Children and Adolescents in Namibia, a situation analysis (2010). UNICEF Namibia

Children and Adolescentsin Namibia 2010

Children at a Glance

GeneralIndicator Recent estimates

Estimated total population (2011)a

Urban

Rural

2,184,091

35%

65%

Estimated population under 18 years (2011)a 921,184 (42%)

Estimated population under age 5 years (2011)a 291,757 (13%)

Estimated school going population 7 – 13 (2011)a 328,504 (15%)

Estimated school going population 14 – 18 (2011)a 244,654 (11%)

Estimated population of youth 15 to 24 (2011)a 469,174 (21%)

Life expectancy at birth (2001)b

Male

Female

48 years

50 years

Infant Mortality (per 100 live births) (2006)c 46

Under 5 Mortality (per 100 live births) (2006)c 69

Maternal Mortality (per 100 live births) (2006)c 449

GNI Per Capita(2010)d US$4,210

Gini Coefficient of Inequality (2003/4)e 0.743

Poverty (2003/4)f

Poor households

Severely poor households

28%

14%

Average Number of Children Per Household (2003/4)f

Non-poor

Poor

Severely poor

1.8

3.6

3.9

EducationIndicator Recent estimates

Number of schools(2009)g 1,677 (1,040 primary schools)

Number of learnersf (2009)

Primary

Secondary

585,471

406,920

169,390

Net School Enrolment Ratio (2009)1

Primary

Secondary

93.1% (M 91.4%, F 94.8%)

98.3% (M 96.6%, F 100.1%)

54.8% (M 48.8%, F 60.7%)

This table provides a statistical snapshot of the status of children in Namibia to use as reference.

Children and Adolescents in Nam

ibia2010

Children and Adolescentsin Namibia 2010

a situation analysis

National Planning Commission

Luther Street

Government Office Park

Private Bag 13356

Windhoek

Namibia

This Situation Analysis was commissioned by the National Planning Commission with support from UNICEF. The National Planning

Commission recognises the work of SIAPAC who prepared the report and the members of the Techinical Working Group for the

Situation Analysis of Children and Adolescents 2010. The opinions expressed within this report are those of the authors and do not

necessarily reflect the policies or views of the National Planning Commission nor UNICEF.

Published by John Meinert Printing, for:

National Planning Commission

Luther Street

Government Office Park

Private Bag 13356

Windhoek

Namibia

ISBN -13: 978-99916-835-4-6

EAN: 9789991683546

© NPC

PHOTOGRAPH CREDITS:

Front cover photos:

©UNICEF/Namibia2006-2010/Tony Figueira

©UNICEF/Namibia2010/Manuel Moreno

Top strip photos:

©UNICEF/Namibia2006-2008/Tony Figueira (Pic. 1, 2, 5 and 6)

©UNICEF/Namibia2006-2010/Manuel Moreno (Pic. 3 and 4)

Top right photos for sections:

©UNICEF/Namibia2006-2010/Tony Figueira

©UNICEF/Namibia2010/Manuel Moreno (Sec. 6, Pag. 67-73)

Margins photos:

©UNICEF/Namibia2006-2010/Tony Figueira (Pages i, ii, iii-5, 7-9, 25-33, 35-51, 53-65, 67-73, 91-97 and 99-133)

©UNICEF/Namibia2006-2010/Manuel Moreno (Pages i,iii, 11-23 and 75-89)

General photos:

©UNICEF/NYHQ2008/ John Isaac (Pages 22, 36, 46 and 80)

©UNICEF/Namibia2006-2010/Tony Figueira: (Pages 2, 3, 4, 6, 8, 10, 14, 24, 27, 30, 33, 34, 37, 41, 42, 47, 49, 51, 52, 54, 55, 57,

60, 65, 66, 69, 83, 84, 86, 88, 90, 94, 95 and 96)

©UNICEF/Namibia2006-2010/Manuel Moreno (Pages 12, 17, 18, 20, 38, 40, 44, 50, 56, 59, 63, 70, 72, 74, 76, 78 and 98)

©UNICEF Namibia Photolibrary (Page 48)

SITUATION ANALYSIS i

ContentsMAP OF NAMIBIA

LIST OF TABLES

LIST OF FIGURES

LIST OF ABBREVIATIONS

FOREWORD

PREFACE

INTRODUCTION

OVERVIEW

1. INTRODUCTION 1.1 WHY THIS REPORT

1.2 METHODOLOGY

1.3 STRUCTURE OF THE REPORT

2. THE NATIONAL FRAMEWORK 2.1 INTRODUCTION

2.2 NATIONAL AND INTERNATIONAL FRAMEWORKS

2.2.1 Namibian Constitution

2.2.2 Vision 2030

2.2.3 Third National Development Plan

2.2.4 Millennium Development Goals

2.2.5 Convention on the Rights of the Child

2.2.6 African Charter on the Rights and Welfare of the Child

2.2.7 Other Conventions and Covenants that Directly Impact on Children

2.3 NATIONAL POLICIES, LAWS AND PROGRAMMES

2.3.1 Policies

2.3.2 Laws

2.4 GOVERNMENT MINISTRY SUPPORT FOR CHILDREN

2.4.1 Ministry of Gender Equality and Child Welfare

2.4.2 Ministry of Education

2.4.3 Ministry of Health and Social Services

2.4.4 Ministry of Labour and Social Welfare

2.4.5 Ministry of Safety and Security

2.4.6 Ministry of Justice

2.4.7 Ministry of Youth National Service Sport and Culture

2.4.8 Ministry of Information and Communication Technology

2.4.9 Ministry of Home Affairs and Immigration

2.4.10 Ministry of Regional and Local Government, Housing and Rural

Development

2.5 OTHER AGENCIES

2.5.1 Civil Society Organisations

2.5.2 Development Partners

2.5.3 Other Agencies

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3. CHILDREN AND YOUNG PEOPLE: SOCIO-ECONOMIC BACKGROUND 3.1 INTRODUCTION

3.2 ECONOMIC TRENDS

3.3 CHILDREN AT RISK OF POVERTY

3.4 SOCIAL WELFARE GRANTS – NOT REACHING THEIR POTENTIAL

3.5 INVESTMENT IN CHILDREN – UNFINISHED BUSINESS

3.6 SUMMARY

4. CHILDREN AND YOUNG PEOPLE: ISSUES AND CONCERNS 4.1 INTRODUCTION

4.2 URBANISATION

4.3 FACILITIES AND NETWORKS

4.4 THE FAMILY

4.4.1 Children’s Views of the Family

4.4.2 Changing Family Structures

4.4.3 Child Headed Households

4.4.4 Violence in the Family

4.4.5 Alternative Care to Children

4.5 CHILDREN IN SPECIAL CIRCUMSTANCES

4.5.1 Child Labour

4.5.2 Children with Disabilities

4.5.3 Refugee Children

4.5.4 Children and HIV and AIDS

4.6 CHILDREN AND COMMUNICATION

4.7 CLIMATE CHANGE: IMPACT AND RESPONSE

4.8 SUMMARY

5. INFANTS AND YOUNG CHILDREN (0 – 5 YEAR OLDS) 5.1 INTRODUCTION

5.2 CARE OF MOTHERS

5.3 CARE OF BABIES AND INFANTS

5.3.1 Infant Deaths

5.3.2 Infanticide and Baby Dumping

5.3.3 Postnatal Health Care

5.3.4 Common Childhood Illnesses that Can Lead to Death

5.3.5 Immunisation

5.4 LEGAL IDENTITY

5.5 THE ROLE OF SERVICE PROVIDERS

5.6 GETTING A GOOD START IN LIFE

5.6.1 Nutrition of Children

5.6.2 Early Childhood Development

5.7 SUMMARY

6. CHILDREN (6 – 11 YEAR OLDS) 6.1 INTRODUCTION

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ii CHILDREN AND ADOLESCENTS IN NAMIBIA 2010

SITUATION ANALYSIS iii

6.2 PRIMARY EDUCATION

6.2.1 Availability of Primary Education

6.2.2 Standards of Primary Education

6.2.3 Education Support for Vulnerable Children

6.2.4 Food Support

6.3 CHILDREN UNDER STRESS

6.3.1 Child Labour

6.3.2 Violence and Stress at Home and in School


6.3.4 HIV and AIDS

6.4 SUMMARY

7. ADOLESCENTS (12 – 17 YEAR OLDS) 7.1 INTRODUCTION

7.2 EDUCATION

7.2.1 Reasons for Leaving School

7.3 LIFE SKILLS, HEALTH AND SEXUALITY

7.3.1 Health Care and Life skills

7.3.2 Emotional Growth and Sexuality

7.3.3 Adolescents Living with HIV

7.3.4 Attitudes to HIV and AIDS

7.4 SAFETY AND PROTECTION

7.4.1 Adolescent Sexual Vulnerability

7.4.2 Safety in School

7.4.3 Safety in the Community

7.4.4 Exploitation

7.5 CHILDREN IN CONTACT WITH THE LAW

7.6 SUMMARY

8. SUMMARY 8.1 OVERVIEW

8.2 THE LIFE CYCLE APPROACH FROM BIRTH TO ADULTHOOD

8.2.1 Infants and Young Children (0 to 5 Year Olds)

8.2.2 Children (6 to 11 Year Olds)

8.2.3 Adolescents (12 to 17 Year Olds)

8.3 INFORMATION AND POLICY NEEDS

8.4 CHILDREN AS A NATIONAL RESOURCE

BIBLIOGRAPHYANNEXES

ANNEX A: LIST OF KEY INFORMANT INTERVIEWS AND EXTENDED TECHNICAL

WORKING GROUP MEMBERS

ANNEX B: LIST OF CHILDREN’S FOCUS GROUPS

ANNEX C: FOCUS GROUP DISCUSSION INSTRUMENT

ANNEX D: KEY INFORMANT INTERVIEW INSTRUMENT

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iv CHILDREN AND ADOLESCENTS IN NAMIBIA 2010

Map of Namibia

SITUATION ANALYSIS v

List of FiguresFigure 1: CSOS by sectorFigure 2: Namibia per capita GDP, based on Purchasing-Power-Parity (PPP)Figure 3: Income inequality across the worldFigure 4: Trends in unemploymentFigure 5: Child and total poverty rates by regionFigure 6: Children receiving child welfare grants in Namibia Figure 7: Average distance to selected services by poor and non-poor households (kilometres)Figure 8: Percent of children living with both parents or no parents by regionFigure 9: Percentage of children living with both parents or no parents by income quintileFigure 10: Percent of mothers not receiving a postnatal check up by regionFigure 11: Percent of women not receiving post natal care by level of educationFigure 12: Percentage of infants receiving full vaccinations by education of motherFigure 13: Percent of registered children under 5 yrs in 2000 and 2006Figure 14: Education background of teachers, 2002 – 2009Figure 15: Percentage of orphans in school by regionFigure 16: Number of boys and girls in grades 11 and 12 by regionFigure 17: Percent of prevalence: pregnant girls aged 19 and below, compared to national average, 1992 – 2008

List of TablesTable 1: Age breakdown of children in Namibia, 2011 population projectionTable 2: Contribution of industries to GDPTable 3: Water and sanitation for severely poor, poor and non-poor householdsTable 4: Source of energy for severely poor, poor and non-poor householdsTable 5: Percent of men and women in a formal relationship, 2000 and 2006/2007 NDHSTable 6: National plan of action: strategic areas and targetsTable 7: Primary health care service provision by locality in Katutura and KhomasdalTable 8: Use of mosquito nets and malaria related deaths in high incidence regionsTable 9: Vaccination coverage for Kavango and Kunene regionsTable 10: Percentage of stunted, wasted and underweight children under 5 yearsTable 11: Percent of boys and girls who stay in school to grade 5Table 12: Percent of learners reaching level of competence, 2000Table 13: Child disciplineTable 14: Survival rates for grade 8 and grade 11, 2001 – 2008Table 15: Reasons why learners leave schoolTable 16: Poverty share and average number of children per household in four regions with the largest poverty shareTable 17: Regional allocation of recurrent expenditures for MOHSS and MoE.

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List of AbbreviationsARI Acute Respiratory Infection AIDS Acquired Immune Deficiency SyndromeART Anti Retroviral TherapyBEN Bicycle Empowerment NetworkBIG Basic Income GrantCBN Cost of Basic Needs CBS Central Bureau of StatisticsCCPB Child Care and Protection Bill CHI Child Helpline InternationalCRC Convention on the Rights of the ChildCSO Civil Society OrganisationCUBAC Children Used By Adults to Commit CrimeDCW Directorate of Child Welfare ECD Early Childhood DevelopmentEMIS Education Management Information SystemETSIP Education and Training Sector Improvement Programme EU European UnionFGD Focus Group DiscussionGDP Gross Domestic ProductGNI Gross National IncomeGRN Government of the Republic of NamibiaGTZ Gesellschaft für Technische Zusammenarbeit (Germany)HAMU HIV and AIDS Management Unit (Ministry of Education)HIV Human Immunodeficiency VirusICT Information and Communication TechnologyILO International Labour OrganisationIMF International Monetary FundISCBF Institutional Strengthening and Capacity Building FacilityKI Key InformantKII Key Informant InterviewKRA Key Result AreaLAC Legal Assistance CentreMBESC Ministry of Basic Education, Sport and CultureMDG Millennium Development GoalMGECW Ministry of Gender Equality and Child WelfareMHAI Ministry of Home Affairs and Immigration MICT Ministry of Information & Communication TechnologyMLRR Ministry of Lands, Resettlement and RehabilitationMoE Ministry of EducationMoF Ministry of FinanceMoHSS Ministry of Health and Social ServicesMoJ Ministry of JusticeMoLSW Ministry of Labour and Social Welfare

vi CHILDREN AND ADOLESCENTS IN NAMIBIA 2010

SITUATION ANALYSIS vii

MRLGHRD Ministry of Regional and Local Government, Housing and Rural DevelopmentMSS Ministry of Safety and SecurityMYNSSC Ministry of Youth, National Service, Sport and Culture MTC Mobile Telecommunications CorporationMTEF Medium Term Expenditure FrameworkMWACW Ministry of Women Affairs and Child WelfareNAMCOL Namibia College of Open LearningNANASO Namibia Network of AIDS Service OrganisationsNANGOF Namibia Non-Governmental Organisations’ Forum TrustNDHS National Demographic and Health SurveyNDP3 Third National Development Plan NER Net Enrolment RatioNETSS National Educational Technology Service and SupportNGO Non-Governmental OrganisationNHIES Namibia Household Income and Expenditure Survey NIED National Institute for Educational DevelopmentNPA National Plan of Action for OVCNPC National Planning Commission NSF National Strategic Framework for HIV and AIDS OPM Office of the Prime Minister ORT Oral Rehydration Therapy OVC Orphans and Vulnerable ChildrenPDNA Post Disaster Needs AssessmentPEPFAR The President’s Emergency Plan for AIDS Relief (USA)PETS Public Expenditure Tracking SurveyPLHIV People Living With HIV and AIDSPMTCT Prevention of Mother to Child Transmission of HIVSACMEQ Southern and Eastern Africa Consortium for Monitoring Educational Quality SACU Southern African Customs UnionSADC Southern African Development CommunityTB TuberculosisTWG Technical Working GroupUN United NationsUNAM University of NamibiaUNAIDS The Joint United Nations Programme on HIV/AIDSUNDP United Nations Development ProgrammeUNESCO United Nations Educational, Scientific and Cultural OrganisationUNFPA United Nations Population FundUNHCR United Nations High Commission for RefugeesUSAID United States Agency for International DevelopmentUNICEF United Nations Children’s FundWACPU Woman and Child Protection UnitsWHO World Health OrganizationWFP World Food Programme

viii CHILDREN AND ADOLESCENTS IN NAMIBIA 2010

SITUATION ANALYSIS ix

Foreword

Today, more than ever, our national development relies on ensuring that our children, adolescents and young people are properly cared for and protected. Thus Namibia’s future relies on the well-being of our children. Protecting and promoting their rights are pivotal to

national efforts, which encourage sustainable development towards reaching the goals set out in Vision 2030.

It has been 15 years since the last comprehensive Situation Analysis for Children in Namibia was undertaken. Spearheaded by the National Planning Commission and assisted by a Steering Committee drawn from different stakeholders, the study has enabled our Government to assess where Namibia is with its commitments to its children and how much progress has been made in ensuring that their rights are met. The human rights to which children are entitled under international conventions form the basis for the analysis of children’s needs and rights during different stages of their life. Throughout the study, the voices of the children, the adolescents, the government and civil society partners are recorded to communicate what it is like to be a child in Namibia today and made recommendations on what needs to be done to promote the rights of Namibian children and adolescents.

Namibia, through its steady economic growth and stability in the last twenty years is blessed with unique opportunities. Our country is at a crucial juncture in efforts to pave the way for a better, more secure and peaceful nation for our young population. As policy and decision makers, community leaders and mobilisers, it is our obligation to spare them from poverty and deprivation and to maximise opportunities to further their optimal development and participation in the economic mainstream.

Steady economic growth will benefit Namibia’s children and adolescents. However more emphasis should be placed on ensuring equal access to quality services for those who have remained excluded from adequate social services and basic social protection for one reason or another.

Let me reiterate that the Government of Namibia is fully committed to ensuring that the rights of children are met. In this context, we are proud of our collaboration with the United Nations Children’s Fund (UNICEF) in Namibia which has played a vital role in facilitating the completion of this report.

Our ultimate goal is to build for every child in Namibia a world filled with opportunities and safety, where he or she could realise his or her full potential. Only by ensuring those rights can we create a secure, stable and prosperous Namibia.

His Excellency, the President of the Republic of Namibia, Hifikepunye Pohamba

Preface

x CHILDREN AND ADOLESCENTS IN NAMIBIA 2010

Children and adolescents are at the heart of Namibian society, the forefront of national development, and the leaders of the future. When we focus on economic growth, poverty reduction, service provision or social inclusion, we need to ensure that the benefits reach

the nation’s children and young people, as they are integral to reaching our shared objectives, and their empowerment is essential for success in achieving our long term goals.

Government and its partners are challenged daily by the task of trying to improve food security, increase access to basic services, improve livelihoods and create a safe and equitable environment within homes and communities. This task is fundamental to our shared pledge to rural development and poverty reduction, which remains our central commitment and priority for development.

In spite of the progress made in ensuring policies, systems and resources are in place, it is evident that many children continue to face challenges in meeting their basic needs and fulfilling all their rights. The devastating effect of HIV/ AIDS and the pervasive poverty are challenges that need to be overcome so that children can lead healthy lives acquiring adequate knowledge and life skills in the process and enjoying a decent standard of living. Turning these challenges into opportunities are critical for reaching the targets we have set in reaching the Millenium Development Goals while at the same time ensuring that no single child is left behind from this holistic development process.

Children are in some settings do not have their universal rights fulfilled and they cannot rightfully access and enjoy the benefits of services established for them. In many respects, the interests of children are left to come after those of adults. This Situation Analysis emphasises the need to re-focus our efforts and address the gaps by making use of child sensitive approaches to data collection, analysis, planning and monitoring.

The Situation Analysis provides a comprehensive overview, allowing us to understand the overarching situation of children and adolescents in Namibia today, pointing to areas where closer collaboration can increase efficiency and effectiveness, and highlighting some of the challenges that exist in prioritising our actions for children. Hence, I urge that this report be used as a tool for policy dialogue and advocacy at all levels of government and civil society.

Hon. Doreen Sioka, Minister of Gender Equality and Child Welfare

SITUATION ANALYSIS xi

Introduction

Children and Adolescents in Namibia 2010 is the first comprehensive situation analysis in Namibia since 1995. The study highlights that with over 40% of its population under the age of 18, Namibia is rich in terms of children and therefore opportunity, but this potential has yet to be fully harnessed.

Ten years ago, world leaders adopted the Millennium Declaration, pledging to create a more peaceful, tolerant and equitable world in which the special needs of children, women and the vulnerable are met. The Millennium Development Goals (MDGs) were developed as a set of ambitious goals to the practical manifestation of the Declaration’s aspiration to reduce inequity in human development among nations and peoples by 2015, and Namibia wholeheartedly committed to act to achieve the MDGs.

The situation analysis shows that Namibia has made significant progress towards achieving the MDGs, and the national development targets to ensure the rights of Namibia’s children are all met. However, it also highlights that with the MDG deadline only five years away, accelerated action is essential if Namibia is to achieve its targets.

The situation analysis clearly indicates that reaching the poorest and most marginalized children and communities is pivotal to the achievement of the MDGs and the realisation of Vision 2030. It highlights that the strong economic growth since Independence in 1990 has not narrowed the significant disparities across Namibia in child poverty, survival, development, and access to essential services. It points to the unique challenges faced by Namibia due to its historical legacy and the devastating impact of HIV and AIDS on children’s lives, and the commitments and action taken by the Government to accelerating results for the survival, protection and development of Namibia’s children.

In doing so, the report points to the opportunity for an even-greater emphasis on a child-centred equitable development approach, which refocuses on the poorest and most marginalised children and families. Such an equity-based approach focusing on those most in need is rarely argued against: being right in principle and even sound in logic. However, it has sometimes been questioned whether, in practice, such strategies are worthwhile, given their cost and difficulty, particularly in such a vast country as Namibia, where it can be hard to reach the very poor. But over the last decade, there has been mounting evidence from programmes in Namibia and across the world, to show the cost-effectiveness and efficiency in achieving impact of new ways of delivering interventions and ensuring that social services reach out to all children and communities.

The process for the development of this situation analysis was innovative and unique, with the extensive literature and research review and key informant interviews supplemented by focus group discussion with children and adolescents across the country. By using a life cycle approach, the report clearly identifies issues that are pertinent for children in the different stages of their lives: from birth to five years, during the primary school age years 6-11, and then as adolescents from 12-17 years. The focus on adolescents is key as it is during these years that they face many and varied challenges. As the situation analysis points out, there is a need for greater depth of qualitative and quantitative information about this time in their lives.

UNICEF, along with our sister UN agencies, congratulates the Government of the Republic of Namibia, under the leadership of the National Planning Commission and the Ministry of Gender Equality and Child Welfare for the important initiative to commission this situation analysis, and its commitment to ensure its findings are a central resource for planning, guiding the definition of goals and approaches that will further accelerate action towards the MDGs, the national development goals, and the fulfilment of all rights of each and every Namibian child.

Ian Macleod, Representative, UNICEF Namibia

xii CHILDREN AND ADOLESCENTS IN NAMIBIA 2010

SITUATION ANALYSIS 1

Overview

Namibia acknowledged its commitment to children during its own infancy. The Namibian Parliament ratified the Convention on the Rights of the Child (CRC) in 1990, just months after its Independence. In doing so, Namibia agreed to extend protection to children

across all aspects of their lives. Two kinds of reports support this commitment. One, submitted to the United Nations Committee on the Rights of the Child documents the country’s achievements and challenges in implementing the rights described in the various articles and protocols of the CRC and the other is a Situation Analysis, the main audience for which is within the country. Such a report looks backward and forward, aiming to analyse social and economic trends that affect children, consider actions taken on behalf of children, illuminate areas that need further discussion and stimulate discussion among policy makers, service providers, parents, caregivers and children about the areas of need.

The Government of Namibia completed the first situation analysis in 1990 and submitted its first CRC report in 1992 which described the status of children in a country that had just emerged from a century of colonial rule. The second situation analysis for children was completed in 1995 (UNICEF, 1995) and focussed on the rights that are guaranteed to children in a country facing a post apartheid reconstruction. In 2009, the government submitted a second CRC report on the country’s activities over the previous 15 years.

This document is the third comprehensive situation analysis. It represents the work of numerous stakeholders, including children. A Technical Working Group (TWG) oversaw the process. The core TWG included members of government, National Planning Commission Secretariat (NPCS), Ministry of Gender Equality and Child Welfare (MGECW), the Ministry of Education (MoE) and the Ministry of Labour and Social Welfare (MLSW), development partners (United Nations Children’s Fund (UNICEF) and United Nations Development Programme (UNDP), academia (University of Namibia (UNAM) and civil society (the Non-Governmental Organisation Forum (NANGOF Trust). The core TWG provided direct guidance to the project through regular meetings with the team. An expanded TWG met twice to consider overall direction of the report and make in-depth comments from a wide array of perspectives.

Two critical groups of stakeholders contributed to the report. Over 200 children participated in 26 focus group discussions (FGDs) spread over four regions – Karas, Kavango, Kunene and Omaheke. Groups were selected according to gender, age, in school and out of school children. Trained facilitators with experience in leading children through group discussions led and reported on each session. Fifty-three Key Informants (KIs), including practitioners and other officials in regional settings and policy makers at national level, also contributed from across government, development partners and civil society

This report covers the period from 2000 until 2010. The analysis examines a more mature, but still youthful, response to the needs and rights of children. A solid infrastructure is in place, but what exists is incomplete.The need to refine and strengthen a good foundation for the well-being of children and adolescents is a major theme of this report. Namibia has done much for its children. When new crises or issues have emerged, such as HIV and AIDS, the response has often been successful. Yet, despite the successes, pockets of disparity and lack of access remain. There is a minority of Namibians who for one reason or another do not benefit. A central part of the analysis is to identify and understand the reasons for this disparity and the resultant inequities. Namibians tasked with service delivery for children must plan better and smarter to reach and serve those in need.

Strengthened and coordinated planning is needed to ensure that social services reach all Namibians.

This 2010 situation analysis has three broad sections. The

first examines the frameworks and structures in place to protect

a child’s rights. A rich array of policy and legislation is in place. Many

international human rights initiatives have been adopted and government structures that provide support for and services to children are identified. A second section presents a number of cross cutting issues that affect all children. Among the issues described are children in special circumstances and in the family. Each of these issues has its own dimensions and facets. The last section of the report uses a life cycle approach to children and their needs. This places the child at the centre of the analysis as a person with a clear set of rights. The way in which these rights are supported becomes the guiding question. The approach is different from an issue based analysis that approaches children as if they are made up of separate parts; instead it stresses the interrelated nature of fulfilling the rights of a child. Each of these sections is discussed in greater detail below.

Namibia’s framework for children rests on three national documents: the Constitution, Vision 2030 and the Third National Development Plan (NDP3). The Constitution commits the country to a rights based framework for its citizens. Vision 2030 guides Namibian development by establishing long-term goals. NDP3 implements Vision 2030 with short and medium term actions.

The Constitution establishes a broad framework of rights in Chapter 3, Article 15 defines rights of children and Article 14 defines the rights of the family as the fundamental unit of society. Namibia has adopted a number of international human rights instruments that strengthen and extend the rights base for children. Primary among these is the CRC, which in its 54 Articles and two Optional Protocols, commits the country to internationally defined standards of rights for children. The African Charter of the Rights and Welfare of the Child echoes the CRC but takes account of the specific social, economic and developmental conditions prevailing in Africa as they relate to the rights of a child. Other major human rights instruments relating to children that Namibia has adopted include the International Labour Organisation’s Conventions 138 on Minimum Age for Employment and 182 for Elimination of the Worst Forms of Child Labour, the Convention

Against Transnational Crime and the Protocol to Prevent the Trafficking of Persons. The Child Care and Protection Bill which is currently under review will include further measures relating to the prevention of trafficking.

Vision 2030 aims to transform Namibia into a developed country by guiding policy development and long-term initiatives. Eight specific objectives are defined to create a society that cares for the health, education and rights of its citizens; a society that has fully developed human resources capable of maximising their potential and makes sustainable use of its natural resources. Namibia, in support of this, has developed a wealth of policies, many of them targeted toward children. The National Plan of Action (NPA) on Orphans and Other Vulnerable Children (OVC) provides a mechanism to coordinate a multiagency and multisectoral response to the needs of OVC. The Education Sector policy on OVC provides protection to such children within the education sector. The Education and Training Sector Improvement Programme (ETSIP) is a broad effort to improve teaching and learning across all segments of the education sector.

NDP3 guides progress to Vision 2030 until 2012. It is divided into individual Key Result Areas (KRAs) that correspond to specific Vision 2030 goals. In this way the plans and outcomes of government activities are linked through a KRA to Vision 2030 goals. The Millennium Development Goals (MDGs) add country-defined indicators of Namibia’s performance in eliminating poverty and achieving the goals outlined in the National Development Plans. MDGs focus on national targets in areas of health, education, women’s rights, sustainable resource use and international partnerships. The goals are a benchmark against which progress in long-term development can be measured in an incremental manner towards the end date of 2015.

NDP3 as an action plan brings together the efforts of government, civil society and development partners. In 2005 the Ministry of Gender Equality and Child Welfare (MGECW) was created as a lead agency for activities devoted to children. The situation analysis identifies nine other ministries that provide services to children. Aside from the MGECW, the Ministries of Education, Health and Social Services, Safety and Security, Justice and Home Affairs and Immigration are each particularly involved with children.

2 CHILDREN AND ADOLESCENTS IN NAMIBIA 2010

The analysis points to the existence of pockets of

disadvantaged within all

regions of the country.

The Ministry of Education (MoE) is responsible for a school system that enables over 90% of children to attend at least five years of school. High levels of attendance in early years of schooling are not matched in secondary school where only 40% of students have a chance to complete Grade 12. Issues of quality have dogged the system. A decade long programme to increase the qualifications of teachers has increased the number of fully qualified teachers dramatically. The impact of this improvement on learner outcomes is not known however.

The Ministry of Health and Social Services (MoHSS) provides a life-long series of services to a child that starts in the womb: antenatal care; postnatal care; immunisation; Prevention of Mother to Child Transmission (PMTCT); and, together with the Ministry of Home Affairs and Immigration (MHAI), the births of children delivered in health facilities are recorded. Reproductive health and services related to HIV and AIDS are provided later to adolescents.

The Ministry of Safety and Security (MSS) provides children in need of protection with a front line service of referrals through its Woman and Child Protection Units (WACPU). The Namibian Police are involved with children when they initially come into contact with the law. The Prison Service looks after children in prison, though a long-term preference of diversion programmes for child offenders has led to a sharp decline in the number of children detained. The Ministry of Justice (MoJ) protects children’s rights when they are brought before a court or where a child gives evidence in court. Magistrates are required to consider the status of a child before pronouncing judgements.

The Ministry of Gender Equality and Child Welfare (MGECW) works closely with civil society. In 2008 over 59,000 OVC received some form of support from civil society organisations. Civil society

comprises over 600 organisations that mainly work in health, training or education. Civil society is represented on all major policy

platforms that deal with children. The Legal Assistance Centre (LAC) provides

significant input into d e b a t e s

about

children through their research and policy programmes. Development partners often maintain their own institutional focus when it comes to providing services, though they are guided by national development priorities. UNICEF is engaged in activities ranging from project implementation to policy development. The European Union (EU) supports education at all levels from Early Childhood Development (ECD) to tertiary education. The HIV and AIDS pandemic attracts support from almost every development partner, with the Global Fund, USAID and the Presidents Emergency Plan for AIDS Relief (PEPFAR) providing significant inputs into the response to the pandemic. The World Bank (WB) and Millennium Challenge Account (MCA) support different aspects of the ETSIP programme to improve education.

Namibia however lacks mechanisms for regular analysis of programmes designed

to support children. A children’s budget is needed to identify key areas of

government expenditure and track allocations over time. Data from a

children’s budget could provide the baseline for measuring the effectiveness of service delivery programmes and the extent to which resources reach intended beneficiaries.

The second broad section of this situation analysis addresses cross cutting issues. A number of

concerns affect children regardless of their age or

level of development. The issues covered are economic

growth and child poverty, support for children, the family, children

in special circumstances and climate change.

Poverty has a disproportionate impact on children. Just over one quarter of Namibian households are poor, but due to the fact that poor households have more children than non-poor households, close to 40% of children are in poverty. Poverty is a predominantly rural phenomenon concentrated in the northern regions of the country. The Kavango, Ohangwena, Omusati and Oshikoto regions contain 60% of the nation’s poor households (Central Bureau of Statistics (CBS), 2008). Education status and age are linked to poverty

status. The lower the level of education of the head of a household, the greater is the likelihood that the household is poor and, in a similar way, the older the age of the household head, the greater the chance of being poor. Poverty plays a critical role in preventing access to services that are needed by children.

Namibia has a safety net for children in the form of Child Welfare Grants (CWG) which go directly to the caregivers of children. They are intended to support a child deemed vulnerable. The programme of support grants has scaled up from almost zero during the middle of the decade to 117,934 in 2010. A more long standing system of support goes to the elderly over the age of 60. This system, which predates Independence, provides significant support for rural families. A recent evaluation of support grants finds that grants to the elderly are more effective in poverty reduction (Levine, van den Berg, & Yu, 2009). The importance of selection criteria for beneficiaries of grants to the elderly, which is different from selection criteria for child welfare payments, is noted as a reason for this discrepancy.

The Namibian family is defined by the Constitution as the fundamental unit of the society. Families have a right to protection and support by the government but the nature of the family structure is undergoing change. The number of adults reporting that they have been married or are in a permanent relationship is declining. The number of children who live with both of their parents is below 30%. Long term processes such as urbanisation and the weakening of traditional family support structures, place families under stress. The HIV and AIDS epidemic has seen child headed households emerge as parents and other adult caregivers have died. The impact of all these changes to family structure and family life is unknown.

Namibia has developed a system of alternative care to assist families and children in need. Where a child needs alternative care, preference is given to placing children either with relatives, or within the community. Namibian courts must take the interests of the child into consideration. The MGECW assists the courts in determining the best course of action to protect and support a child. However, an insufficient number of social workers at the MGECW blocks effective implementation of Namibia’s alternative care system.


Poverty has a disproportionate impact on children.


Children interviewed for this

study regularly spoke of verbal, emotional and physical

abuse in the home.

Child labour is prominent in rural areas where children are often required to assist with household chores. Approximately 30% of children complain that their household chores interfere with other aspects of their development – school work or time to play. The extent of child labour is not clear. A key factor in this deficiency of information is a lack of trained labour inspectors.

Children with disabilities have the right to attend school. Almost all children with a disability attend school within their community. Poverty and access to services for disabled children is a major concern. Specialist services are located in only a small number of hospitals around the country making access difficult for low income and poor families. Despite the fact that many children with disabilities are in school, the capacity of teachers and school staff to support a disabled child is weak.

Climate change may produce changes in agricultural productivity and patterns that could have a disruptive impact on children. Northern parts of the country have experienced floods in recent years that may be linked to climate change. The floods of 2009 in central northern Namibia were particularly disruptive with thousands of people displaced and major services such as transport, education and health affected. Southern and central regions of the country could be affected through increasing dryness. In the long term, low income and poor households will be more vulnerable to climate change because they lack the additional resources needed to respond. The Namibian government has put a disaster management policy in place that requires each region to actively prepare for disaster. This will include local analysis of potential events (for example, flood, drought, or disease), and contingency planning by sector. A key component of this process is the regionally based capacity to champion the needs of children in such plans. The lack of social workers for the MGECW, however, is a concern because their voice is needed at regional level to ensure that disaster management plans cater for the child.

The third broad section uses the life cycle approach. Three phases of a child’s life are defined; 0 to 5 years, 6 to 11 years and 12 to 17 years. The first 12 months of a child’s life requires a set of interrelated services that are critical to the well-being of a child for the rest of his or her life. The majority of Namibian children receive these services but a minority do not. MDG goals for infant, under five and maternal mortality may not be met due to increases in these rates over the past decade. Analysis of those who miss out reveals that education, income and location are factors that can deny a child services to which he or she has a right. A child whose mother has low education, low income or who lives in certain regions in Namibia is more likely not to receive post natal care, PMTCT treatment, a full set of immunisations or a birth certificate. The key for service providers is to use this knowledge to develop procedures and programmes to reduce barriers to participation. Good nutrition is also important at this age but close to 30% of Namibian children are stunted. The education level of the mother, low income and region are again factors that are indicative of a child being stunted. Diseases such as malaria and respiratory infections may be linked to living and housing conditions, though this needs to be confirmed. Recent policies and initiatives to raise the profile of ECD as a positive input to a child’s development have begun. ECD plays an important role in developing the full potential of the child, and thus helps to meet Vision 2030 goals.

Not all children in the age group 6 to 11 go to school. Just over 90% of all Namibian children are likely to complete five years of primary school, when life-long literacy should be assured. But Vision 2030 calls for a highly skilled workforce which means that basic literacy alone is not adequate. The quality of Namibian education was low at the beginning of the decade, when Namibian students measured last or close to last in basic skill tests when compared to children in other African countries. Major efforts to improve the skills of teachers have been made since then and the results of this will show in another future study which again compares Namibian students with students in other African countries. Children come under stress due to labour issues and problems in the home. Child labour is problematic in rural areas. A majority of children feel that

work disrupts their lives, including interfering with their ability to do home work. Children interviewed for this study regularly spoke of verbal, emotional and physical abuse in the home.

A child between the ages of 12 to 17 faces many challenges. Success in the final years of secondary school is important for finding work later in life. Yet, only 4 in 10 children pass into grade 11. Reasons for this include inadequate space in senior secondary schools,

low qualification levels because of poor quality of education in lower grades, poverty, child labour issues and pregnancy. Those who miss out can use adult education to rewrite their exams. Others face a life of unemployment at worst or low paying jobs at best.

HIV and AIDS is a concern to children of this age in two ways. The first is the potential for infection through unprotected sex, although sentinel surveys show that the rate of HIV among girls under 19 is declining. Despite this trend, the need to continue life skills training and other interventions remains. The second concern is the emergence of HIV positive adolescents who are taking Anti Retroviral Treatment (ART). These children have special needs regarding stigmatisation, entry into sexual relations and maintaining treatment regimes. The two concerns raise the need to expand quality life skills training to children.

Sexual violence, particularly in sexual debut, is high – 20% to 40% of adult Namibians report that their first sexual experience was forced. Safety in other areas of life emerges as an issue. One quarter of learners report that they sometimes skip school out of fear for their own safety (MoHSS, 2008a). Just fewer than one in five are the target of bullying (MoHSS, 2008a). Adolescents are increasingly targets of exploitation. Modern communication technologies expose children to new ideas and knowledge. Both opportunities and challenges are brought to children by modern technology. Increased access to knowledge can enrich their lives and enhance their education but easy and quick communication can open avenues of abuse through bullying. Exposure to predatory adults and their enticements can increase the chances of sexual exploitation and trafficking.

The life cycle approach highlights the importance of community for a child. A child is not a set of issues to be analysed; children are integral members of the communities in which they live. Their well-being and successful development becomes a community concern. Communities need the means by which they can best support their children. This goes beyond providing services to arming communities with the knowledge required to become active partners in national development efforts.

Namibia’s response to the varied needs of its children is not yet fully formed. Twenty years of independence have seen many positive efforts to improve the lives of all Namibians, including Namibian children. Gaps however remain. Many of these gaps are in the implementation of existing programmes and policies. Specific segments of the population do not receive the basic services that are their right. Those who miss out can be identified and programmes adjusted or created to extend services to them.


The well-being and successful development of children is a

community concern.


1. IntroductionTwo decades of Independence have seen the creation of a comprehensive set of policies, structures and services for the development and protection of children and young people. This Situation Analysis of Children and Adolescents describes what has been achieved for children and adolescents and what more is needed if Namibia is to achieve Vision 2030 (Office of the President, 2004).

The situation analysis sets out to examine support for children and adolescents coming from the objectives set by Vision 2030 along with the supporting plans, policies, laws and institutional frameworks. It reviews the results through an extensive literature review, interviews with key stakeholders at national and regional levels and through hearing what children themselves have to say. The approach has been to look at children’s experiences through their growth to adulthood and thereby identify what gaps exist and where they exist.

