Population policy south africa

Population Policy Of

South AfricaPRESENTERS :

AYANTIKABINAYAK SAMEER

SHATRUGHAN

FLOW OF PRESENTATION:

DEMOGRAPHIC SCENARIO NEED FOR AN EXPLICIT POPULATION POLICY PAST POLICY AND PLANNING THE CURRENT PARADIGM FERTILITY & CONTRACEPTION MORTALITY & MORBIDITY (MNCWH) & NUTRITION ABORTION POLICY GOALS & OBJECTIVES

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DEMOGRAPHIC SCENARIO The population of South Africa -53,139,528 0.73% of the total world population. Rank 25 Growth rate 1.34% Birth rate 19.61 births/1,000 population Death rate 16.99 deaths/1,000 population Life expectancy 61 years

-male 59 years

-female 63 years Fertility rate 2.4 children born/woman Infant mortality rate 43.78 deaths/1,000 High dependency ratio i.e. 54%.

WHY SOUTH AFRICA NEEDS AN EXPLICIT POPULATION POLICY ?

• Number of major population issues -major being the long history of apartheid.• Inequities based on race & quality of life. Racial segregation of blacks and whites. Bring about changes in population trends.• Remove flaws in past policies.• To set out various interconnected programmes for the many social and economic problems facing the country.

PAST POLICY AND PLANNING CONTEXTS FOR POPULATION AND DEVELOPMENT

Apartheid ideology :enacted in 1948 -Prohibition of Mixed Marriages Act -Immorality Amendment Act Restricted movement and resettlement of the population, especially blacks; -restricting the access to educational and employment opportunities -restricting their access to water resources and water-resourced arable land Reducing the country's rate of population growth by reducing the fertility by coercive means; Population Development Programme (PDP) was established in 1984 – -Achieve a TFR=2.1 by 2010. -Fertility reduction through family planning and by intervening other areas that have impact on fertility level.

THE CURRENT POPULATION AND DEVELOPMENT PARADIGM

Focus on Sustainable human development- Population as the driving force + ultimate beneficiary

Improving education and health conditions; promoting sexual and reproductive health (including family planning) and

reproductive rights; Changes in various development indicators - increasing levels of income,

education and the empowerment of women => better health, declining fertility and mortality rates, migration from rural area.

Establishing factual bases for understanding and anticipating the interrelationships of population, socio-economic and environmental variables, and for improving programme development, implementation, monitoring and evaluation.

POPULATION POLICY GOALS, OBJECTIVES

VISION OF THE POLICY- is to contribute towards the establishment of a society that provides a high and equitable quality of life for all South Africans

GOAL OF THE POLICY- to bring about changes in the determinants of the country's population trends, so that these trends are consistent with the achievement of sustainable human development.

MAJOR NATIONAL POPULATION CONCERNS- MAJOR NATIONAL POPULATION CONCERNS-

1.the pressure of the interaction of population, production and consumption patterns on the environment;

2.the high incidence and severity of poverty in both rural and urban areas;

3.inequities in access to resources, infrastructure and social services, particularly in rural areas, and implications for redistribution and growth and the alleviation of poverty;

4.the reduced human development potential influenced by the high incidence of unplanned and unwanted pregnancies and teenage pregnancies; 5.the high rates of infant and maternal mortality, linked to high-risk child bearing; and high rates of premature mortality attributable to preventable causes6.the rising incidence of sexually transmitted diseases, especially HIV/AIDS, and the projected socio-economic impact of AIDS;

OBJECTIVES OF THE POLICY

1.the systematic integration of population factors into all policies, plans, programmes and strategies at all levels and within all sectors and institutions of government;

2. developing and implementing a coordinated, multi- sectoral, interdisciplinary and integrated approach in designing and executing programmes and interventions that impact on major national population concerns;

3. making available reliable and up-to-date information on the population and human development situation in the country in order to inform policy making and programme design, implementation, monitoring and evaluation at all levels and in all sectors.

Fertility

CBR- 37.2(1970-75) 31.2 (1985-90) 21(2013) TFR- 2.41 (2012) considerable gap between preferred and actual family size CPR- 60-65%(DHS 2003) Large differentials geographically Negative correlation between age at marriage and fertility level doesn’t seem to

hold- marriage losing its importance for child bearing financial and economic considerations , age(eg, younger gen women more likely

to be involved in decision making about the family size) , children's educational needs

Unintended pregnancies- 39% (among 49.1 mn pregnancies in 2008)

Contraceptive use major portion modern contraceptive methods

racial and gender variations regarding choice of method

majority of women use contraceptive injection

Males- mainly urban habitation ( if don’t use- main reason is reliance on partners for FP)

factors, including developmental, psychological, interpersonal, social, cultural and economic, influence youth reproductive health behaviour and protection

Contraception and fertility planning guided by South Africa’s constitutional and legal framework, with its emphasis on human rights, the key elements of which are given below.

