?

% Yes

Average Alfred Nzo Read as: Prevalence

rates are high and

secrecy is relatively low,

suggesting

stigmatization may be

dropping in face of

unavoidability of the

epidemic

25

HIV & AIDS: Proportion who accept the following statements

33

80

82

85

83

55

82

78

82

76

0 10 20 30 40 50 60 70 80 90

Mosquitoes pass on HIV

Infected mothers canpass on virus through

breastfeeding

Healthy looking personcan have AIDS

One can get AIDS fromsharing razors

Condoms preventtransmission of HIV

% who agree

Average Alfred Nzo

Read as: High awareness

of how HIV is

transmitted, except half

(55%) gave incorrect

answer re mosquitoes

26

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 (albeit that the node is slightly worse than the average scores for ISRDP), except in the case of Mosquitoes. This is however, not a surprising response in an area which is NOT affected by mosquito-borne diseases such as Malaria

• Despite high levels of awareness of AIDS sufferers in their communities few respondents can actively assist – Less than 2% in the node reported on providing support to orphans or

providing Home Based Care• Despite high incidence of HIV across Alfred Nzo, levels of poverty are so

crippling few can do much to assist those who are infected and suffering• These findings support the need for an urgent integrated intervention in the

node that incorporates health, poverty, GBV, HIV and AIDS

27

Conclusion

Index Challenges StrengthsPoverty • Gloomy scores

especially re infrastructure

• Access to regular income

Social Capital

• Best social capital scores in the ISRDP, high on all items

Health • Shifting attitudes towards GBV & Sexual Reproductive Health• Expanding DSD/UNFPA activities (esp. HIV & AIDS)

• Access to & quality of Health Care

Service Delivery

• Increasing penetration of DSD grants in the node

• Quality of service delivery

Development

• Negative scores across all types of development activity

Despite worrying scores in some areas, compared with other ISRDP nodes, Alfred Nzo has a slightly above Despite worrying scores in some areas, compared with other ISRDP nodes, Alfred Nzo has a slightly above

average average “Global Development” rating “Global Development” rating