1.1 Why this Report

Just under half of all Namibians are below the age of 18. The conditions in which children live, the legal and social protections provided for them and the extent to which a child’s growth is nurtured are crucial measures of our society. Over the past twenty years, Namibia has made

great strides in social, economic and institutional development. Included in this process have been extensive policy and legal frameworks for the care, support and protection of children. Nationally, the developmental strategy is set by Vision 2030, (Office of the President, 2004)1 supported by the Third National Development Plan (NDP3): 2007/2008 – 2011/2012 (NPC, 2008a)2 , which provides detailed, intermediate plans through which Vision 2030 can be achieved. Namibia is a signatory to international frameworks, such as the Convention on the Rights of the Child (CRC) (United Nations [UN], 1989), and the Millennium Development Goals (MDGs) (UN, 2000c). Namibia is thus bound to a rights based approach for its long term social and economic development.

The situation analysis for children and adolescents provides a comprehensive picture of a country’s development efforts. It identifies priority issues and can be used to assist government to identify the most critical problems to address when designing programmes and interventions that strategically deal with barriers to making progress toward the achievement of the rights and well-being of children.

Caring for children is a complex venture that includes many facets of social life and development. Education, health care, social support, protection of families, protection against exploitation, protection when in contact with the law and poverty reduction are all relevant to supporting children. Thus, an assessment of how Namibia cares for its children gives policy makers and service providers an opportunity to consider their efforts and consider a way forward. One such opportunity

1 From now on referred to as Vision 2030.2 From now on referred to as NDP3.

was taken in 1990 and then 1995 with the country’s first

two situation analyses. Written five years after Independence,

during a time when strategies and policies were being developed for a

country just emerging from its colonial past, the 1995 situation analysis had a strong

focus on rights embedded within the CRC (United Nations Children’s Fund [UNICEF], 1995). Namibia was commended for its vigorous work to redress the inequalities of apartheid during its first five years of existence. The country was also reminded that children’s well-being is a right, and that the nation had committed itself to ensure those rights when it ratified the CRC just six months after Independence.

This situation analysis has been written at the halfway point between Independence and 2030 – the year in which long-term development goals should be realised. This document comes at a crucial time when a wide ranging stock-taking provides the opportunity for mid journey course corrections. As will be seen in the pages that follow, sustained investment in social development over the past 20 years has considerably improved the education, health and welfare services for children. Namibia is now an upper middle-income country (World Bank, 2010a). This status is the result of economic policies that have resulted in steady economic growth (Toé, 2010). However Namibia’s leaders (its policy makers, children’s advocates, and those who provide services) are challenged to use the nation’s wealth in ways that effectively promote the fundamental and developmental rights of children.

It is on this basis that the National Planning Commission, Government of Namibia, supported by the United Nations Children’s Fund (UNICEF), conducted this situation analysis of children and adolescents in Namibia.

1.2 Methodology

This analysis is a combination of two approaches: a review of national development as it affects children is combined with the voices of children and those who support children. Together, the success of Namibia’s efforts at social development can be reported and areas where more work is required can be highlighted. The review considered a wide range of policy documents, studies and reports. Information

gleaned was used to describe the status of children. The voices of children, along with those who support them, provide a constant reminder that policies and programmes have an immediate impact on the lives of children and families. To obtain this crucial data component both Key Informant Interviews (KII) and FGDs were used. The manner in which this data was collected is described below.

Fifty-three Key Informants (KI) representing 35 organisations were asked for their opinions on the status of children. Thirty-three KI were based in Windhoek and provided a national perspective on children’s issues. The remaining 20 were from the Karas, Kavango, Kunene and Omaheke regions. Their contributions provided on-the-ground insights from those who experience national level policies and programmes. Twenty-one were from Ministries, six from Development Partners and 23 from NGOs, along with a regional councillor, an educationalist and a representative of a municipal council.

Two hundred and eighteen (218) children contributed to the analysis through 26 group discussions held in February and March 2010 in four regions that highlighted the range of challenges facing children and their families, particularly relating to poverty.3 Children came from many different backgrounds: in-school (84%) and out-of-school (16%), rural (42%) and urban (58%), street children (4%), San or ovaHimba (16%), disabled (13%) and children held in prison or police cells (4%). The ages of the children were equally spread between the age of eight and 17 and there were slightly more girls (54%) than boys (46%). Just over half (55%) were orphans. Children of similar backgrounds, ages or gender were grouped together, to allow the children to express themselves with ease.

Various ethical research techniques were used during the course of the child participation exercises to avoid making the children feel vulnerable and to protect the children from any distress. Organisation of FGDs with the children was conducted in close cooperation with regional social workers from the MGECW, or with relevant schools or local organisations who work with children. Social workers were very helpful in organising the groups and were also on stand-by in case sensitive issues were discussed where children might need psycho-social support or referrals. Parents or caregivers

Some questions asked during the situation analysis included:

Are the strategies, • laws, policies and plans in place and adequate? Are the resources • available to achieve the strategies?Is the implementation • framework in place and working well?Do parents and • other carers have the knowledge, skills and resources to play their roles as duty bearers?How does child • development and protection work in practice?What do children think • about these issues?

3 The four regions selected by the TWG were Karas, Kavango, Kunene and Omaheke. The disabled children were from various regions but schooling in Khomas, therefore they were interviewed in Khomas Region. A list of relevant details about the Focus Group Discussions appears in Annex B



(or the schools or organisations helping to identify the children) were asked to give their consent to the children’s participation in the groups. The UNICEF Consent Form was used for this purpose. In the introductory remarks before each discussion started, the children were asked for their consent to participate (see Annex C for the focus group instrument including introductory remarks). They were also notified that they could opt out of the discussion at any time or refuse to respond to any specific question that might make them uncomfortable. All questions were asked in the form of “Do you know of children in your community or classmates who find themselves in situation XX?” rather than “Are any of you in situation XX?” They were informed that their responses would be confidential and that their responses would not be linked back to them in any way or form. They were also told that “nothing that was said in the room should leave the room,” to preserve confidentiality among themselves. Each group discussion lasted about two hours with a short break in the middle with refreshments. Opportunities, during the break or after the discussion was concluded, were given for private conversations with the FGD facilitator where necessary. For example, if a child drew their own situation in the drawing exercise, any drawing depicting a sensitive issue was not shown to the other children in the discussion; rather the child was asked more about the drawing during the break or after the discussion.

The purpose of the group discussions was to enable children and adolescents to share aspects of their lives with children around them. Listening to the children was an opportunity to see how children themselves saw their daily lives. Doing so in the settings where services, support and resources were less likely to be available was a check on the analysis. For example, official records of child labour might suggest quite low numbers of children involved. However, children’s views about their daily tasks in the home might suggest that the scale, extent and impact of those chores on their rights to education and recreation. The children’s contributions are included in this analysis as words and pictures. Captions indicate the age group and gender of a child but avoid further information that might make it possible to identify a child through the information used.

In addition, a Technical Working Group (TWG) was consulted on a regular basis throughout report preparation. The group was made up of officials from the National Planning Commission Secretariat (NPCS), UNICEF, the United Nations Development Programme (UNDP), the Ministry of Gender Equality and Child Welfare (MGECW), the Ministry of Education (MoE), the Ministry of Labour and Social Welfare (MoLSW), the Ministry of Health and Social Services (MoHSS), the Non-Governmental Organisation’s Forum (NANGOF) Trust and the University of Namibia (UNAM). Other individuals joined the Technical Working Group when needed. An Extended TWG reviewed the process and reports at two points: 1) after the initial literature review was conducted and 2) after completion of this report. The Extended Technical Workshop Group consisted of approximately 40 people drawn from NPCS, MEGCW, MoHSS, MoE, Lifeline/Childline, Regional HIV and AIDS Coordinators, UNICEF, UNDP, European Union (EU) and the NANGOF Trust. Both national and regional views and opinions were therefore taken into consideration.

1.3 Structure of the Report

The report starts with an introduction and a review of the national frameworks, policies, laws and institutions, and describes the nature of poverty and its impact on children. There then follows a detailed analysis of the critical issues of life and development for children. Subsequently there is an analysis of the life cycle of children as they grow from birth to adolescence.

Chapter 2 describes the policy, legal and institutional framework that supports children, with some commentary. However, the analysis of how well this framework appears to function is concentrated in Chapters 3, 4, 5 and 6.

Chapter 3 outlines the resources which Namibia has available for supporting its children. Namibia has seen steady economic growth over the past two decades and in 2008 reached the status of

...children’s views about their daily tasks in the home might suggest that those chores impact on their rights to education and

recreation.

an upper middle income country. Despite this growth, challenges in income distribution and poverty reduction remain.

Chapter 4 considers the critical issues that affect the life and development of the child and the nation’s support for a child. Questions such as the following were considered: How many children are there? How have they fared as Namibia has grown economically? How do they fare as growing wealth is divided? Poor households and the children living in them are discussed in detail before other factors that affect children at any time in their lives are considered. Emerging and changing family structures and parenting patterns are also discussed. Special circumstances that children may face (such as child labour, violence, disability or that of a refugee) are also discussed in this chapter, which finishes by looking at emerging issues, such as expanding communication networks and responses to climate change and natural disasters that children are exposed to.

Chapter 5 follows a child from birth to around the age of five. These are key years for basic physical and emotional development. How does a mother fare, since her health and well-being is a critical starting point for her child? How well are infants and young children nurtured and given the basics for development, through immunisation, registration and by gaining access to Early Childhood Development (ECD) programmes?

Chapter 6 deals with children from six to 12 years when they attend primary school to learn the basic skills needed for society as well as developing their individual identities and

values. These are years in which a child builds a foundation of language, knowledge, identity, values and social skills without which they will not be able to take the fullest advantage of their future. Questions such as the following are considered: How well do they do at school? What support is available for those in particular need? What protection do they require and receive so that they have the opportunity to take full advantage of these childhood years?

Chapter 7 follows children between the ages of 13 to 17 years as they make the transition to adulthood. Children at this stage experience significant biological and emotional changes. They need advanced skills and knowledge to become effective and economically independent adults. At the same time they require protection because they are transitioning from childhood to adulthood.

The final chapter, Chapter 8, brings together the analysis of gaps and service delivery challenges that have been identified. Rather than provide a set of recommendations, it describes the level at which different services could be strengthened. In some cases, policy and legislation interventions are required, while in other cases better coordination between community-level and regionally based service providers are necessary to fill a gap. Namibia has made good progress in terms of child rights. The need is not so much to create something new, rather it is to sharpen what is often good, prioritise the need of the whole child, and ensure that promises to support children and their rights are attuned and match the economic growth the country has experienced in the last decade.



2. The National FrameworkInvesting in children is central to the development targets set out in Namibia’s long-term strategy, Vision 2030 (Office of the President, 2004). The Government’s medium term development plans shape children’s rights by guiding development and operational activities in a way that meets the best interests of children. These interests are defined in national policies and laws, which are shaped by international documents, which set standards and enhance international collaboration. An institutional framework that includes nine out of 19 Ministries, many NGOs and development partners, is identified and focuses on the development support and protection of children in Namibia.

Today’s newborn child will be an adult citizen in 2030. A generation of children has already matured in an independent nation that is now ranked as an upper middle-income country. A Namibian child exists within a comprehensive web of rights, such as the right to education, the right to protection, the right to participation, the right to good health and many more. Vision 2030 (Office of the President, 2004) seeks to support Namibians to ‘fully realise their full potential’. Investment in children, from the new born child and his or her mother through to adulthood, calls for a comprehensive and integrated approach.

2.1 Introduction

Namibia has built an impressive framework of support for its children. Almost all children enrol for primary education. Health care is widely accessible. Women and children in need can find referral services from Woman and Children Protection Units (WACPUs) which operate in all regions and large population centres. A range of grants are available for those in need. These, and other services, are examples of the nation’s commitment to its children’s development. Their existence is based on the investment of resources to put these services in place and make sure the services reach and are used properly.

The programmes also depend on a strong legal and institutional framework and this Chapter describes this. The overall context lies in the National Constitution and Vision 2030 sets the Strategy. NDP3 establishes the detailed plans that lead towards Vision 2030. International and regional conventions and agreements establish standards and tools by which national frameworks can be supported in an integrated world. National policies, laws and programmes that guide strategies, standards and plans in practice are described, followed by the institutions that put the whole framework into practice.

2.2 National and International Frameworks

2.2.1 Namibian Constitution

Namibia’s Constitution provides a comprehensive set of fundamental rights and freedoms for all. Article 15 speaks specifically to children and their circumstances:

Children shall have the right •from birth to a name, the right to acquire a nationality and, subject to legislation enacted in the best interests of children, as far as possible the right to know their parents and to be cared for by them.

Children are entitled to be protected from •economic exploitation and shall not be employed in or required to perform work that is likely to be hazardous or to interfere with their education, or to be harmful to their health or physical, mental, spiritual, moral or social development. For the purposes of this Sub Article, children shall be persons under the age of sixteen (16) years.No children under the age of fourteen (14) •years shall be employed to work in any factory or mine, save under conditions and circumstances regulated by Act of Parliament. Nothing in this Sub-Article shall be construed as derogating in any way from Sub-Article (2) hereof.Any arrangement or scheme employed on •any farm or other undertaking, the object or effect of which is to compel the minor children of an employee to work for or in the interest of the employer of such employee, shall for the purposes of Article 9 hereof be deemed to constitute an arrangement or scheme to compel the performance of forced labour.No law authorising preventive detention shall •permit children under the age of sixteen (16) years to be detained.

Other parts of the Constitution also affect children and are touched upon in this analysis. Article 14 recognises the family as “the natural and fundamental group unit of society…entitled to protection by society.” Article 20 protects the right of all persons to education, including the right to primary education without charge (Government of Namibia, 1990).

2.2.2 Vision 2030

Vision 2030 is a strategy, adopted in 2003, through which Namibia might achieve developed country status by 2030. It contains eight broad goals (Office of the President, 2004). With children representing almost half the population, particular goals are directly relevant to this analysis4:

Objective 1.• Ensure that Namibia is a fair, gender responsive, caring and committed nation, in which its citizens are able to realise their full potential, in a safe and decent living environment. Objective 2.• Create and consolidate a legitimate, effective and democratic political system (under the Constitution) and an equitable, tolerant, free society that is characterized by sustainable and equitable development and effective institutions, which guarantee peace and political stability. Objective 3.• Develop diversified, competent and highly productive human resources and institutions, fully utilising human potential; and achieving efficient and effective delivery of customer-focused services, which are competitive, not only nationally, but regionally and internationally. Objective 4.• Change Namibia into an industrialised country of equal opportunities, for all Namibians. Make the country globally competitive with maximum growth potential on a sustainable basis.Objective 5.• Ensure a healthy, food-secured and breastfeeding nation, in which all preventable, infectious and parasitic diseases are under secure control, and in which people enjoy a high standard of living. Ensure that the people have access to high quality education, good health and other vital services, in an atmosphere of sustainable population growth and development.Objective 6.• Ensure the development of Namibia’s natural capital (land, minerals, marine resources, wildlife and beautiful landscapes) for the country’s social, economic and ecological well-beingObjective 7.• Accomplish the transformation of Namibia into a knowledge-based, highly competitive, industrialised and eco-friendly nation, with sustainable economic growth and a high quality of life.

4The presentation follows that of NDP3 (NPC, 2008a) to show the harmony with the KRA of NDP3.

Namibian Constitution:

Children have a

right to a name and nationality

Children shall

not be employed

Vision 2030:

...ensure that Namibia is a fair, gender

responsive, caring and committed nation.



Objective 8.• Achieve stability, full regional integration and democratised international relations. Change Namibia from a recipient of foreign aid to a provider of development assistance.

2.2.3 Third National Development Plan

NDP3 is the first intermediate development plan that aims to guide national activities up to 2012 in the direction of Vision 2030. NDP3 has eight Key Result Areas (KRAs) that match the main goals of Vision 2030 (NPC, 2008a). Development activities of government are defined and measured according to their contribution to achieving KRAs. The eight KRAs of NDP3 are listed below along with the corresponding Vision 2030 objective from above:

Equality and Social Welfare (Objective 1)1. Peace, Security and Political Stability (Objective 2)2. Productive and Competitive Human Resources and Institutions (Objective 3)3. Competitive Economy (Macro-Economy and Infrastructure) (Objective 4)4. Quality of Life (Objective 5)5. Productive Utilization of Natural Resources and Environmental Sustainability (Objective 6)6. Knowledge Based Economy and Technology Driven Nation (Objective 7)7. Regional and International Stability and Integration (Objective 8)8.

Children and their rights are embedded in all aspects of social and economic development. While some Vision 2030 and NDP3 goals might seem more relevant than others, the need to hold the rights of a child paramount in all aspects of Namibia’s vision and plans remains strong.

2.2.4 Millennium Development Goals

The MDGs (NPC, 2004) are a series of commitments intended to be met by 2015. Goals 1 to 7 directly impact on children, while the eighth goal indirectly affects children:

Eradicate Extreme Poverty and Hunger1. Achieve Universal Primary Education 2. Promote Gender Equality and Empower Women3. Reduce Child Mortality 4. Improve Maternal Health5. Combat HIV and AIDS, Malaria and other Diseases6. Ensure Environmental Sustainability 7. Develop a Global Partnership for Development8.

Part of the responsibility arising from Namibia’s signing in support of the MDGs is to report regularly on its progress. Reports were submitted in 2004 and 2008 indicating good progress in goals 1, 2 and 3 (as it relates to girls). However, the analysis records that child and maternal death rates have been rising and in all the MDG areas there are changes in measures (such as those for poverty), uncertainty as to the future (such as what climate change will bring) and broader measures (such as wider targets for vaccination compared to the narrow focus on measles). All these mean that the analysis has looked at the MDGs as just one (though important) component of this analysis of children.

2.2.5 Convention on the Rights of the Child (CRC)

Parliament ratified the CRC (UN, 1989) in 1990. The CRC consists of 54 Articles and two Optional Protocols, (UN, 2000a & UN, 2000b) also adopted by Namibia, and reinforce the rights provided under the Constitution. CRC rights are generally divided into the following four main categories:

Guiding Principles• of the CRC give children rights to survive, develop and participate in decisions that affect them. They commit Namibia to act in children’s best interests.

NDP III:

...aims to guide national

activities up to 2012 in the

direction of Vision 2030

Survival and Development Rights• are what children need to live and grow. This includes adequate food, clean water, shelter, education, skills, health care, and the chance to be children through leisure and cultural activities. Very importantly, children have the right to know and understand these rights. Protection Rights• mean that children cannot be exploited, abused, neglected, or treated with cruelty. Children displaced within the country, who flee to Namibia as refugees, or who come into conflict with Namibia’s legal system are particularly protected. Participation Rights• give children freedom of expression, particularly in matters that affect their economic, social or cultural development. This includes the right to obtain the information they need to understand and act on their rights.

As with the MDGs the CRC calls for governments to report regularly on progress. After the initial 1992 report on progress the next report was only compiled in 2008, although the Convention asks for reports every five years. The next report is due in 2012.

2.2.6 African Charter on the Rights and Welfare of the Child

Parliament ratified the African Charter on the Rights and Welfare of the Child (ACRWC)(Organisation of African Unity (OAU), 1990) in 2004. The Charter aims to reaffirm the principles of ‘the best interests of the child’ and contains a comprehensive set of rights, universal principles and norms for the status of children. To ensure full coverage of issues affecting children, Southern African Development Community (SADC) member countries (including Namibia) have developed further protocols (for example, on health, gender and development and education) that deal with the welfare of children and women. The African Charter strengthens protections guaranteed by the CRC by taking into account social and economic conditions specific to the African continent. Examples of those protections are:

Article 11 calls for the teaching of positive •African values and morals and a respect for people of different ethnicities or tribes. Article 11 provides protection to girls who •become pregnant and must interrupt their

schooling. It requires the state to give such girls the opportunity to complete their education.Article 14 speaks to the basics of health •care, clean water, sanitation, adequate nutrition and basic health care. Article 21 prohibits child betrothal or •marriage. Article 30 protects the rights of children •whose mothers have been imprisoned.

2.2.7 Other Conventions and Covenants that Directly Impact on Children

Other conventions and covenants that have been adopted and which relate to children are:

SADC Protocol on Gender and •Development (Southern African Development Community [SADC], 2008) provides girl children with protection against discrimination, violence and exploitation, and trafficking. Girl children are given rights of access to education and reproductive health care. International Covenant on Economic, •Social and Cultural Rights (UN, 1966).International Labour Organisation •Convention 138 (International Labour Organisation [ILO], 1999) on the Minimum Age for Admission to Employment and Work, 1973, ratified in 2000 and applied through the Labour Act 11 of 2007. International Labour Organisation •Convention 182 (ILO, 1973) on the Prohibition and Immediate Elimination of the Worst Forms of Child Labour, 1999, ratified in 2000. Convention Against Transnational •Organised Crime and the Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children (UN, 2000d). Both were signed in 2000 and ratified in 2002.Convention on the Rights of Persons with •Disabilities, (UN, 2006) ratified in 2007.

2.3 National Policies, Laws and Programmes

2.3.1 Policies

Namibia has a well-developed set of policies relating to children. Twelve major policies and initiatives that impact on children have been developed since 2001, as listed below:

Convention on the Rights of the Child, ratified in 1990

54• Articles + 2 Optional Protocols

African Charter:

reaffirms the • best interests of the child

teaches • positive African values and moralsprotects girls • who become pregnantprohibits • child marriages



National Policy for Reproductive Health, 2001, establishes the framework for the development •of reproductive health services (MoHSS, 2001b).Namibian HIV/AIDS Charter of Rights, 2002, prohibits discrimination towards children •affected by the HIV and AIDS pandemic, ensures quality health care for them and affirms their right to a nurturing environment (LAC, 2002a).National Policy on HIV/AIDS for the Education Sector, 2003, includes policy statements to •ensure children from families affected by HIV and AIDS can go to school even when they are unable to pay school fees (Ministry of Basic Education, Sport and Culture [MBESC], 2003).National Policy on Orphans and Vulnerable Children, 2004, reaffirms CRC rights for OVC in •Namibia (MWACW, 2004).Education and Training Sector Improvement Programme, 2005, calls for specific support in •education and training for OVC. National Policy on HIV and AIDS, 2007, commits to the involvement of children in relevant •policies on HIV and AIDS. Asserts the need to protect children from sexual abuse and exploitation (Government of Namibia, 2007).National Integrated Early Childhood Development Policy recognizes the importance of •Integrated ECD in national development (MGECW, 2007b).National Plan of Action 2006 –2010 for Orphans and Vulnerable Children, 2007, sets out •national plan of action towards OVC. Volume 2 is a monitoring and evaluation framework for the plan and annual progress reports are published each year (MGECW, 2008b).Education Sector Policy for Orphans and Other Vulnerable Children in Namibia, 2008 (MoE, •2008a).National Action Programme on the Elimination of Child Labour addresses issues of child •labour and exploitation (Ministry of Labour and Social Welfare [MoLSW], 2008).National Policy for School Health, 2008, deals with the issues of health surrounding children •at school (MoHSS, 2008e).National Gender Policy, 2009–2018, sets out the framework for approaching the full •participation of women in all sectors (MGECW, 2010a).Namibia National Disaster Risk Management Policy (Government of Namibia, 2009a)•Learner Pregnancy Policy, 2010, addresses the problem of teenage pregnancy among school •children and gives girls who become mothers the right of support from the school and to continued education (MoE, 2010b).

Four of the policies deal with vulnerable children and three deal with different aspects of HIV and AIDS. With HIV and AIDS being such an important challenge there is a tendency to regard the large number of orphans (155,000) as a result of the pandemic, but only 69,805 (45%) are orphaned as a result of AIDS; a reminder that HIV and AIDS while being critical is only one of the sources of vulnerability for children.

2.3.2 Laws

Legal development follows policy development. Seven relevant pieces of legislation have been passed since 2001:

Education Act, 2001 (Act No. 16 of 2001)• Combating of Domestic Violence Act, 2003 (Act No. 4 of • 2003) Maintenance Act, 2003 (Act No. 9 of 2003)• Criminal Procedure Amendment Act, (Act No. 24, 2003)• Prevention of Organised Crime 2004, (Act No. 29 of 2004)• Children’s Status Act, 2006 (Act No. 6 of 2006)• The Labour Act of 2007 (Act No 11, 2007)•

The Child Care and Protection Bill (CCPB) (MGECW, 2009a) is designed to replace the Children’s Act of 1960, which is still the present basis for much of the law relating to children. Crucially, the Bill defines a child in accordance with international practice as an individual under the age of 18, as well as defining the parent, guardian, family member and caregiver. These latter definitions

Once enacted, the Child Care and Protection Bill will replace the 1960 Children’s Act – an update after 50 years.

are sensitive to the social conditions under which many children live in Namibia (MGECW, 2008a, p. 7). Other significant aspects of the CCPB are that it will enable:

Implementation of the Hague •Conventions that provide protection for children across international borders in child custody cases, procedures for inter country adoptions and international collaboration in areas of child protection.Creation of a Child Welfare Advisory •Council to provide advice to government on issues relating to children and oversee implementation of the Act.Creation of Children’s Ombudsperson •with the power to investigate complaints that arise under the CCPB. The Ombudsperson, who will have powers to ensure cooperation from relevant stakeholders, will be part of the MGECW and will report to the Minister. Establishment of a national Child •Protection Register to identify perpetrators of abuse against children. Revamping and modernising of •Children’s courts, which have been in existence since 1960, allowing greater

scope to include family members in deliberations about children. Children will be protected in giving evidence with proceedings held in a non-intimidating atmosphere. The privacy of children will be paramount in such proceedings. A child can be declared ‘in need of protection’ creating special protections for a child.

Harmonisation of Namibian definitions on •child trafficking with current international practice. Lowering from 18 to 14 the age of consent •for medical treatment and testing. This will remove a barrier to children learning about their HIV status by allowing them to seek testing and counselling once they become sexually active.

The process by which the CCPB was drafted and modified was extensive; many people and children from all parts of Namibia took part in the preparation of the Bill.

Other pieces of legislation are at different stages of development. The Child Justice Bill will regulate the juvenile justice system. Through it, children and young people involved in this process will have access to diversion programmes designed to draw them away from committing offences and avoid a criminal record. The Divorce Bill provides protection for the best interests of the child in divorce matters and aims to reduce blame in a divorce and thus reduce some of the stress that can impact on a child. Bills that are less advanced include one to recognise and register customary marriages and divorces. A review of inheritance laws to eliminate current inequities in inheritance law (primarily customary law) for women, girl children and children born outside marriage is also under way.

2.4 Government Ministry Support for Children

Ten ministries form the core of government support for children. Nine provide direct services to children in areas of child welfare, education, health, labour, security, justice, youth, information and identity. The regional and local government ministry is included because of its role in developing and supervising the authorities that are increasingly important to effective service delivery at regional and local level.

2.4.1 Ministry of Gender Equality and Child Welfare

The MGECW, founded in 2005, has a dual function to provide services to children and lead advocacy for children. The MGECW has three main programme areas: Gender Equality and Women Empowerment, Community Mobilisation and ECD, and Child Welfare.

The Gender Equality and Women Empowerment programme supports equal access to resources and sustainable development. Its main activities are building capacity and raising awareness at community level on issues such as women’s rights, sexual and reproductive health for adolescents and HIV and AIDS.

The Community Mobilisation and ECD programme supports economic development among women through entrepreneurial training and support for small businesses and promotes the national ECD policy. The ECD policy promotes improvement in ECD

MGECW:

provides services to children and

leads advocacy for children

Over 117 000 child welfare grants were handled by social workers

in 2010



services. A particular focus is on community based preschools. Resources for the ECD programme are severely restricted. For example, the 2010/2011 budget proposes just N$400,000 for assistance in the construction of community based ECD centres. ECD centres in communities are a core part of the community mobilisation strategy because they provide a central point through which messages about health care, HIV and AIDS, social services and other issues can be distributed.

The Directorate of Child Welfare is the most extensive child support programme in the country. Based throughout the regions, the programme’s social workers and other officers cover a range of services:

Advocacy and coordination - community awareness on issues of gender •based violence and vulnerable children; maintaining the !Nam Child Wiki website; secretariat for the Permanent Task Force on OVC; policies and guidelines for services to vulnerable children.Community mobilisation and services - household visits to families in need •of services; support for WACPU; assist children and families in need; assist the courts in cases involving children, including situational and family evaluation and other advocacy activities on behalf of the child.Monitoring and evaluating - in relation to places of safety and residential child care •facilities; child welfare programmes; vulnerable children; children with disabilities and foster children who seek government support.

Social workers at the Directorate have handled the rapid growth in Child Welfare grants from a few thousand in 2005 to 117,934 in 2010. This was done despite the critical lack of social workers within the Ministry which has a shortfall of close to 200 social workers. This shortfall has a broad and negative impact on the delivery of services for children. The system of alternative care is hampered by the lack of social workers to liaise between courts and places of safety, discussed in section 4.4 below. The analysis on the effectiveness of child welfare grants in section 4.3 points to the fact that beneficiaries of such grants may not be the neediest. This failure to identify the neediest is likely to be linked to the common perception that regionally based social workers are spread too thinly to be fully effective. KIs noted that coordination on children’s issues in the regions is hampered because MGECW staff are not available to organise regional OVC forums. As this analysis develops, the need to fill current staff shortages within the MGECW is an issue that will recur. This is an indication of the priority that needs to be placed on filling this vital gap.

2.4.2 Ministry of Education

Namibia has 1,677 schools with 1,571 run by the state and 106 private schools (MoE, 2010a.) A total of 585,471 learners were registered in these schools in 2009 (MoE, 2010a), with 21,607 teachers. Most learners, (555,442) are registered in state run schools. Activities of the MoE are central to the lives of Namibian children. A review of the education sector identified the shortage of skilled workers as a critical impediment to meeting the goal of Vision 2030 (MoE, 2007). The Education and Training Sector Improvement Programme (ETSIP) is a 15-year programme to improve all aspects of the educational system with nine components:

ECD and pre-primary education• General education• Vocational education and training• Tertiary education and training• Knowledge creation and innovation• Adult and lifelong learning • Information communication technology (ICT) in education• HIV and AIDS• Capacity development•

ETSIP:a 15 year

programme

to improve all aspects

of the education

system

ETSIP activities began in 2006 with some activities due to start only in the second phase of the programme in 2013. Each of the relevant components will be discussed below. Chapters 5, 6 and 7 below also deal with issues of education in greater detail as they relate to different phases of a child’s life.

ECD is recognised for its positive role in preparing children for school (MoE, 2007). In 2007, the National Institute for Educational Development (NIED) completed the recommended curriculum for ECD which caters for children from zero to four and for pre-school children. The Ministry has since begun to offer a pre-school year to children, with approximately 7,500 children enrolled in 2010. NIED has also participated in the development of a curriculum for the certificate and diploma programmes for ECD. These qualifications will be offered to ECD teachers and caregivers through the Namibia College of Open Learning (NAMCOL) (MoE, 2008b).

General education is a core concern of Chapters 6 and 7 below. Chapter

6 examines primary education, where the success at providing

opportunities is highlighted. Over 90% of children attend primary school, and obtain at least five years of education. However, questions of quality and the extent to which primary education prepares a child for secondary and tertiary schooling are under question. In 2000, the

Southern and Eastern Africa Consortium for

Monitoring Educational Quality (SACMEQ) carried

out a regional assessment of student competencies.

The assessment found that the majority of Namibian learners only

had basic competency in maths and reading when compared to students in fourteen other countries (Makuwa, 2005). Namibian teachers, who were also measured in the same study, were only average in their own competencies in reading and mathematics (Makuwa, 2005). The past decade has seen a major effort to improve

the quality of teachers. The percentage of fully qualified teachers has risen from 55% to 80% (MoE, 2010a). The analysis of the third SACMEQ data (collected in 2007) is currently underway. Initial findings indicate that Namibia has seen overall improvement in both teacher and learner skills in reading and maths, although there are regional variations (MoE, 2010c). Once the analysis is complete, Namibia will be able to see if there has been an improvement in comparison to the other SACMEQ countries and it will provide an indication of the success of staff improvement programmes on learner performance. The SACMEQ III report is due to be completed by the end of 2010.

Secondary education is considered in Chapter 7. The percentage of learners who complete secondary school is low. Six out of ten students do not enter the final two years of secondary school (MoE, 2010a). The past three years have seen an increase in the numbers of learners passing on to Grade 11; still the rate of attrition is a concern. Vision 2030 calls for an educated and skilled workforce (Office of the President, 2004). The high level of dropouts from secondary school makes achieving that goal questionable.

ICT skills are viewed as core elements in a modern economy (MoE, 2007). ICT skills will be integrated into all levels of education, taught as a subject and as a set of skills to complement other subjects. The Ministry has committed to connecting all government run schools to the Internet. Private sector partners have been brought in to train teachers on the use of ICT. NIED has developed modules for integrating ICT into different subjects. The National Educational Technology Service and Support (NETSS) centre was established to deliver ICT to schools and provide follow-up support for technical and connectivity issues. As of 2010 over 330 government-run educational institutions (schools, teacher resource centres, libraries, etc.) have had computer laboratories installed. Chapter 7 examines matters related to ICT access and children.

The MoE has had a high level focus on HIV and AIDS and its impact on education since 2000 (MoE, 2007). Currently, the HIV and AIDS Management Unit (HAMU) coordinates HIV and AIDS related activities. Major activities of HAMU are:

7500children enrolled in MoE pre-school programmes in 2010

there are less than 2 public and

8 private health care professionalsper 1000 population



Awareness-raising: In 2007 over 127,000 materials were distributed at a total of 78 events, •reaching over 243,000 people (MoE, 2008b). Mainstreaming: HAMU proceeded with further integration of HIV and AIDS prevention into •school curriculum, with 529 teachers trained in life skills education. Around 4,700 HIV and AIDS clubs were established, and close to 32,000 people reached through peer education (MoE, 2008b). Developing regulatory frameworks: This work included development of codes of conduct for •learners, teachers and other employees on protection and safety at school and hostels (MoE, 2008b). Addressing OVC issues: In 2008, 83,000 learners participated in the school feeding •programme (MoE, 2009b). In 2007 over 35,000 learners received some form of counselling and psychosocial support. During that same year, 61 teachers received training in basic counselling and bereavement issues (MoE, 2008b).

The Institutional Strengthening and Capacity Building Facility (ISCBF) is jointly supported by the European Commission and the Swedish International Development Agency. As discussed in Chapters 6 and 7, capacity building among teachers has been a focus of the government for over a decade. The number of fully qualified teachers has improved dramatically. The impact this improvement may have on SACMEQ measurements may not be known for some time (MoE, 2009a).

2.4.3 Ministry of Health and Social Services

The MoHSS runs a national system of health care that includes three regional referral hospitals around the country and one national referral hospital (MoHSS, 2008c). Thirty district hospitals, 38 health centres and 269 clinics provide primary health care services to most of the population (MoHSS, 2008c). In 2006 the Ministry also registered 844 private health facilities. Among these were 13 hospitals, 75 health care clinics and eight health centres (MoHSS, 2008f). The services provided under primary health care programmes are crucial to the well-being of pregnant women, infants and children in their first five years. Medical services for communicable diseases, HIV and AIDS and reproductive health take prominence in the later stages of a child’s development. Chapters 5 and 7 below examine the delivery of these services in detail.

In general, economic and geographic imbalances are a concern for the health care sector. Namibia has a large private health care sector with roughly the same number of health care professionals as the public sector. The MoHSS estimates that there are eight private sector health care professionals per 1,000 of the population it serves (MoHSS, 2008c). For the public sector the ratio of health care professionals to population served is below two, which does not meet the World Health Organization benchmark of two per 1000 (MoHSS, 2008c). Those who can afford private health care are much better served. Private sector health care workers are also concentrated in urban areas, which in turn increase inequality between towns and rural areas. Only 24% of doctors and 39% of nurses are based in rural areas (MoHSS, 2008c). The 2001 Census (CBS, 2003) found that close to two thirds of the population was rural, and one third urban which means that the distribution of health care workers is roughly the reverse of the distribution of people.

A key theme in Chapter 5 is the lack of capacity in health care workers in rural settings. In 2007 more than a thousand positions for nurses were vacant - 25% of nursing positions (MoHSS, 2008c). Yet, as is mentioned later in this document, a shortage of staff means that only one nurse per clinic is the situation in the Kavango (MoHSS, 2008c) – a region where concerns about the delivery of services are high. Understaffing at clinics leaves gaps in services and high employee burn out (MoHSS, 2008c). This analysis highlights the critical role of clinics in providing frontline services to children and families in areas where socioeconomic conditions limit the ability of people to access services. The MoHSS recognises this issue and has approved a plan to both retain existing staff and increase the supply of health care professionals (MoHSS, 2008c).

Namibia’s efforts to combat HIV and AIDS, led by the MoHSS have seen success. The prevalence rate among pregnant women has declined in the past three sentinel surveys (MoHSS, 2005; MoHSS,

83 000learners in

school feeding programmes in

2008

MoHSS:

primary health care

programmes are crucial to

the well-being of pregnant women,

infants and children under

five

2007; MoHSS, 2008d). Two key programmes in the response to the epidemic are Prevention of Mother to Child Transmission (PMTCT) and Anti Retroviral Therapy (ART). Both have been introduced and have achieved high levels of coverage (MoHSS, 2009b; MoHSS, 2009c). The impact of these two programmes on children is discussed in Chapters 5 and 7.

2.4.4 Ministry of Labour and Social Welfare

Three programmes of the Ministry of Labour and Social Services (MoLSW) have an effect on children:

The Labour Services programme monitors •workplaces for compliance with the Labour Act and health, safety and child labour practices. In 2007/2008 over 5,600 complaints were investigated. The number of cases relating to children is not provided. Inspections appear to be carried out largely in formally registered workplaces, which are not the places where child labour is most common (MoLSW, 2008a; MoLSW, 2008b; see also section 7.4.4 below). The Labour Market Services Programme •produces the National Child Activities Survey (MoLSW, 2008c). The document provides basic data on children and work. Orientation programmes are provided to schools throughout the country. In 2007/2008 a total of 73 schools were visited and basic information about labour issues was provided (MoLSW, 2008b). The Social Welfare programme has a •direct impact on many children because it manages and disburses social welfare

grants to the elderly. Just over 140,000 beneficiaries receive payments on a monthly basis.Social welfare grants provide children in •low income and poor households with significant support; this is discussed further in section 4.2.

2.4.5 Ministry of Safety and Security

The Ministry of Safety and Security (MSS), in its Combating of Crime Programme of the Namibian Police, plays an important role in relation to children (together with the MoHSS), through the fifteen Woman and Child Protection Units (WACPUs) that it runs throughout the country. WACPU provide children in need a key entry point into the services and support available. Data on the number and types of cases seen by WACPU staff is not available; neither is the nature and disposition of referrals. WACPU staff interviewed for this, as well as other reports, speak about the stress and burdens of working in the units, and the need for personal support (Rose-Junius & Küzner, 2006).

The Prisons Service runs the penal system for the country through its Safe Custody programme. The manner in which children are detained has undergone major changes in the past decade. Children and juveniles who are sent to prison are no longer kept at a central national facility (MGECW, 2009b). The Elizabeth Nepembe facility for juveniles, located in the Kavango region, has recently closed. Special facilities have been constructed at regional prisons to allow children more frequent contact with their families (MGECW, 2009b). The use of diversion programmes by the courts as a first option for a child charged with a crime has also halved the number of children in prison to less than 300 (MGECW, 2009b).

Another category of children who are detained is children who are arrested by the police. Children who are detained should be released to their parents, or caregivers. When release to a caregiver is not possible, children are detained in police holding cells. In some instances children have not been separated from the adult population (Walters, 2006) and have been held at police holding facilities where the conditions have been described as “shocking” (Walters, 2006).

MoLSW:

monitors child labour practices through the Labour Services programme

MSS:

runs 15 Woman & Child Protection Units



2.4.6 Ministry of Justice

The Ministry of Justice (MoJ) operates the court system through the Administration of Justice Programme. Namibia’s courts are supportive of children. Magistrates are also appointed as Commissioners of Child Welfare, hence when a child is brought before the Court, they are required to protect the interests of the child. Court proceedings involving a child are closed, and protect the identity of the child. A social worker from MGECW provides an evaluation of the child and his or her situation. If needed, the child is sent to a diversion programme run by the Ministry of Youth, National Service, Sport and Culture (MYNSSC). The Directorate of Legal Aid provides legal representation for those unable to afford the service. For the year 2007/2008, the Directorate provided services for over 4,600 individuals, although the number of children who received assistance is not known (Ministry of Justice [MoJ], 2008). Data to analyse the performance of the court system in its treatment of children, is not readily available. This deficiency hinders more effective design and evaluation of programmes to support children. Section 7.5 below discusses these issues as well as the broader topic of children in contact with the law.