Different categories of cross-border migrants are granted differential rights to access free public health care services. Asylum seekers and refugees are governed by the Refugee Act (1998); other cross-border migrants are governed by the Immigration Act (2002).

Clause 27 in the Bill of Rights (in the South African Constitution, 1996) states that everyone has the right to have access to health care services. The National Health Act (2003) and the Constitution assures everyone in the country, regardless of immigration status, access to care in life-threatening circumstances.

The Refugees Act 130 (1998) states that refugees should have access to the same basic health services that are available to all South Africans (there is ambiguity in relation to asylum seekers). The 2007 Financial Directive1 from the DOH confirms that refugees and asylum seekers, with or without a permit, have the same right as South Africans to access free basic health care and ART in the public sector.

Other documented cross-border migrants (such as those with visitor, work or study permits) should be charged a ‘foreign fee’ at the point of use. However, in terms of undocumented migrants the legislation is unclear and they are only covered if they are refugees or asylum seekers, as per the 2007 directive.

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Mortality and Morbidity

CDR- 17.49 (2015)

LEB-  61.2 year (2014)

IMR- 40.97 (2015)

<5 mortality rate- 45 per 1000 LB (2014)

Causes of death among children

three quarters of deaths among African infants were due to perinatal causes, diarrhoeal and respiratory diseases.

Measles- another leading cause of child mortality and morbidity

leading notifiable causes of child mortality and morbidity in South Africa are malaria, viral hepatitis, typhoid fever (which is strongly associated with contaminated drinking water, poor sanitation, and overcrowding), meningococcal disease, and cholera. Acute respiratory infections, likewise, are a major cause of childhood mortality. Diarrhoeal diseases, respiratory infections and allergies outnumber all diseases in both ambulatory facilities and hospital admissions.

Causes of death among adults

TB, flu and pneumonia emerged as the leading killers overall. TB accounted for 8.8 per cent of all deaths and flu and pneumonia 5.2 per cent.

HIV/AIDS was the third most common cause at 5.1 per cent

increasing deaths from diabetes and hypertensive diseases emerged as a concern.

TB was the leading cause of death in six provinces, except in the Western Cape, where it was diabetes; the Northern Cape, where it was HIV; and Limpopo, where flu and pneumonia were the top killers.

Sex, age, residence

CAMPAIGN ON ACCELERATED REDUCTION OF MATERNAL, NEWBORN AND CHILD MORTALITY IN AFRICA(CARRMA)

 to trigger concerted and increased action towards improving maternal and newborn health and survival across the continent. As such, CARMMA is not a new initiative; rather, it is derived from the key priority areas enshrined in the AU Policy Framework for the promotion of Sexual and Reproductive Health and Rights in Africa (2005) and the Maputo Plan of Action (2006).

availability and use of universally accessible quality health services, including those related to sexual and reproductive health that are critical for the reduction of maternal mortality. The focus is not to develop new strategies and plans, but to ensure coordination and effective implementation of existing ones. CARMMA aims to renew and strengthen efforts to save the lives of women who should not have to die while giving life. CARMMA believes in ensuring accountability: every single loss of a mother’s or child’s life should be reported.

HEALTH PROMOTION- National Health Plan(1994)

The principal tenets of the policy on health promotion include the following:

Health promotion is central to the success of primary health care.

Within primary health care the role of health promotion should encompass responsibility for community participation, community development, intersectoral development, education, mass media campaigns and disease prevention and health promotion in specific areas such as women's health, HIV/AIDS, adolescent health etc.

Health promotion requires the skills of a multi-disciplinary team of workers from many different sectors e.g. teachers, drama specialists, workers, community organizers, advertisers, health workers etc.

The health sector has adopted a 10 Point Plan for 2009-2014, which consists of the following priorities:

i. Provision of Strategic leadership and creation of a Social Compact for better health outcomes;

ii. Implementation of a National Health Insurance Plan (NHI);

iii. Improving Quality of Health Services;

iv. Overhauling the health care system and improve its management;

v. Improving Human Resources Planning, Development and Management;

vi. Revitalization of physical infrastructure;

vii. Accelerated implementation of HIV & AIDS and Sexually Transmitted Infections National Strategic Plan 2007-11 and increase focus on TB and other communicable diseases;

viii. Mass mobilization for better health for the population;

ix. Review of the Drug Policy;

x. Strengthening Research and Development

THE 10 POINT PLAN (2009-14)

Policy - Strategic Plan for Maternal, Newborn, Child and Women’s Health (MNCWH) and Nutrition in South AfricaGoal: To reduce the maternal mortality ratio and neonatal, infant and child mortality rates by at least 10% by 2016· To empower women, and to ensure universal access to reproductive health services· To improve the nutritional status of all mothers and children.Strategies:Strategy 1: Address inequity and social determinants of healthStrategy 2: Develop a comprehensive and coordinated framework for MNCWH & Nutrition service deliveryStrategy 3: Strengthen community-based MNCWH & Nutrition interventionsStrategy 4: Strengthen provision of MNCWH & Nutrition services at PHC and district levelsStrategy 5: Strengthen delivery of MNCWH & Nutrition services at district hospital levelStrategy 6: Strengthen the capacity of the health system to support the provision of MNCWH & Nutrition servicesStrategy 7: Strengthen human resource capacity for delivery of MNCWH & Nutrition servicesStrategy 8: Strengthen systems for monitoring and evaluation of MNCWH & Nutrition interventions and outcomes