2.4.7 Ministry of Youth, National Service, Sport and Culture

The MYNSSC has its most direct impact on children through the Directorate of Youth. The Youth Health Programme provides children with life skills training using the My Future My Choice Programme. The programme caters for both in-school and out-of-school youth. During 2005/2006 18,000 children between the ages of 15 to 18 were reached with life skills training (Ministry of Youth, National Service, Sport and Culture [MYNSSC], n.d.). Problems have been detected with the training and support of facilitators, who are volunteer young people themselves. These issues are discussed in section 7.3 below. The Youth Directorate runs juvenile justice diversion programmes, together with life skills training as the preferred option. Coordination between MYNSSC, service providers of life skills training, court officials and social workers is an issue of concern and is discussed in section 7.5 below.

2.4.8 Ministry of Information and Communication Technology

The Ministry of Information and Communication Technology is responsible for timely, coordinated and effective information service, to promote constructive dialogue towards socio-economic development and democracy, with the view towards making Namibia an informed and knowledgeable society. The Ministry, through its directorates and regional presence, coordinates strategy development and implementation of social and behavioural change communication addressing social issues affecting the lives of women and children. The Ministry has been taking a lead role in HIV/AIDS communication through chairing the National Communication Campaign on HIV/AIDS involving multiple local and international partners. In addition to campaigns, the Ministry through its use of mobile units and video productions takes information to the household level particularly on issue on social norms addressing gender based violence, alcohol abuse, safe sexual practices etc. The Ministry’s regional offices, which are situated in towns where the Government’s 13 Regional Councils are housed, assist the Ministry in the dissemination of information to the grassroots level. For empowering young people in Namibia, the Ministry also provides opportunities for young professionals in media training.

2.4.9 Ministry of Home Affairs and Immigration

The Ministry of Home Affairs and Immigration (MHAI) plays the central role in ensuring that children have a legal identity by providing birth certificates. The 2007 National Demographic and Health Survey (NDHS) found that only two-thirds of newborn children had a birth certificate (MoHSS, 2008b). A programme jointly carried out by MHAI, MoHSS and UNICEF, to redress this deficit began in 2008. A three-pronged approach involved the creation of mobile registration teams to visit remote communities, sub-regional registration offices were established, and registration offices were created at high volume maternity hospitals to improve access to registration services.

A birth certificate provides a legal identity for children

Since 2008, almost 21,000 newborns have been registered (Sakaria & Forsingdal, 2010). Sub regional offices have been established in almost one-fifth of Namibia’s constituencies, with further offices planned. Birth registration offices have been

established in 11 of 13 high volume maternity hospitals. Problems in coordination between MoHSS staff and MHAI staff at these hospitals have been encountered (Sakaria & Forsingdal, 2010). Section 5.4 provides a more detailed analysis of factors that prevent children from receiving full birth documentation. The measure of success for the programme will be determined in the next NDHS.

The MHAI also provides for refugee children. The Osire Camp houses approximately, 2,600 children. Most of the children come from Angola and the Democratic Republic of the Congo (MGECW, 2009b). Repatriation for Angolan nationals willing to return to their country is on-going. Primary and junior secondary schools have been established. Medical services are provided at the camp with referrals to regional level hospitals if required (MGECW, 2009b). The 2009 CRC report found no major issues or problems with children at the Osire Camp (MGECW, 2009b).

2.4.10 Ministry of Regional and Local Government, Housing and Rural Development

The Ministry of Regional and Local Government, Housing and Rural Development (MRLGHRD) has three programmes that impact children.

The Regional and Local Government Coordination Programme provides operational funds to Regional Councils and Local Authorities. In 2007/2008 over N$159 million was allocated to Regional Councils (Ministry of Regional and Local Government, Housing and Rural Development [MRLGHRD], n.d.). Assistance to regional councils is key to the decentralisation of services to regional and constituency level, because it creates the infrastructure for service delivery. As an example, the construction of constituency offices creates space for local registration of birth and death certificates. Twenty-three villages and town councils receive N$37 million annual revenue support (MRLGHRD, n.d.). Part of this money goes to basic service delivery such as water and sanitation. Capacity at regional and local levels hinders effective decentralisation. As will

be discussed below in Chapter 4, the lack of social workers at MGECW prevents effective coordination of children’s services at the regional level. Management skills in municipal, town and village councils are often weak, leading to incidents of disrupted services (such as water and electricity) due to non-payment of fees.

The Housing Programme provides improved shelter to poor and low-income families. A loan scheme provided N$33 million in housing loans to almost 1,100 beneficiaries in 2007/2008 (MRLGHRD, 2008). Loans went to both rural and urban homeowners. Support for the Lüderitz municipality provided both improved water services and assistance in building 218 houses. Water and sanitation infrastructure was provided to four settlements and 62 shack dwellers received assistance in building houses. When compared with the scale of migration to urban locations that is taking place, these programmes seem small in scale. The recent MDG report commits Namibia to provide a comprehensive review of housing needs and the means by which those needs can be met (NPC, 2008b). Direct links between housing conditions and children is required and these are discussed in sections 4.2 and 5.3.

The Rural Development programme manages the food/cash for work activities. It provides either food or cash to unemployed and poor rural residents. Food/cash for work can be targeted to areas of specific need. Examples are areas affected by drought or crop failures or chronically high unemployment. This programme is also tasked with the empowerment of San communities through the promotion of food security. The impact of these programmes on children has not been determined, although this analysis reports, in Chapter 5 on the high proportions of stunted children in the population as a whole.

2.5 Other Agencies

A range of other agencies support the work of government ministries with children through a mixture of service support, research, advocacy, resource mobilisation and financial support.

2.5.1 Civil Society Organisations

Unpublished research by the NANGOF Trust (Namibia Non-Governmental Organisation’s Forum Trust [NANGOF], n.d) suggests that


there are nearly 600 Civil Society Organisations (CSOs) with over 4,000 full time and part time staff and around 30,000 volunteers. CSOs are disproportionately focused on health (67%), training (52%) and education (45%). Programmes are mainly service based. For example, a report by the Namibia Network of AIDS Service Organisations (NANASO) showed 131 centres as supporting 59,385 orphans in 2008 and 79 centres undertaking behaviour change programmes among 74,275 young people (Namibia Network of AIDS Service Organisations [NANASO], 2009). An example of how this work supplements government programmes is the work of the Mount Sinai Centre which, on a monthly basis, sees over 100 HIV positive mothers with their children, monitoring the children’s growth, distributing food and formula milk and giving advice on nutrition and health care.

Some NGOs, such as the Namibia Red Cross Society and the Lutheran Medical and Catholic Health Services have become an integral part of government service support to children. Other NGOs may raise funds to support children directly or indirectly. The Church Alliance for Orphans has a growing programme of grants support to children through church groups and the Basic Income Grant Coalition (BIG) piloted a programme of a basic grant for all in Omitara (Basic Income Grant Coalition [BIG], 2008).

However, CSOs are not just involved in service delivery but also include advocacy, analysis of policy and practice and the development of specialist approaches in relation to minority groups or topic areas. Examples of this are the different contributions from the Legal Assistance Centre (LAC), Association for Children with Language, Speech and Hearing Impairments of Namibia (CLASH), the Bicycling Empowerment Network of Namibia (BEN), the Society for Family Health, the Omaheke San Trust and the NANGOF Trust contained in this analysis. The Urban Trust of Namibia will shortly commence a study of the impact of the national policy on teaching in local languages during the first years of school. These are just examples of civil society activities that can have an important impact on children’s growth and development, particularly by identifying gaps, working with marginal groups and in developing appropriate solutions.

2.5.2 Development Partners

Development partners are actively involved in establishing an enabling environment to respond to the needs of children by technically and financially supporting policy development, programming and implementation of response strategies for children. Amongst the international development partners providing support to Namibia’s efforts to ensure the rights of children are met, include:

UNICEF:• Child health, nutrition, water and sanitation, hygiene, life skills, HIV and AIDS, prevention of mother to child transmission, gender-based violence, basic education, social protection and OVC.United Nations Educational, Scientific and Cultural Organisation (UNESCO):• Education (primary, secondary, ECD, teacher education, higher education, literacy and HIV and AIDS education).United• Nations Development Programme (UNDP): Poverty alleviation and environmental sustainability.United Nations Population Fund (UNFPA):• Reproductive and maternal health.The President’s Emergency Plan for AIDS Relief (PEPFAR):• HIV prevention, care and support to children infected or affected by HIV and AIDS.United Nations High Commission for Refugees (UNHCR): • Refugees.World Health Organization (WHO):• Maternal and child health, HIV prevention and care.European Union (EU):• Education (primary, secondary, ECD, teacher education, higher education, literacy and HIV and AIDS education.


Figure 1: CSOs by Sector

Source: NANGOF, n.d

United• States Agency for International Development (USAID): Education, nutrition and OVC.US Centers for Disease Control (CDC)• : HIV prevention, treatment and care; primary health careSpanish Cooperation:• Basic education and gender equalityMillennium• Challenge Account: education and poverty alleviation.

Other development partners such as UNAIDS and the World Food Programme (WFP) also provide development support to families and communities, which indirectly support children. The Small Grants Project under UNAIDS is one example. The WFP provides nutritional services to communities and families and has sponsored a food scheme for vulnerable children through the MGECW.

One of the main challenges for all stakeholders in development is lack of coord inat ion of efforts. Development partners have responded to

this challenge by creating several platforms such as the Development Partners Forum and the UN Joint Team on AIDS to enhance collaboration and coordination. However, there are still concerns that development partners are not responding to the needs of children in a demand driven fashion resulting in less than ideal impact on the lives of children. Programming is still very much supply driven rather than community driven.

Another main challenge is that donor support is strong in some areas and less strong in other areas. Concerns were raised during some national level KIIs that donor agencies are sometimes agenda driven and respond to agency priority, which are not always in line with country priorities. Enhanced coordination and guidance from the National Planning Commission and from relevant ministerial offices will help to better channel development support towards the overall goals and expected outcomes for children.

2.5.3 Other Agencies

The media plays an important role in shaping the messages that children receive and how children are seen and understood. The analysis draws attention to the Youthpaper, a weekly supplement for children published by The Namibian newspaper and also highlights existing radio programmes for children. The children’s discussion groups that contributed to this analysis often reflected lack of information. How children and parents can be kept informed is a major question and one in which the media (and the Ministry of Information and Communication Technology) can assist.

Parliamentarians show an active interest in children’s matters as part of their responsibility to make and monitor the nation’s laws. This chapter notes the legislation that has been passed relating to children since 2000, as well as the legislation that is still in the pipeline.

Higher education institutions, such as the University of Namibia and the Polytechnic of Namibia, are important both for the research they undertake and the training that they provide to service providers and young people.

Civil society organisations supported

59 385 orphans and vulnerable children in 2008



3. Children and Young People: Socio-Economic Background

Economic growth has given Namibia the resources to invest in children. Even within the current international economic crisis, the government is expanding investment in children. While the MoE continues to receive the largest allocation of resources, the MGECW has received a substantial increase to pay for grants for over 100,000 vulnerable children. The Ministries of Health and Social Services and Labour and Social Welfare, which both have programmes with a major impact on children, each receive 10% or more of the national budget.

Population estimates predict that, by 2011, 42% of Namibians will be children. Despite the economic growth and major resources being set aside to support children, the NPC reports that 27% of households and 43% of children are in poverty. Other poverty studies suggest that the numbers of poor may be higher. Poor Namibians are concentrated in Kavango, Ohangwena, Omusati and Oshikoto regions. Rural areas have higher proportions of poor compared to urban areas. Female-headed households are more likely to be poorer than male-headed households, and the risk of a household being poor rises as the age of the household head rises. Severely poor households have on average over twice as many children as households that are not poor. While the family is the unit through which children are supported and nurtured it is also the place where children can be most vulnerable.

The high levels of poverty are an aspect of high income inequality in Namibia. High levels of unemployment make this worse. One response is for the government to invest in services, of which health and education are important for children. However, there is little evidence that high levels of spending are actually going to those who need it most. Social grants are another mechanism that can redistribute income; again it appears that of the many households that are not receiving this support a high proportion are those who need this assistance most.

Namibia’s inherent wealth and steady economic growth over the past two decades provide the resources to invest in children at the levels that Vision 2030 calls for. Much more needs to be done to make sure that those who are in the greatest need benefit the most from the investment that is being made.

Goal 1: Eradicate extreme Poverty and Hunger 1993/1994 2003/2004 2006/2007MDG Targets for 2012

Reduce Number of Poor Households by One Half 38% 28% 28% 19%

GDP Growth 3.6% 4.7% 4.3% 5.0 – 6.5%

Source: NPC, 2008a

Table 1: Age breakdown of Children in Namibia, 2011 Population Projection

Age Groups Girls Boys Total

0-4 years 145,979 145,778 291,757

5-9 years 126,018 125,797 251,816

10-14 years 115,069 115,269 230,338

15-17 years 74,165 73,109 147,274

Total Population under 18 461,231 459,953 921,185Source: CBS, 2006a.

3.1 Introduction

By 2011, almost 42% (921,185) of Namibia’s population (2,140,091) will be children (CBS, 2006a), with roughly equal numbers of boys and girls. This is slightly lower than the 2001 Census when children were 45% of the population and reflects higher levels of urbanisation and reduced fertility rates (CBS, 2003). Rural areas have a younger population in comparison to urban areas.

This chapter looks at the economic and social background in which these children find themselves. The country has achieved steady economic growth and generally received praise for its economic policies and annual government budgets. The wealth created in the economy has offered the means for social and economic development. Yet income inequalities are among the highest in the world. As a result, many Namibians are poor and children bear the brunt of poverty. Poverty extends beyond a lack of income. Children and their caregivers are limited by the constraints of poverty in their ability to access the services needed to reduce the impact of being poor. This in turn impacts on the critical outcomes needed for children and adolescents. This theme appears in each of the chapters that follow.

3.2 Economic Trends

Namibia reached upper middle-income status in 2008 with a per capita Gross National Income (GNI) of US$4,210 (World Bank, 2010a), reflecting a sharp increase over the past five years. This trend is shown in the figure at right.

Economic growth has largely been driven by the mining sector and high mineral prices. The global economic crisis and the resulting drop in both demand and prices for minerals has led to a downturn in the Namibian economy – from an average annual economic growth of 5.5% from 2006 to 2008 to a contraction by 0.8% in 2009. The government used reserves to maintain public expenditure and pursued a countercyclical approach in response to the crisis. In 2010 the Namibian economy is recovering with GDP growth projected to be between 2.5% and 3.8% for 2010, accelerating over the next few years. Similarly revenue is forecasted to increase despite the dip in 2011/2012 (MoF, 2010a). Overall government expenditure will grow from N$25.4 billion in 2009/10 to N$28.9 billion in 2010/11. Taking inflation into account this represents a real increase of about 5% (Schade, 2010). However, fiscal revenue remains under pressure as a significant drop in revenue from the Southern African Customs Union (SACU) is expected for 2011/2012 (International Monetary Fund [IMF], 2010). Namibia will receive a net share of N$6 billion for 2010/2011, down from the N$7.9 billion which was expected in the Medium Term Expenditure Framework (MTEF) (MoF, 2010b).

Despite the steady economic growth, Namibia remains the most unequal society in the world, as indicated both by the GINI coefficient and the ratio of income of the richest 10% to the poorest 10% of the population. The highly

Namibia is the

most unequal societyin the world


1

inequitable economic growth is a contributory factor to this immense gap.

This is partly due to the high dependency on the mining sector that is mainly capital rather than employment based. Indeed, in 2008 only some 6,000 people were formally employed in the mining sector, contributing 15.9% to GDP and accounting for much of the recent growth in GDP. Other major contributors to GDP are manufacturing (12.5%) and wholesale and retail (10.5%). Non-mining sector company taxes reached a share of 21.9% for the 2008/2009 fiscal year, exceeding expectations and showing some level of economic diversification (Chamber of Mines, 2010; MoF, 2010b; CBS, 2009).

Figure 3: Income Inequality Across the World

Source: UNDP, 2009

Figure 2: Namibia GDP Per Capita, based onPurchasing-Power-Parity (PPP)

Current International $, PPP*(August 2010)Source, IMF April, 2010

*Purchasing Power Parities – a measure allowing international comparisons of poverty data based on a specific US$ conversion formula that takes into account the national consumer price index.

Table 2: Contribution of Industries to GDP

Industry 2006 2007 2008

Primary industries 22.0 20.1 24.4

Agricultural and Forestry 6.1 5.4 5.5

Fishing and fish processing on board 3.6 3.7 2.9

Mining and quarrying 12.3 10.9 15.9

Secondary industries 19.7 21.8 18.9

Manufacturing 14.4 15.6 12.5

Electricity and water 1.9 2.5 2.2

Construction 3.4 3.7 4.2

Tertiary industries 51.9 51.8 50.8

Wholesale and retail 10.9 10.9 10.5

Hotels and restaurant 1.7 1.8 1.7

Transport and Communication 4.7 4.7 4.8

Financial intermediation 4.1 4.1 4.0

Real estate and business services 8.3 8.1 7.5

Community, social and personal services activities 3.3 3.2 3.0

Public administration and defence 8.2 8.0 8.3

Education 6.9 6.9 7.4

Health 3.0 3.0 3.2

Private household with employed persons 0.7 0.7 0.7Source: CBS, 2009

The International Monetary Fund (IMF) highlights the limited opportunities in the non-mining sectors as one of the key factors leading to high unemployment and income inequality (IMF, 2009). According to the 2008 Namibia Labour Force Survey, the unemployment rate stands at 51.2%. People are regarded as unemployed if they are 15 years or older and

available for work but are without work. The strict unemployment measure uses active job search as additional criteria for unemployment. On this measure the unemployment rate is 29.4%. Unemployment is young, female and rural: 67.7% of 20-24 year-olds are unemployed; for 15-19 year olds dropping out of education, this rate reaches 83.6%. Women of all ages are more likely to be without work than men (58.4% compared to 43.5%). Unemployment in rural areas stands at 64.9% compared to 36.4% in urban areas. Once unemployed it proves very difficult to take up work again – 72.2% of the unemployed have been out of work for more than two years (MoLSW, n.d.).

Youth unemployment has risen sharply in recent years, though on the strict unemployment measure rates have remained relatively stable at a high level. This indicates that an increasing number of young people are not just unemployed but are no longer even actively searching for work. Young people who are

67.7%of 20 to 24 year olds are unemployed


Figure 4: Trends in Unemployment

Source, MoLSW, n.d.


inactive without any work prospect are at risk of not finding any work later on and of becoming caught in continuous cycles of poverty and marginalisation (MoLSW, n.d.). They are also at risk of being exploited as a result.

3.3 Children at Risk of Poverty

Children are at higher risk of poverty than the general population. 43.3% of children compared to 37.8% of the total population are poor. The Namibia Household Income and Expenditure Survey (NHIES) measures poverty in terms of households rather than individuals living below the poverty line. On this measure too, children are at a higher risk of being poor - 34.8% of households with children compared to 27.8% of households overall are poor (CBS, 2008). Poverty is defined using a Cost of Basic Needs approach, reflecting the costs of minimum caloric intake plus some allowance for basic non-food items. The children in the focus groups saw poverty as a central issue. Of the ten top problems they listed as ‘very serious’, six relate to the lack of money:

Hunger • Poverty• No money for school fees, school exams, or uniforms• Lacking clothing• Parents’ unemployment• No family income•

According to the last NHIES (CBS, 2006) in 2003/04 the poverty line amounted to N$262.45 per adult equivalent per month. Equivalence scales assume different needs for adults and children but also assume economies of scale, i.e. that the per capita consumption needs of a family of five are lower than that of five single persons. Against this background in the NHIES children up to the age of five are assigned a weight of 0.5, children between six and 16 a weight of 0.75 and adults 16 years and over a weight of one. This means that the actual poverty line for young children is just N$131.23 (N$262.45 x 0.5) and for older children N$196.84 per month (N$272.45 x 0.75). It is questionable whether the basic food and non-food needs of a young child can be met with just about N$4.30 a day (N$131.23 / 30 days) (CBS, 2008).

A recent reassessment of the NHIES data sets the child poverty rate at 43.4% with little difference in poverty among orphans (45.3%) and non-orphaned children (42.9%). This is also supported by National Demographic and Health Survey (NDHS) data on children lacking one or more basic material needs – one pair of shoes, two sets of clothes and a blanket (MoHSS, 2008b). Half of all children lack at least one of these items – and should therefore be considered poor (Levine, 2010, MoHSS 2008b).

A second reassessment of NHIES data (Jauch, H., Edwards, L., Cupido, B., 2009) reports on a range of different poverty thresholds. Using the concept of a ‘Household Subsistence Level’ based on a basket of essential food and non-food items that was developed at the University of Port Elizabeth and applied to Namibia, the poverty line would stand at N$399.80 per person per month. On this measure poverty in Namibia would stand at 82%. Based on the international poverty line of US$1 a day (at current exchange rates) there would be 62% poverty, while United Nations Department of Economic and Social Welfare reports 44% poverty on US$1.25 a day PPP5

(United Nations Department of Economic and Social Welfare [UNDESA], 2009). These variations in poverty rates based on relatively small shifts in poverty thresholds point just as much to the high levels of income inequality in Namibia. Income for the majority of the population is low, while the expenditure of the top quintile, representing just 13% of the population, amounts to 69% of total expenditure (CBS, 2008).

The CBS (2008) report provides an analysis of poverty risks and profiles. Poverty in Namibia is concentrated in rural areas – 38.2% of rural households are considered poor compared to 12% of urban households. This is alarming, considering the fact that 67% of the Namibian population lives in rural areas and 43.8% of the total rural population are children under 14 years of age (CBS, 2003). The highest incidence of child poverty is found in Kavango, Ohangwena and

5 Purchasing Power Parities – a measure allowing international comparisons of poverty data based on a specific US$ conversion formula that takes into account the national consumer price index.

43.3%of children

are poor

Oshikoto (all with child poverty rates above 50%). Almost one

in two poor households lives in these regions. Child poverty rates in

Oshana, Erongo and Khomas on the other hand are well below the national

average. On the other hand, the Khomas and Erongo regions contain only 6.8% of

the nation’s poor households, although in 2001 19.5% of the total population lived there. These regions generally attract people from rural areas. For example, the northern suburbs of Katutura in Windhoek, where many new migrants settle, are growing at a rate of 9.47% per year (Heita, 2010). Disparities can also be found for different language groups. The most vulnerable groups of children are speakers of Khoisan (74.7%), Rukwangali (67%) and Nama/Damara (48.9%). Khoisan speakers are the group most vulnerable to poverty, but because of their small population share, they only represent 2.9% of poor households. About half of all households in poverty speak Oshiwambo (Levine, 2010; CBS, 2008).

Pensioner households are at a high risk of poverty, even though the value of pensions is well above the poverty line. Poverty rates in households headed by a 60 to 64 year-old are 42.6% and for those 65 years and older 47.5%. According to a recent assessment of the effectiveness of child welfare grants, more than a third of both OVC caregiver and child participants in focus groups reported that their

household received old age pensions. Given the large number of orphans and vulnerable children this suggests that many pensioner households may be caring for children and with no additional income source may become more vulnerable to poverty (CBS, 2008; MGECW, 2010b). Larger families are more likely to be poor than small households. The presence of children in the household increases the poverty risk by 75% and there are twice as many children in poor than in non-poor households (3.6 versus 1.8). Low levels of education and unemployment are further risk factors for poverty. Nevertheless, 23.1% of the poor have salaries as main source of income and 42.3% are engaged in subsistence farming. There is a clear lack of adequate employment opportunities that would enable people to provide for their families.

Other factors increase the risks of children and young people to grow up poor. The HIV and AIDS epidemic places severe pressure on families. An increasing number of children are taken care of by extended families or other members of their community. Caregivers who are incapacitated by HIV and AIDS cannot provide for their families. Additional expenditures for medical care and nutrition drain families’ financial resources. Families may not be able to maintain farming activities and be forced to decrease the amount of land under cultivation or switch to different crops. Children may have to take on care responsibilities for their parents, grandparents or siblings or take care of house and farmland. As a result children who become caregivers may have to drop out of school or become unable to keep up with school work – increasing their risk of staying poor as adults. A small number of children without parental care are, in effect, heading households, taking responsibility for their siblings and in some cases elderly grandparents.

While there is no specific research yet assessing child poverty in Namibia, a strong record of research from low as well as high income countries highlights the adverse impacts poverty has on children’s health, cognitive and social-emotional development. In early childhood poverty increases the risks of low birth weight and poor nutrition, which in turn leads to higher child morbidity and mortality, as well as lower cognitive development. Some studies also identify direct impacts of poverty on children’s education. Research suggests that many children are not able to catch up as they

38.2%

of rural households are poor


Figure 5: Child and Total Poverty Rates by Region

Source: Levine, 2010 (based on NHIES 2003/04)


grow but, on the contrary, the gap becomes wider over time. Poor education outcomes and school drop-out translate directly into more limited job opportunities and earning potential – leading to cycles of intergenerational transmission of poverty (Grantham-McGregor, S., Cheung, Y. B., Cueto, S., 2007; Suryadama, D., Pakpahan, Y. M., Suryahadi, A., 2009; Magnuson & Votruba-Drzal, 2009; Victora, C. G., Adair, L., Fall, C., 2008).

The impacts of poverty are interrelated with poor hygiene and sanitation, lack of access to health care and education and poor quality of services. Poverty can also affect the ability of parents to provide a nurturing and enabling environment for their children. The quality of family relations is one of the most important mediating factors for children’s experiences of poverty. Family stress, depression and domestic violence as well as parents’ low education and inadequate parenting practices prevent children from developing to their full potential. The situation can become especially difficult for children affected by HIV and AIDS who experience the illness and/or death of a parent, or children who become victims of violence and abuse (Grantham-McGregor et al 2007; Walker, S. P., Wachs, T. D., Meeks-Gardner, J., 2007; Chilton et al. 2007; Ahmed, 2007).

Many poor children and young people experience feelings of shame or exclusion at school or in their peer group, for instance, because they may not have shoes, school uniforms, books and stationary or may not be able to pay school fees. They may become vulnerable to risky behaviour or to exploitation through adults, especially if they experience problems within their families. At the same time many children and young people show remarkable resilience in dealing with adversity and working hard to succeed in their education (Evans, 2005).

3.4 Social Welfare Grants – Not Reaching Their Potential

One of the most important policies in place to tackle child poverty is the social welfare grant system which plays an important role in mitigating poverty. But recent analyses show that the system does not reach its full potential to reduce families’ poverty. Namibia has three different grants – basic state grant (old age and disability pensions), child welfare grants (maintenance grant, foster care grant, special maintenance grant and place of safety allowance) and grants for war veterans. Because of the small number of beneficiaries the latter are not included in the following analysis.

Old age pensions are non-contributory and paid to every Namibian citizen or permanent resident who reaches 60 years of age. As such, they are universal rather than means-tested. Similarly, every person above the age of 16 who is diagnosed as temporarily or permanently disabled by a State doctor receives a disability pension. Both grants have the same value, currently N$500. In December 2008 around 130,000 people were receiving old age pensions, and 20,000 were receiving disability pensions. The grants are administered under the MoLSW (Levine, S., van der Berg, S., Yu, D., 2009).

Child welfare grants are administered by the MGECW and include four different cash transfers for orphans and vulnerable children. Child Maintenance Grants are paid for children under the age of 18 (or 21 if in full-time education) to single parents or a parent whose other parent is receiving a pension, has died or is in prison. The grant is means tested with an income threshold of N$1,000 per month and is implicitly conditional on a child’s school attendance. Similar regulations apply to Foster Care Grants paid to caregivers who have children in custody. Unlike maintenance grants these are not means-tested. Both grants have a value of N$200. Special Maintenance Grants are paid to disabled children under the age of 16 (N$200 per month) and the Place of Safety Allowance is a grant of N$10 per day for children placed in short-term care. Over the last eight

Figure 6: Children Receiving Child Welfare Grants in Namibia

Source: !Nam Child Wiki

years the number of child welfare grants has grown from just 9,000 beneficiaries in 2002 to 113,995 in April 2010 (MGECW, 2010b) as may be seen in Figure 6. The grants, however, are mainly going to orphaned children; the wider group of children in poverty is not being reached.

A recent review of child welfare grants show that they make an important contribution to families. Grants are mainly being spent on essentials: food & beverages and education, especially school fees. To a lesser extent money goes to children’s clothing, housing costs and child health. Although child welfare grant recipients are supposed to be exempted from school fees, the review shows that many schools still expect them to pay fees (MGECW, 2010b).

Expenditure on social grants is expected to decrease from 5.7% to 5.5% over the MTEF period – despite the increase in the value of pensions and child welfare grants and a planned expansion in coverage announced for 2010/2011. Despite the expanding coverage of child welfare grants they are allocated just 0.3% of GDP or some 1.2% of total government expenditure – too little to be effective in reducing child poverty (Schade, 2010; Levine et al., 2009; UNDP, 2009).

Social cash transfers – pensions, child welfare grants and war veteran grants – have a modest impact on poverty rates, reducing the poverty headcount from 42% to 37.8% and, more significantly, the poverty gap from 16.8% to 12.9%. So, while few people are lifted above the poverty line the receipt of cash transfers makes them less poor (Levine et al., 2009). Given their substantially higher value and larger number of beneficiaries, pensions are likely to be more effective in reducing poverty, including child poverty, than child welfare grants. The design of child welfare grants suggests that

large numbers of poor children who are vulnerable because of their poverty rather than because of exposure to HIV and AIDS are not reached and also may be less likely to live with grandparents than orphaned children. But overall it seems clear that while a considerable number of children live in households receiving both pensions and child welfare grants, many others are missing out on both.

3.5 Investment in Children – Unfinished Business

Compared to other African countries, Namibia is among the top five spenders in terms of health and education expenditure as a share of the total government budget. High levels of social sector spending, however, do not automatically translate into spending on children and towards their health, learning and development outcomes. In fact, as the following chapters will show, child outcomes remain well below what investments in health and education would suggest. There is a lack of recent budget analysis and public expenditure tracking that would allow better understanding of how social sector expenditure benefits children and fosters their development towards holistic outcomes.

Namibia has maintained high spending levels even during the recent global economic crisis by adopting a counter-cyclical approach. Budgetary pressures stem not only from a decline in exports and commodity prices but also from a substantial fall in transfers from SACU. Nevertheless, additional expenditure has been allocated to social sectors, as well as the capital budget, at the cost of increasing budget deficits beyond the target of 5% of GDP (Schade, 2010).

Allocations to social sectors have remained relatively stable over time. The education sector receives currently 22.4% of the total budget. About half of this (10% of total budget) is allocated to primary education, but funding for secondary education halved from 5.9% in 2000/01 to 2.9% in 2010/11 and will drop further to 1.5% in 2012/13 – making it difficult to improve the quality of basic education outcomes. Health expenditure has declined in recent years (not counting the drop in expenditure related to the shift of contributions to social grants to the MoLSW) to currently 9% of total expenditure, well below the Abuja Declaration of spending which advises a 14%

Family stress, depression and domestic violence

as well as parents’ low education and inadequate parenting practices prevent children from developing to their full

potential.



share of government budget to be spent on health. Nevertheless, per capita expenditure on health was US$218 in 2007, comparatively high for countries in the region. It is not clear, however, how much of the health budget is allocated to and spent on children’s health and nutrition as well as the share of resources going towards preventive compared to curative health care for children.

While levels of public expenditure are relatively high, they do not sufficiently translate into good child-related outcomes. Gaps in service delivery and quality of provision persist, raising questions about the efficiency of spending. There are no recent comprehensive public expenditure reviews or public expenditure tracking surveys (PETS) that could shed light on how resources are spent and how they contribute to the country’s development objectives. The last PETS for the health and education sector were conducted in 2004. The education PETS point to the difficulties in actually determining any possible leakage of resources between the central level and individual schools, as many schools kept incomplete records. Those schools with complete records showed a mixed picture with both over- and under spending. At that time 80% of the primary and secondary education budget was spent on human resources with information on numbers of teaching staff not matching the actual situation in schools. Staff fluctuations may not always have been communicated to the next higher level, and the report calls for stricter control in schools to exclude the possibility of personnel remaining on the payroll. The survey also identified substantial disparities between rural and urban areas as well as between regions, reflected in differing funding levels, differences in qualification and experience of teachers, levels of teacher absenteeism and the availability of textbooks, equipment and facilities. Unsurprisingly, in disadvantaged areas schools reported higher repetition rates of students, higher levels of school drop-outs and more students not reaching the required marks at grades 10 and 12 (Schade & Ashipala, 2004).

Similarly, the PETS of the health sector identified huge discrepancies in the allocation of financial and human resources per person of catchment area and per patient between regions with no clear criteria for the allocation of resources such as population or health characteristics. Other problems that were identified included the lack of qualified medical doctors and pharmacists in the public health sector, leading to gaps in medical care and supply of drugs. At the time of the survey, one in five nurses heading a clinic only had a school certificate rather than a nursing diploma; among employed nurses this figure rose to 57%. As in the education sector, the report identified discrepancies between numbers of staff reported by different levels of the administration. Finally, the survey identified a lack of maintenance of equipment, especially vehicles and specialised equipment imported from abroad with no local technicians being trained in carrying out maintenance and basic repairs (Schade & Naimhwaka, 2004).

While substantive investments have been made to address some of these issues in the education and health sectors, new analyses are needed to give up to date information. In relation to investments being made in these two sectors, child outcome indicators are still lagging. Spending on social

grants, especially child welfare grants, may have to be further increased to better meet the needs of children in poverty and deprivation. An analysis of how the benefits of the wealth of natural resources and royalties coming out can be enhanced to help nurture and develop Namibia’s children needs to be carried out. The resources are available; coming out of the economic crisis, government revenues are already projected to grow beyond pre-crisis levels and the Ministry of Finance has been successful in strengthening tax law compliance. Against this background there is still adequate fiscal opportunities for planning and investing

for children – for ensuring that the resources necessary to establish comprehensive social protection systems encompassing quality social services are available, an effective legal system that is sensitive and responsive to children is in place and the mechanism for administering financial grants

is strengthened so that the critical resource gaps that children within vulnerable families encounter can be effectively addressed.

3.6 Summary

Namibia’s record is mixed when it comes to providing for its children. Steady economic growth has brought Namibia into the group of upper middle income countries. The global economic crisis has led to a downturn in the Namibian economy but the government took a countercyclical approach in response to the crisis and maintained current levels of public expenditure. Government spending on education and health as a percentage of the annual budget is regularly among the highest in Africa. This spending has produced major gains in access to those basic services. Despite these successes problems remain. Income disparities between the rich and the poor are among the highest in the world. Half of the working-age population is without work.Children bear a disproportionate burden of continued poverty.

43.3% of children are poor, compared to 37.8% of the general population. Children living in rural areas are much more likely to be poor than their urban counterparts. Disparities also persist between different language groups with Khoisan, Rukwangali and Nama/Damara speakers the groups at highest risk of poverty. As will be seen in following chapters, poor children often miss out on the benefits and programmes that Namibia provides.

A key issue is the effectiveness and efficiency of government spending. High levels of social sector spending do not automatically translate into spending on children and good child outcomes. Currently there is not sufficient recent analysis available to understand how resources are allocated within sectors and how they are benefiting children. Social welfare grants are an important instrument in reducing child poverty. Namibia provides three different grants: basic state grants (old age and disability pensions), child welfare grants and war veteran grants. Especially pensions have a modest but significant impact on poverty. Child welfare grants are mainly reaching orphans. Over the past eight years the programme has expanded from serving 9,000 children per month to providing financial support for 113,000 children per month. The growth is a measure of the commitment and ability of the society to provide for its people. Studies on the effectiveness of these grants highlight areas of improvement. The grants are found to clearly benefit children by raising the income levels of households. Further, in most cases the funds are spent on essentials for children such as food and education. Designed to support mainly children who are orphaned by AIDS, child welfare grants are not reaching the wider group of vulnerable children, including those in poverty. Many poor children may live in households without any regular source of income but are not affected by HIV/AIDS – and therefore remain without support. The rest of this document provides greater detail on the ways in which Namibia needs to improve the ways in which it delivers services to its people.

High levels of public expenditure do not

sufficiently translate into good child-related outcomes.



4. Children and Young People: Issues and Concerns

This chapter considers non-financial resources and services that affect children across all age groups. Poor households also have less access to good drinking water, sanitation and electricity. They also live further away from social support, such as clinics and education, and facilities that can give access to support, such as post offices and magistrate’s courts.

The above is a result of the growth of cities and towns, where levels of poverty are much lower. This means that an increasing proportion of the poor live in rural communities. But the areas where the cities and towns are growing the fastest – the informal settlements – are also areas where facilities and services are under pressure or not provided. The move to towns also puts social pressures on families as family structures change and people move away from their rural social networks.

While the family unit is seen as a core unit of society, only one quarter of children live with both their parents. This may not be a problem where households are large and multi-generational. But adult relationships are changing, such that over two thirds of men and women were not in a formal relationship. Over one-third of children live with neither their father nor their mother. Children describe how they do not always find the care and protection that they should receive in a family setting. While a small number of children form child-headed households, most children who lose one or both parents (some 155,000 children) are absorbed into the extended family or their community.

Violence within the family is common, causing stress, anxiety and/or physical harm to the children affected. Institutions, such as the WACPU, seek to offer protection and the different protection measures are described. However, it is clear that lack of staff and other resources mean that not enough support is available.

The nature and extent of state support for children in special circumstances is also considered. Child labour seems to be concentrated in rural communities, but there are not enough people to ensure that child labour does not, at the least, increase from the present level of 8%. Social and economic pressures on children to work increase as they grow older, particularly among those who drop out of school.

Children with a disability and those who care for them indicate anger and frustration at the fact that they feel left out. A review of the support for children who are hard of hearing suggests that parents do not know enough and there are not enough care and support systems to meet the needs of these children.

Excellent examples of how children can be included in policy making are given, based on group discussions with the children themselves. However, there is a risk that these opportunities to participate in discussions are focused on children who are already well supported and cared for. Changes in information technology offer real opportunities towards gaining a broader base for communication.

Finally, another emerging change relates to changes in the climate. The long term effects of climate change and its impact on children are still not fully known. But recent natural disasters, such as flooding in the north, underline the need to be prepared. In respect of children this sets its own challenges to various ministries which are tasked to ensure that the needs of children are fully recognised in this planning and preparedness processes.

Goal 7: Ensure Environmental Sustainability 1990 2000 2006MDG Targets for 2015

Households with Access to Safe Drinking WaterUrbanRural

99%74%

98%68%

97%80%

100%87%

Households with Access to Basic SanitationUrbanRural

86%14%

85%20%

58%14%

98%65%

Source: NPC, 2008a

4.1 Introduction

This chapter covers issues that affect all children regardless of their age. The issues considered are: urbanisation, access to services, the family, children in special circumstances, children and communication and climate change.

4.2 Urbanisation

One third of Namibians live in urban areas (CBS, 2003). By 2025 this will rise to one half, according to a study done in the late 1990s (Fuller and Prommer, 2000). The draw of the main economic centres is strong (Mufune, Indongo, Nickanor & Eiseb, 2008). Windhoek remains a major destination for people looking for a better life in an urban setting. The suburbs

of Katutura are growing at a rate of 9.5% per year (Heita, 2010). Other major economic centres such as Swakopmund and Walvis Bay in the Erongo region, and Lüdertiz, Rosh Pinah and Aussenkehr in the Karas region are also growing but at unknown rates. The creation of formal municipalities such as Oshakati, Ondangwa and Rundu in former communal area creates regional centres with the potential to draw people from rural areas. Attempts to stem this flow by promoting economic development in rural areas may slow the movement of people.

Families who move to an urban area move into neighbourhoods where those living close by may be neither relatives, nor of the same language group or religion. This may cut them


2


off from the traditional support and coping mechanisms of rural life. When they come under stress, the personal, family and social resources offered by rural life are not readily available. Problems can linger and become systemic. People moving into urban areas face uncertain tenure arrangements. Permission from a municipality may be provided, but the land itself is not registered in the name of the migrant (NPC, 2008b). Uncertainty of tenure inhibits investment, meaning that many migrants only erect the most basic form of shelter. Children living in substandard housing face the potential of disease. The lack of privacy becomes an important issue as a child matures. While the impact of housing conditions on educational performance in a Namibian context is not clear, the MDG tasks Namibia to create “an overview of the shelter situation with the emphasis on security of tenure, right to adequate housing (sufficient living area – not more than two people sharing the same room), access to land, access to credit, and access to basic services such as sanitation, water, energy and roads” (NPC, 2008b, p. 44).

Another concern, particularly for children, is the pressure this flow of migrants places on towns to provide access to water and sanitation through serviced land. For example, the City of Windhoek is spending N$75 million per year to service land for migrants but expects to run out of land by 2016, according to Heita (2010). City officials note that squatting has already become a problem in the settlement areas with the city having to spend considerable resources on removing people from illegally settled land. Migrants and their children moving into unserviced areas will be denied access to water and sanitation.

4.3 Facilities and networks

Chapters 5 to 7 look at the services and facilities that children need at different periods in their lives. This section looks at some of those services and facilities that are used throughout childhood and adolescence, such as water and sanitation, energy and communication, and the distance people have to travel to receive these services, and also the opportunities that communication networks offer in reaching information on services to the population.

Water and sanitation are basic services. In 2008, 97% of urban households had access to safe drinking water, as did 80% of rural households (NPC, 2008b). These figures suggest that Namibia is likely to meet the MDG goals for safe drinking water in rural areas and could meet the goal for urban areas. Progress towards access to sanitation is less satisfactory with only 58% of urban and 14% of rural households having access to acceptable levels of sanitation. Looking at the detail, it becomes clear that those who miss out on these services are more likely to be poor.

Table 3 shows the type of water and sanitation services available to poor and non-poor households. Households in poverty are much less likely to have water on site or nearby, with water from a public tap being the most common source for poor households. The CBS (2008) review of poverty found that poor households had to travel an average of 1.1 kilometres to the nearest drinking water, while non-poor households had to travel half that distance on average (0.5 kilometres) (CBS, 2008). Poor households are also much less likely to have access to transport beyond walking, whether this involves a car, donkey carts, a wheelbarrow, or draft animals (CBS, 2008). Hence, the effort required to obtain water is much more likely to be higher for poor households because they tend to live farther from the water source and are likely to have much more difficulty bringing the water back to their homes. The section on climate change below also considers how poor households may be much more likely to use lower quality water sources that are closer to the household.

Sanitation remains a national problem. As can be seen in Table 3, the percent of households using bush toilets is high but poor households are twice as likely to use these compared with non-poor households. Very few poor households (7.3%) have flush toilets connected to a sewer when compared to non-poor households (44.5%). This lack of access to safe sanitation will affect a child’s risk of becoming malnourished and ill, to be discussed in the next chapter.

Very few poor people have access to electricity for either lighting, heating or cooking. Overall, the CBS (2008) reports that slightly more Namibians use candles for lighting than those who use electricity. Just under half of non-poor households have electricity for lighting compared to less than one in ten poor households. Just under a third of non-poor households use candles compared with over

half of poor households. While wood is the source of cooking fuel for 60% of Namibian households, this drops to 48% among non-poor households, while 90% of severely poor and poor households use wood for cooking. Using wood as a main source of energy requires, in most cases, time and energy to collect and carry the wood back to the home. Increasingly the distances travelled can be measured in kilometres, taking time away from child care or other productive purposes. The heavy reliance on wood as a source of fuel also has the potential for significant deforestation, particularly in urban areas.

Projections made in 1997 for 2006 estimated that by 2006, urban-based use of wood as a fuel would amount to 315,806 tonnes (Klaeboe & Omwami, 1997; see also Kojwang, 2000). Data on overall fuel usage appears in Table 4.

Table 3: Water and Sanitation for Severely Poor, Poor and Non-Poor Households

Water and Sanitation Services Severely Poor

Poor Non-Poor

Drinking water

Piped in 3.3 4.2 37.9

Piped on site 10.5 11.5 15.8

Neighbour 7.5 7.5 4.6

Public tap 35.5 36.4 21.7

Private Borehole 4.1 3.9 1.8

Communal Borehole 11.4 10.8 5.4

Flowing 11.7 8.9 3.1

Unprotected Well 7.5 7.8 4.5

Dam/Pool Stagnant 2.4 2.8 1.6

Other 6.1 6.2 3.6

Sanitation

Flush (sewer) 5.7 7.3 44.5

Flush (septic system) 0.7 0.9 3.1

Pit Latrine 7.8 7.9 8.7

Bush 83.4 81.8 42.5

Other 2.4 2.1 1.2

of urban households and

58%

of rural households have access to acceptable levels of sanitation

14%


Source: CBS, 2008


Table 4: Source of Energy for Severely Poor, Poor and Non-Poor Households

Fuel Severely Poor

Poor Non-Poor

Lighting

Electricity (mains) 7.3 8.5 46.2

Paraffin 13.7 16.8 14.5

Wood 15.9 14.2 3.4

Candles 56.0 54.6 32.2

Heat


Wood 64.3 66.1 38.1

None 30.7 29.2 32.9

Cooking


Gas 1.7 2.3 7.2

Paraffin 2.1 2.6 5.1

Wood 91.6 89.7 48.1

The further a household lives from services, the more difficult it is for them to access them. Poor people tend to live farther from basic services than the non-poor. The lack of resources in poor households presents more difficulties in travelling those distances. A poor household may not be able to send a child, parent or caregiver to a clinic or school simply because they cannot afford to do so. Many services, vaccinations, or applications for school fee waivers require several trips to a clinic or school. Making the trip the first time may be possible. Making the trip the second, third or fourth times may become impossible. The CBS measured the distance for both poor and non-poor Namibian households to a series of basic services as shown in Figure 7.

Poor Namibians on average travel 30 kilometres to a Post Office and 45 kilometres to a Magistrates Court. Accessing government services often requires a postal address. Thirty-two percent of social welfare grants are paid into either post office or bank accounts (Levine et al., 2009). The travel costs required to receive financial assistance at a post office reduce the positive impact of social grants on poverty reduction. The distance to Magistrates’ Courts can be even more problematic. Courts are located in administrative centres, the place where caregivers for children obtain identity document, death certificate or apply for grant assistance. The problem of distance to administrative services emphasises the importance of constituency offices as a decentralised point for issuing birth documents.

Communications can be part of the solution to problems of distance and access to services. Mobile Telecommunications Corporation (MTC), the main cell phone company, reports that there

Figure 7: Average Distance to Selected Services by Poorand Non-Poor Households (Kilometres)

Source: CBS, 2008

Source: CBS, 2008

of child-headed families. Families and their well-being are fundamental to children. The condition and strength of a child’s family impacts his or her development at all ages.

4.4.1 Children’s Views of the Family

In subtle but profound ways the social relations of Namibian society have moved considerably since Independence. One anthropologist found that young Namibians were redefining their cultural heritage to incorporate their experiences of living in a postcolonial world. These changes emerge in their performances of ‘traditional’ culture (Fairweather, 2006). Social practices and taboos that regulated sexuality in pre-colonial and colonial times have changed because of the impacts of AIDS (Mufune, 2003). The HIV and AIDS pandemic places local social structures under stress as once supportive family and other social networks are also placed under stress (Thomas, 2007). Hailonga-van Dijk (2007) examines the changes that have occurred with the ways in which adolescents are introduced to sexuality. This section examines these trends.

One way to gauge the state of families is to listen to what children themselves have to say. Lifeline/Childline operates a counselling service in Namibia. In the early 2000s children contacted the service largely for assistance with relationships both with peers and their families (Child Helpline International [CHI], 2005). In 2005, the number of contacts was overwhelmingly for information about HIV and AIDS (CHI, 2007). The following year, 2006, saw a shift of requests to suicide and child abuse as the most common reasons for seeking assistance (Lifeline/Childline Namibia, 2007). Data from 2008 shows abuse and violence as the second most common reason for needing help (CHI, 2009).

In the focus groups children were asked to list the problems they saw. The following are three of the ten top problems that are considered to be ‘very serious’. They are faced by more than half of the children:

Family members abusing alcohol• Domestic violence • Being physically abused.•

4.4.2 Changing Family Structures

The number of Namibians in formal relationships is low and declining. The 1992 NDHS found that

are approximately 1.4 million cell phone subscriptions in

Namibia (MTC, 2010). The CBS notes that roughly 67% of households either own or have access to a cell phone, although among severely poor or poor households this drops to approximately 45% (CBS, 2008). This growing coverage offers new ways of informing people of services and is increasingly used by the private sector. There are recent examples

of how this coverage can be used for non-

commercial use: Lifeline/Childline recently launched

a service to report abuse; MoHSS distributed messages

on days such as national HIV testing day; the National

Social Marketing Agency offered a messaging service relating to HIV and

AIDS. As children who have access to a cell phone are likely to be some of the more active users of messaging services, these developments offer new opportunities for informing children and carers of the services that are available.

In rural Namibia, radio is still the most widely used means of communicating messages. CBS data shows that close to 80% of Namibian households in poverty either own or have access to a radio. The potential of using radio to inform people about development and provision of services is high. However that portion of the population who do not obtain services may also be the 20% who lack access to a radio, that is the very poor.

4.4 The Family

Article 14 of the Constitution recognizes the family as the “natural and fundamental unit of society and is entitled to protection by society and the State.” Article 15 gives a child the right to know and be cared for by his or her parents. Namibian families come in many forms - single parent families, nuclear families and extended families. The AIDS pandemic has resulted in the emergence


Another way to express this data is that two-thirds of men and women (69% of men and 65% of women) are not in a formal relationship (MoHSS, 2008b). Poor couples may lack the cash to give their relationship formal status. Difficulties in finding work may cause one partner to seek employment elsewhere. The long history of internal labour migration from northern Namibia into other parts of the country may be a factor. Demographic and social changes brought about by the AIDS pandemic may also be at play. In this context, there needs to be better understanding of how parenting responsibilities are carried out. The low rate of marriage or other formal arrangements is reflected in the levels of children living with both their parents under the same roof. Just over 25% of Namibian children live with both parents, while just over a third, 36% do not live with either parent. Within the context of the impact of HIV and AIDS where care giving is done by grandparents or other extended family, there needs to be better understanding of how the child is being cared for and who takes the ‘parental’ responsibility for providing the financial, emotional and physical security of the child.

Figure 8 shows the percent of children living with both parents and those living with no parent by region. Only six of the thirteen regions show a

higher rate of children living with both parents. The Kunene, Ohangwena, Omaheke, Omusati, Oshana and

Oshikoto regions form a cluster where far more children do not live with either parent than

live with both parents. Labour migration could be a factor, as all regions have traditionally sent economically active men and women to other parts of the country for work. The sub cluster of Ohangwena, Omusati, Oshana and Oshikoto regions in particular were

part of the apartheid system of labour migration. Cultural factors in Kunene

and Omaheke, where Otjiherero-speaking groups are prominent may also be a factor.

Table 5: Percent of Men and Women in a Formal Relationship, 2000 and 2006/2007 NDHS

Gender NDHS 2000 NDHS 2006/2007

Married Living Together Married Living together

Men 22.6 12.8 18.1 12.7

Women 22.7 16.0 19.9 15.3

Source: MoHSS, 2001 and MoHSS, 2008b

27% of women were married (Katjiuanjo et al., 1993). By 2000 the figures had dropped to 22.7% by 2000 and to 19.9% by 2006/2007 (MoHSS, 2001; MoHSS, 2008b). Similar declines in men and women reporting that they were either married or in a formal relationship were also recorded. These results can be seen in Table 5.

Two teenage girl views of family

At home, my parents fight, which make me

feel bad. In 2007 my mom and stepfather

were always fighting in front of me. Sometimes

he will point a gun to my mom and tell me he is going to shoot her. It

is affecting my studies. I am always cried in class.

… It really hurts me a lot seeing my mom beaten … that’s the

reason I come to school here because I couldn’t

study at home.

The thing that my father isn’t with me… is affecting me badly ‘cause whenever my

friends talk about their fathers I feel bad,

and I just stop talking or just go out of the

room. Sometimes I often cry when I think

about my family or mostly about my father, because this is the time

that I need him more than ever, cause of my examination fees, my

farewell etc.

““

Figure 8: Percent of Children Living with Both Parents or No Parents by Region

Source: MoHSS, 2008b


The percentage of boys and girls living with both parents is equal, while slightly more girls than boys do not live with either parent. This may partially explain the higher proportions of girls who receive child support grants compared to boys. The higher the income, the more likely a child is to experience a family life with both parents, as shown in Figure 9. However, it should be noted that even among the wealthiest families, only 4 out of 10 children live with both parents.

4.4.3 Child-Headed Households

Between 3,500 and 4,000 households (1% of all households) are headed by children (Kuhanen,

Shemeikka, Notkola, & Nghixuliwa, 2008). This figure does not include households headed by young people who are over 18, but not yet considered a full adult in their community (Kuhanen et al., 2008). The number of such households is unknown, though it is likely that they face many of the same problems and challenges as households headed by children.

A study of child-headed households in northern Namibia found that the process by which such households form can be complicated (Ruiz-Casares, 2006). One or both parents die, often due to the effects of AIDS, and children from the household end up taking care of themselves. Sometimes relatives take in infants or very young children leaving older siblings to run the remaining household. Sometimes all children are absorbed into different units of the extended family. Surviving children may prefer to remain together as a family unit rather than be

split among different households (Ruiz-Casares, 2006). The range of options is indicative of the many forms of household to be found among traditional extended families in Namibia.6

The social networks that child-headed households form play an important role in their development and survival. Children and adolescents require material, social and emotional support from adults. However, the number or extent of social networks is less important than the quality of the networks. Children value levels of reciprocity, material benefits and care and concern in their social networks (Ruiz-Casares, 2006).

Children report that staying in a familiar place helps them through the grieving process after the loss of a parent (Ruiz-Casares, 2006). This may be the reason why some children prefer to stay together alone. It may also be a reason why children prefer social networks that also offer guidance and comfort. At the same time, children in child-headed households are found to have high levels of depression and thoughts of suicide (Ruiz-Casares, Thombs, & Rousseau, 2009).

4.4.4 Violence in the Family

Namibia has developed a system of alternative care for children. It seeks, as much as possible, to keep a child within his or her social context, before options of removal to a residential facility or for adoption are considered. This section examines the reasons for this system as well as Namibia’s National Plan of Action for OVC, which was implemented to support children with specific circumstances. In later chapters the ways in which this system addresses the needs of children in different developmental cycles will be discussed.

Some children live in a home that is less than nurturing. In the focus groups that formed part of this analysis, children reported varying levels of abuse in the family. Sometimes the abuse is verbal but it can escalate to physical abuse. One young girl indicated that she is beaten with a sjambok (horse whip); another said she is beaten with a shoe or has stones thrown at her; another girl said that her grandmother bit her once; another said she was once tied to a tree by her uncle and beaten. The incidence of beating a child seems commonplace. Young children in Opuwo all said they are beaten if they have

3 500 to 4 000households are

headed by children


Figure 9: Percentage of Children Living with Both Parents or No Parents by Income Quintile


6 These will be discussed in the next section


not done their household chores or have stayed in the street playing until late. However, they said they do not consider this to be child abuse because “it doesn’t happen every time, and we are not badly beaten.”

Other forms of abuse leave children feeling sad or frightened and some have the feeling that they are not loved. Children in Omaheke reported having to sleep outside if they have done something wrong or have come home late. Pre-teen boys in Kunene said their fathers are always shouting at them for no apparent reason: “We never seem to do anything right in the eyes of our fathers.” Children spoke of neglect such as not providing adequate food, clothing or toiletries or only allowing them to bathe once or twice a week. The children saw not showing love or affection as the worst form of neglect.

In contrast, one group of pre-teen girls in Kunene said they have never been abused and they did not know of anyone who had been abused. But the extent and range of the comments highlights a need for wider education to both children and their parents on proper forms of punishment. It also highlights the degree to which some form of violence seems to be a part of the lives of many families.

Violence in a domestic setting is common in Namibia. A study that covered eight SADC countries, (Andersson, Ho-Foster, Mitchell, Scheepers, & Goldstein, 2007) reported that 15% of 1,100 Namibian men interviewed for the study had an argument during the previous year in which violence occurred with their spouse or partner. 70% of the sample responded that they feel that violence against women is a problem in their community. However, 44% felt that women/spouses sometimes deserve to be beaten.

In the same study 17% of 1,400 women interviewed had been in an argument with their husband or partner where violence occurred. A majority of the women (73%), said that violence against women is a problem in their community. Remarkably, there were surprisingly high levels of acceptance (29%), towards women being beaten when they ‘deserve’ it.

A key point of entry into the alternative care system is through the WACPUs, which are a joint effort of the Namibian Police and the MoHSS. The first WACPU was established in Katutura in early 1993. Fifteen are now in operation in all thirteen regions. The units are currently in the process of transforming into one-stop centres where children’s and family service agencies are clustered.

Several interviews were held with WACPU staff as part of this research. Issues that emerged were coordination, transport and support. Coordination between WACPU staff and health care workers is at times difficult with WACPU staff citing problems of getting doctors to attend to victims, particularly with the administration of rape kits a priority. Given that WACPU are located at MoHSS facilities this is surprising. WACPU staff believe that assigning a specific doctor to deal with their issues and clients would improve operations. Service delivery suffers because only one vehicle is available in each unit; yet there are many needs. Finally, officers at WACPU state they are in need of professional in-service training and personal support due to the emotionally taxing nature of their work. These comments echo those of a 2006 study (Rose-Junius & Küzner, 2006); an indication that the status and operations of WACPU continue to need attention.

4.4.5 Alternative Care to Children

Namibia’s most common alternative care system is based on its families. Families often care for children of relatives or neighbours for a number of reasons. A parent may move to an urban

Being beaten and yelled at by my father

““

Family Conflict

I experience abuse from my mother. One

day I asked her to give me the money to go

and pay my school fees, but she told me that she didn’t have

the money, and that I must go and look for

my father where he is.Sometimes people are always talking about us, that we

should have mothers and fathers who

are supportive. But they are the ones

neglecting us.15-17 year old learner

area in search of a job, so he or she leaves children with relatives. A child may need to go to a school nearby so an aunt, uncle or adult cousin takes them in. The practice of moving children between different households of an extended family is encouraged in some parts of the country so a child will feel comfortable with a wide network of relatives who can later provide support (Fuller, 1993). As noted in the previous section, when parents have died, leaving children on their own, absorption into

other extended family units often occurs. This system and ethos is the foundation for Namibia’s bias towards alternative care for children. The preferred nature of care for children living away from their birth parents is ‘kinship carers’ (MGECW, 2009c) drawn from the child’s family. ‘Foster carers’, who are not related to the child, are the next option. A study to strengthen this system recommends that both kinship and foster carers receive training and some form of financial support (MGECW, 2009c).

Placing children in residential childcare facilities is the third option. Procedures exist to make court orders for short and long term placements of children (MGECW, 2008a). Standards for children’s homes have been developed and, by 2008, 42 children’s homes with just over 1,000 children in residence were registered (MGECW, 2008a). A more recent baseline report on residential childcare facilities nationwide found 73 facilities with just over 2,000 children in residence, with over half

of these facilities being in Khomas and Erongo (Pact Namibia, 2009). In addition, over 13,000 children were in registered foster care in 2008 (MGECW, 2008a).

Adoption is seen as the final, and least preferred, option of alternative care for a child. The MGECW is preparing local guidelines to accede to the Hague Convention. Adoptions are infrequent in Namibia at about 100 per year (MGECW, 2009c). Currently, inter-country adoptions are not permitted. Proposals before the ministry call for legislation to regulate adoptions, limiting inter-country adoptions to nations that are also signatories to the Hague Convention. This would ensure a basic package of rights for the child in his or her new country of residence.

An analysis of capacity to manage the system of alternative care found that a chronic shortage of social workers impeded full implementation (MGECW, 2008a). Regionally based social workers in particular had heavy demands on their time. Often short-term placement orders were sought by social workers because they lacked the resources needed for the evaluation and reporting required for a long-term placement order. The same analysis notes that some magistrates were resisting this pattern of sequential short-term orders (MGECW, 2008a).

Interviews with regional caregivers indicated problems with regional and community based coordination. In the regions visited it was reported that OVC committees used to operate but are now dormant. MGECW staff coordinated these committees in the past but the meetings are no longer called. Social workers are difficult to reach because of their heavy workloads and interagency cooperation has decreased. Facilities for children in need, such as places of safety or children’s homes are in short supply. Those interviewed stated that regional officials need to re-establish OVC forums. The effect of missing champions for children at local and regional levels is seen as a major blockage to efficient and timely service delivery. Given the mismatch between capacity of and demands on social workers to provide an array of services, this is not surprising.

4.5 Children in Special Circumstances

4.5.1 Child Labour

Namibia has instituted the programme: Towards the Elimination of the Worst Forms of Child Labour. The action programme estimates that 72,000 children are engaged in work (MoLSW, 2008a) - close to 8% of all children. A slight

From the Life ofa Teenage Boy

My problem is I do not have a father because I only saw him when I

was eight and he gave me three hundred

dollars. I want to see him again. If he was

here I would have gone to school and

everyday I would have something to eat and

not have stayed in the streets.

Orphaned child

“ “44 CHILDREN AND ADOLESCENTS IN NAMIBIA 2010


majority, 55% of working children are between the ages of six and 14, with 45% between the ages of 15 and 18. Almost all working children (95%) live in rural areas with the most common worksite being the household in a communal area. The Action Programme concludes that the majority of child workers are engaged in “reasonable household chores that are considered as part of children’s family responsibilities” (MoLSW, 2008a, p. 12). This assessment applies to work carried out by both boys and girls. The 2005 National Child Activity Survey asked rural children on their perception of whether or not their activities took up too much of their time. Almost 9,000 children responded with 80% stating that the work took up only a little of their time, while only 7% felt that their work took up much of their time (MoLSW, 2008c).

In 2009, Cabinet directed the MoLSW to visit eight regions and discover the extent of child labour and child trafficking. Teams from MoLSW and the Namibian Police were assigned to each region. A total of 104 charges were laid against adults for violations of child labour laws. The team that visited Ohangwena also focused on child trafficking. A constraint mentioned in interviews with MoLSW staff was the low number of labour inspectors - 38 at present. With over 20,000 registered workplaces each labour inspector would have to visit close to 2.5 per day to visit all the work places each year. This does not take into account other duties or the unknown number of informal, unregistered workplaces. It also appears that there is no training programme for labour inspectors in relation to child labour, which limits their efficiency.

Poverty and income inequalities are seen as root causes for child labour. Children who have left school are particularly susceptible to the need to work in order to support their household. Chapter 7 shows how the numbers that are not in school increases quickly once primary schooling is complete. Children in households affected by HIV and AIDS often assume duties such as cooking, caring for sick family members and younger siblings as well as household management. Poor children are also concentrated in rural areas with a high overlap between working children and vulnerability.

The home, particularly if it is in poverty or affected by HIV and AIDS, can become a site of labour exploitation. Some boys in the focus groups in Kunene Region spoke of having to look after livestock, a task that often took them far from the homestead and placed them in danger. Children in towns or larger settlements spoke of participating in income generating activities. Selling apples, sweets, vetkoek or firewood were daily chores that they were required to do in order to buy food. Children in more rural settings spoke of fetching water over long distances. Often the children carry large containers that are extremely heavy when filled. KIs were concerned that there was not a clear understanding among some community members, especially those in rural areas, on what was regarded as unacceptable child labour and acceptable tasks for a child. Awareness about the dangers of child labour and its implications on child development was considered to be lacking.

The risk of children engaging in commercial sex work also exists. One study at the Oshikango Border post found that 18% of commercial sex workers were under the age of 18 (Sechogele, 2008). Another study carried out by the LAC indicates that poverty is a common motivation for young men and women to engage in commercial sex work (LAC, 2002b). The Action Programme places high emphasis on poverty reduction as a means of preventing child labour (MoLSW, 2008a).


Just under 5% of Namibians have a disability; with most of them living in rural areas. As with many other issues, poverty has a disproportionate impact on the disabled due to the additional costs of specialist care required (MoHSS, 2008b, p. 39). The MoE has a long standing policy of inclusive education for learners with disabilities (Wietersheim, 2002). Of 30,000 students with some disability, approximately 29,000 attend

“I have to collect water even when it is raining.”

A young boywith a dream

I live on the streets because my father

chased me out of the house when I was

eleven years old and he told me that he will not pay for my

school fees. My mother doesn’t work; that’s

why I left school and live on the streets

and take care of myself. Everyday in

the morning when I wake up I thank God

for each and everyday. I clean cars, and with

the money I buy myself food and toiletries. I want you to help me

because I still want to go back to school, because living on the

street is not nice. I am a young boy with a

dream which I want to fulfil. One day I want to be a police officer.

““


schools with their fellow students (MoE, 2010a). A report carried out in 2002 notes concern about the low numbers of teachers with training on how to integrate learners with disabilities into daily school activities (Wietersheim, 2002).

A more detailed review of the area of hearing disability highlights the interrelationships and limits to what is achieved. Causes of hearing impairment in Namibian children are regrettably common and often preventable - poor or no treatment of middle ear infections, high incidence of malaria and meningitis, malnutrition and low standard of pre- and post-natal care. There are no accurate statistics; estimates vary from 3,000 to 12,000 profoundly deaf children in Namibia. Presently, the vast majority of hearing impaired children do not reach their potential and will not play their part in the development of the country.

Although the limited access in rural settings or poorly resourced communities may be a result of distance and location, anecdotal data suggests that children with severe to profound hearing loss are also denied access because of their parents’ lack of understanding of their child’s condition.

The public health system provides specialised ear, nose and throat and audiology services in only two state hospitals with additional audiology services offered in Rundu. As a consequence, identification and intervention for children with hearing loss does not take place early and consistently enough, with the result that:

many children with preventable hearing loss •are not treated at a stage when permanent hearing impairment could still be preventedresidual hearing in hard-of-hearing children •is not utilised to enhance acquisition and development of spoken language

only a few deaf children are enrolled in •schools7

Twenty-eight children with disabilities contributed to the FGDs. What was most striking was the lack of positive things the children had to say about their lives. The children were very sad and angry because of the attitude of people, especially those who are supposed to love and care for them. Interviews with their school carers showed a similar level of anger at the isolation that the children felt. “There is a misperception with regard to disabled people. People, especially parents, see them as not able to do anything. Most parents do not want to pay school fees because they think they are not getting anything out of it. They have already concluded in their minds that these children are worthless and will not have any contribution to the society”. Challenges in relation to children who are deaf or hearing impaired are likely to be repeated in relation to children with other disabilities.

4.5.3 Refugee Children

Namibia hosts refugees at the Osire Refugee Camp (MGECW, 2009b). The camp has a primary school with 1,996 children and a junior secondary school for an additional 693 children. The MoHSS operates a heath centre there in partnership with United Nations High Commission for Refugees (UNHCR). Pre- and post-natal services are available for all mothers. All refugee children receive the same immunisations as all Namibian children. In 2008, 1,334 children below the age of ten were vaccinated. A total of 42 residents of the camp are on ART. Of this figure, 6 are children (three girls and three boys). The CRC report notes no major issues or challenges for refugee children and there does not appear to be material on the attitudes of refugee children about their status or their aspirations (MGECW, 2009b).

of commercial

sex workersat Oshikango are

under the age of 18

18%


7Data from the Association for Children with Language, Speech and Hearing Impairments of Namibia


4.5.4 Children and HIV and AIDS

A range of issues with regard to children and HIV and AIDS will be discussed in the following chapters, while this section deals with children and ART and the OVC Plan of Action. The MoHSS estimates that there are approximately 13,000 children under the age of 15 who are HIV positive in Namibia. Children may become infected at or around the time of birth or in adolescence. ART was introduced in 2003 and by early 2009, 81% of identified people living with HIV were enrolled in ART, which is presently available at 62 of the 343 health facilities in the country (MoHSS, 2010). 12% (7,750) of the 64,637 people on ART are aged between zero and 14. Unfortunately, children between the ages of 15 to 18 are counted as adults in this dataset but the figures suggest that one in six of people on ART are children. The number of children annually receiving ART is expected to reach a peak of just below 20,000 in the year 2014/2015.

The National Plan of Action on Orphans and Vulnerable Children was adopted in 2007. The plan came into being because of the recognition that increasing numbers of Namibian children were at risk. Poverty and the impacts of the HIV and AIDS pandemic were seen as the main sources of this risk. The Plan defines an orphan as “a child who has lost one or both parents because of death and is under the age of 18 years” and a vulnerable child as “a child who needs care and protection” (MGECW, 2007a). Under this definition the term ‘vulnerable’ is left vague in appreciation that it is likely to evolve as social conditions change or new issues emerge. The current definition determines that there are approximately 250,000 vulnerable children of whom 155,000 of them are orphans (MGECW, 2008b). 45% of these are believed to have been orphaned as a result of the effects of AIDS. The plan is divided into five areas: Rights and Protection, Education, Care and Support, Health and Nutrition, and Management and Networking. Specific targets are associated with each area as shown in Table 6.

A review of the plan’s activities in 2008 found both successes in meeting these targets, as well as remaining challenges (MGECW, 2008b). As recorded in this analysis, successes include progress towards tabling the new Children’s Bill in parliament, equal enrolment of vulnerable children and non-vulnerable children at primary school level, the enrolment, as of May 2010, of 114,536 children in the Child Welfare Grants programme, and the percentage of 15 – 19 year old girls who are HIV positive has decreased from 10% in 2006 to 5% in 2008. The Permanent Task Force on OVC meets regularly and its members have taken an active role in pursuing the plan.

Table 6: National Plan of Action: Strategic Areas and Targets

Strategic Area Target

Rights and Protection All children have access to protection services by 2010

Education Equal proportions of OVC and non-OVC of school-going age attend school. OVC who are out of school will receive educational opportunities.

Care and Support 50% of all registered OVC receive some form of external support by 2010.

Health and Nutrition 20% reduction in under five mortality of all children by 2010 and equal proportions of OVC to non-OVC are not infected with HIV by 2010.

Management and Networking

Multi-sectoral coordination & monitoring of quality of services improved by 2010.

Source: MGECW 2007a

4.6 Children and Communication

This section examines the ways in which children in Namibia have access to

communication services. Communication means more than expressing one’s views. It also means the ability to secure and share information.

Namibia has a number of outlets to give children a voice in their affairs. Well over 95% of schools have Learners Representative Associations (LRAs) who provide a liaison between students and school administration. The national NGO, Lifeline/Childline, sponsors Uitani Radio – a radio programme produced and reported on by children. The Namibian newspaper carries a weekly supplement that provides a platform for discussions on children’s needs and issues. Parliament, in partnership with MGECW, holds an annual Children’s Parliament, which brings children’s issues to the attention of Members of Parliament and makes recommendations on how to include the needs and opinions of children in national debates. Windhoek, the capital city, holds a Children’s Council, following a similar process to that of the Children’s Parliament. Discussions are underway with Regional and Municipal Councils to adopt their own parallel children’s assemblies.

An excellent example of involving children in decision-making is the process followed during the development of the new Children’s Bill, which included a parallel Children’s Reference Group. This informed the planning for the drafting of the Bill and ensured children’s views were included. Another example is that of the City of Windhoek, where the “Junior Mayor, Cllr Nadien Boois, and her team successfully implemented a number of projects, within the framework of the Vision and Mission of the Council.”9

The voices of children in this report also highlight the need to listen to children right down to community and school level. In most of the above examples children from affluent family backgrounds are more likely to participate. But in every school, children may be given the opportunity to be heard. They are certainly interested in this, as reflected in the recent report on school counselling: “Learners often expressed frustration at the lack of self-determination, at not having a say, not being

taken seriously, not having their needs met and not being consulted. Secondary school principals did not seem to see it as their role to promote autonomy in secondary school learners” (MoE, 2010c, p. 41). The same may be said in relation to parents and carers. Chapter 6 describes violence towards children in the family. Parents and carers are challenged to find alternative approaches to punishment; the adage ‘a child should be seen and not heard’ is no longer adequate.

Information increasingly comes via information and communication technology. Namibia has an excellent ICT infrastructure. The country has a fibre optic telecommunications backbone that reaches most municipalities (Fuller & van Zyl, 2007). The mobile cellular network covers 95% of the population (World Bank, 2008). There are approximately 1.4 million mobile phone subscriptions in a population of 2.2 million (MTC, 2010). There are an estimated 135,000 active Internet users in the country (World Bank, n.d.). The MoE has established an effort to connect all government schools to the Internet under the Tech/Na programme (MoE, 2006). Children are increasingly gaining access to information through ICT programmes available in school and through the mobile phone network. The challenges that come with these opportunities, such as bullying through cell phones, is touched upon in different parts of this analysis and it is a dimension that needs to be increasingly considered as policies for children are further developed.

4.7 Climate Change: Impact and Response

Namibia is regularly faced with environmental events that impact on children. As the driest country in sub Saharan Africa, Namibia is prone to drought and, for this reason, the 1997 National Drought Policy encourages local and farmer level planning for drought. Floods occur regularly in certain regions that result in temporary dislocation of people. This section examines some of the impacts of these events and the response of the country. The discussion begins with climate change before turning to shorter-term events.One review predicts that the annual loss to the country resulting from climate change may rise to between 1% and 4.8% of Gross Domestic Product (GDP) over the next 20 years (Reid, Sahlén, Stage, & Macgregor, 2008). In the past century mean temperatures

9 Aloe, Monthly Newsletter for Residents - City of Windhoek, March 2010

“We have been listening to the voices of children who are vulnerable because of their different life experiences. They are children haunted by uncertainty brought about by HIV AND AIDS. How do we as adults assure them of hope? Simply by giving them love, care and understanding, and by listening to what they say”.

Nahas Angula (Prime Minister of Namibia quoted in Chldren’s Voices, Positive Vibes)


SITUATION ANALYSIS

in Namibia have climbed by 0.2 degrees Celsius. The government predicts a further rise in this century of between two and six degrees Celsius (Government of Namibia, 2002). Rainfall is expected to decrease in the Northwest and Central regions of the country. This may lead to an expansion of deserts and arid lands and a decrease in savannah and grasslands (Midgely, Hughes, Thuiller, Drew, & Foden, 2005 cited in Reid et al., 2008). Increased temperatures will increase evaporation rates. Agriculture will be significantly affected with the potential to lose between 20% to 50% productivity in the livestock sector, particularly among small stock farmers in southern Namibian. Many livestock producers already operate at or near maximum carrying capacity and are thus vulnerable to any decline in rainfall and grazing conditions (Reid et al., 2008, p. 458). The authors argue that traditional dryland agriculture could see production declines of 40% to 80%.

Reid et al. (2008) conclude that the loss of productivity measured in GDP has the potential to wipe out gains in the reduction of inequality as measured by the Gini Coefficient. With most of the country, particularly poor households in Northern Namibia, dependent in some way on dryland agriculture this predicted decline, even if partially correct, could see widespread increases in poverty and social distress. Urbanisation is likely to increase. But the changes could also impact on the fisheries sector. Different analyses, as reported in Reid et al. (2008), suggest contradictory results. At best, there will be no change in the sector; at worst there will be a major decline. If the latter occurs, the country would see a large decline in a major economic sector and decreased government revenue, which could reduce the resources to cope with other impacts of climate change.

Vision 2030 foresees increased urbanisation and an advanced agricultural sector, able to maximise its use of environmental resources (Office of the President, 2004). Improvements in drought resistance crops and improved irrigation techniques may buffer the impacts of decreased rainfall. Transformation of the economy towards a knowledge based economy means less dependence on agriculture and more economic growth from services and manufacturing. Nevertheless, the need to include the impact of climate change in current development policies is clear.

Climate change affects the poor and vulnerable to a greater degree than the general population. Vulnerable households lack the coping mechanisms to compensate for a reduction in basic resources, or decreased access to resources. A study on resources available to mothers and young children found that poorer households were more likely to take more risks with water, such as taking water from unsafe sources or using unsafe storage methods (Remmelzwaal, 2003). As was noted above in the section on poverty, female-headed households have a higher incidence of poverty than male-headed households. A study on gender and climate change notes that in crisis situations women are more vulnerable along four different axes: financial - due to their average lower earning power and higher levels of poverty; social - due to the levels of vulnerability in female headed households; psychological - due to higher potential for violence in times of social disruption; and physical - due to a higher concentration of poor households in environmentally marginal areas (Angula, 2010). Women’s roles as primary care givers are magnified in times of stress. Climate change in Namibia may deplete water and timber resources. This means that women and children are likely to be required to spend more time on drawing water and gathering firewood (Angula, 2010).In rural areas people gain access to communal land through traditional structures. The LAC found positive attitudes on the part of traditional authorities towards unmarried women obtaining title (Werner, 2008). However, these attitudes appear to apply mainly to women

who can meet the costs involved in acquiring communal rights. The extent to which poorer women can do so is unclear. If climate change creates pressure on land use, lower income households headed by women could fail in their attempts to define and protect their rights to land.

Climate change may also increase the rate at which people move to towns and cities. The trend for people to move to the city has already been mentioned (Heita, 2010). The City of Windhoek’s chief executive officer is reported as saying that the City is concerned about its ability to find enough land and money to supply space, water and sanitation to people coming to live in the city. Should the numbers coming to the city increase, the city may find itself unable to cope with increased migration; new arrivals will move into areas where they have no land security, clean water or sanitation. Children in such families will be at risk. The City of Windhoek is the best resourced municipality in the country. The ability of other municipal areas to provide services and land is likely to be much less, making any existing problems worse.

While floods have been the focus of attention in relation to natural disasters in Namibia, climate change may also result in desertification, changing rainfall patterns and the loss of livelihood. In some regions of South Africa, where drought appears to have become persistent, concerns have been raised about loss

of livelihoods and the impact this will have on children. As governments increase spending on responses to natural disasters, developmental activities can suffer from funding constraints. The social disruption brought about by environmental change has a strong impact on children who can be deprived of education and basic social support. KIs agreed with this,

indicating that inaccessibility to services for children is heightened during floods, especially for those on ART. Displacement of families and communities and the subsequent impact felt by children is not yet understood in the Namibian context. Some news reports of the 2009 floods suggested that unhealthy social practices took place in displacement camps. The Post Disaster Needs Assessment (PDNA), conducted by the Office of the Prime Minister (OPM), noted increased potential for transactional sex and gender based violence in areas where displaced persons were housed (GRN, 2009) Children were affected by these events, but how and what the long-term effects might be are unknown.

The 2009 floods in Namibia caused an estimated N$1.1 billion in damage and an added N$637 million in outright loss (GRN, 2009). These figures only measure the costs of infrastructure. Estimates of those affected are as high as 700,000 people, with 50,000 internally displaced. Children were particularly affected. A total of 328 schools were damaged and 94,000 learners had their education disrupted. Internally displaced children had both their schooling and lives interrupted for a number of months while they waited for waters to recede and reconstruction to allow return to their homes. While there was much less damage to health facilities, disruption to roads made problems of access to health facilities much greater. Issues that emerged from the floods were the potential disruption of treatment for people on ART. Reports circulated about prostitution and alcohol abuse in the resettlement camps.