INDICATOR CURRENT STATUS TARGET YEAR

Maternal Mortality Ratio

310 per 100,000 live births (2008)

270 per 100,000 live births

2014

Neonatal mortality rate

14 per 1000 per live births

12 per 1000 live births

2014

Infant mortality rate

40 per 1000 live births

36 per 1000 live births

2014

Under-5 mortality rate

56 per 1000 live births

50 per 1000 live births

2014

ABORTION POLICY:

Abortion in South Africa was legal only under very limited circumstances until 1 February 1997, when the Choice on Termination of Pregnancy Act (Act 92 of 1996) came into force, providing ABORTION on demand for a variety of cases.Under the new policy, women have the right to abortion on request during the first 12 weeks of gestation, to protect the health and well-being of the mother or fetus and for reasons of rape/incest between 13-20 weeks (with approval of one physician), and after the 20th week if mother or fetus is at risk of harm (approved by two physicians or one physician and a midwife)\An amendment of the CTOP in 2008 increased access to abortion care by further decentralizing control of facility licensing to the provincial level and expanding provider cadres to include trained nurses  National Abortion Care Programme (NACP) in 1998, which expanded high-quality abortion care services to public clinics and health centersDecline in Abortion-Related Mortality By the 2005-2007 period, annual abortion-related deaths accounted for only 3.3% of all maternal deaths which was  32.69 deaths per 1,000 abortions in 1994

1. Historical Background: South African Migration policy before 1994:

Before 1994 the Govt. Of S.A had announced a policy related to” Aliens control act ” and it`s aim was to control the entry of Aliens into the country. The Aliens Control Act stated unambiguously that a person could only immigrate to South Africa if that persons habits of life is suited to the requirements of South Africa. The foreign worker appointed under the agreement as contact base for limited two year and after end of their decided month again send their country

Foreign workers were not allowed to bring in their families while in South Africa and their movement was restricted to the area of work. These workers were undocumented migrants and severely restricted and without a doubt a source of cheap labour for the mines and farms.

Migration Policy In South Africa

2. Migration to South Africa post-1994

After 1994 the pattern of migration the government of S. Africa changed dramatically and by 1995 the New South African government had lifted most of the aforementioned restrictions. In 1994, the Department of Home Affairs (DHA) announced that unskilled or semi-skilled immigrants would not be permitted to work in SA.

Currently, the largest number of migrants entering South Africa is from other African countries whether they are refugees as defined by the UN Refugee Convention, forced or economic migrants or simply job-seekers. As South Africa is perceived by many to be economically prosperous, at a time when European asylum policies are becoming more and more restrictive, South Africa is viewed almost as the only answer.

NET MIGRATION IN SOUTH AFRICA: 1990-2000

Year Immigration

Emigration Net Migration

1990 14661 4694 9967

1991 12245 4153 8092

1992 9262 4181 5081

1993 9996 8152 1844

1994 6398 10235 -3837

Year Immigration

Emigration Net Migration

1995 5064 8725 -3661

1996 5351 10347 -4996

1997 4188 8943 -4755

1998 4371 8276 -3905

1999 3669 8487 -4818

2000 3028 10280 -7252

Before 1994: After-1994

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Immigration:-

•International migration important for development of a country. Both sending and receiving countries benefit from migration.

SA to take into account skilled, semi-skilled and other categories of migrants.

At the moment the focus is more on skilled migration and no provision for low and semi-skilled migration and yet it is an important use these areas are sometimes seen as areas of concern with potential to create tensions between citizens and non-citizens

Emigration:-Need to look at the skills base that SA is loosing to other countries as this will assist in developing a balanced migration policy taking into account both gains (brain gain from immigrants, remittances from S. African living abroad) and losses (through brain drain, lost revenue)

Refugee Protection

• South Africa is a signatory to UN and OAU Conventions on the protection of refugees

• It is important to note that there is no way of reversing these commitments but for the country to improve on these.

• In this regard, some of the proposal on the African National Congress Peace and Stability document proposing reducing rights for asylum seekers are concerning and need to be in line with the International Relations sections which recognises the value SA plays in regional, continental and global stages

• Current practice and proposals to limit rights of asylum seekers concerning

Purpose of the Migration Policy

• In developing a migration policy, it is important for South Africa to clearly define what the country wants to achieve with it.

• For instance, questions related to this include: is it aimed only at international migration or includes local migration?

• Our understand is that Migration Policy will help to guide the SA government to manage international migration into South Africa but also address issues related to emigration by South Africans.

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THANK YOU