Responses to these problems were deemed successful in this instance. The Post Disaster Needs Assessment (PDNA) carried out by the OPM, found that most of these issues were resolved (GRN, 2009). Health services were interrupted for a short period. Learners were able to return to schools and caught up on their lessons by attending classes during the next school break. Police and community leaders took action to ensure a safe and healthy environment at the resettlement camps.

The Namibia National Disaster Risk Management Policy, approved by Cabinet in 2009, (GRN, 2009) adopts the Hyogo Framework for Action. This framework encourages a movement away from disaster response to the integration of risk management into development activities.

during the 2009 northern floods94,000 learners had their education disrupted



The Emergency Management Unit within the OPM has directed each region to establish Regional Disaster Risk Management Committees. These will conduct regional vulnerability assessments and establish plans to integrate response to disasters into operational activities. Each line ministry will be responsible for its area of operations in the event of a disaster. MoE staff will deal with educational needs during a crisis, MoHSS staff with health care needs and MGECW staff with children’s needs, including the extra needs that can arise in an emergency. For example, the MoHSS in a specific region will have to consider the potential for increased prevalence of malaria as a result of flooding. Annual work plans and resource requirements would then be adjusted to incorporate whatever may be required to address the problem. MGECW needs to ensure that other line ministries include children’s needs in their disaster management strategies. Currently, the lack of capacity at MGECW makes effective promotion of children’s needs in disaster management a challenge.

4.8 Summary

The previous chapter considered the financial resources that affect children in general. This chapter considers other general issues that affect all children, whatever their age.

One major underlying factor is the increasing proportion of people who live in towns and cities. These changes are both material – households newly arriving in a town may live in informal settlements with limited services – and social – family support structures are changed, making it more difficult to manage problems.

Non-financial services include water, electricity and sanitation. Overall, water supplies are good but it is clear that poorer households are the ones that have to travel further to access good water. The availability of good sanitation and electricity is relatively low in rural areas and alternative sources of fuel are becoming increasingly scarce or expensive. This has a bigger impact on the poorer household.

The move to towns is one of the factors that relate to changes in the family. Children describe how they do not always find the care and protection that they should receive in the family. Family structures are diverse and are also changing, with fewer adults reporting that they are married or in a formal relationship. Within this context and especially due to the impact of HIV and AIDS on families, where care giving is done by grandparents or other extended family, there needs to be a better understanding of how the child is being cared for and who takes the ‘parental’ responsibility for providing the financial, emotional and physical security of the child.

A small number of children form child-headed households although most other children who lose one or both parents (some 155,000 children) are absorbed into the extended family or community in different ways. Violence and oppression in the family appears to be common, causing stress, anxiety or physical harm to the children affected. Institutions such as the WACPU seek to offer social protection and the different forms of social protection are described. However, it is clear that lack of staff and other resources mean that not enough support is available.The nature and extent of state support for children in special circumstances is also considered. Child labour seems to be concentrated in rural communities. But not enough people are available to ensure that child labour does not, at the least, increase. Social and economic pressures on children to work increase as they grow older, particularly among those who drop out of school once their primary schooling is finished.

328 schools were damaged

Another group of children in special circumstances are those with a disability. MoE policy is to include these children in mainstream schools. While there are sound educational reasons for this, disabled children and their carers who were interviewed for this situation analysis indicate their anger and frustration at the fact that they feel marginalised. Moreover, a review of the support for children who are hard of hearing suggests that parents do not know enough and there are not enough care and support systems to meet the needs of these children.

Responsibilities towards refugee children seem to be met, including providing ART to those in need, which is a considerable achievement. However, the fact that the numbers of children who are in need of ART is likely to double within the next five years may present a resource challenge, especially in a resource-constrained environment.

Some excellent examples of how children can be included in policy making that

affects them are given. However, the risk of these opportunities being concentrated on only the more connected children exists. Changes in information technology offer real opportunities towards gaining a broader base for communication, although the radio still remains the most accessible medium of communication across all communities.

Finally another emerging change relates to changes in the climate. The long term effects of climate change and its impact on children are still not fully known. But recent natural disasters, such as flooding in the north, underline the need to be prepared and to plan. This presents a real challenge to the MGECW, as a lead agency for children’s policy.

With this background, the following chapters look at children in their age groups – infants and young children (0 – 5 years of age), children as they move through early school years (6 – 11 years of age) and finally young people (12 – 17 years of age) as they mature into adults.



5. Infants and Young Children (0 – 5 Year Olds)

Most mothers today attend antenatal clinics and very many give birth with a medical professional present. Yet the number of children and mothers dying at childbirth or in the year after is rising again after falling in the 1990s, so much so that it is unlikely that the MDGs will be reached. This disappointing trend is despite the fact that over 90% of mothers are receiving antenatal care and over 80% are attended at birth by a trained birth attendant.

The rising death rates are partly explained by the indirect effects of AIDS, although just how great this effect is, is not clear. But HIV and AIDS is present not just in relation to rising death rates. One in four of all new HIV infections occurs in the first year of a life, emphasising the importance of PMTCT efforts and avoiding a lifelong cost to child and state.

Other reasons for the rising death rates are explored. In relation to the health system, the costs of access, particularly when treatment such as antenatal care and vaccinations require several visits to a clinic, have an effect on how well a programme is followed through and completed. The different quality of health care support according to location may also have an effect, with pockets of lower standard care and with northern rural areas being found to suffer particularly from staff and resource shortages.

Other factors relate to the social, economic and education status of the mother. Children of mothers over 40 years are particularly at risk, as are, to a lesser degree, children of teenage mothers. Children who are born within two years of a previous child are also at greater risk. The way in which mothers handle diseases like diarrhoea also has its effect; mothers know about oral rehydration therapy but the children of less educated mothers are more likely to die from diarrhoea than other children.

The degree of poverty of a mother has its impact in many ways. Poorer mothers live further from health facilities, report difficulty in getting to these health facilities because of cost, attend less frequently for post natal care, are not able to afford formula milk if they are HIV positive and have to use wood for cooking (a factor in acute respiratory infection). Low birth weight and high numbers of children (40%) who are found to be either moderately or severely stunted are also likely to arise because of poverty and lower levels of education of parents or carers.

Progress towards vaccination targets for children is not as strong as was hoped when policies were written and resources allocated. Only 70% of births are being registered. These are important foundations for a child’s future. Efforts have been made to work across ministries and departments to remedy these challenges and this analysis highlights how it appears that children and mothers at risk can be identified according to their background. More joint working and targeting of at-risk infants and children would be valuable.

Finally, the importance of early childhood education is slowly being recognised through programmes of the MGECW and the MoE, with the City of Windhoek also being active in this field. Around 50,000 children benefit from ECD programmes (about half the number of children who should benefit) but further efforts will be needed to ensure that all provision meets basic standards.

Goal 1: Eradicate Extreme Poverty and Hunger 1992 2000 2006/2007MDG Targets for 2012

Children under five malnourished, stunted, in % of all children under five

28.4% 23.6 24.2% 18%

Goal 4: Reduce Child Mortality 1992 2000 2006/2007MDG Targets for 2012

Under 5 mortality per 1000 live births 83 62 69 45

Goal 5: Improve Maternal Health 1992 2000 2006/2007MDG Targets for 2012

Maternal mortality per 100,000 live births 225 271 449 337

Antenatal Care 87% 91% 94.6% 80%

Assistance at delivery by trained health staff 68% 78% 81.4% 95%

Adolescent birth rate 22% 18% 15% 13%

Source: NPC, 2008a

5.1 Introduction

A child has a right to life, survival and development. He or she has a right to health and health services, as well as a right to an adequate standard of living. He or she has a right to an identity. Namibian infants and young children are likely to find these rights fulfilled, though there are areas where society fails to provide these basics to all children. Progress in the support and care of babies and infants is mixed. Successes include the high numbers of mothers who receive antenatal care, who

give birth in health facilities and who receive PMTCT where needed. Concerns arise in thef ollowing areas: the rising rates of maternal mortality, little or no improvement in infant mortality, high rates of wasting and low levels of immunisation and birth registrations.

This chapter looks at the needs of a child from birth until the child goes to primary school. This period is often described in separate stages – ‘neonatal’ being the first month of life; ‘infant’ being from month two to month twelve; and child, being year two to year five. ‘Under fives’

In 1992, 225 mothers died for every 100,000 children

born. In 2006/7, the figure had doubled to 449

1

4

5



refers to all these stages collectively. Some of these services can best be grouped into a single package to be given to each child either at birth or during the first years of his or her life. Postnatal care, PMTCT, immunisation, interventions to prevent stunting and wasting and birth registration are necessary to provide the continuum of care towards a strong start in life. Many mothers and children receive these services but some do not. Knowing who is not receiving these services, and why, is important.

5.2 Care of Mothers

The health of a mother in pregnancy, at birth and immediately after delivery is closely linked to the health of a child (MoHSS, 2008b, p. 114). The MDG table on page 54 shows that the number of women dying during childbirth has grown steadily since 1992 when there were 225 deaths per 100,000 live births. By 2000, the rate of death had increased to 271, while in 2006/2007 the number ballooned to 449, making it unlikely that the MDG target of 337 (a target that is already above the 1992 rate) will be reached.

HIV and AIDS plays a major role in this increase, and as an indirect cause (Hogan et al., 2010); however, specific analysis for Namibia has not yet been undertaken. Efforts to reduce the impact of this factor concentrate on reducing the rates of HIV among women, knowing the HIV status of an expectant mother and providing PMTCT services.

The most important direct causes of death around childbirth are severe eclampsia, haemorrhage and obstructed and/or prolonged labour (MoHSS, 2007a). Efforts to reduce these risks of a mother dying during birth have included increasing the number of births where a trained birth attendant is available. The proportion of women giving birth with the support of a trained health care attendant present rose from 68% in 1991 to 81% in 2006/2007. This suggests that the MDG target of 95% attendance will not be reached, although the 2008 progress report suggested that it was likely to be reached (NPC, 2008b).

Antenatal care is another important factor in reducing the number of deaths (Hogan et al., 2010, and Rosenfield, Main, & Freedman. 2006). Health care workers can diagnose and treat other illnesses during antenatal care visits and so MoHSS guidelines recommend a total of 12 to 13 visits to an antenatal care clinic - once every four weeks for the first twenty-eight weeks, once every two weeks between the twenty-ninth and thirty-sixth weeks, and every week after this until labour begins (MoHSS, 2008b). Attendance at antenatal clinics has risen from 87% in 1992 to 94% in 2006/2007, although this figure does not mean that all those who attended made the 12 to 13 visits, as the figures only record the numbers of women who made four or more visits.

In all but one region, attendance at antenatal clinics is over 90%. In Kunene Region the rate drops to 81%. Cultural attitudes among groups such as the ovaHimba may play a role, but distance is also likely to be a factor. The CBS (2008) found that in Kunene Region the average distance of a household to a health care facility was 33 kilometres, three times the national average. Improving the rates of attendance in Kunene region may require expanding community based health care, such as through the use of community health care providers and health extension workers, as outlined in the guideline released in February, 2010 (MoHSS, 2010).

High rates of attendance by region may mask problems of access within a region. Local pockets of poor service delivery can be found. For example, Khomas Region usually scores the best on any social indicator. However, a survey of primary health provision in Windhoek found that clinics in outer Katutura are understaffed when compared to clinics in older, more established parts of Katutura or Khomasdal (Bell, Ithindi, & Low, 2002), as can be seen in Table 7 on page 56.

Table 7: Primary Health Care Service Provision by Locality in Katutura and Khomasdal

LocalityDemand Supply

Number of visits at clinic

Number of nursing staff

Number of doctors

Number of rooms

Okuryangava 2,268 5 0 8

Wanaheda 1,251 4 0 8

Hakahana 793 4 0 8

Katutura Health Centre and Donkerhoek 2,657 32 3.5 38

Khomasdal Health Centre 566 8 2 14

Total 7,535 53 5.5 76Source: Bell, Ithindi and Low 2002

There is a general perception that Katutura and, to a lesser extent, Khomasdal (the former Black and Coloured townships, respectively, of apartheid times) are pockets of poor services within Windhoek as a whole. The above data comes from a study made in 2002 and shows that there are variations in service availability even within Katutura. Today it is possible that the newer settlement areas around Goreangab, Havana, and Okahandja Park have taken the

place of the low performing areas in northern and western Katutura.

The level of income of a mother does not appear to be a significant factor affecting antenatal attendance. Over 90% of pregnant women from all income groups attend antenatal care, though the percentage is higher among women from upper income levels (MoHSS, 2008b, p. 116). However, the impact of income is probably strongest when the number of recommended visits is considered.

A recent study that focused on people living with HIV and AIDS (PLHIV) shows

that transport to health care services is a major limiting factor for low income

and poor people (Bicycle Empowerment Network [BEN], 2009, p. 3). Each visit to a clinic costs between N$15 to N$20 per trip when transport and health care fees were considered (BEN, 2009, p. 3). A pregnant mother travelling to an antenatal clinic can expect to pay between N$180 to N$260 to attend if she follows the MoHSS guidelines of a total of 12 to 13 visits. Nationwide, the survey found that poor households lived on average 12.5 kilometres from the nearest heath facility, meaning that most poor women need to pay for transport when they need medical care.

In a poor household this expenditure is likely to be beyond the means of available income. The NDHS finds that 70% of women indicate problems in accessing health care (MoHSS, 2008b, p. 100). Distance to a health facility and the cost of transport are cited as the most common problems.

Cost of travel (apart from cultural reasons) may also partly explain why some women delay their first antenatal care visit. The MoHSS finds that, on average, a woman first seeks antenatal care halfway through pregnancy (MoHSS, 2008b). Waiting too long before initial visits and/or spacing the number of visits decrease the chance of early diagnosis and timely intervention when pregnancy complications occur. But it may not be just a question of cost. Attendance by expecting mothers with no education is below 80%, while above 90% of women with higher levels of education attend.

5.3 Care of Babies and Infants

5.3.1 Infant Deaths

Neonatal and infant mortality fell in the 1990s but started to rise again after 2000 (Katjiuanjo et al., 1993). Child mortality has continued to fall, although improvements after 2000 have been small (MoHSS, 2003b; MoHSS, 2008b). These trends suggest that it is unlikely that the 2012 MDG targets of reducing infant deaths to 38 per 1,000 live births and under 5 deaths to 45 can be met.

The top three direct reasons for Neonatal deaths are pre-term births, birth asphyxia, severe infections, and congenital anomalies, in that order. Among children after the first four

dead babies are found every month at the sewage works in Windhoek

13



weeks of life, the reasons for death are AIDS, diarrhoea and related diseases, acute respiratory infections (ARIs) and injuries (World Health Organization [WHO], 2009). In an analysis of the deaths according to the circumstances of the mothers and babies, the measures show a similar pattern. Rural death rates are higher than urban death rates (MoHSS, 2008b). Children of mothers with primary education or less are more likely to die than children whose mothers have at least some level of secondary education. In the same way, children of mothers with lower incomes are more likely to die than those of mothers with higher incomes (MoHSS, 2008b).

Children of older women (above 40 years old) are almost three times as likely to die in their first month of life and almost twice as likely to die during their first year when compared to children of younger women (MoHSS, 2008b). A woman who gives birth for a second time in less than two years places that second child at risk - the rate for neo natal deaths among women who gave birth less than two years previously is 59 compared to the average national rate of 24. The rate of infant deaths is 92 compared with a national average figure of 46 for all infants (MoHSS, 2008b). The size of a newborn baby is also a factor in whether he or she survives or not. Babies who are either small or very small are almost twice as likely to die shortly after birth or as infants compared to babies born more than two years after a previous baby. These data highlight the importance of educating women on the risks of having children after the age of 40 or in too quick succession. It also highlights the importance of supporting mothers in taking good care of their own health while they are pregnant.

At the other end of the age range, the number of adolescent mothers is falling and it is likely that the MDG target will be reached. NDHS 2006/2007 reports that teenage pregnancy is a major health concern because of the higher risk of death for both the mother and child. It also has adverse social consequences on mothers because women who become mothers in their teens are more likely to stop school education. Childbearing among teenagers increases rapidly between the ages of 17 and 19 - from 14% among women age 17 to 35% among women age 19. Rural teenagers (18%) are more likely than urban teenagers (12%) to start childbearing.

Regions with high teenage pregnancy rates are Omaheke (27%), Otjozondjupa (27%), Caprivi (30%), Kunene (31%), and Kavango (34 percent); regions with rates below 10% are Khomas, Ohangwena, Omusati, and Oshana (MoHSS, 2008b). The NDHS finds that 58% of teenagers with no education have started childbearing, more than twice the rate for teenagers who have incomplete primary school (25%) and almost ten times higher than the rate for those who completed secondary school (6%). Teenagers from the poorest households are nearly five times as likely to have been pregnant as those from the richest households (22% compared with 5%) (MoHSS, 2008b).

5.3.2 Infanticide and Baby Dumping

Infanticide and baby dumping occurs on a regular basis, although the number of cases is unknown given the sensitivity of the problem. While police statistics between 2003 to 2007 record between 6 and 23 cases of concealment of a birth per annum, and while the number of officially recorded cases of infanticide appears steady since the 1990s (Hubbard, 2008), other evidence indicates that the problem is more widespread. At the Gammans Water Care Works in Windhoek, staff reported that they found an average of 13 dead babies per month in the sewage. This figure represents only those bodies that are found. In rural areas, babies that are dumped are usually taken into the veld, where they may only be found by chance (Hubbard, 2008). The issue has been discussed in Parliament (UNICEF, 2009). Despite this, very little is known about the phenomenon. A small group of KIs in northern Namibia suggested that mothers dump babies because of cultural and economic reasons (Hubbard, 2008). Included in these reasons were fears of rejection for having a child outside marriage, fear of having to leave school, inability to support the

child financially and lack of knowledge of where to give a child up for fostering or adoption. But the small number involved in the study means that the extent and causes of infanticide and baby dumping is not fully understood. Until this knowledge gap is filled, better information for pregnant women about safely handing over their child for care where they themselves do not want to keep the child might be worthwhile.

5.3.3 Postnatal Health Care

Postnatal care involves care for both the mother and the child. As with prenatal care, postnatal care can deal not only with the immediate health needs of the mother and child but it can be a point where a possible disability is identified; chapter 3 highlighted the importance of early diagnosis and response to reduce the long term impact of disability on a child and his or her family. PMTCT is vital in the context of

the HIV and AIDS pandemic and a full set of immunisations gives a child protection against known and preventable diseases.

The NDHS notes that “a large proportion of maternal and neonatal deaths occur in the first

50%of children and mothers in Kavango do not receive a post natal check up. In Erongo, only 8% are not checked

48 hours after delivery” (MoHSS, 2008b, p. 123). Complications for both mother and child that are identified in a timely manner can be treated. Nationally, 78% of mothers and their infants receive a check up after delivery. Of these, 65% are seen during the first 48 hours, as recommended. Approximately 10% receive a check up but after two days, while 21.6% do not receive any postnatal care (MoHSS, 2008b). Three factors, location, income and level of education, contribute to the reasons why this group of mothers and infants are left untreated.

There are regional differences in the numbers who receive postnatal checkups as can be seen in Figure 10. The high figures for Kunene may be accounted for by the distance that many people in Kunene have to travel to a health care centre and by the fact that 11% give birth at home. But, these factors do not explain the high figures for Kavango or Ohangwena. A deeper analysis of the data sets for the NDHS may be required.

Income and level of education are important factors in relation to postnatal care. The lower the income and the lower the education level of the mother, the higher the risk of the mother and child not receiving care. 41% of women in the lowest income group do not receive a postnatal check up compared while only 8.1% of women in the highest income group. Similarly, 40% of mothers who have no education do not receive postnatal care, compared with just under 5% of women with post-secondary education. When they fail to receive postnatal care, mothers and families also miss out on vital information about their health care needs.

There are specific regions where the numbers of women not receiving postnatal care are high; but income and education are also clear indicators of whether or not mothers will access and use this service.

PMTCT is another important intervention that a mother must take on behalf of her newborn child. One study on early infant diagnosis in Namibia by MoHSS (2009b) states:

...new evidence highlights early HIV diagnosis and antiretroviral treatment as critical for infants and indicates that a significant number of lives can be saved by initiating antiretroviral treatment for HIV-positive infants immediately after diagnosis within the first 12 weeks of life (p. 3).



Figure 10: Percent of Mothers Not Receiving a Postnatal Check up by Region

Figure 11: Percent of Women Not Receiving Post Natal Care by Level of Education

Source: MoHSS, 2008b.


The study estimates that in 2008 there were 8,200 HIV positive women who gave birth and that 92% received PMTCT (MoHSS, 2009b, p. 8). Namibia’s programme on PMTCT is very successful considering that it was only introduced in 2002. Yet mothers are often late in seeking initial diagnosis and follow on treatment. The national average for first testing of an infant is 14 weeks, compared to the recommended 6 weeks (MoHSS, 2009b, p. 12).10 Infants are placed in danger because of this delay and this may be seen in the fact that, in 2007, 12% of children born to infected mothers are themselves infected with HIV (MoHSS 2009a). Twenty-five percent of all new HIV infections occur among infants aged less than one year, probably through mother to child transmission (MoHSS 2009c). With 93% of mothers choosing to breastfeed their child (MoHSS, 2008b), only 23% of mothers reported breast milk as the sole source of food for a child up to six months. While this poses a challenge in paediatric HIV infection, the new PMTCT guidelines and soon to be launched infant and young child feeding guidelines, provide opportunities for ensuring that babies continue to be exclusively breastfed up to the age of six months which increases their chance of survival (MoHSS, 2010a).

5.3.4 Common Childhood Illnesses that Can Lead to Death

Diarrhoea, fever and acute respiratory infection (ARI) are common childhood diseases that can lead to death. The 2006/2007 NDHS (MoHSS, 2008b) found 12% of children under five had had diarrhoea in the two weeks before the survey. The highest rate was in Kavango (with just over 20% of children reported), followed by Omaheke (19%) and Caprivi (13%) (MoHSS, 2008b). Diarrhoea can lead to dehydration and even death but can be treated with simple oral rehydration therapy. Knowledge of the treatment among mothers is very high at 91% nationally. Even 85.5% of women with no education knew about the treatment (MoHSS, 2008b). Yet the child of a mother lacking education has a higher chance of getting diarrhoea (15.4%) than a mother who has completed primary school (13.7%) and one who has competed secondary school (10.9%). Less than half (46%) of children with diarrhoea whose mothers have no education receive any form of rehydration compared with a national average is just over 60% (MoHSS, 2008b). This suggests that the reason why children do not receive oral rehydration therapy is not simply lack of knowledge. Issues of reaching the right information as well as studying the current practices of handling diarrhoea need to be studied and better understood.

In Namibia malaria is seasonal and regional with the highest prevalence beginning in May after the rainy season. The incidence of malaria is highest in the northern regions of Namibia. Approximately, 400,000 cases of malaria occur annually with 1,000 deaths (MoHSS, 2008c). Annual mosquito spaying campaigns are carried out. In 2007 spraying efforts reach 89% of the malaria-affected areas with over 650,000 structures sprayed (MoHSS, 2008c). The MoHSS reports that it has provided close to 400,000 mosquito nets to pregnant women, though the time period over which these have been provided is not clear (MoHSS, 2008c). Table 8 provides basis statistics on mosquito net use and malaria related deaths.

Table 8: Use of Mosquito Nets and Malaria Related Deaths in High Incidence Regions

Region House owns at least one mosquito neta

Child slept the previous night under a neta

Pregnant woman slept previous night under a neta

Malaria related deaths in 2005/2006b

Caprivi 65 48 43 60

Kavango 35 21 35 287

Ohangwena 41 10 6 275

Omusati 34 11 5 263

Oshana 44 24 21 54

a Source, MoHSS 2008cb Source, MoHSS, n.d.

10 The study in question does not investigate the reasons why mothers do not come on time for diagnosis. Rather, it focuses on the actions of caregivers at the clinics and how they can intervene to encourage mothers and caregivers of newborn infants to seek PMTCT. This part of their analysis will be discussed below.

Bed net use is most frequent in the Caprivi region.11 For both

children and pregnant women, the highest use of mosquito nets is the Caprivi

region. In the 2005/2006 malaria season, MoHSS staff in the Caprivi reported 60 malaria related deaths. In Kavango 287 deaths were recorded. In Ohangwena 275 deaths, and Omusati there were 263 malaria related deaths (MoHSS, n.d.).

The NDHS of 2006/2007 found that 17% of children

under five had a fever in the two weeks before the survey. The Caprivi had the highest percentage at 38% followed

by Omaheke at 26%. The Oshana

and Oshikoto regions had percentages of 8% and

10% respectively. Mothers with no education took their children to a health facility 62% of the time, compared to mothers with complete secondary education who took their children to a facility 48% of the time (MoHSS, 2008b). This is the opposite of the pattern found in the rest of this chapter where mothers with lower levels of education do not bring their children in for medical care as regularly as mothers with more education.

Respiratory infections were also investigated in the NDHS. A child with a cough and short rapid breathing in the two weeks prior to the interview is considered as having ARI (MoHSS, 2008b). In the 2000 NDHS (MoHSS, 2003b), 18% of children were reported to have had ARI; this level fell to 4.3% in the NDHS 2006/2007 (MoHSS, 2008b). The Caprivi region has the highest incidence at 11.8% of children compared to Erongo and Khomas which both had levels below 2%. ARI is roughly three times as prevalent among children in households where wood or straw is used as the main cooking fuel (MoHSS, 2008b); it has already been noted in the previous chapter that wood remains the cooking fuel for many Namibian households. Of the four regions that have above average ARI rates, more than three quarters of households use wood for cooking. As mentioned the Caprivi region has the highest rate of ARI and 89% of its households cook with wood. Omaheke region has the second highest ARI rate at 8.5%, while 76% of households use wood. The ARI rate in

the Kavango is 6.6% with 89% of households using wood for cooking. In Omusati region there is a 5.9% ARI rate with 93% use of wood by households. According to the 2001 Census, 61% of households use wood for cooking (CBS, 2003). Four out of ten households are described as traditional (CBS, 2003). Just over half (52%) of households were reported as having a floor made of sand, mud or clay (CBS, 2003). Data from the NDHS suggests one link between the living conditions of a child and his or her health. The effects of other aspects of living conditions on children in Namibia require investigation.

5.3.5 Immunisation

The recommended course of vaccinations for a Namibian infant is:

BCG (which protects against tuberculosis) •Measles•DPT (which protects against diphtheria, •pertussis and tetanus) and requires three doses.Polio that includes a dose given at birth and •three follow up doses

Ideally these should be given in the first year of life (MoHSS, 2008b, p. 135). The international standard for coverage of major vaccinations in all health districts is 90%. The NDHS 2006/2007 reports that only 64% of children had received a full set of vaccinations before their first birthday. This is a slight improvement from the NDHS 2000, which reports that 59% of infants had received their full vaccinations before reaching one year in age (MoHSS, 2003b). Since 2004 national coverage levels for BCG has only exceeded 90% twice (UNICEF/WHO, 2010, p. 120) and coverage for the first level of DTP has exceeded 90% once. Coverage for measles vaccinations has yet to rise above 75% (UNICEF/WHO, 2010).

These levels of vaccination seem to be in conflict with those reported in the 2008 MDG Progress Report that suggests that measles vaccination had reached 83% in 2008 against a 2012 target of 85% (NPC, 2008b). What is clear is that vaccination rates are well below the MoHSS target rates of 90%. Having said this, current campaigns by the MoHSS and efforts in introducing new vaccines against hepatitis, meningitis and pneumonia caused by Haemophilus Influenza are evidence that the MoHSS is seeking to make progress in this area.

11 The reader is cautioned about statistics on the use of bed nets and incidence of fever because the NDHS for 2006/2007 was carried out between November 2006 and March 2007. This is outside the malaria season that runs from March to June (MoHSS, 2008b).

36% of children are not fully vaccinated before

their first birthday



Vaccination coverage in the Omusati region is the highest at 81%. Coverage in other regions is between 66% and 76% except in Kunene (35%) and Kavango (47%) (MoHSS, 2008b). In the discussion of postnatal care above, these two regions also stood out as regions in which high number of births took place at home and assisted by relatives or traditional birth attendants. It would be easy to point to these factors as the reason for low vaccination rates, but the picture is more complicated.

The first polio vaccination is given at birth. In the Kavango 87% of newly born babies receive this dose. This indicates that women and their birth attendants know and obtain this service soon after birth. In the Kunene, however, only 64% of infants receive this first polio dose (MoHSS, 2008b). This suggests women and their family or traditional birth attendants know less about the importance of the zero dose or are less able or willing to access it.

Table 9 shows how vaccination coverage falls in relation to follow up doses. This suggests that there are barriers to repeat attendance at antenatal clinics. In Kavango, levels of severe poverty are high which places serious constraints on mothers from such households to pay the transport and other opportunity costs of repeated visits. In Kunene the limitations imposed by poverty is coupled with the long distance of most households from a health facility. Similarly low levels of vaccination are apparent. Fewer mothers in the Kunene go to health care facilities for initial vaccinations and the fall in follow up visits is steep.

A mother’s level of education and, to a lesser degree her income, also affects whether her child is fully immunised (MoHSS, 2008b, p. 135). Figure 12 and Figure 13 show how the number of children who are fully immunised rises as the mother’s education level and income rises.

Table 9: Vaccination Coverage for Kavango and Kunene Regions

Region DPT 1 DPT 2 DPT 3 Polio at Birth

Polio 1 Polio 2 Polio 3

Measles

Kavango 88 82 72 87 88 83 72 55

Kunene 75 59 51 64 86 71 40 60


5.4 Legal Identity

Both the Namibian Constitution and the CRC require that every child is given a legal identity. Without a birth certificate a child cannot get into school, be registered for assistance if he or she needs it, obtain a passport, or gain access to any number of services that require positive identification. The 2006/2007 NDHS found that only 67% of births were registered (MoHSS, 2008b). In 2008 the MHAI, MoHSS, MGECW and UNICEF developed a strategy to increase the birth registration rate. MHAI sent out mobile registration teams to remote villages and settlements every second month in 2008 and 2009. Close to 21,000 children were registered for birth certificates (Sakaria & Forsingdal, 2010). MHAI and MoHSS also established birth registration offices at 11 hospitals where there are high numbers of births.

Figure 12: Percentage of Infants Receiving Full Vaccinations by Education of Mother


A review of operations of these efforts found that they were well received by clients, but were not used to the extent that was expected. Only two of the eleven hospital-based MHAI offices registered more than 75% of the births at that hospital. A number of factors were identified for this lower than expected rate (Sakaria & Forsingdal, 2010):

In some areas cultural factors mean that a •child is only named some months after he or she is born. This delays registration. Some mothers do not have the proper •documentation with them when they try to register a child. They may not have been given the proper instructions on what documents are needed or may not have understood the instructions.Weak links between MHAI staff and staff •in antenatal care units mean that messages about the need, requirements and benefits of birth registration are not adequately transmitted to expectant mothers.

Regional variations in birth registration can be seen in Figure 13. Only 46.3% of infants were reported as having a birth certificate in the Kavango region by the NDHS. While the hospital in Rundu was chosen as a site for an MHAI office, it only opened in March of 2010. Kavango and Kunene (with 55% of children registered) are both regions with high rates of home births attended by either relatives or traditional birth attendants. Ohangwena is also a region with low rates of registration where cultural factors may play a role in the delay. The NDHS notes a “positive relationship between birth registration and wealth quintile” (MoHSS, 2008b, p. 24). Only 46% of children born from the poorest mothers had a birth certificate while 91% of children from the wealthiest mothers had a birth certificate. It appears that poverty, knowledge and awareness, ease of access and tradition all play their part.

5.5 The Role of Service Providers

This chapter has discussed five interrelated services – antenatal care, postnatal care, PMTCT, immunisation and birth registration. All are available either during pregnancy or within the first year of the child’s life. They may even be given at the same facility, possibly at the same time and perhaps by the same staff. Most children benefit but some do not. Understanding the reasons for this is a step towards developing solutions that also take into account the constraints facing service providers.

The child who is not likely to receive any or all of the above interventions probably has a mother who is poor, with no, or only primary, education, comes from the Kavango, Ohangwena, Kunene or Oshikoto regions and may belong to an ethnic group that prefers home delivery or has naming practices that prevents registration of the birth just after delivery. One other characteristic of the mother of a child who is not likely to receive the full range of services is that she has made at least one visit to an antenatal clinic. This gives the health system the opportunity to identify her, assess the potential that she may not bring her child in for further care or services and plan how to overcome the factors that prevent her from receiving the full range of care for her and her child.

A study on PMTCT (MoHSS, 2009b) found that dropout rates from treatment could be lowered and mothers encouraged to seek more timely treatment if a specific staff member at a PMTCT clinic took responsibility for follow-up. The study also noted the potential to combine immunisation follow up with PMTCT programmes. Birth registration could be included in such a combined approach.

Shortages of staff and lack of transport are barriers in the delivery of health services. Follow-up, including liaison between different health care programmes is difficult where there are not enough staff. In 2009 the Auditor General in a performance audit on health care delivery found that shortages of staff, equipment and the ‘poor condition of transport at health facilities’ were the cause for lower than expected delivery of services (Auditor General, 2009b, p. 7). The MoHSS Health and Social System Review (MoHSS, 2008c) highlights the

33% of children do not have their birthsregistered


Figure 13: Percent of Registered Children under 5 yrs in 2000 and 2006

Source: MoHSS 2003b, 2008b


problems of recruiting and retaining staff especially in regions such as Kavango, Kunene and Ohangwena. KIs agreed that this was a serious challenge, especially in specialised disciplines. Social workers with a first degree are not necessarily specialised in child welfare, highlighting the need not only for more social workers, but also more social workers specialised in specific fields such as child welfare.

Transport is another component of the solution. The impact of poverty as a barrier to travel to a clinic, even if only a few kilometres, has been described. It is not just a problem in Kunene where distances to a health care facility are great. Follow up activities may require travel to the homes of at-risk children and their mothers. The Auditor General’s report found that transportation for clinics is inadequate. A total of six clinics were visited for the audit and two were found to have posts for drivers (Auditor General, 2009b, p. 18). Yet, the two drivers assigned to the clinics were actually stationed at district hospitals and also had other duties. The two clinics had only intermittent access to the vehicles. Transportation requests were made through the district office, which caused delays in referrals. A similar situation was found at health centres, although one health centre did have a driver and vehicle at the centre. In addition to the deployment of drivers, the audit found that only 69% of ambulances were roadworthy, 12% were not operable, and the rest were written off (Auditor General, 2009b, p. 18). The MoHSS claims over 1,000 outreach points that are regularly visited (MoHSS, 2008c). The frequency and regularity with which outreach points are visited must be questioned in the light of the performance audit findings. Rural nurses are unlikely to travel to outreach points when they have no transport. KIs confirmed this constraint. Sharing resources, such as transportation, at local level was regarded as extremely limited, e.g. if MoHSS, MoE and a NGO needed to visit a community for a community meeting, then all the organisations will travel separately. Indeed CLaSH reports that its volunteers are not able to travel in MoHSS vehicles; insurance concerns are the reasons given. Vehicle mileage limits on vehicles used for extension and outreach work were regarded as restrictive, partly because some government vehicles are used for purposes that are not always official.

Community based service providers have the potential to fill some gaps in service delivery. In 2006 the MoHSS had over 4,700 community-based volunteers (MoHSS, 2006). Most worked on Home Based Care initiatives or as community health workers. The MGECW through its Directorate of Early Childhood Development and Community Mobilisation has its own programme of community workers. NGOs such as the Churches Alliance for Orphans and Catholic AIDS Action, have established links with a community-based groups that also provide volunteer services to communities. Effectively used, volunteers can complement service programmes but most usually need higher levels of support and supervision. Eliciting community understanding and partnerships for issues of service provision can also increase uptake of services for children by mothers and caregivers.

5.6 Getting a Good Start in Life

5.6.1 Nutrition of Children

Good feeding is essential if a baby is to grow well. Stunting reflects a long-term deficiency in proper nutrition (MoHSS, 2008b). Its effects, such as lower levels of physical and cognitive development, are permanent. Stunting can contribute to early mortality. Another indicator is wasting that reflects a short-term deficit in nutrition. It can be reversed, though it can also be the precursor of continued illnesses and chronic malnutrition.

The trends shown in Table 10 are of concern. Even though the latest NDHS uses a new method to calculate these values – one that may result in higher rates – moderate or severe stunting appears to have increased to 30% of children, while the percent of wasting and underweight children has been static. This suggests that the MDG target of only 25% of children under five who are malnourished or stunted will not be reached as originally projected in the 2008 Review

(NPC, 2008b). The number of low birth weight babies has also increased from 5.7% in 1992 to 8% in 2000 and 14% in 2006/7. Low birth weight “negatively influences the future growth and development of a child...” (WHO, 2009, p. 38).

A range of actions can be taken to reduce maternal and child under-nutrition (Bhutta et al., 2008), including:

Promoting breastfeeding and the use of •Vitamin A and zinc supplementsPromoting complementary feeding. This •requires education and information and, for poor groups, food supplements or cash transfersProvision of supplements (iron foliate, •micronutrients and calcium) to mothers Investing in improved education and •economic status of women

Namibia provides all of these interventions, though coverage is incomplete. Poverty clearly plays a role in this situation. Maize meal or mahangu porridge, often with sugar, is the staple of most diets in poor households. By themselves, these foods are not sufficient for pregnant mothers, babies or young children. Poor diet, especially for the young can lead to blindness, goitre development and anaemia and, in the longer term decreased cognitive ability and lower stamina to work. Supplementary foods (nuts, fruits or many vegetables) that contain necessary nutrients (e.g. Vitamin A, iodine, iron, protein) are needed but are often beyond the means of poor or severely poor households. A study carried out by Namibia Economic Policy Research Unit on the impact of HIV and AIDS on poor rural households

showed that over 90% do not have enough food to meet basic daily requirements (Fuller & van Zyl, 2007). Stunting is linked to the health and socioeconomic situation of the mother as well as geography. Children were more likely to be moderately or severely stunted if their mother has incomplete primary or no education (MoHSS, 2008b). The same holds true if the mother is located within the lowest or second lowest wealth quintile (MoHSS, 2008b). Regions with high rates of stunting are Kavango, Ohangwena and Oshikoto.

This issue of poor nutrition was borne out in the children’s focus groups, where hunger was the top ranked issue. Many of the children say they only have one or two meals a day and, for some, these ‘meals’ are only a small bowl of maize meal porridge. Some go to bed without eating all day. In Omaheke, some children said they sometimes must go for days without eating anything. For some, the only meal of the day is the porridge that they get at school. Children who were living in school hostels (in Karas Region) were described as being better off than other children because they received three meals a day. Children who are hungry do not even want to go to school or some go to school to steal food from other children. For children living with their grandparents who are pensioners, there is never enough pension money to feed the whole family properly. The children also said that sometimes the old people spend their money on alcohol instead of buying food for the family. This lack of nutritious food was said to cause malnutrition, illness and disease. While these are the experiences of children who are older than the focus of this chapter, their circumstances highlight the issues that face infants in poorer households.

5.6.2 Early Childhood Development

ECD typically covers the two years prior to Grade 1 and all KIs who discussed it regarded it as extremely important. They especially welcomed the government’s decision to reintroduce pre-primary education as part of the responsibility of mainstreamed schools; the MoE takes formal responsibility for education in the year immediately prior to Grade 1. The MGECW takes responsibility for ECD prior to this pre-primary year. MGECW staff commented on the strong link between increased cognitive development and ECD attendance and believes that children who go

Table 10: Percentage of Stunted, Wasted and Underweight Children Under 5 Years

Indicator 1992 2000 2006/2007

Moderately stunted 28 24 30*

Severely stunted 8 8 10*

Moderately wasted 9 9 8*

Severely wasted 2 2 2*Moderately underweight 26 24 17*Severely underweight 6 5 4*

*For the 2006/7 NDHS, different methods for calculating stunting, wasting and underweight children were introduced. These new methods may result in higher figures.Source: MoHSS, 2008b.

“No food! “13 year old San boy

Over 90%of poor rural households do not have enough food to meet basic daily requirements



through early childhood development opportunities are much better prepared for and likely to succeed in school.

A key informant estimates that approximately 50,000 children attend ECD centres throughout Namibia - about half of the children in the age range. The quality of the teaching and support is highly variable. Some centres are well run with a clearly defined curriculum, trained staff and ample facilities while other centres are not well run12. The importance of ECD was recognised in policy terms first in 1996 with the National Early Childhood Development Policy. This recognition was strengthened when the MGECW was formed in 2005 and given the role of strengthening and improving the quality of ECD; a task taken forward when the National Integrated Early Childhood Development Policy was adopted in 2007.

The updated policy recognises the role of ECD in meeting key national development goals. ECD centres can be a vehicle through which children receive basic educational skills, health care, nutrition and other social skills. Parents and caregivers are also assisted with materials and programmes in support of their children’s development.

Owing to its community mobilisation mandate, the MGECW works mainly with community based ECD centres outside of the main municipal areas; smaller municipalities and rural communities had been under-serviced with regards to ECD. Community mobilisation is carried out before centres are established and continues afterward through messages on a variety of social and care issues ranging from the need for immunisation to basic health care and sanitation, nutrition, and HIV and AIDS. Standards for ECD caregivers and facilities are discussed and a small budget is available to assist communities with start up costs for construction and instructional materials. Training for community members who are ECD staff is carried out on a regional basis. In the past this training has been somewhat ad hoc, in response to demand. In service courses usually lasting a week were held. In the near future a 12-week course developed in conjunction with the NIED will be offered through NAMCOL.

The MoE began the roll out of ECD across the country in 2006 and currently aims to introduce pre-school classes in 10 schools per year. Recent figures indicate that over 7,500 students are currently enrolled in MoE pre-schools.

By early 2010, 190 ECD centres had been registered by Windhoek City Council; officials estimate that another 350 ECD centres are in operation in the city. Over 6,400 children attend the registered centres, staffed with over 500 caregivers. The City inspects the registered centres using its own ECD policy, although the standards are harmonised with MGECW standards (City of Windhoek, 2007). The standards cover issues such as physical plant, sanitary facilities, classroom size and curricula, care and instruction. The City also provides short term training for caregivers and is in the process of creating its own ECD centres as model institutions for other ECD providers. It also offers educational meetings with parents. No other municipality regulates its ECD centres, though the City has begun working with Walvis Bay and the Association of Local Authorities to share knowledge and experience.

The process of promoting ECD at community and national level is still new. Issues such as how to relate to existing private sector ECD centres have not been completely addressed. Implementing and enforcing standards will take time. The MGECW acknowledges a gap in national capacity at many levels. A critical gap is the lack of ECD training and research at UNAM or other higher education institution. Research and tertiary-level training on ECD issues typically takes place outside the country. NIED established a national committee to examine the broader issues relating to ECD. The committee has strong government membership along with development partners, UNAM and the Polytechnic of Namibia and the private sector. These and other issues will be addressed in this forum.

12Much of this data in this discussion comes from key informant interviews.

5.7 Summary

This chapter has looked at children and their mothers from pre-birth through to the time when they start primary school. Death rates among both children and their mothers around the time of birth appeared to be falling in the 1990s but are now rising, to the point where MDG targets in these areas will not be reached. There is also the possibility that vaccination targets will also not be reached.

Efforts to change this position are many. Attendance rates for ante and postnatal care are rising and the number of births where a trained birth attendant is present is also increasing. Improvements in the response to childhood diseases such as diarrhoea and ARI can be seen. But there are factors that work in the opposite direction. HIV and AIDS increase the risk of death around birth for both mother and child but despite substantial efforts to reduce these risks through general programmes to tackle the spread of HIV and specific PMTCT programmes, 25% of new infections are among children aged less than one year.

Other factors that work against the efforts to improve death rates relate to a range of social and economic factors. Children of mothers over the age of 40 are much more likely to die at birth or in their early years; at the other end of the age range, teenage mothers are also likely to suffer higher death rates both among themselves and their children. How soon a child is born after a brother or sister affects the chances of survival. The level of education a

mother reached and her income level both make a difference. There are sharp differences among regions as well, arising from where poverty is concentrated; pockets of disadvantage may also be found within regions.

How easy it is to access care is also important, particularly around pregnancy and childbirth and in relation to vaccinations. These are times when a mother has to attend several times if she and her child are to benefit fully. The cost of this and the fact that poor people tend to live further from health care facilities means that it is the poorer mothers who tend not to take advantage of services that are available. However, it is clear that the education level of the mother also plays its part.

A response to the above is to identify women and children who are likely to be at risk and to initiate follow up programmes. However, to achieve the best results requires working across ministries and departments, as well as sufficient staff and resources such as vehicles. These are all areas where surveys have shown gaps already exist. These types of gaps are some of the factors that explain why only 70% of childbirths are registered.

Other factors that are important in the care of a growing child are nutrition and ECD. Up to 40% of children are undernourished to some degree, meaning that MDG targets in this area will not be reached. However, progress is being made in relation to ECD by the MGECW, MoE and the City of Windhoek, the work of the last being a strong example to other local authorities.



6. Children (6 – 11 Year Olds)Children between the ages of 6 and 11 go beyond basic development to the journey of acquiring the skills and emotional confidence they need to operate within society. Education becomes a major part of their experience and character and confidence building. While almost all children are enrolled in primary school, attendance rates by Grade 5 are almost down to 90%, meaning that more needs to be done to meet the constitutional requirement that all children receive and complete at least 5 years of schooling. Numbers of children at school begin to fall more quickly in Grades 6 and 7 so that slightly less than 8 out of 10 children move on to secondary school. The quality of education is an issue; Southern African regional studies suggest that children’s reading and maths standards are some of the lowest in the region. In response, the MoE is making major efforts to increase the quality of primary school teachers.

Schools are places where vulnerable children can be supported. Attendance of orphans is higher than non orphans. School feeding programmes cover just under half of those who are vulnerable. However, there are reports that primary schools do not always present as ‘units of social support’ providing ‘pastoral care and guidance’. The degree to which schools properly support disabled children is also in question.

Similar concerns about the degree to which children do not always find their home to be their main place of safety arise. Over a quarter of children under 12 years of age report being forced to have sexual intercourse. Hunger and being beaten are also impacting issues; inappropriate levels of punishment can have effects that last into adulthood. The same tension as to what is acceptable exists in relation to child labour. Two thirds of children are recorded as working in northern rural regions to the point where some are kept out of school and most felt that it affects their lives.

Goal 2: Achieve Universal Primary Education 1992 2000 2006MDG Targets for 2012

Net primary school enrolment* 89% 91% 92.3% 99.1%

Survival rate for grade 5 70% 94% 94% 99.2%

Survival rate for Grade 8 59% 75% 81% 80.2%

Goal 3: Promote Gender Equality and Empower Women

1992 2000 2007MDG Targets for 2015

100 females in primary education per 100 males 102 98 100 100

Adolescent birth rate 22% 18% 15% 13%

Goal 4: Reduce Child Mortality 1992 2000 2006/2007MDG Targets for 2012

Under 5 mortality per 1000 live births 83 62 69 45

Source: NPC, 2008a

6.1 Introduction

This chapter explores a child’s experience as he or she grows towards adolescence. A child in this phase of life has the right to education, leisure and play, and increasingly they have begin to exercise their right to have their views respected and heard. A child cannot be forced into labour or exploited. This period of life is the time when the foundations of basic literacy and numeracy are laid. However, it is evident that primary education is not universal nor is the quality as high as it should be. The chapter also looks at other stresses that some children experience, such as having to work beyond reasonable levels of help at home or experiencing violence or oppression in the home or school or stresses that arise experiencing mental or physical challenges as a disabled child.

6.2 Primary Education

6.2.1 Availability of Primary Education

“Primary education shall be compulsory and the State shall provide reasonable facilities to render effective this right for every resident within Namibia, by establishing and maintaining State schools at which primary education will be provided free of charge. Children shall not be allowed to leave school until they have completed their primary education or have attained the age of sixteen…” This quote from Article 20 of the Namibian Constitution is supported by Article 13 of the International Covenant on Economic, Social and Cultural

Rights and Article 17 of the African Charter on Human and People’s Rights. Education is fundamental for children. The higher the level of education, the fewer the chances are of being poor. Education also and strengthens the ability to access services. Reports dealing with child labour and commercial sexual exploitation of children show that children who lack education and/or leave school early are more likely to be victioms. Participation in education has a wide range of benefits beyond learning.

Since the mid 1990s over 93% of all eligible children in Namibia have enrolled in primary school. Of those children, 86% to 95% of them have completed Grade 5, the year in which a learner is expected to be able to read, write and add up at basic levels and be able to do so for the rest of his or her life. This is called functional literacy (MoE, 2010a, p. 58). The numbers of children who stay in school until Grade 5 for the years 2001 to 2008 are shown in Table 11.

The number of children who stay in school to Grade 8 falls to only 77%. This means that one in five children who entered Grade 1 do not reach secondary school. Vision 2030 in its aim for a knowledge-based economy sets the education standard much higher than functional literacy (Office of the President, 2004); to achieve this as many children as possible should stay in school as long as possible. However, it is the quality of functional literacy that is the foundation on which higher standards can be built.

does not reach secondary school

1child in5


4

3

2

*The Net Enrolment Ratio (NER) is the number of learners of appropriate age enrolled in a range of grades, divided by the population in the same age group. In 2009, for example,there were 323,368 learners aged between six and thirteen enrolled in Grades 1 to 7 out of 328800 people in the same age range in the projected population. The NER of 98.3% is 323,368 divided by 328,800.


The 2001 Education Act established the legal framework for the school development fund, along with a system of fee waivers. The Education Sector policy for Orphans and Vulnerable Children reinforces the duty of schools and staff to ensure that no OVC is denied access to school (MoE, 2008a). However, the Auditor General found that few schools had actually received funds for children who might have qualified for fee waivers (Auditor General, 2009a) and it appears that the system of fee waivers is no longer in operation.

Many aspects of poverty affect schooling. Many children in the focus groups reported that they had no money to pay the school fund or buy school uniforms, books and stationery. Making contributions to the school fund or the need to buy a uniform may be a reason why some children never start school. Others who do not enter school despite these challenges find that their status becomes a source of ridicule. They may be bullied or teased because they are not wearing a school uniform, have dirty or worn clothing or do not have any food to eat at break-time. Children are also embarrassed if their families have not paid their school fund. Several orphan girls in the group discussions said they are not kicked out of school if they have not paid, but they are also not exempt from paying and they are made to feel very bad. One group said that the names of those with outstanding amounts are announced at assembly in front of all other children. “This is very embarrassing and other children make fun of us”, reported FGD participants. The International Committee on Economic, Social and Cultural Rights (cited in Hancox, 2010), when considering the right to free primary education, said: The nature of the right to primary education free of charge is unequivocal… Fees imposed by the government, local authorities or the school, and other direct costs, constitute disincentives to the enjoyment of the right and may jeopardise its realisation. They are often highly regressive in effect. Their elimination is a matter… required by article 14 of the Covenant. Indirect costs, such as compulsory levies on parents (sometimes portrayed as being voluntary, when in fact they are not), or the obligation to wear a relatively expensive school uniform, can also fall in to the same category according to the Committee.

The comments of the children in the focus groups and the findings of this report in relation to those who are poor, strongly support both the fact that the Educational Development Fund and other costs of attending school are a barrier to universal primary education and are ‘highly regressive’ in their effect – that is to say they have their greatest negative impact on those who are the poorest.

6.2.2 Standards of Primary Education

The Southern and Eastern Africa Consortium for Monitoring Educational Quality (SACMEQ) conducts major evaluations of the quality of school systems with fifteen ministries in fourteen southern African countries. Namibia is part of the consortium and has completed two full evaluations: SACMEQ I in 1995, SACMEQ II in 2000. SACMEQ III was conducted in 2007 and is currently in the analysis and report writing stage. Namibia’s performance in reading and mathematics skills for both students and teachers are measured and compared to those of the other members of the consortium.

Table 11: Percent of Boys and Girls who stay in school to Grade 5

2001 2002 2003 2004 2005 2006 2007 2008

Total 95% 90% 86% 89% 88% 94% 89% 92%

Females 97% 91% 85% 88% 88% 93% 89% 91%

Males 94% 89% 88% 91% 88% 95% 89% 92%

Source: MoE 2010a

One of SACMEQ’s measures is the performance of students in Grade 6. This gives a good evaluation of the basic skills students learn in primary school. In the 2000 evaluation the reading scores of learners placed Namibia 13th ahead of only Zambia and Malawi. The country’s ranking for mathematics was worse as Namibia was placed last (Makuwa, 2005).

One reason why Namibia performs poorly in literacy is the linguistic challenges related to the implementation of its Language Policy for schools. A draft language policy that supports teaching in mother tongue for the first 4 years

of schooling exists, but has never been formally adopted. An Urban Trust of Namibia assessment and consultative workshop in October 2009 on key linguistic challenges and how they affect literacy levels found that the lack of a clear policy is a factor in poor educational results in Namibia. Participants in the workshop concluded that one of the reasons why the policy has not been adopted and implemented

Table 12: Percent of Learners Reaching Level of Competence, 2000

Level Reading % Achievement Maths % Achievement 2005

1 Pre Reading 12.8 Pre Numeracy 19.6 88%

2 Emergent Reading 30.6 Emergent Numeracy 57.0 88%

3 Basic Reading 26.6 Basic Numeracy 14.9 88%

4 Reading for Meaning 14.3 Beginning Numeracy 3.5

5 Interpretative reading 6.0 Competent Numeracy 2.0

6 Inferential Reading 3.6 Mathematically Skilled 2.1

7 Analytical reading 3.9 Problem Solving Ability 0.7

8 Critical Reading 2.2 Abstract Problem Solving 0.1

Source: Makuwa, 2005

“is the result of resistance from political leaders, educational managers, school boards and an articulate group of parents who strongly hold to the notion that English is the key to empowerment, despite substantial evidence that local language teaching is a strong platform for later learning in languages other than a child’s mother tongue”13. In practice, many schools teach in local languages in the early years. But the materials and teaching resources are not extensive enough for local language teaching to have the impact that it should have; and minority groups, such as the San, have even less access to mother tongue teaching than children from the more common language groups.

SACMEQ has developed a ranking of skill levels in reading and maths. These levels go from the most basic concepts to advanced analytical skills. The results of student evaluations can be seen in Table 12. By the year 2000 Namibia was very successful in getting education to its young children, but not very successful in giving them a quality education.

SACMEQ also measures the skills of teachers because this is a critical factor in the performance of students. In the 2000 measure of performance teacher reading scores put Namibian teachers in 7th place among the 15 countries. For mathematics skills they were last (Makuwa, 2005). A 2005 study on Namibian school performance confirmed the link between the skills of teachers and student performance for local conditions. Using SACMEQ II data taken in 2000 from 275 schools nationwide, Shaningwa (2005, p. 36) found, “… that in most cases the best group of learners in the four regions were taught

13UTN assessment and consultative workshop on key linguistic challenges and how they affect literacy levels, December 2009


Figure 14: Education Background of Teachers, 2002 – 2009

Source: MoE, 2009b; MoE, 2010a.

by teachers who had many years of schooling.” The qualifications of teachers varied considerably by region. In Rundu teachers who had no tertiary qualifications taught students reading. In Windhoek, the majority of teachers had tertiary qualifications. Namibian teachers with tertiary qualifications produced students who scored in the top half of all student scores measured in the thirteen countries (Shaningwa, 2005).

Since 2000, the MoE has made significant progress towards increasing the number of teachers who are trained, so that today 96% of teachers have taken formal teacher training. In addition, the number of teachers with more than two years of tertiary education before taking teacher training has risen from 55% in 2002 to 80% in 2009 as shown in Figure 14. An increase in teacher performance in reading and maths skills may possibly be reflected in the current SACMEQ III evaluation.14

There are differences in the qualifications of primary and secondary school teachers. Secondary school teachers tend to be better qualified. In 2002 45% of primary school teachers and 76% of secondary school teachers had more than two years of tertiary education and teacher training. The latest EMIS data shows that 77% of primary teachers and 93% of secondary school teachers have reached this threshold.

6.2.3 Education Support for Vulnerable Children

More vulnerable children (94.6%) attend primary school than non-vulnerable (93.2%) - a success, given the many challenges that these children can face. Statistics from EMIS in 2008 show approximately 197,000 vulnerable children in schools (126,000 orphans and 71,000 who are vulnerable in other ways)15. The regional breakdown of the orphans is in Figure 15. It should be noted that Figure 15 deals with all children in school and also applies to chapter 6; orphans tend to be concentrated in regions where other socioeconomic problems, such as high rates of poverty and lack of access to services, dominate.

6.2.4 Food Support

In keeping with the Policy on OVC and education, (MoE, 2008a), Namibia has instituted school feeding programmes for children, as hungry children cannot concentrate on their schoolwork. EMIS (2009b) data shows that 83,000 children were in the school-feeding programme, 42% of the total vulnerable children in school. Thus it is not surprising that some children in the Kunene focus groups noted that hunger was what actually pushed some to attend school because they knew there would be one meal for them that day.

6.3 Children under Stress

6.3.1 Child Labour

A high percent of children aged 6 to 11 are engaged in work. While much of this may seem like household chores carried out in rural, farming areas, the labour that they do has the potential to interfere with their education and recreation. The Namibia Child Activity Survey of 2005 (MoLSW, 2008c) defines child labour as any child who has spent one hour in the past seven days engaged in the following:

Any kind of business for oneself• Unpaid help in a family business• Help on the family plot• Help on the family cattle/ livestock post•


14 It should be noted that the rate at which learners are passing Grade 10 exams and moving into Grade 11 has increased the last three years running. This may be a result of improved qualifications of teachers. The data appears in the next chapter.

83 000children

in school feeding

programmes in 2008

15OVC data for the 2009 EMIS is not yet available.

Figure 15: Percentage of Orphans in School by Region

Source: MoE, 2009b

Beg for money or food in public• Unpaid collection of water• Any work for a wage or salary• Preparation of food• Planting or weeding in the family • field

Using this definition the survey found that out of approximately 269,000 children aged 7 to 11 almost 180,000 (67%) worked (MoLSW, 2008c). Girls outnumbered boys in the sample by 139,000 to 131,000, but almost the same percentage of both worked – 67% of girls and 65% of boys. Over 88% of girls and 84% of

boys working under this definition were still in school (MoLSW, 2008c). When asked

why they worked, just under half gave the reason ‘other’ while over

a quarter stated that they were forced to work.

Child labour is a largely rural phenomenon with northern regions of (Ohangwena, Omusati, Caprivi and Oshikoto regions) having over 87% of the children recorded as participating in work (MoLSW, 2008c). In rural areas 9% of children reported that they stayed away from school to work

during the busy season for agriculture, although this was

the third most common reason for staying away from school,

after illness and unspecified ‘other’ (MoLSW, 2008c). Among

those children who worked 84% of girls and 89% of boys felt that the work

they did affected the quality of their lives. The first reason given was ‘no reason given’; second and third most common reasons given were not enough time to do homework, or no time to play (MoLSW, 2008c)16. Both the last points impact upon educational and social development of children between the ages of 6 to 11.

6.3.2 Violence and Stress at Home and in School

The MoHSS found that over a quarter (27.4%) of children under 12 reported being forced to have sexual intercourse (MoHSS, 2008a). The children in the focus groups who reported violence in their families were often primary

school children. A recent research project to evaluate counselling services in schools in three regions of Namibia (Khomas, Kunene and Oshana) found similar disturbing evidence of the degree to which young children encounter violence and oppression in their daily lives: “Our findings show that many of the primary school learners are exposed to hunger and neglect. The dearth of caring, compassion and educational stimulation in their daily lives was conspicuous, preparing them for a future as uncaring and under-stimulated adults, who will have few sustaining experiences to draw on in their future relationships with the children in their care, and little recourse to constructive problem-solving when faced with the vicissitudes of life. With the exception of a few teachers, primary schools generally did not present “units of social support” providing “pastoral care and guidance” and support” (MoE, 2010c, p. 24). The report found that the factors causing stress were found to be (in order of importance):

Hunger: in all schools ‘hunger’ was the •first problem that was mentioned by the learnersBeing beaten: by parents, teachers, other •childrenLack of resources for school•Having no money for food, school clothes, •school fees, boarding school fees, school booksThe death, or fear of death or illness of •a mother or parent and /or self (MoE, 2010)

An MGECW report on gender based violence also asked questions about how children aged between 2 and 14 were disciplined in the home. Parents and carers reported high levels of non-violent behaviour when disciplining their children. But at the same time 55% reported shouting, yelling or screaming at a child, 29.2% reported hitting the child with something like a belt, hairbrush, stick or other hard object and 5.9% admitted beating the child with an implement over and over (MGECW, 2009d).

The report goes on to note that parent and carers (particularly those who were older) felt less able to control their children because physical punishment in schools was now recognised as illegal. On the other hand, the problem of violence during childhood being The report goes on to note that parent and

27.4% of children under 12 are

forced into sexual intercourse

16“Not recorded,” “no time for homework,” and “no time for play” were the three most frequent responses.



carers (particularly those who were older) felt less able to control their children because physical punishment in schools was now recognised as illegal. On the other hand, the problem of violence during childhood being repeated in adulthood was also noted. “Both male and female abused and neglected children reported significantly higher rates of ever hitting or throwing things at a partner than [those who were not abused]… Overall the results reveal a link between early childhood victimisation and later perpetration of violence against partners for both men and women” (MGECW, 2009d, p. 87).


The National Policy on Disability ensures that education is available to any child with a disability. (Ministry of Lands Resettlement and Rehabilitation [MLRR], 1997). The MoE has a long standing practice of inclusive education for learners with disabilities (Wietersheim, 2002). Children with disabilities, who attend school, do so as far as possible within the general population. Of 30,000 students with some disability, approximately 29,000 attend schools with their fellow students (MoE, 2010a). A report carried out in 2002 notes concern about the low numbers of teachers with training on how to integrate learners with disabilities into daily school activities (Wietersheim, 2002). A MoE report of 2004 found that, “At present, the needs of children with disabilities and learning difficulties are met through special classes in mainstream schools or special schoo1s. However, access to both special classes and special schools is limited due to the shortage of places. It is suspected that the educational needs of a significant number of children with disabilities and special learning needs are not being addressed. This is especially true for girls with special needs” (MoE, 2004, p. 12).

A disturbing finding of a situation analysis for people with disabilities and HIV and AIDS was its omission of schools as a resource for young people with disabilities (Janssen, 2007). Generally, this report found that basic skills for dealing with people having disabilities were low. There are few people with sign language skills. Books and materials in Braille were scarce. The discussion on children with disabilities in Chapter 5 above refers to the lack of testing and support facilities for children with

Table 13: Child Discipline

Type of Discipline Yes No

Took away privileges, forbade something the child liked, or did not allow the child to leave the house

41.5 57.6

Explained why the behaviour was wrong 69.7 29.5

Gave the child something else to do 46.7 52.4

Shouted, yelled at or screamed at the child 55.3 44.3

Called the child stupid, lazy, or another name 31.3 66.9

Shook the child 29.4 69.3

Spanked, hit or slapped the child on the bottom with a bare hand

40.2 59.0

Hit the child on the bottom or elsewhere on the body with something like a belt, hairbrush, stick or other hard object

29.2 69.5

Hit or slapped the child on the face, head or ears 18.1 78.9

Hit or slapped the child on the hand, arm or leg 30.3 67.2

Beat the child with an implement over and over 5.9 90.3

Source: MGECW, 2009d

It is suspected that the educational needs of a

significant number of children with disabilities and special learning needs

are not being addressed. This is especially true for girls with

special needs.

disabilities. These findings are echoed by a study carried out for Cheshire Homes Namibia that recommends increased training for teachers on better implementation of inclusive education for children with disabilities (Ndengejeho, 2006).

6.3.4 HIV and AIDS

The MoHSS estimates that there are 13,000 children under the age of 15 who are HIV positive (MoHSS, 2009c). As these children begin attending school they will require assistance with taking ART. They may also be vulnerable to stigmatisation by other children – an issue that will be covered in the next chapter. ART means that HIV positive individuals can expect longer and more productive lives as long as they adhere to treatment. The number of HIV positive children is expected to peak at just below 20,000 per year and remain steady at that level at least until 2015 (MoHSS, 2009c). The ability of the MoE to provide the kind of support to HIV positive children in primary school has not been explored.

Children in poor or severely poor households are already under threat. HIV and AIDS compound this threat when parents, breadwinners or caregivers become incapacitated or die due to AIDS. The resilience of families and community structures are diminished. The disease strikes people at their most economically active period of life. When ill and longer able to work, they place added burdens on healthy family members. On death, the family structure often breaks down. Most orphans, 54.6%, do not live with their siblings (MoHSS, 2008). They often live in households where there have been a series of deaths; with each death children are moved from one caregiver to another in a chain of constant change and uncertainty. At home there are additional needs such as helping with household work, caring for younger siblings, or caring for sick parents or relatives. As a result, these children are more likely to drop out of school as they get older.

6.4 Summary

Despite the legal commitment, not all children of primary school age attend school. A factor

in this, highlighted at many points during the research that led to this report, is the need to pay towards the school development fund, introduced in the 2001 Education Act. However, the waiver arrangements that were intended to accompany the introduction of the fund have been discontinued, leaving a barrier to access that impacts poor households the most. Hostel fees have the same effect for those who do not live close enough to a school. The school feeding programme, only reaches 42% of those who would appear to be likely to benefit from food support.

For those who do go to school, most stay at school for the first five years, after which the number attending starts to fall to the point where one in five have left school before secondary school starts. Regional studies in 2000 suggested that the quality of teaching was among the lowest in Southern Africa. However, the MoE has made great efforts to increase the numbers of trained teachers. Recent improvements in Grade 10 and 12 pass rates referred to in the next chapter may indicate that these efforts are bringing results. However, this chapter also highlights 2010 research that refers to ‘the dearth of caring, compassion and educational stimulation’ in primary schools.

Children of primary school age suffer stress in other ways. Two thirds of children in certain northern regions report having to spend more than one hour per week working, to the point where the labour demands are the third highest reason given by children for missing school. A quarter of girls under the age of 12 report being forced to have sexual intercourse. Experience of the policy of inclusive education does not appear to be meeting the policy objective that ‘children and youth with disabilities have the same right to education as children without disabilities’ (Ministry of Lands, Resettlement and Rehabilitation [MLRR], 1997). Although many schools follow a practice of teaching in local languages for the first four years of schooling, as directed by the draft language policy, lack of teachers and teaching materials in minority languages means that marginalised groups, such as the San, are not able to benefit from this approach.

54.6%of orphans don’t live with their siblings



7. Adolescents (12 – 17 Year Olds)Transition marks the ages of 12 to 17. Children experience puberty, learn to think and act independently and become adults. They make decisions about their lives that have long lasting effects in their adult life. Adolescents live in a ‘world of contradictions’. While they may look and sometimes act like adults, they are on the doorstep of an adult world they do not fully understand. Neither do they possess all the skills to effectively operate within the adult world. Adolescents, no matter how much they deny it, require assistance, protection and support to become empowered. A stable home life at this time is essential.

Three main support areas are described - school, health care support and social protection. Success or failure at school determines the economic and social opportunities a child will have as an adult. Studies from 51 countries show that each year of schooling increases wages by 9.7% (MoHSS, 2010). Adolescents take the basics learned in primary school and move into more advanced levels of knowledge and skills. Yet only around a third of children entering school will qualify for higher education and a much greater choice in the jobs that are open to them.

Added years of education have been shown to enhance the ability of both girls and boys to negotiate safer sex practices such as delaying the start of sexual activity and using condoms when sexually active (MoHSS, 2010). Girls do better at school but one in six will become pregnant and leave school; in Kavango and Kunene this is likely to be one of the reasons why fewer girls than boys are at school. The physical changes children undergo in their teens mean new needs regarding health care. Reproductive health issues including protecting oneself against HIV arise. All these points highlight the need for high quality life skills training, health care and other services that are specifically designed for the adolescent in both school and community settings.

These needs are well recognised at policy level. However, health care programmes in schools are not widely available; a shortage of staff at clinics limits implementation of school health programmes in some regions. Life skills programmes are again not nationally available and school counselling programmes require additional resources and training for the counsellors. Adolescents who are HIV positive feel isolated at school and if caregivers are not supportive or communicative, face stigma and isolation at home too. The need for continuing protection for adolescents at home, school and in the community is clear. Disturbingly high numbers of girls report their first sexual experience as being forced. Forty percent of rapes reported to the police

are below the age of 18. Bullying is commonly reported. Twenty-eight percent of learners report having missed at least one day at school in the previous because they felt unsafe at school or on the way to school. The ability of adults to exploit adolescents for commercial gain or sex requires additional efforts of protection. While trafficking does not appear to be an issue presently, there is a clear need to ensure adequate training of those who have the care of children to ensure that it is identified and acted upon. Adolescents who commit crimes also need protection through appropriate settings and processes that recognise their age; it is important to have good national monitoring systems to ensure that diversion programmes are successful.

Goal 3: Promote Gender Equality and Empower Women 1992 2000 2007MDG Targets for 2015

100 females enrolled in secondary school per 100 males 124 112 117 100

Goal 5: Improve Maternal Health 1992 2000 2006MDG Targets for 2012

Unmet Need for Family Planning 24% 25% 7% 6%

Contraceptive Use 23% 38% 47% 56.6%

Goal 6: Combat HIV and AIDS, Malaria and Other Diseases 1992 2000 2006MDG Targets for 2012

HIV Prevalence Rate 15 to 19 years Old 6% 12% 5.1% 8%

Source: NPC, 2008a

7.1 Introduction

This chapter describes the situation of children from the age of 12 to 17. The age range is not exact, covering mainly secondary school age children but also the wider physical and emotional range of adolescence, a range as wide as 10 to 19 (Edberg, 2009). Children experience many social, emotional and psychological changes during this time. They contribute to family and community through a growing ability to assume responsibilities. Sexuality becomes important. Yet, it is this proximity to adulthood that makes them vulnerable. Their growth can be distorted by poor living conditions. Predatory adults can exploit children’s lack of knowledge and sophistication. While children in this age group are increasingly able to look after themselves the need to care and protect them continues. Children in this age group require protection against exploitation, be it sexual exploitation or some form of labour. Education remains a basic right, as does an educational system that promotes the full development of the child. Freedom of thought and the ability to express

their views becomes increasingly important. So too, the right to have information has increased priority. This chapter follows the child as he or she matures towards adulthood with a focus on education, life skills, health and sexuality, safety and protection, and contact with the law.

7.2 Education

Vision 2030 foresees an educated and internationally competitive workforce (Office of the President, 2004). Achieving this goal requires large numbers of secondary school graduates who go on to some form of higher education. On these terms, the education sector is not doing well. Despite recent improvements, not enough young people are leaving school with sufficient skills for the workplace (other than in unskilled or semi-skilled jobs) or with the knowledge to go into further education.

Table 14 shows the percent of children moving from primary to secondary school and on to senior secondary school. As noted in Chapter 5, around 90% of children complete Grade 5


3

5

6

A long-standing constraint to entering Grades 11 and 12 has been the number of spaces available in senior secondary schools. The Khomas and Erongo regions have the highest number of schools offering senior secondary level with 31 and 16 respectively. Hardap, Kunene and Omaheke regions have 5 schools each. Students who academically qualify may be denied a place because they live in a region where the number of places in senior secondary schools is limited. While some families are able to send students to other regions this option is not available to poor households due to their inability to afford the hostel fees and travel costs. The link between completed secondary education and lower rates of poverty is reason alone to suggest that the number of spaces for students in senior secondary schools should be expanded.


(MoE, 2010a) but by the age of 14 or so just under one quarter of Namibian children have left the school system. Statistically these early leavers are much more likely to spend the rest of their lives in poverty – previous chapters have shown a clear link between poverty and lack of secondary education. Girls who leave school before entering secondary school are more likely to die in child birth or fail to take advantage of post natal care and experience other problems as mothers wanting to provide for their newborns.

If getting into secondary school is a challenge, getting into senior secondary school (Grades 11 and 12) is an even greater challenge. Students who complete secondary school are much more likely to get jobs. Children who are out of school face a hard road. Unemployment among 15 to 19 year olds is 67% (MoLSW, 2006). Out of school children have limited job choices of elementary occupations such as domestic work, gardener, street vendor, driver, basic agricultural or fisheries work, craft and trade work, sales staff, skilled fisheries, or agricultural work (MoLSW, 2006). Some learners may opt to continue their studies via the NAMCOL. The Namibian Training Authority has recently run vocational training programmes for young people who failed to reach Grade 10. Namibia runs a number of Vocational Training Centres throughout the country. In 2006 approximately 2,000 students were registered in vocational training programmes (MGECW, 2009b).

Namibia’s record on getting children into senior secondary school has not been good. For the five years between 2001 and 2005 approximately 31% young people moved into Grade 11; this rate rose to 39% for the three years 2007 to 2009 with girls beginning to show higher rates of success than boys. In the previous chapter it was noted that secondary teachers are more likely to have higher qualifications than primary school teachers. Better teachers may be a factor in the increase of students entering Grade 11. But in spite of these improvements six out of ten students do not reach senior secondary school. 60%

of learners do not reach senior secondary school

Table 14: Survival Rates for Grade 8 and Grade 11, 2001 – 2008

Grade Sex 2001 2002 2003 2004 2005 2006 2007 2008

Grade 8 Total 78% 73% 70% 73% 69% 81% 72% 77%

Females 82% 77% 66% 69% 72% 82% 74% 79%

Males 74% 70% 73% 76% 66% 79% 70% 76%

Grade 11 Total 34% 31% 27% 31% 31% 39% 38% 40%

Females 34% 31% 26% 30% 33% 40% 40% 41%

Males 34% 32% 27% 31% 28% 36% 35% 37%

Source: MoE, 2010a

Figure 16: Number of Girls and Boys in Grades 11 and 12 by Region

Source: MoE, 2010a

Figure 16 also shows a higher number of girls than boys are succeeding. Of

approximately 37,000 learners in Grades 11 and 12 in 2009, just over 20,000

were girls. Girls are 55% of the student population at senior secondary school. As

can be seen in Figure 16, only the Kavango and Kunene Regions have a lower percent of girls in senior secondary school than boys.

7.2.1 Reasons for Leaving School

In 2009, the MoE lists data on school leavers, including the reasons why they leave as shown in Table 15 (MoE, 2010a). National reasons given by 12,800 learners for leaving school are set out below. In Kunene distance to school was given as the most common reason for leaving by 171 students out of 927 school leavers (MoE, 2010a). Other reasons given for leaving school are hunger (97 responses), illness (59 responses), parents’ demand (57 responses) and pregnancy (53 responses) (MoE, 2010a).

Table 15: Reasons Why Learners Leave School

Reason Number % Responses

Unknown 4,880 38

Pregnancy 1,735 14

Distance 1,038 8

Parents’ Demand 815 6

Discipline 682 5

Learner’s Age 620 5

Job 552 4

Illness 428 3

Failure 399 3

Parent’s Moved 397 3

Teacher attitude 303 2

No caretaker 229 2

Hunger 208 2

Early Marriage 196 2

Fund 100 1

Other 218 2

Source: MoE, 2010a

In the Kavango region the most common reason given for leaving school was parents’ demand, stated in 424 cases out of a total of 2,652 students who left school. Pregnancy was second highest with 382 cases and the third most common reason – 221 responses – was distance to school.

A curious feature among the reasons offered for leaving is the differences in attitudes to travel to school among regions. In the Kunene, the CBS (2008) reports that the average distance to a primary school in that region is 17.2 km for a non-poor households and 13.2 km for a poor household. For secondary schools the distance is greater - 62.9km for non-poor and 50.0 km for poor households. This compares with a national average for primary school travel of 6.9 km for non-poor households and 7.4 for poor households and 23.9 km for non-poor households and 31.1 km for poor households for secondary school travel. With travel distances being typically 3 times the national average, the fact that distance is stated as the prime reason for leaving school in Kunene may be understood. However, in Kavango the CBS (2008) records that the average distance of a non-poor household to a primary school was 2km and for a poor household 4.9km; average distances to secondary schools are 17.8 km for non-poor and 24.1 for poor households. Despite travel distances that are well below the national average, distance to school is ranked as the third most important reason for leaving school.

It is clear that the reasons for the high number of children leaving school before senior secondary school are complex and the relative importance of the different explanations is unclear. Children in the focus groups suggested many reasons including having to work; pregnancy; having to walk very long distances from home to school or, for those staying in hostels, problems of getting home at school holiday time. Having no school uniforms was another issue mentioned as a common problem as was substance abuse; failing a grade; or not having money to pay the school fund. Some KIs highlighted the role of some parents or carers who had less money to pay school fees because of alcohol or substance abuse or who failed to encourage children to stay in school or support them with their school work and in extra curricula activities. ‘Unknown reasons’ makes up 38% of the number of children who left school in 2008. The lack of money to cover school related costs at the beginning of a school year might be a factor in this figure, causing a child to simply not turn up for the new school year.

Nationally, five regions, Kavango, Ohangwena, Omusati, Oshikoto and Otjozondjupa, account for 62% of all school leavers in 2009 (MoE, 2010a). These regions also account for 70% of children who left school due to pregnancy. As

14%of children leave school because of pregnancy



only girls are likely to leave school because of pregnancy, the figures, which cover both girls and boys, point to pregnancy being a significant factor in why girls leave school early. As was seen in Chapter 4, close to half of mothers in the Kunene and Kavango regions who have just given birth do not receive a postnatal check up. Girls between the ages of 15 to 19 in these two regions have very high levels of fertility. Both regions have high numbers of teenage girls who leave senior secondary school - in the Kavango, pregnancy is the second highest reason for leaving school early, although this reason is quite low for the Kunene. All this suggests that many adolescent girls in Kavango and Kunene become pregnant, leave school as a consequence and also fail to receive adequate postnatal care. By not getting adequate care, these young mothers put themselves and their own children at risk. The same processes could be at work in other regions, representing a group at risk that can be identified through factors of income, education level and location.

In the focus groups adolescents tended to highlight caution towards teenage pregnancy, discussing the many negative consequences, not only for the girl, but also for the baby and her family. They reflected that those already living in poverty will most probably struggle even more to take care of the new addition to the family. The young mother is faced with an uncertain future of not knowing how she will survive as a single parent ‘because most guys move on to other girls’. Girls in Outjo said that most girls find it difficult to go back to school after having their baby. Knowing this leads some girls to have abortions.

Children who have left school are susceptible to different social ills. Out-of-school children are vulnerable to exploitative labour practices (MoLSW, 2008a). In 2004, just over a third of out-of-school children reported using alcohol in the previous month (MoHSS, 2008a). They are more exposed to interpersonal abuse than their school going peers (UNICEF, 2006). NAMCOL can offer a way back into education, but even though its costs are reasonable for basic education, poor families may not be able to support a child. In addition, NAMCOL only offers basic education courses for Grades 10 and 12. Children who have left before Grade 10 will have to catch up on their own if they wish to resume their education

7.3 Life Skills, Health and Sexuality

7.3.1 Health Care and Life skills

Adolescence is a time of intense physical and mental change and development. The clear success of falling HIV rates among adolescent girls, described below, is evidence of how a combined approach in the family, health and education services can make a real impact on how adolescents negotiate these changes.

Aside from the family, school is the most important social arena for children. Schools can offer children social, psychological, and emotional support, particularly to those who are vulnerable. School feeding programmes can reach those who need food. Life skills training is important. However, serious gaps exist in services for adolescents.

The level of health care in schools is a concern. The MoHSS, in a survey of students, reports that access to basic health care for school children is problematic. Counselling in reproductive health issues is often not available despite the particular needs of adolescents in this regard (MoHSS, 2008a, p. 2).

The National Policy on School Health (MoHSS, 2008e) acknowledges that youth are not well served when it comes to meeting their reproductive health needs (MoHSS, 2008e, p. 3). Health services for schools are described as “varied and fragmented … (lacking) uniformity and adequacy of service delivery …” (MoHSS, 2008e, p. 2). Schools in some northern regions are visited only once a year, largely during national immunisation days. Central and southern schools are more likely to receive three visits per year. In the Kavango and Caprivi regions, chronic staff shortages typically mean there is just one nurse per clinic. As a result teachers in those regions take students to a health care facility only when needed (MoHSS, 2008e, p. 2) and nurses are unable to visit schools. Reproductive health care messages are largely unavailable to students, particularly in regions where

5regions: Kavango, Ohangwena, Omusati, Oshikoto and Otjozondjupaaccount for

62%of allschoolleavers.

70%of children in these regions leave school because of pregnancy

most required. Teenage schoolgirls in Kavango spoke of how the lack of access to reproductive health care was a contributing factor to teenage pregnancy - the region with the greatest problem of teenage pregnancy in its schools.

In response, MoHSS implements the Health Promoting School Initiative through its School Health Programme. The initiative is offered in all thirteen regions, but uptake has been uneven and weak. Only five regions - Erongo, Khomas, Hardap, Omaheke and Otjozondjupa - have

carried out awareness creation activities and of their schools only 140 (of approximately

1,600) have implemented the initiative (MoHSS, 2008c).

Adolescent children need to learn about the biological

and social dimensions of sex. They need to understand about family planning, contraception and the implications of sexual relations. The MoE recognises this need and has updated its Learner Pregnancy Policy (MoE, 2010b). The policy emphasizes education and

prevention for learners. A girl who

becomes pregnant will not be punished;

rather the school must support the well-being of

the mother and her child. The mother will be assisted

in continuing her education. Should the father of the child also

be in school he will be encouraged to have regular contact with mother and child. He will be encouraged to remain involved in the development and support of the child. The policy challenges schools and their staff to create supportive environments for learners who become parents. As noted, life skills teaching is not sufficiently available. Until the situation with life skills classes improves, staff at local health care facilities are the main source of reproductive health counselling for adolescent children. In cases of forced sex or rape, referrals and transportation to WACPU may be necessary.

National level duty bearers particularly in the MoHSS need to address staff shortages that inhibit the delivery of school based health care. Kavango has well documented needs for health care delivery. The region suffers the long-term effects of deficiencies in health care delivery. Meeting them should be a priority.

Children at schools have other needs as well. About a third of both boys and girls report having contemplated suicide (MoHSS, 2008a). Family problems, pregnancy and poor performance in school were noted as the most common reasons. Interestingly 9.3% of boys who had contemplated suicide cited pregnancy as the reason compared to just 6.7% of girls (MoHSS, 2008a). Reactions to emotional problems came through in the FGDs where children reported that they or their friends are often unhappy, sad, depressed, frightened, embarrassed or confused, to the point where some children contemplate or even try suicide.

Schools can offer protection, particularly from sexual and economic exploitation. Each school is expected to have at least one designated teacher/counsellor. This person should serve as the first contact point for a learner with problems. A recent report on school counsellors reflected the value of this role. “The concept of counselling and the need for such a service is overwhelmingly supported by the learners. They do complain that in some instances the wrong teachers are appointed as counsellors. Where the teacher counsellors are liked, found to be empathic and trusted, their service is used and appreciated… Learners were able to give a range of useful suggestions for improving the counselling service in their schools that ranged from the appointment of more and full-time counsellors, giving them a say in the choice of the counsellors, introducing peer support groups, ensuring a safe and separate space for counselling and improving communication between learners and teachers” (MoE, 2010c, p. 38). At the same time, the report says that negative experiences at school “range from a poor to absent teaching and learning environment, widespread corporal punishment and bullying, fellow learners who display a range of negative behaviours, lack of motivation and alienation from the school system. It is against this background that the teacher counsellors struggle to provide a counselling service for these learners” (MoE, 2010c, p. 38).

...six out of ten of the wealthiest Namibian children do not live with both parents and for other income groups the numbers not living with both parents are much higher.



Life skills courses give children the skills to make informed decisions about sexuality and health care. Adolescents in secondary schools also have the chance to establish supportive peer relationships that they might not enjoy in a family environment that is under stress. Stigmatisation can be learnt about and challenged. Despite its positive potential, life skills’ training is missing from many schools (Chandan et al., 2008). KIs noted that, not only should life skills training reach all children in school, it should also be available to out of school youth. Adolescent Friendly Health services provide a suitable opportunity to reach those children about of school. Roughly one quarter of young people do not attend secondary school and six out of ten do not attend senior secondary school. They need to learn more about health care, sexual choice, risky behaviour and attitudes towards HIV and AIDS through community based support activities, including life skills training in out of school settings. Communication skills between a child and his or her peers, family and community are part of life skills training. Children who are not in schools need these skills to better contribute to their communities.

7.3.2 Emotional Growth and Sexuality

The importance of life skills training is evident in relation to adolescents and their attitudes to sex. Nearly half of the focus groups thought that many children become sexually active at an early age. Opinions varied but one suggestion was made that probably 80% of the girls between the ages of 13-17 had experienced sex and 70-75% are sexually active. Children knew that sex could lead to them becoming parents at an early age as well as exposing them to sexually transmitted infections and HIV. Practical evidence of this knowledge comes through in the significant falls recorded in HIV prevalence among adolescent girls as discussed in the next section.

Namibian society has undergone significant changes since 1990 (Hailonga-van Dijk, 2007) and the ways in which Namibian children are exposed to sexuality has changed as well. Adolescents are increasingly exposed to global messages about sexual relations: messages that may differ greatly from those of their own society and culture (Hailonga-van Dijk, 2007). The parts of the social structure that support and guide children as they discover their sexuality (family, church and community) need to respond to these changes (Hailonga-van Dijk, 2007).

Supporting emotional growth among young people is complex and can be affected by events outside their control. Depending on the study, anywhere from 18% to 50% of Namibians report being forced into their first sexual intercourse. For most of them this happened while they were adolescents. Just less than one quarter of students reported being bullied during the previous month. Events in adolescence shape the way in which a person relates to others as an adult.

Stable adult relationships are important for children. Children with two supportive parents are widely seen as better off. Figure 9 in Chapter 4 shows that among income groups the highest percent of children living with both parents is also the highest income group. The percentage however is only 40%. In other words, six out of ten of the wealthiest Namibian children do not live with both parents and for other income groups the numbers not living with both parents are much higher. For a large percentage of adolescents who experience trauma during their first sexual intimacy, the long term effect of that trauma is not known.

18% to 50% of Namibians

report being forced into their

first sexual intercourse

7.3.3 Adolescents Living with HIV

A general picture of HIV prevalence among adolescent girls comes from the national surveys of pregnant women. As Figure 17 shows, prevalence rates among young women below 20 years are falling quickly, with the latest sentinel survey showing that prevalence is one-third of the national level and down to levels last seen in 1994.

The NDHS of 2006/2007 shows that the age at which a child first has sex is rising. Namibian children are listening to prevention messages and either delaying their first sexual encounters or protecting themselves. Programmes like My Future, My Choice and Windows of Hope appear to be having a positive effect.

According to the MoHSS (2009c) approximately 13,000 children under the age of 14 are HIV positive.17 ART was introduced in 2003. By 2009, 84% of people identified were enrolled in ART (MoHSS, 2009c). Many of those who receive ART will survive into adolescence where they will confront issues of peer pressure, fitting in and sexuality. They may see these issues differently from other adolescents because of their status and the treatment requirements. A recent article on HIV positive adolescents in Uganda notes an array of issues specific to becoming a teenager while infected (Faris, 2010). Children may be too embarrassed to take their ART medication.

17 Unfortunately the MoHSS includes children 15 to 17 in the adult population.

Students and teachers who learn of their status may offer ridicule and abuse. Some may see unprotected sex and infecting their partners as a way of getting back at a world that has wronged them. The behaviour of adolescents with chronic diseases is mixed. Adolescents do not follow medical regimes well.

A recent analysis of learners with HIV found that many felt isolated and in a world that did not provide adequate support (Ward & Mendelsohn, 2008). They faced a number of key deficits. Teachers in their schools were poorly equipped to encourage open discussions about HIV status and stigmatization. Some parents of HIV positive children were not able to explain a child’s HIV positive status to the child or explain why the child was taking medication (Ward & Mendelsohn, 2008). Most children interviewed felt that doctors and staff at ART clinics were their best source of information about their status and treatment. Young people with HIV learned to live in a situation where they often received good information from medical personnel but felt isolated and alone in a school where teachers and fellow pupils are unable to provide support.

KIs indicate that children who are displaced by floods in Namibia find it more difficult than adults to adhere to their ART programme because they depend on adults in their difficult situation to collect their medicine. This can have significant implications since ART has to be followed consistently. While the specifics of the Namibian situation are not clear, the message from Uganda is that a better understanding of the situation of adolescents living with HIV in Namibia is needed.

For children who become HIV positive during adolescence (currently about 31% all new infections), testing for HIV status is an important part of prevention and control of the disease. The NDHS shows that among 15 to 19 year olds only 12.9% of boys and 31.3% of girls have been tested (MoHSS, 2008b). Boys, in particular, do not see it as important to know their status, even though the children in the focus groups report high rates of sexual activity. Currently, 123 sites run by MoHSS and 19 run by the Society for Family Health offer rapid testing. It is essential that these centres are adolescent friendly in their approach, since the rate of testing among adults is much higher - 32% of adult men and 50% of adult women have been for testing.

12.9% of boys and 31.3%of girls aged 15 to 19

have had an HIV test

Figure 17: Percent of Prevalence: Pregnant girls Aged 19 and Below, Compared to National Average, 1992 – 2008

Source: MOHSS 2001a; MOHSS, 2003b; MOHSS, 2005; MOHSS, 2006a; MOHSS, 2008d



A child currently needs to be 18 to give consent for medical treatment. This has implications for children who wish to know their HIV status. While the National Policy on Reproductive Health (MoHSS, 2001b) commits to health services for adolescents, testing without parental consent may be in conflict with the law, if testing is classed as a ‘medical procedure’. Adolescents are reluctant to disclose their sexual activities to adults, particularly parents and other relatives. Adolescent friendly centres offer the opportunity to take an integrated and confidential approach to sexual and reproductive health and the CCPB will, when passed in the Parliament, expand the right of adolescents to obtain health care without parental consent, including testing for HIV and reproductive health matters.

7.3.4 Attitudes to HIV and AIDS

A striking feature of the focus groups discussions is how few children appeared to have direct knowledge of people living with AIDS. This suggests that children who were infected at birth are passing through school without being recognised by their peers as infected. Data is not available on what this means for the infected child but it emphasises the continuing need to deal with stigma and discrimination in life skills education. Notably neither of the OvaHimba groups of children knew any children who were HIV positive nor did they know anyone who was affected by HIV and AIDS. Typical comments among the other focus groups were that “they knew that there are children in Namibia infected with the virus, but do not know the extent of the problem. They heard and learned about this in the media and during HIV and AIDS clubs and programmes at school such as ‘Stepping Stones’, ‘My Future My Choice’ and ‘Girl Child/Boy Child’.” My Future My Choice is a peer education programme run in Namibian schools. The programme has been successful in creating enhanced awareness among children on HIV and AIDS (Chandan et al., 2008). In addition to HIV and AIDS, students are taught communication, decision making and problem solving skills. The programme has been found very successful in spreading positive messages about life skills, particularly in rural areas (Chandan et al., 2008).

The relatively low degree to which children reported that they know people very close to them such as their mothers, fathers, brothers, and sisters who are HIV positive or have died of AIDS is surprising. Children knew of children whose relatives have died but they do not know if the cause of death was AIDS related or not.

7.4 Safety and Protection

7.4.1 Adolescent Sexual Vulnerability

KIs were concerned about escalating sexual violence against children, indicating that this is an area that needs urgent attention. In 2005, the WHO reported that 17% of Namibian women between the ages of 15 to 49 had experienced sexual violence sometime in their life (WHO, 2005). The fact that over a quarter (27.4%) of children under 12 reported being forced to have sexual intercourse has already been noted in chapter 5 (MoHSS, 2008a). The same report found that 17.7% of children aged 13 to 15 and 25.5% of children 16 and older reported forced sexual intercourse. Equal numbers of boys (20%) and of girls 20.7% reported being forced to have sexual intercourse (MoHSS, 2008a).

Forced sex is widespread. One study conducted in Windhoek found that half of the women interviewed claimed that their first sexual encounter was against their will (MoHSS, 2004). Of the women who reported having their first intercourse before the age of 15, one third stated that they were physically forced to have sex. A study carried out in the Kavango, Ohangwena and Omaheke regions showed that one quarter of respondents between the ages of 10 to 14 reported that they had been sexually abused. Of respondents between the ages of 15 to 24, half had experienced intercourse. Of these, 18% reported that their first intercourse was forced (UNICEF, 2006, cited in LAC, 2008).

13,000 children under

the age of 14 are HIV positive

Adolescent girls in particular are at increased risk of sexually transmitted infections and HIV infection due to ‘sexual violence, abuse and coercion’ (MoHSS, 2008a). A MoHSS survey found that just over half (51.7%) of school children had a boyfriend or girlfriend and that 13% of these children had experienced violence from a boyfriend or girlfriend - 15.7% of boys reported violence from their girlfriends while 11.1% of girls reported violence from their boyfriends (MoHSS, 2008a). Violence and sexual violence are often about one partner in a relationship expressing abusive power over

the other. Rose-Junius (2007) writes about the long

term and destructive effects of abuse

within families, and calls for a comprehensive understanding of the causes and effects of

violence and abuse in the Namibian

context.

Adolescents in Keetmanshoop talking about the issue felt that rape

happens at clubs, in the streets, and at home. One focus group with 15-17 year old girls indicated that many girls are victims of rape, mostly those who go to clubs: “They get so drunk that they don’t know where they are and boys or men kidnap them and gang rape them. There are also those who ask men to buy them drinks and later, when he asks for sex and she refuses, he will then take her by force.” There is also a lot of sex happening ‘behind closed doors.’ According to the same girls some of the rape incidents are happening within the family – by an uncle or a father. An example was given of a 10-year-old who was raped by her uncle for over a period of five months. They lived in the same house and the man threatened that if she told anyone, they

will laugh and make fun of her, saying that she is involved in evil practices. The parents only found out when the girl developed a vaginal rash and had to be taken to the hospital where she was diagnosed with herpes. The uncle has since been sentenced to five years in jail and the girl now lives with her grandmother on a farm. In another case a pre-teen girl in a Kavango focus group said her uncle, who is now in jail, raped her.

These are not isolated comments. Girls in one focus group said that most teenage girls silently experience sexual abuse at the hand of uncles and stepfathers. Sometimes the mother or someone else will know about the abuse but they will pretend that it is not happening. According to the girls, this really has a bad effect: “you feel dirty, hating yourself, feel like dying and develop a fatalistic approach to life – you just don’t care anymore and you end up doing stupid things.” The girls said that this is the reason why some of them will end up being rebellious and the parents wonder why. Some girls say they hate their mothers because they fail to protect them.

The children also reported a small amount of sexual harassment by teachers. Apparently, girls do not report these incidents to anyone because they fear others will laugh at them or get in trouble or “because nothing is ever done”. Consequences of this are girls being impregnated by teachers. An example was given of the step-sister of one focus group participant who is four months pregnant with her mathematics teacher’s child. Asked if they have reported the case to the police, school or MoE, the girl said that as far as she knows, her parents did not tell anyone and just kept quiet about the situation. However, the same teacher was moved from a different school because he impregnated another student at that school.

Police statistics from 2003 to 2007 show that roughly 40% of rape victims were children (MGECW, 2009b). The children’s voices heard in this analysis show that forced or coerced sex is not an exceptional event. Rather, sex against their will can occur in the community, at school or in the home. Children, girls in particular, learn that sex is not an event that they control. Added to forced sex is the notion that sex is a commodity. Sex is something to be exchanged for clothes, food or approval. These all point to the challenge that Namibia faces if it is to strengthen the security in which a child can grow.

Girls in one focus

group said that most teenage girls silently experience sexual abuse at

the hand of uncles and stepfathers.



7.4.2 Safety in School

A report that focused on conditions for girl learners in Rundu found that girls in school hostels were vulnerable to sexual harassment and rape. The lack of adult supervision, particularly on weekends and the lack of secure accommodation contributed to this situation (Felton & Haihambo-Muetudhana, 2002). In the development of the ETSIP initiative, schools and hostels were noted as places where sexual harassment occurs. The project document calls for an improved regulatory framework to enhance the safety and security of learners, and to improve conduct by students, teachers and hostel staff (MoE, 2007).

A school and hostel should be a place of safety. As just noted, this is not always the case. The MoHSS (2008a) found that 28% of learners countrywide had missed at least one day of school in the previous month because they did not feel safe either at school or on the way to school. Thirteen percent of learners in this study missed 4 or more days in the previous month because they felt unsafe. This represents one quarter of their learning time. Slightly more boys (65%) than girls (60%) felt unsafe. Half of students reported that they had been bullied at school at least once in the previous month, while 18% reported that bullying was inflicted upon them between six days a month to every day in the previous month (MoHSS, 2008a).

The Report on School Counselling recorded that: “School behavioural problems were the most frequently cited problem across all schools in the Kunene and Oshana regions and in two of the three Khomas secondary schools. These included problems relating to lack of discipline, fighting, lack of respect for other learners and/or teachers, general bad behaviour, breaking school rules, swearing, not listening to teachers, coming late, not doing homework, absenteeism/bunking, vandalism, jealousy, stealing, throwing papers around, breaking the school down, abusing other learners, swearing, and making a noise in class. These problems appear to be particularly severe in the Oshana region. In two schools in this region between 36% and 50% of all personal problems mentioned by the learners related to school behavioural problems” (MoE, 2010c, p. 39).

The report continued: “Corporal punishment is endemic in the schools and was a frequently mentioned problem in the learner focus groups. We personally observed incidences of corporal punishment, despite it being denied by many teachers, teacher counsellors and school principals. In some schools learners are too terrified to ask to go to the toilet and are beaten for the slightest infringement. There appears to be a limited ability to discipline constructively in schools” (MoE, 2010c, p. 41).

The Student Health Survey reports that almost one fifth of learners, 18.5%, reported being passengers during the previous month in a vehicle that was driven by someone who had been drinking (MoHSS, 2008a). This risky behaviour raises the issue of accidents. In 2009, 364 learners (out of 585,000 students in the system) died (MoE, 2010a). Accidents were reported as the cause for 144 of these cases, though the type of accident is not specified (MoE, 2010a). Increased knowledge about the levels and types of personal injuries among both school going and out-of-school children is required.

7.4.3 Safety in the Community

In a focus group with eight street boys in Keetmanshoop, only two of the boys live on the streets, but all eight work there. These boys only have one blanket that they share and they sleep on cardboard boxes. There are other boys (not part of the discussion) who sometimes sleep at the open market when the vendors leave. The boys indicated that they have no clothes, shoes and toiletries. They also indicated that winter is the worst time because they do not have warm clothes. All of them said that they are struggling to buy decent clothes and have bought the clothes that they were wearing with the money earned from the streets or sometimes they have the luck to get jackets and jerseys from tourists and locals. They also said that they feel uncomfortable because they are often dirty and have an unpleasant smell.

28%of learners report having missed at least one day at school in the previous month because they felt unsafe at school or on the way to school.

Street children in Namibia often come from existing families with whom they have almost daily contact (Grundling & Grundling, 2005). One author has called these ‘home based street children’ (Kombarakaran,

2004, p. 853). The home situation of children often drives

their move to the streets. Street children describe their home life as

filled with poverty, alcohol abuse by parents, and neglect for their needs

(Grundling & Grundling, 2005). Some of the street boys in focus groups for this

analysis confirmed this and indicated that they experience physical and verbal abuse at the hand of their caregivers and this is often the reason why they spend most of their time on the street. The boys also reported that they are victims of police or security guard abuse when they are seen begging on the streets; when they are caught they are taken to the police station and physically abused. The authors of the 2005 study cite a report from 1991 (Tacon, 1991) that estimated a total of 2,300 street children nationwide. Up to date information on the extent and distribution of street children is needed.

The children in the Rosh Pinah focus group

said that some children are

begging on the street b e c a u s e they are hungry, but somet imes it is just

children who want money

to go and buy sweets, cigarettes

and alcohol. They find these children annoying when

they constantly asked for money. In addition, they expressed the opinion that if many people are giving money to these children, the number of children begging on the street will only increase.

One type of bullying is found in street fighting in gangs. According to focus group participants in Keetmanshoop, this is a big problem in the area and it is not safe for anyone. There are a lot

of gangs who have territories and other gangs are not allowed to come there; when they do, the fight will last for days. These gangs are also harassing people in the streets. The focus group participants felt that it was not safe for young people, especially girls, to be out late on the streets.

When asked to describe these gangs, the children said that some of the gang members are from poor households, but “some are just evil and want to be naughty.” Some have run away from home because of many problems such as physical abuse, alcohol abuse, and poverty. According to the focus group participants, most of these boys do not have father figures in their lives, so they are probably looking for a sense of belonging and a father figure because the gang leader is always a bit older (3-5 years) and in charge. A KI indicated that, “Some parents have lost control over the discipline of their children and they will end up bad and see violence as the solution to everything.” Children seek a gang because it provides the needs that he or she is not getting at home (Grundling & Grundling, 2005).

7.4.4 Exploitation

Namibian adolescents are increasingly exposed to exploitation. Integration into regional and world economies, the growth of tourism and improved transport links bring many benefits for the society. Communication technology has expanded dramatically; many children have access to cell phones and the Internet. While these bring a world of advantages they also bring the potential for contact with predators and those who want to take advantage of children. Social structures that used to regulate and protect a child’s entry into adult life, particularly sexual life, are under stress. This was discussed above in the section 7.3 on sexuality. While exploitation and trafficking are not major problems in Namibia, their potential in an increasingly connected world cannot be ignored.

Sexual exploitation is considered to take three forms. The first is where a child exchanges sex in return for clothing, food, and shelter. These kinds of transactions occur usually with a neighbour, or member of the same household or community. This type of sexual exploitation is often referred to as ‘transactional sex’. The second is cross generational sex where children have sexual relations with men or women much older (usually 10 years or older) than they are. This type of sexual relationshep is

The home situation of children often

drives their move to the streets. Street children describe their home life as filled with poverty, alcohol

abuse by parents, and neglect for their needs



usually accompanied with receiving gifts, such as cell phones, clothes, jewellery, etc. The third is commonly known as commercial sex work where a child actively solicits customers who pay (usually cash) for sex. There is a general perception that transactional sex is by far the most common practice of the three, though there is no evidence to support this claim. Clearly with 40% of children in poverty, the likelihood that a child may exchange sex for favours cannot be dismissed.

Similarly, the number of people engaged in commercial sex work is unclear. This applies to both adult and child commercial sex workers. Most studies on the subject are largely qualitative but all studies note the presence of children being exploited as sex workers. The author of an article that appeared in a local magazine was able to interview ten children engaged in sex work in Windhoek. He did not mention any difficulties with locating children engaged in commercial sex work. In other studies, existing adult sex workers frequently mention the presence of children selling sex. A large study done by the LAC notes that many adult sex workers stated that they began when they were under the age of 18 (LAC, 2002b). A study of over 100 sex workers at the Oshikango Border Post found that 18% of their informants were under the age of 18 (Sechogle, 2008).

A study by the MoLSW with the International Labour Organisation (ILO) (Terry, Jauch, & Cownie, 2008) found no quantitative data about the extent of sex work in Namibia nationwide and the available literature provided very little insight into the extent of child sex work. Despite this, while the ILO Towards the Elimination of the worst forms of Child Labour study was being conducted, many more child commercial sex workers were identified than expected. Although sometimes the children were paid with food rather than cash, it was still considered as commercial sex work, because the child was actively soliciting or being forced to solicit clients. Most children engaged in sex work are ‘low-end’ sex workers, working out of shebeens, bars and hotels with room rates ‘by the hour’. Case evidence indicates that some children start in commercial sex work at as young as 12 years of age. Some children said they were trying to raise money for school fees. Trafficking of children for the purposes of commercial sex work does not appear to be common in Namibia. According to the LAC (2002), Namibia is not yet known as a destination for ‘sex tourism’, but this could become a problem in the future and prevention measures are needed

Trafficking has received public attention over the past year. The MGECW conducted a major survey on the issue in 2009 (MGECW, 2009e). To date, evidence for the existence of trafficking has been sparse. Studies on trafficking have relied upon KIIs that provide mixed opinions on the existence and nature of trafficking in Namibia. A study carried out by the MoLSW and the ILO provides an extensive review of data and looks at activities, such as commercial sex work, that are often associated with trafficking (Terry et al., 2008). One of the key findings of this review is that trafficking in Namibia may take different forms. There can be cross border trafficking run by international criminal syndicates or internal trafficking that exploits unemployed youth. Trafficking can also take place in long standing patron-client relationships between households where children from poor families are sent to wealthy households to perform domestic or agricultural work. Certain cultural practices may be considered trafficking. Combating this may be more a question of education and awareness-raising rather than criminalisation of the activity. This kind of analysis indicates the need for a deeper understanding of the phenomenon within Namibia.

A study by Kiremire (2005) on a case of the trafficking of young Zambian women by an Australian national is indicative of the challenges faced by Namibia. Well-trained police and immigration officials able to recognise trafficking are necessary, and appropriate legislation needs to be in

Most children engaged in sex work are ‘low-end’ sex workers, working

out of shebeens, bars and hotels with room rates ‘by the hour’. Case evidence

indicates that some children start in commercial sex work at as young as 12

years of age.

place to provide the tools to stop criminals engaged in trafficking. Kiremire in her case study points to these critical gaps. Namibia has passed legislation that makes trafficking a crime but, in the absence of hard data on its existence, the reasonable course is to provide training and support to relevant law enforcement staff.

7.5 Children in Contact with the Law

Diversion programmes, where children who have committed an offence are kept out of prison, are a preferred option in Namibia. In 2008, 272 children were arrested for breaking various laws. This is down from 357 in 2004. Only 297 children were imprisoned in 2007 compared with 2000 when 567 children were imprisoned after being found guilty (MGECW, 2009b). Children who are imprisoned are kept in special facilities at regional prisons to make family visiting easier.

The Ministry of Justice, MGECW and the MYNSSC operate diversion programmes for underage offenders. Diversion programmes consist of basic skills training, educational assistance and counselling. Under diversion, a Court will refer a child to the MYNSSC. The child is then enrolled in a life skills course held at a local youth centre or youth office and the MYNSSC reports back to the

clerk of the court once a child has completed the course. National data on the number of children in different stages of diversion are not available. MYNSSC officials are able to state that for

Oshakati and Windhoek, approximately 35 children

completed life skills training as part of diversion

in 2010 and another 45 were waiting for a new course

to begin. MYNSSC officials note that coordination with social workers

from MGECW is rare. Youth workers would benefit both in terms of follow up on specific cases and in terms of building their capacity in dealing with court referrals if they could have greater insight into the process. Absence of national data broken down by region and basic demographic characteristics limits the ability to evaluate different approaches to diversion.

According to an ILO/MoLSW study (Terry et al., 2008), the most common offences for which a child was in prison or awaiting trial in police cells was rape, housebreaking, murder and different forms of theft (robbery, shoplifting, stock theft, breaking into shops or hotels). Children in diversion programmes were most commonly arrested for theft, grievous bodily harm, common assault, shoplifting and stock theft. The same study notes that the main causes of children committing offences are poverty, hunger and peer pressure. While data is incomplete, it is estimated that 10% to 30% of children within the justice system are there as the result of Children Used by Adults to Commit Crime (CUBAC) (Terry et al., 2008). There appears to be no data on either the social, economic or family backgrounds of child offenders. Regional and local variations in the type of offences committed are unknown. Such knowledge would be useful in determining appropriate interventions and programmes for diversion programmes.

The children in custody interviewed for this study described the physical aspect of their confinement:

Two of the boys spent two days in •

10

to 30% of children in the

justice system are there as a result of adults using themto commit crime



police custody. They slept in the corridor among other prisoners because the cells were overcrowded. They were the only children. Both claimed that they were beaten and took a few slaps from other prisoners for no apparent reason. However, they said that they were lucky because they were not sexually assaulted. After two days in jail, they were released into the care of their parents.

A 16-year-old boy spent four days in jail, •also sleeping in a corridor because the cells were too crowded. The other prisoners treated him well; however he felt that the police were punishing him because they always woke him very early to run outside and do 200 push-ups. He is now out on bail and under the care of his parents.

A 14 year old who is still in jail said that •there are no other children at the jail where he is held and he is treated very well, with the opportunity to spend time outside because he is tasked to wash the police vehicle.

During a child’s court proceedings, a social worker from MGECW provides the court with a report of the child’s situation and the circumstances that led to the offence. The social worker is also required to assist in follow-up reports and the final decision process in the event a child enters a diversion programme.

The CRC report (MGECW, 2009b) notes two areas of concern with regard to children in contact with the law. The first is the lack of special facilities at police holding cells for children. The second is the lack of trained social workers to support effective diversion programmes.

7.6 Summary

Adolescence is a time of intense emotional and physical change and the chapter reflects the challenges of this for parents, carers and caring institutions and for the young people themselves.

The chapter starts by looking at the rapid fall in numbers of children in schools, from the 75% of children who enter secondary school to the 40% who reach Grade 12. These low numbers are not sufficient to reach the ambitions of Vision 2030 (Office of the President, 2004) and young people who leave school before Grade 10 in particular are restricted to unskilled or semi-skilled work. The reasons for leaving school early are many and complex but high levels of child labour in the northern regions may be a reason there. Poverty, the costs of going to school and, for some the distances to get to school are all factors, as pregnancy is for girls. The lack of a safe and secure environment reported in schools may be another factor, along with the fears that young people have about getting safely to school.

A range of responses are offered to the greater needs of children in schools, such as school health care programmes, school counsellors and life-skills training; the greatest challenge they all face is the need to ensure that they are as widely available as possible and that those who run them have enough resources and training.

The home and community are at least as important as schools in the support of growing adolescents. Many report that they do not find the security they need there. Girls in particular experience high levels of sexual violence, often when they are still very young, but there

is widespread evidence that many young people are afraid of the violence that appears to surround them. This may be a reason why around a third reported considering suicide.In spite of this gloomy picture, adolescent girls appear to be negotiating responses to their sexual growth that enable them to avoid HIV infection. This seems to be a mixture of safe sex and delaying sexual activity, although the numbers of girls who are testing their status is much lower than adults. Boys are particularly reluctant to discover

their status. Despite these successes, 31% of new infections overall happen within this age group. As a result of this and the infection of children while they are babies, means that perhaps one in six of people who are receiving ART are below the age of 18.

Finally, the response towards children who commit crimes is discussed but lack of data makes it difficult to know how well the policy of seeking to keep children out of prison and away from the stigma of criminality is working.



8. Summary8.1 Overview

Two factors influence the future care for Namibian children, both of which point to a need for a smarter and accurately targeted use of resources for the benefit of children. First, the country is well resourced to take care of its children. Namibia is one of five countries in sub-Saharan Africa to now be classified as an upper middle-income country (World Bank, 2010a). However, Namibia carries the burden of gross income inequalities that require a sustained effort to direct wealth to a larger segment of the population (CBS, 2008). Second, the analysis on preceding pages shows that the task facing the country is not one of creating institutions and programmes to meet the needs of its people. In almost all cases examined above, institutions exist and programmes are in place. Most, if not all, institutions and programmes reach the majority of those who require specific services. However, there remains a critical minority of Namibians who do not benefit from these opportunities resources and services. The task is to understand who these people are, where they live and the barriers and factors that prevent them from obtaining the services to which all Namibians are entitled.

The child is used in this report as the starting point of a comprehensive analysis. The child has a right to an array of services and support from society. At different stages of his or her life the nature of those services changes. The point is to understand the different services a child needs for a specific part of his or her life, and to investigate the factors that either promote, or prevent a child from getting what he or she needs. In Namibia, such an analysis must begin by looking at income distribution and poverty. A disproportionate number of children live in poverty. 26.7% of Namibian households are in poverty, but those households contain close to 40% of Namibia’s children. The reason for the difference is that severely poor and poor households have more children than non-poor households. Equivalence scales assume different needs for adults and children but also assume economies of scale, i.e. that the consumption needs of a family of five are lower than that of five single persons. Against this background in the NHIES children up to the age of 5 are assigned a weight of 0.5, children between 6 and 16 a weight of 0.75 and adults 16 years and over a weight of 1. This means that the actual poverty line for young children is just N$131.23 and for older children N$196.84 per month. It is questionable whether the basic food and non-food needs of a young child can be met with just about N$4.30 a day (CBS, 2008).

A further refinement can be made in terms of where those poor children live. The CBS (2008) calculates the percentage of poor households by region. The Kavango and Ohangwena regions have the highest share of Namibia’s poor households with 17.8% and 16.5% respectively. Add in the two regions with the next highest shares, Omusati and Oshikoto, to identify the location of 60% of Namibia’s poor. The disproportionate impact of poverty can be seen when the average number of children per household is considered. This data appears in Table 16.

An expectation of a government response would be to redirect resources to those four regions where poverty is concentrated. Indeed, that process had already begun even before the CBS published its findings. Table 17 shows the breakdown of expenditures by region of the Ministries of Health and Education.

The Kavango, Ohangwena, Omusati and Oshikoto regions have received the largest budgetary allocations. Clearly the government’s

response in terms of total expenditures is in place. Data from the previous chapters shows that the higher expenditures do not necessarily translate into better outcomes for children. Other concerns associated with poverty such as access to education, access to health care, treatment for HIV and AIDS, adequate shelter, personal safety, require more than budget allocations and expenditures. To understand how these issues need to be addressed comprehensively, a life cycle approach was used in this analysis.

8.2 The Life Cycle Approach from Birth to Adulthood

This section reflects the way chapters 5 to 7 are organised in this report. In keeping with the focus on the whole child, each identified phase of life from 0 to 18 is considered and divided into three broad age ranges as follows – 0-5, 6-11 and 12- 17 years. These broad age ranges form the basis for identifying and investigating the main opportunities and environment which

can support the development of the child or adolescent, and the challenges, data, information, policy and service gaps associated with each specific period of life. To ensure that children are at the heart of national development, a comprehensive strategy that addresses the specific needs of the child from 0 (at birth) to 18 (until the start of adulthood) that takes into account factors that effectively address both poverty and deprivation and taps the full potential of all children needs to be drawn up.

8.2.1 Infants and Young Children (0 to 5 Year Olds)

From birth to the first few days and years of life is a time when a child can be sheltered from early death,

obtain a name and identity, be fully nourished, immunised, stimulated and protected from long term and debilitating diseases. These are the fundamentals that will allow her or him to fully grow, develop and reach his or her potential. The state, the community and the family have the opportunity to ensure the rights and significant interventions on behalf of the child. Two broad areas for intervention are identified here that will benefit both the young child and those around him or her are. A combination of essential care that a child

Table 16: Poverty Share and Average Number of Children per Household in Four Regions with the Largest Poverty Share

Region Poverty Share (%)

Average Number Children per Household

Severely Poor Poor Non-Poor

Kavango 17.8 4.2 4.1 2.6

Ohangwena 16.5 4.9 4.5 2.6

Omusati 12.7 3.8 3.9 2.7

Oshikoto 11.9 3.6 3.6 2.3

Namibia N/A 3.9 3.6 1.8Source: CBS, 2008

Table 17: Regional Allocation of Recurrent Expenditures for MoHSS and MoE

RegionMoHSS FY 2005/2006 MoE FY 2007/2008

Budget (000) Percent Budget (000) Percent

Caprivi 33,432 5 162,140 6

Erongo 53,053 8 134,986 5

Hardap 41,709 6 133,102 5

Karas 55,683 8 106,485 4

Kavango 68,260 10 303,948 11

Khomas 30,308 5 280,824 11

Kunene 28,399 4 110,517 4

Ohangwena 67,246 10 317,250 12

Omaheke 23,245 3 119,465 5

Omusati 86,580 13 377,996 14

Oshana 23,243 3 182,901 7

Oshikoto 97,646 15 249,386 9

Otjozondjupa 63,258 9 172,019 6

Total 672,067 99 2,651,019 99

Source: MoE, 2008b; MoHSS, n.d.



needs in his or her first few days, months and years of life; and ensuring that this young child gets a good start for future growth and development.

The Essential Care Combination

The following continuum of care package for every new born, infant and young child guarantees the healthy life, growth and development of every Namibian child, if carried out systematically. Regular and timely check-ups of pregnant women including for preventing mother to child transmission of HIV; starting breastfeeding within half an hour of birth; follow ups for both the child and the mother to identify any complications that may endanger mother or child; testing of the infant at six weeks of life (if he or she is HIV exposed due to mother’s positive status) and begin treatment if necessary; completion of full schedule of immunisation; registration of the birth to provide the baby with an identity and nationality, and the legal means to access government services in the future and provision of early child hood care at home and through play schools and centres where the child can be socialised outside of a family setting.

This report finds that this combination of interventions for care happens for most children. However, a critical and significant minority of new-borns, infants and babies are consistently left out of this continuum of care. The challenge is to find ways and means to identify and reach this group. Those that are likely to miss out most often also have mothers or care givers with little or no education, and who come from low income or poor households. Children and mothers from the Kavango, Kunene, Ohangwena, Omusati and Oshikoto regions (identified as housing most of the poor in Namibia) were less likely to receive this care. In addition the analysis presented in Chapter 5 also points to the existence of pockets of disadvantaged within all regions of the country. For example, babies in the newer and northern suburbs of Katutura are likely to be more at risk than in the rest of Windhoek due to challenges in reach of services and other conditions. Additional factors such as cultural preferences mentioned in the Kunene and Ohangwena regions, or the problems of distance to services as mentioned in the Kunene region, mean that local conditions have to be factored into find and roll out effective solutions.

Once basic issues are identified, opportunities to locate solutions also emerge. For instance, indicators, such as the level of education achieved by the mother can be used to locate infants and babies that remain out of reach of the services and care. This will help in drawing specific strategies and interventions targeted to these specific groups and locations. Information or outreach programmes that are not just facility initiated but community planned and generated can target groups that need the care most. Appropriate media and community level partnerships and social networks for reaching people can be identified and used to support such targeted approaches.

Recognising and appreciating the critical role of those who deliver services at the local level needs to be complemented by filling the gaps in essential services. Local staff are an effective and strong local resource. This report identifies that the regions where the largest gaps in service delivery are, are also those regions where a full complement of staff, particularly health care professionals at rural clinics, are not available. Community based staff on the frontlines of delivery are often best able to identify and reach the critical minority that is left out of care. The report identifies an instance where staff at a clinic developed an effective solution to ensure that mothers kept follow up appointments. Local level initiatives in solving problems of service delivery present opportunities to be both explored and encouraged. A Good Start Translates into Strong Gains in Human Development

Nutrition and early childhood care and stimulation are central to a child’s physical, social and cognitive development. Over 40% of Namibian children are moderately or severely stunted. They

A good start translates into

strong gains in human development

e v e n t u a l l y wi l l suffer physically and inte l lectual ly because their

growth wi l l be diminished.

A child with a mother who is

poor ly educated and comes from a

low-income household is more likely to be

stunted.

The link between poor nutrition and the status of the mother

provides opportunities to extend programmes designed to improve access to the cluster of postnatal services to also include information, and support for good nutrition to both the mother and the child. Investments in outreach and information programmes is required. Addressing local capacity as well as empowering service providers is also an emerging opportunity.

A key component to ensuring a strong foundation for the young child is sustained and substantive commitments in ECD. This is

essential to address the nutritional and s t i m u l a t i o n needs of an age group of young children who are not yet eligible age-wise to

enter pre-primary centres run by the MoE. A multi-sectoral approach among the MoHSS, the MGECW and the MoE will ensure that from the start of birth the infant receives the continuous care, monitoring and support that prepares the child and the family to reach the developmental milestones such as proper physical and psychological growth and learning outcomes.

8.2.2 Children (6 to 11 Year Olds)

A heightened exposure to the outside world and interactions with people outside of the immediate circle of concern (family and care givers) characterises this phase in a child’s life. In school, household and community settings

children begin to acquire the basic life skills they will need later on to cope in life. This is also the stage in their life, when, after being given a good start in life, children get the opportunity to get their basics right and can start laying the building blocks for their values and skills. Challenges in access and quality of basic education are compounded by certain other factors such as child work, violence, disability and HIV. The latter set of factors poses heightened stress that has a negative impact on the education achievements of children particularly within poor households.

Getting the Basic Rights Through Primary Education

Children in Namibia have access to school. The survival rate for children through Grade 5 is 92%. During these first years of school, children acquire foundation level skills in reading, mathematics and writing. Despite the high percentage of learners in school, access to education still remains a concern for the critical minority mentioned earlier. Families are required to pay costs towards the school development funds and cover the costs of uniforms or books and supplies. MoE policy is that no child should be denied entry to school if they cannot pay these costs. In practice, however, a waiver of these costs is difficult to obtain. Households that are poor, or have low incomes or are affected by the HIV and AIDS epidemic bear a disproportionate burden when it comes to obtaining the concessions that will help them to support the child in completing education. A report by the Auditor General on assistance to children found that the involvement of a social worker on behalf of a family applying for fee waivers was a critical factor in success (Auditor General, 2009b). The opportunity for better collaboration between school officials and social workers from the MGECW exists, which will mean more children can attend and complete school.

A second area of concern for education is quality. In 2000 a SACMEQ evaluation of Namibian schools found that the majority of students only have basic skills in reading and mathematics. Over the past decade the MoE has emphasized the upgrading of skill levels of teachers. The percentage of qualified teachers has risen from just over 50% to 79%. SACMEQ III is currently in the analysis and report writing stage. The results will show whether the investments in teacher training have paid off.

ECD is vital for ensuring a strong foundation for

young children


Conditions Impacting on Educational Achievements

According to MoLSW definition, roughly 67% of children between the ages of 7 to 11 perform some form of work. This includes tasks and chores done within the household. A large majority of children felt that the work they were required to undertake interfered either with their schoolwork or their playtime. Child labour is more prevalent in rural than in urban areas. One in 10 children in rural areas reported having to stay away from school during times of high demand for agricultural labour. The extent to which children are aware of their rights with regard to labour is not known. The MoLSW carries out some orientation programmes with schools, though the number of schools visited is probably less than 10%. The number of labour inspectors is insufficient. Like social workers, labour inspectors who work for government have heavy caseloads that leave little time for community outreach and mobilisation. An opportunity exists to develop information campaigns to expose children and care givers regarding the child’s right to education and the duties of caregivers and communities in supporting children to complete their education.

Violence towards children emerges as a concern. Children of primary school age in FGDs spoke regularly of violence in their homes. Studies by the MoHSS (2008a) and MGECW (2009d) found high levels of violence toward children under 12 as well as verbal or emotional abuse. Violence emerges as an issue for adolescents. One approach to consider at this point is to find ways to incorporate good parenting messages into community mobilisation strategies suggested in the previous section.

Children with disabilities have access to school and education to this group is inclusive. Approximately 29,000 out of 30,000 learners with a disability attend school with their fellow students (MoE, 2010a). However, teachers have been found to have low skill levels when it comes to integrating disabled learners into classroom activities (Wietersheim, 2002; Ndengejeho, 2006; Janssen, 2007).

The ability of schools to support children with HIV has also been raised (Ward & Mendelsohn, 2008). ART means that children with the HIV virus can expect to live longer and have productive lives. Children in primary school will require assistance with ART regimes. This may leave them open to stigmatisation or worse. Current estimates on the HIV and AIDS epidemic predict that the number of children living with the HIV virus will peak at 20,000 (MoHSS, 2009c). Extension of School Health Programmes provides an opportunity to address issues of disability and the

management of ART for HIV positive learners. A lack of capacity of health care professionals at local levels has been identified as a barrier to more frequent visits to schools (MoHSS, 2008e). The extensive reach across all areas of the education sector and long-term horizon of the ETSIP programme (through to 2020) makes it a logical choice to address the education related issues of support for children and adolescents living with HIV. 8.2.3 Adolescents (12 to 17 Year Olds)

Adolescents in this age group begin a more extensive transformation into adulthood. Their

ability to assume responsibilities grows, as does their potential to contribute to

family and community. Awareness regarding sexuality develops and

with it comes new forms of vulnerability.

Education

S u c c e s s f u l l y completing school becomes one of the major challenges for a child at this time. The transition from primary to secondary school sees a decrease in survival rates from over 90% to just below 80%

(MoE, 2010a). The transition from

Grade 10 to Grade 11 and into senior

secondary school is harsher as only 40% of

students survive as learners (MoE, 2010a). Yet, students

who leave after Grade 10 obtain a Junior Secondary Certificate, and

are able to move into adult learning classes through NAMCOL. Learners who leave school after Grade 7 do not obtain a certificate and have no option for further study because NAMCOL only offers courses from Grade 10 onwards. This situation points to a critical gap. Out of school youth require additional attention because being young and unemployed and away from supervision in school increases their vulnerability. The opportunity presented is to

link programmes from the MYNSSC, however, youth are usually defined as aged 16 to 24. There may be a need to expand programmes to capture those children who leave school at the end of Grade 7, and are likely to be between the ages of 13 to 16. Coordination among MoE, MGECW and MYNSSC will be required to address this issue.

Life Skills, Health and Sexuality

As Hailonga-van Dijk (2007) notes, Namibian adolescents are maturing in an era when many traditional support structures for children are undergoing rapid change. Children are exposed to messages about sexuality and relationships from a global perspective and these messages may vary dramatically from those of the community or culture into which they were born or brought up into. Tension between these two sets of messages, and the fact that local support structures are changing, perhaps losing some relevance, only increases the need to provide timely and appropriate information and health care about reproductive health and related issues. Emotional development is heightened in adolescence. The MoHSS found that nearly one third of students had contemplated suicide (MoHSS, 2008a). The need for supportive counselling and professional mental health services for children exists.

HIV and AIDS introduces an additional dynamic to children’s needs. As children living with HIV move into adolescence they face stigmatisation should their status become known. The fear of stigmatisation could interfere with treatment regimes of ART, leaving children exposed to increased levels of infection. As children become interested in relationships and sexuality, HIV positive status can introduce significant, possibly disruptive, dynamics to this important phase of life. The need for structured support mechanism for this group of children is significant.

Both a policy and a programme exist to bring health care to schools on a regular basis, but the lack of capacity of rural health care workers inhibits the implementation of the programme. An assessment of counselling services available at schools has found them wanting (MoE, 2010c). Once again, this calls for multi-sectoral strategies on reaching the critical mass of adolescents through government ministries responsible for health, social services, education, community development and youth, combined with efforts from the civil society.

more research into children’s issues is needed



Safety and Protection

Adolescents are almost adults. They can look and behave like adults, but their inexperience can lead them into harm. The analysis found that roughly 25% of children were forced to submit to their first sexual intercourse (MoHSS, 2008a). Studies carried out with different segments of the population support the premise that 20% to 40% of Namibians were forced during their sexual debut (MoHSS, 2004; UNICEF, 2006). Children in FGDs reported multiple instances of rape and sexual abuse within the home and outside in the community. One quarter of students reported that they did not attend school for at least one day in the previous month because they felt unsafe. 13% of learners did not attend school for at least four or more days in the previous month because of fear for their own safety. Being the victim of bullying is also reported by 18% of students (MoHSS, 2008a). Addressing sexual violence will most likely require a set of initiatives ranging from policy and legislative development to community mobilisation and publicity, to improved methods of law enforcement. There is also a greater need for making the public aware of their rights and legal provisions as well as generating greater public debate on the specific issues faced by adolescents.

Children in Contact With the Law

Namibia has a preference for diversion programmes as opposed to incarceration of children who are brought before a court. The number of children imprisoned has almost halved since 2000. Yet, data on the overall performance of the system of juvenile justice is sparse. No agency has been tasked with taking the lead in gathering and processing statistics on different aspects of the legal system as it relates to children. This includes data from the police on arrests and nature of complaints, to the number of cases brought before courts or any compilation of outcomes. This deficiency hinders wider analysis of issues such as recidivism, patterns of criminal activity and socioeconomic indicators of crime. The MYNSSC, which runs diversion activities, has little evidence on which to evaluate its programmes. A compilation of data on children and justice enables analysis and evaluation of the system. Children who come into contact with the law do have problems. In 2006 the Ombudsman investigated conditions at police holding cells and criticised the manner in which children in custody are held (Walters, 2006). The evidence found through this analysis indicates a need to follow up on the recommendations of the Ombudsman’s report.

8.3 Information and Policy Needs

Namibia provides many basic services to its people. The analysis points to a lack of information and knowledge about the importance of services such as postnatal care, immunisation or PMTCT as one barrier that prevents a family from fully benefitting. Poverty and poor education of a mother are factors as well. With many services available, the need is to bring people to them. Effective delivery of messages on the time, data and location where services can be obtained and messages that explain the importance of a particular service are vital.

The issue of communication and information for development purposes goes beyond children to many other activities. Thus, it may be necessary to develop a national framework for development communication that complements the implementation of the National Development Plan with appropriate strategies, resources, messages and media/channels to deliver them. Targeted strategies are needed to reach information to communities that remain unreached.

The analysis has identified areas where information and policy level gaps may exist. There is a need to conduct regular and comprehensive research on critical issues that impact on the proper growth and development of children as part of national surveys; these include research on children’s issues within academic institutions and research agencies in the country; involve students at secondary level and universities in conducting short tracer studies, operational research and surveys in order to gather regular information and at the same time bring about a national awareness within the younger generation on these issues. National monitoring systems need strengthening to collect data on indicators relating to children and linking them to development planning and budgeting processes.

Data needs to be better linked to planning and budget processes

8.4 Children as a National Resource

Every Namibian child has the potential to build and expand the society. In order to have the ability to do that, every boy and girl requires a best start in life, a continuum of care and protection, receive the basics and life skills so that he or she can cope with life as changes occur and challenges and opportunities emerge, have the openings and accompanying knowledge and skills to make a meaningful contribution and grow to full potential as an adult.

Child poverty in Namibia remains widespread and has long-lasting impacts on the children themselves as well as on society as a whole. Child poverty is an impediment to sustainable economic growth and social cohesion. If Namibia is to achieve its Vision 2030, it cannot afford another generation of poor children becoming poor adults. As the preceding chapters showed, poverty affects the lives of children in Namibia across their whole life cycle and in all dimensions of their well-being. The multidimensionality of poverty suggests that only a cross-sectoral, coordinated and integrated strategy can achieve substantial poverty reduction.

The elements of such a strategy should include a mix of employment policies, cash transfers, high quality health, early childhood and education services and targeted support for those children who have additional needs or are not reached by mainstream services. Many policies are already in place but they are often not sufficiently reaching

children in poverty, tend to remain sectoral and are not integrated and coordinated across ministries. The way to introduce this notion into national planning documents is multi-fold. Opportunities exist to impact the national development process through a combination of strategies encouraging communities, children and adolescents themselves to participate in discussions and debate on development, influence national development planning by making children central to national planning processes and preparing and projecting short, medium and long term scenarios for social sector spending that is linked to child and adolescent related indicators and costing and budgeting them accordingly.

A Vote-by-Vote analysis needs to identify specific areas or budgetary lines that have a direct impact on children. When carried over into national planning documents, a child focused planning process becomes the starting point for measuring the impact of proposed policies, plans and allocations. The analysis presented here shows that despite a lot of hard work, significant gaps exist. Perhaps the single most important step in filling these gaps is to refocus an understanding of the problem. The discussion should not centre on issues that require policies and programmes as solutions, rather the focus should be kept on what is best for the Namibian child. The children whom society moulds will be the economically active Namibians responsible for bringing Vision 2030 and other national goals to fruition. Children are the critical resources for long-term national development. They need to be nurtured, cared for, supported and cherished.



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Remmelzwaal, C. (2003). Integrated Early Childhood Development: A Baseline Study On Maternal & Child Care Practices & Resources In Namibia. Windhoek, Namibia: Ministry of Women Affairs.Rose-Junius, S. M.H. (2007). Emotional Abuse and the Dynamics of Control within Intimate Partner Relationships. In, Lafont, S. and Hubbard, D., (2007). Unravelling taboos: Gender and Sexuality in Namibia. (pp314-329).Windhoek, Namibia: Legal Assistance Centre.

Rose-Junius, H. & Küzner, E. (2006) An Investigation into the Functioning of Woman and Child Protection Units (WACPU’s) and Police Stations with Regard to the Protection of Abused Women and Children in Namibia: a report. Windhoek, Namibia: United Nations Children’s Fund.

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Acts of Parliament and laws cited in the document:

Children’s Act, 1960 (Act 33 of 1960, South African Parliament)

Education Act, 2001 (Act No. 16 of 2001)

Combating of Domestic Violence Act, 2003 (Act No. 4 of 2003)

Maintenance Act, 2003 (Act No. 9 of 2003)

Criminal Procedure Amendment Act, (Act 24, 2003)

Prevention of Organised Crime 2004, (Act 29 of 2004)

Children’s Status Act, 2006 (Act 6 of 2006)

Labour Act of 2007 (Act No 11, 2007)



Annex A:List of Key Informant Interviews and Extended Technical Working Group Members

National Level Key Informant InterviewsName Position Organisation

1 Ms. Heidi Beinhauer Director Association for Children with Language, Speech and Hearing Impairments of Namibia

2 Ms. Rahimisa Kamningona Programme Director Catholic AIDS Action

3 Ms. Annaly Eiman Project Coordinator Early Childhood Development

City of Windhoek

4 Ms. Ntwala Mwilima Programme Officer ILO/Ministry of Labour and Social Welfare

5 Mr. William Maginya OVC Programme Officer Legal Assistance Centre

6 Mr. Hiraruka Katjepuuda OVC Project Officer Legal Assistance Centre

7 Ms. Melissa-Jane Smith Regional Khomas Manager Lifeline/Childline

8 Mr. Reginald Mouton Childline Manager Lifeline/Childline

9 Ms. Maria Shaalukeni House Mother Megameno Home for Orphans Trust

10 Ms. Lizette Beukes Head of Centre for Communication and Deaf Studies

Ministry of Education

11 Ms. S. Shaningwa Senior Education Officer, Research and Development

Ministry of Education

12 Mr. S. Shikongo Planning Officer Ministry of Education

13 Ms. S. Van Zyl ETSIP Ministry of Education

14 Ms. Pandu Onesmus Deputy Director, Community Mobilisation and Early Childhood Development

Ministry of Gender Equality and Child Welfare

15 Ms. Helena Andjamba Director, Child Welfare Ministry of Gender Equality and Child Welfare

16 Ms. M. Nghatanga Director, Primary Health Care Services Ministry of Health and Social Services

17 Mr. F Musikubili Director, Labour Services Ministry of Labour and Social Welfare

18 Ms. A. Katjivena Social Worker Ministry of Safety and Security

19 Chief Inspector R Shatilweh Chief Inspector Ministry of Safety and Security

20 Ms. Hilea Imune Juvenile Justice Officer Ministry of Youth National Service Sport and Culture

21 Ms. Christina Garises Founder and House Mother Mother’s Voice Grassroots AIDS Care Project

22 Mr. Bernard Gawanab Project and Youth Coordinator Mother’s Voice Grassroots AIDS Care Project

23 Mr. Samora Ntelamo Director Namibia Planned Parenthood Association

24 Mr. F. Kooper Deputy Director, Disaster Response Management

Office of the Prime Minister

25 Mr. Steve Neri Country Director Project Hope

26 Mr. Leonard Diergaardt National Director SOS

27 Ms. Sara Mwilima HIV and AIDS Programme Officer United Nations Development Programme

28 Dr. Haavesha Neelson Education Officer for Namibia United Nations Educational, Scientific and Cultural Organisation

29 Dr. Panduleni Hailonga Assistant Representative United Nations Population Fund

30 Mr. George Eiseb Land Researcher University of Namibia

31 Mr. Ben Beghie-Glench Acting Regional Coordinator Working Group of Indigenous Minorities in Southern Africa

32 Dr. Bason Osmani Officer in Charge World Food Programme

33 Mr. Agostino Munyiri Chief, Maternal Child Survival, Care and Development Programme

UNICEF



Regional Level Key Informant InterviewsOmaheke

1 Mr. Johanna Hairungu FAWENA Coordinator and school teacher

FAWENA/Gobabis PS

2 Ms. Ndinelao Shikongo Principal Social Worker Ministry of Gender Equality and Child Welfare

3 Ms. Kathryn Blakemore Programme Coordinator Omaheke San Trust

4 Mr. Benediktus Motlatla Project Director The Early Intervention Programme Trust (EIP)

5 Mr. Daniel Pietersen Unit Commander Ministry of Safety and Security

Karas1 Ms. Ndahafa Shoombe Community Child Care Worker Ministry of Gender Equality and Child Welfare

2 Ms. Marlene Hambira Principal Social Worker Ministry of Gender Equality and Child Welfare

3 Ms. Rosa Tjihavero Unit Commander Ministry of Safety and Security

4 Ms. Conny Willemse School Principal Rosh Pinah Academy

5 Ms. Michael Wimmert Coordinator Voice of Karas Region

Kunene1 Mr. Tjeundo Chairperson Church Alliance for Orphans

2 Mr. Mburura Councillor & Headman Epupa Constituency

3 Mr. Nelson Kavari Community Child Care Worker & Record Clerk

Ministry of Gender Equality and Child Welfare

4 Sgt. Samuel and Sgt. Kheis

Police Officers Ministry of Safety and Security

5 Mr. John Zatjinda Project Coordinator Mission for the Education of OVC

Kavango1 Mr. Eric Tjanda Regional Coordinator Church Alliance for Orphans

2 Ms. Charlie Paxton Development Worker and Health Educator

Independent Service Provider

3 Mr. Bayeko Gondwe Principal Social Worker Ministry of Gender Equality and Child Welfare

4 Sgt. Kupembona Unit Commander Ministry of Safety and Security

5 Ms. Elizabeth Hilger Project Director Theresia OVC Foundation

Below, please find the list of Extended Technical Working Group Members who attended the One-Day Workshop to comment on the Draft Situation Analysis on Children and Adolescents Report on 15 June 2010. Some of these members and other members of the Extended Technical Working Group also attended the Inception Meeting where the approach, methodology and main issues of the SitAn were discussed in February 2010.

Name Position Organisation

1 D. Mainga SHPA MOHSS

2 C. Visagie Principle Registered Nurse MOHSS

3 J. Matjila Communication Specialist UNICEF

4 F. Taapopi SHPA MOHSS

5 R. Tnandjila CHPA-FH MOHSS

6 K. Hamalwa DPHCS Engela, MOHSS

7 G. Kabuku RACE Coordinator MOE

8 C. Willemse Principal Rosh Pinah Academy

9 K. Blakemore Coordinator Omaheke San Trust

10 E. Mwasinga-Nawa Social Worker MGECW

11 I. Macleod Representative UNICEF

12 M. Ashok Deputy Representative UNICEF

13 A. Akwenye Deputy Director NPCS

14 N. Amulungu M&E Officer UNICEF

15 S. Okokwu Health Specialist UNICEF

16 P. Hoelscher Social Policy Specialist UNICEF

17 S. Kim Research and Monitoring Officer UNICEF

18 T. Bowra Strategic Information Consultant UNICEF

19 C. Coetzee Programme Assistant UNICEF

20 S. Mangan HIV and AIDS Specialist UNICEF

21 M. Gomes Antonio Executive Director SACHI

22 J. Shityuwete Director Lifeline/Childline

23 S. Tjipueja Chief Economist NPCS

24 N. Houlou Education Officer European Union

25 A. Munyiri Section Chief: Maternal and Child Survival and Development

UNICEF

26 G. Siseho Maternal, Newborn and Adolescent Health Consultant

UNICEF

27 A. Uusiku MFMC Coordinator MOE

28 B. Erasmus MFMC Coordinator MOE

29 F. Amporo Economist NPCS

30 M. Dalling OVC Specialist UNICEF

31 O. Odhiambo Economics Advisor UNDP



Annex B:List of Children’s Focus Groups

Six FGDs were conducted per region in four regions. In addition, groups of children from two schools that make special provision for children with disabilities contributed, giving a total of 26 FGDs with a total of 218 children. The following figure indicates the breakdown of the different groups.

Urb

anR

ura

l

Ag

e 8

- 1

1A

ge

12 -

14A

ge

15 -

17

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oys

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t o

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rph

ans

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reet

ch

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Him

ba

Ch

ildre

nPr

iso

n/ P

olic

e C

ells

Kar

as

Kee

tman

sho

op

(8)

8

8

8

8

5

8

Kee

tman

s (6

)6

66

63

Lud

erti

z (8

)8

44

82

Lud

erti

z (5

) @

Bet

han

ie3

25

55

35

Tses

(10

)10

1010

108

Ro

sh P

inah

(8)

88

44

80

Kav

ang

o

Mu

kwe

(7)

77

77

5

Mu

kwe

(5)

55

55

3

Ru

nd

u (

11)

1111

1111

7

Ru

nd

u (

10)

1010

1010

10

Ru

nd

u (

10)

1010

1010

10

Ru

nd

u (

4)4

44

41

4

Om

ahek

e

Blo

ub

erg

(6)

66

66

16

Blo

ub

erg

(5)

55

55

15

Go

bab

is (

10)

1010

55

1010

Go

bab

is (

10)

1010

55

1010

Dri

mio

psi

s (1

2)12

1212

1210

1

Dri

mio

psi

s (1

1)11

1111

116

Spec

ial S

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n15

55

55

1015

15

Nat

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al In

stit

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fo

r Sp

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714

14

Ku

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e

Oka

ng

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i (7)

77

73

43

7

Oka

ng

uat

i (5)

55

53

21

5

Ou

tjo

(6)

66

66

1

Ou

tjo

(7)

77

77

4

Op

uw

o (

10)

1010

1010

8

Op

uw

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8)8

88

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117

89

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197

231

10

62

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791

7873

6710

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818

434

120

18

2935

9



Annex C:Focus Group Discussion Instrument

1 Region 1- Omaheke 2-Kunene 3- Kavango 4-Karas

2 Community and Main Town near FGD site

3 Location ____ - 1 urban ____ - 2 rural

4 Venue

5 Category ___ - 1 Children in school___ - 2 Children not in school

___ - 3 Orphans___ - 4 Child Head of Household___ - 5 Street children___ - 6 Disabled children___ - 7 San children___ - 8 Children in trouble with law___ - 9 Other ___________________

___ 8-11 Year Olds___ 12-14 Year Olds___ 15-17 Tear Olds

6 Language/s used

7a FGD Facilitator

7b FGD Assistant/ Notetaker

7c FGD Other Assistant or Supervisor

8 # of Participants Males _______________ Females _____________ Total _____________

9 How/where re-cruited

___By Social worker; Name, Position & Dept _____________________________________By NGO Name, Position & NGO_______________________________________________By FBO Name, Position & Church _____________________________________________By Teacher Name, Position & School __________________________________________Other____________________________________________________________________

10 Date and Time Date: _________Start Time: ______ Finish Time: _______ Total Time: ______________

11 OverallCo-operation

____ - 1 high ____ - 2 medium ____ - 3 low

12 Person and Date of Note Rewriting

13 Person and Date of Final Check

14 Person and Date Entered

Situation Analysis of Children and Adolescents in NamibiaFocus Group Discussion (FGD) Instrument

– with Children Age 8-17

Prepared by SIAPACfor UNICEF and the National Planning Commission - Namibia



Introduction

Good day. My name is ______, and this is _____ and _____. We are part of a team conducting research on the situation of children in Namibia; especially children in difficult situations (provide some examples). This study is being carried out by SIAPAC on behalf of UNICEF and the National Planning Commission in Namibia.We are talking to other children like you in many places in Namibia, in places like Karas, Omaheke, Omusati and Kavanago regions. This includes holding group discussions with children in school, children not in school, street children, children who are working, and children who are in prison. We are also talking to adults like school teachers, principals, social workers, staff of NGOs and government people.We are trying to find out more about the problems of children and the effect of problems on children in Namibia. We want to hear your ideas and stories. We also want to hear your ideas about what can be done for children who might need help to get out of a problem situation they might be in. So your ideas count! But we have to mention here that this does not necessarily mean that government will act on your ideas. We cannot make any promises for government and we cannot promise that something we discuss today will actually happen. But by putting forward the idea, maybe there is more chance of it happening.When you tell us about someone you know, you do not have to give us their name; you can just tell us something about them. Anything you tell us will be kept confidential. [Int: make sure they know what this means.]It is entirely up to you whether you want to take part in this study. Please note that you have the right to refuse to answer any question, and only discuss the questions you want to discuss. If any of you feel uncomfortable with a question, just let me know and we can skip it for you. However, because your answers are very important to us, I ask that, if you do agree to be part of this discussion, that you are completely honest and sincere with me when you are saying something. There are no ‘wrong’ and ‘right’ answers. You just answer how you think about something.Do you understand? Any questions? Can we proceed? [Int: Write in your notes that you did or did not get permission to proceed and collect permission forms.]

Introductory Questions

We would like to begin by asking a few questions about yourselves. Please tell us the following: your first name, age, if you are attending school now or not, highest level of education, main language spoken at home between family members, and ability to speak, read and write in Afrikaans and in English, and if both your parents are alive, who you are living with now (the head of household or guardians, not about the whole family). [Int: If possible collect this information individually when they come in, on the table attached.]

Part 1: Types of Situations/Experiences of Children

We want to know about all of the problems or challenges that children in Namibia are facing and about the situations that children are finding themselves in. So let’s begin our discussion by first listing all of the problems or challenges that children are facing and about the situations that children are finding themselves here in community XX. In our introduction we mentioned that some children in Namibia

__)

__)

are very poor, hungry, or not in school. Some are street children, working long hours, or are in prison, police jail cells or diversion programme. Is this true for this community and should we start our list with these problems/situations? [Int: Make the list on a flipchart paper for all to see.] [Note: For the older literate children, this list can also be generated by the use of cards and markers with each child writing one problem on one card, accessing as many cards as desired.] Okay, what else should we add? [Int: Continue list until no more problems/situations are forthcoming. Then if the problems/situations on the list below have not been mentioned, specifically ask if these problems or situations occur in this community. If yes, add them to the list of the flipchart.]

[Int: This part of the FGD will be handled in two ways, depending on the age of the group or interest of the group in drawing or in writing] We want to go into more detail on some of these problems so we would like you to pick the one most pressing problem or most difficult situation that you or your friends or classmates are facing. Depending on what you prefer, make a drawing that depicts this problem or situation OR write a story that gives details about the problem or situation. [Int: Give the children about 15 minutes to do this exercise.]

[Int: The facilitator(s) need(s) to check their understanding of the drawings or stories. Ask if a few children are willing to volunteer to show their drawing and explain it, or to read their story to the whole group. Then ask some clarifying/probing questions to gain more details. If no one is willing to volunteer to do this (do not force anyone), then quickly look at the drawings and read a few of the stories and ask the children individually away from the group for some clarification or more details. The other children can be making another drawing or story on the second most pressing issue so they are kept busy doing something while you are talking to the individual children.]

Part 2: Situation of Children – Severity and Extent of Children’s Involvement in Difficult Situations

Now looking at the list of issues, let’s rank them in order of severity, with 1 being the most serious and the last number the least severe of all of these problems or situations that you have listed. [Note: this exercise can be done verbally, or by ‘voting’ by giving each child stickers or marker pen or bean counters to indicate their own ranking. After all children are done, the scores are totalled up, and problems ranked from most marks to least marks.]

We now want to get an idea of the extent of these problems or situations that you have listed and ranked.

Using 10 items (plastic animals, bottle caps), explain that these ten items represent children in their community. [Int: if you feel the group is too old for plastic animals and they understand percentages then just ask them for percentages, without bringing out the animals.]

Of these items representing children in your community, how many (i.e. what portion: ‘none’, ‘some’, ‘half’, ‘many’, ‘all’) experience the following/might be involved in XX [Int: Start with one example from the list and demonstrate what you mean so they will all understand. Then, start with the number 1 ranked problem and cover at least the top 5 and if possible the top 10, obtaining a percent figure or portion for each issue.]

[After that, covering at least the top 5 and if possible the top 10, ask for each issue:

Why do you think that this many children are involved and how do you know these children are involved? Can you give some examples of the specific situation without naming specific children?]

What do you think is the specific impact of these problems on the child involved? [Int: If not forthcoming with ideas, probe on relevant impacts to the issue being discussed, such as: hunger, poor health, no school uniform; never attending school, drop out of school, too tired to do homework; being arrested or having a criminal record, imprisonment, move from ‘petty’ crime to more serious crime; increased drug and alcohol abuse; leads to pregnancy, being a single parent, HIV & AIDS, STI; isolation, depression, suicide.]

For each situation and impact, ask: How serious is the impact of these situations on the children in your community (not serious, slightly serious, serious, very serious)? Why?

__)

__)

__)

__)

__)

__)

__)

__)



Table to Collect Data on the situation and extent of children

[Int: This is a very long list – tick in column 2 all issues mentioned in column 1 and do ranking in column 3, but only complete columns 4 and 5 for the first 5-10 issues ranked by the children in the ranking exercise.]

Form for Part 2 of FGD

Type of situation Tick if listed as a problem/ situation

Rank Order Children in Situation

% or1) none 2) some 3) half 4) many

5) all

Level of seriousness

1) not serious,2) slightly serious, 3)

serious, 4) very serious

Child labour:

Work in or around home •

Child minding•

Domestic work•

Livestock• herding

Agriculture (crop farming)•

Informal selling/marketing•

Making• or selling alcohol

Other•

Work outside of own home •

Child minding•

Domestic• work

Livestock herding•


Informal selling• /marketing

Making or selling alcohol•

Other•

Has to do so much work that …

they cannot/do not attend school

They cannot do their homework or study

They cannot play/visit with friends

They feel physically or emotionally sick/ unwell





5) all




Child labour:

Work in or around home •

Child minding•

Domestic work•

Livestock• herding


Informal selling/marketing•

Making• or selling alcohol

Other•

Work outside of own home •

Child minding•

Domestic• work

Livestock herding•


Informal selling• /marketing

Making or selling alcohol•

Other•

Has to do so much work that …

they cannot/do not attend school

They cannot do their homework or study

They cannot play/visit with friends

They feel physically or emotionally sick/ unwell

Trafficked for labour exploitation

Involved in crime:

House break-ins •

Car break-ins •

Shoplifting •

Pick pocketing •

Stock theft•

Other examples given by children:•







5) all




Criminal status

Been arrested•

Held in police cells•

In diversion programme•

Prison sentence•

Sexually active

Have had sex at least once•

Have sex occasional•

Have sex regularly•

Commercial sex:

Girls engaged in commercial sex•

Boys engaged in commercial sex•

Transactional sex:

Girls engaged in transactional sex•

Boys engaged in transactional sex•

Other sexual exploitation

Incest•

Rape•

Assault•

Pornography•

Trafficked for sexual exploitation

Parenthood

Ever been pregnant or ever fathered a •child:

Have a child/baby•

Taking care of a child/baby•

Teen mother w/ inadequate support•

Had to drop school due to pregnancy•





5) all




Using alcohol

Have tried alcohol•

Drink occasionally•

Drink regularly•

Smoking cigarettes

Have tried smoking at least once•

Smoke occasionally•

Smoke regularly•

Using Drugs:

Using dagga occasionally•

Using dagga regularly•

Using mandrax occasionally•

Using mandrax regularly•

Using cocaine occasionally•

Using cocaine regularly•

Other drugs?•

Selling drugs:

Selling dagga occasionally•

Selling dagga regularly •

Selling mandrax occasionally•

Selling mandrax regularly •

Selling cocaine occasionally•

Selling cocaine regularly •

Other drugs? List:•

Family status (who head of house)

Living with both biological parents•

Living with one biological parent•

Living with one or both grandparents•

Living with other relative•

Living with non-relative•







5) all




Orphans

Mother• dead

Father• dead

Both parents dead•

Street children

Living on the street•

Working on the street•

Part of a child-headed household

Heading household•

Member of a child-headed household•

Status of schooling

Attending school regularly•

Not attending school regularly•

Children defined as over aged by •educational policies (too old to be in lower grades)

Dropped out before completing Grade 10•

Dropped out before completing Grade 12•

Poor access to services

Clean water•

Health services•

Immunizations•

Electricity•

Telephone•

Computer technology•

Counselling, psycho-social support•

Other• :





5) all




Children with disabilities

Children experiencing abusive or violent home life

Children infected and affected by HIV and AIDS

Children from minority ethnic groups that are considered to be marginalised

Children of farm workers

Children in remote poorly-serviced, rural areas

Children in squatter camps and resettlement camps

Children experiencing natural disasters

Drought

Flood•

Other•

Refugee children

Lack of access for high achievers

Schooling/training at high level•

Resources: books, teachers, materials, •equipment

Mentors•

Opportunities•

Funding•



Children Actually Trafficked to do Labour or Sexual Exploitation__) [Int: Probe in detail as follows if any examples of trafficking have been mentioned in previous exercise.]

Activity

[Int: Introduce this in the form of a story …. “There was a young girl who came from Angola and ……”; “There was a young boy who came from another village in Namibia and ……”]

__) Do you know of children like this, who now live in this community, but have come from outside (i.e. some place else like another community or town or another country like Angola or Zambia. [Int: Also ensure they consider children moved within the extended family, e.g. coming to stay with granny, or auntie, or whatever.]

…. To attend school here…. To do domestic work…. To do childcare/childminding…. For agricultural work (crop or livestock)…. Commercial sex work…. Other

__ ) Ask how many children do they know in each situation. __ ) Describe briefly their situation as far as they know, including where they come from, for how long have they been in this community, who they are staying with, can they speak the local language, any other pertinent details.__) In their opinion, why was the child brought here/how did they find themselves in this situation?__) In their opinion, how is this situation affecting the child? [e.g. do they attend school, do they have time to play …]__) Do you know of children who used to live in this community, but have left and you heard that they left because they had to go and attend school or work someplace else….…. To attend school there…. To do domestic work…. To do childcare/childminding…. For agricultural work (crop or livestock)…. Commercial sex work…. Other

__) Ask how many children do they know in each situation.__) Describe briefly their situation as far as they know, including where they went, for how long have they been away, who they are staying with, can they speak the local language there, and any other pertinent details.__) In their opinion, why was the child sent away/how did they find themselves in this situation?__) In their opinion, how is this situation affecting the child?

Part 3: Preventing or Supporting Children in Difficult Situations‘Story With a Gap’. Strategies for Preventing or Reducing Incidences of Children

in Difficult Situations

Current Situation:__) Show the pictures of children in various situations (these should be photos from magazines/reports and the drawings that the children made in the first activity). Discuss what these pictures depict and how these children might be feeling. Especially make a link between any pictures you have brought with you and the examples children gave in the previous discussions.

Future Situation: __) Get them to draw or talk about how they would like to see the future (a dream or vision of the future with or without these situations). Have some pictures on hand to supplement the drawings/discussion (e.g. children in school, eating nice food, playing, sleeping, relaxing, being cuddled, drinking water from a tap, accessing health care, etc.). __) Filling in “The Gap” – How do we get from current situation to future:Discuss how we can fill in “The Gap” – How can we get from current situation to future. Discuss all aspects, as follows:

__) Strategies for preventing or reducing incidences of children in tough situations [Int: Put into simple words]•__) Strategies for withdrawing, protecting or rehabilitating children in tough situations [Int: Put into simple words]•__) Strategies for providing children with all the necessary resources (human financial material) that they need to achieve •XXX. [Int: Put into simple words]

[Int: Probe on national, regional, community, family, child-level strategies. Probe on existing strategies that they know about and ideas they have for strategies that are currently not happening. If they mention organisations or individuals that can be part of the strategies note down names and locations so they could be contacted as a Key Informant.]

Closure

__) Do you have any final comments before we close our discussion?

[Int: Thank the children for their ideas and the time they spent with you.]



Annex D:Focus Group Discussion Instrument

VERSION 3 – FINAL – 7/02/10

National and Regional LevelKey Informant Interview Guide

Prepared by SIAPACFor UNICEF and the National Planning Commission – Namibia

Information Details

First Name

Surname

National Interview

or

Regional Interview

Title (Mr., Mrs., Ms., Dr., Rev., etc.)

Position

Name of Organisation

Categorisation of Organisation ____ - 1 Government Agency - National____ - 2 Government Agency – Regional ____ - 3 Non-Governmental Organisation - National Office____ - 4 Non-Governmental Organisation – Regional Office____ - 5 Private Firm ____ - # other ________________________

E-Mail/Telephone/Fax as appropriate

Date and Time Date: Start Time: End Time: Total Time:

Co-operation ____ - 1 high ____ - 2 medium ____ - 3 low

Interviewer Name

Interviewer Check:

[Initials and Date]

Person and Date Compiled

My name is ______, and I’m with SIAPAC, a SADC-based social development consultancy established in 1987. We have been contracted by UNCEF to conduct the 2001 – 2010 Situation Analysis of Women and Children:

The aim of this report is to provide “a broad assessment of the status of the realization of the rights of children.” Namibia is a signatory to the Convention on the Rights of the Child (CRC) and has made considerable progress in supporting our children since Independence. This report will assist the government and other stakeholders to plan and execute programmes for children. Information from this interview will be combined with information from a both review of existing literature, and with data from focus group discussions held with children into the final report.

Do you have any questions before we proceed?



Policy/Legislation Adequate Inadequate Reason(s)

1

2

3

4

5

6

1b) Please tell me, briefly, about your programmes that specifically deal with children? Which departments deal with children, who are responsible for those departments, what are the shortcomings and required capacity?

May we proceed? ____ - 1 Yes ____ - 2 No

1) Can you tell us what your office does for children and adolescents? Please provide a brief overview of the activities you provide for children and adolescents)

1a) Which policies and legislation guides your activities for children? Are these policies and legislation adequate in terms of guiding your activities for children? Please elaborate based on response.

Activity Responsible Departments/Persons

Capacity required

Human Financial

1

2

3

4

5

2) Among the programmes you have listed above, what are the successes, and what are the reasons for those successes?

Programme Reason (More than one possible)

Comments

1

2

3

4

5

1 = Sufficient Human Capacity2 = Sufficient Financial Capacity3 = Interministerial/agency Cooperation4 = Development partner Cooperation5 = Civil Society Cooperation

6 = Regional/Local Government/Traditional Authority Cooperation7 = Understanding of the tasks8 = Other (explain) _______________________

3) Among the programmes you have listed above, what are the problems and/or failures, and what are the reasons for those problems and/or failures? What do you see as the solution?

Programme and Problem Reason(s) Cause/Solution

1

2

3

4

5

4) When we look at the problems you discussed above, can we address any of them by making changes to the policies and/or legislation that govern the activities of your institution? If yes, what are the changes:

Programme and Problem Policy/ Legislation Changes suggested

1

2

3

4

5

5) When we look at the problems you discussed above, can we address any of them by changes in operational matters such as human capacity, budgetary capacity, better cooperation with partners, etc.

Programme and Problem Policy/ Legislation Changes suggested

1

2

3

4

5



6) In the experience of your normal activities, what are the issues about children you are aware of that do not receive attention? Please list them, and give us an idea of how they may be resolved?

Issue Solution(s)

1

2

3

4

5

7) Do you have any concerns about children that may fall outside of your professional activities that you want us to be aware of? Please tell us and give a description.

Issue Description

1

2

3

4

5

Thank you.
