MONITORING CHILD WELL-BEING EDITED BY ANDREW DAWES, RACHEL BRAY & AMELIA VAN DER MERWE A SOUTH AFRICAN RIGHTS-BASED APPROACH CHILD INDICATORS Free download from www.hsrcpress.ac.za Published by HSRC Press Private Bag X9182, Cape Town, 8000, South Africa www.hsrcpress.ac.za First published 2007 ISBN 978-0-7969-2177-2 © 2007 Human Sciences Research Council The views expressed in this publication are those of the authors. They do not necessarily reflect the views or policies of the Human Sciences Research Council (‘the Council’) or indicate that the Council endorses the views of the authors. In quoting from this publication, readers are advised to attribute the source of the information to the individual author concerned and not to the Council. Copy editing by Lee Smith Te xt design and typesetting by Christabel Hardacre Cover design by FUEL Design Print management by comPress Distributed in Africa by Blue Weaver Te l: +27 (0) 21 701 4477; Fax: +27 (0) 21 701 7302 www.oneworldbooks.com Distributed in Europe and the United Kingdom by Eurospan Distribution Services (EDS) Te l: +44 (0) 20 7240 0856; Fax: +44 (0) 20 7379 0609 www.eurospangroup.com/bookstore Distributed in North America by Independent Publishers Group (IPG) Call toll-free: (800) 888 4741; Fax: +1 (312) 337 5985 www.ipgbook.com Free download from www.hsrcpress.ac.za Contents Ta bles and figures vi Foreword vii Preface ix Acknowledgements xix Acronyms and abbreviations xxi PART 1 Rationales for indicator development SECTION I Concepts and contexts 1. Monitoring the well-being of children: historical and conceptual foundations 5 Rachel Bray and Andrew Dawes 2. A rights-based approach to monitoring the well-being of children in South Africa 29 Rachel Bray and Andrew Dawes 3. Conceptualising, defining and measuring child poverty in South Africa: an argument for a multidimensional approach 53 Michael Noble, Gemma Wright and Lucie Cluver 4. Neighbourhood indicators: monitoring child rights and well-being at small-area level 73 Catherine L. Ward SECTION II Child survival and health domain 5. Monitoring child health 93 Haroon Saloojee 6. Monitoring child and adolescent mental health, risk behaviour and substance use 111 Alan J. Flisher 7. Monitoring child unintentional and violence-related morbidity and mortality 129 Amelia van der Merwe and Andrew Dawes Free download from www.hsrcpress.ac.za SECTION III Education and development domain 8. Monitoring children's rights to education 147 Linda Chisholm 9. Early childhood development and the home-care environment in the pre-school years 159 Linda Biersteker and Jane Kvalsvig 10. Monitoring childhood disability 191 Marguerite Schneider and Gillian Saloojee 11. Monitoring specific difficulties of learning 213 David Donald SECTION IV Child protection domain 12. Monitoring the well-being of street children from a rights perspective 233 Catherine L. Ward 13. Monitoring the worst forms of child labour, trafficking and child commercial sexual exploitation 247 Lucie Cluver, Rachel Bray and Andrew Dawes 14. Monitoring child abuse and neglect 269 Andrew Dawes and Mihloti Mushwana 15. Monitoring the situation of children in statutory care 293 Jackie Loffell 16. Monitoring children in conflict with the law 329 Lukas Muntingh 17. A monitoring dilemma: orphans and children made vulnerable by HIV/AIDS 359 Andrew Dawes, Amelia van der Merwe and René Brandt PART 2 The indicators Neighbourhood indicators 373 Indicators for monitoring child health 379 Indicators for monitoring child and adolescent mental health 393 Indicators for monitoring child injury morbidity and mortality 401 Education indicators 413 Indicators for monitoring early childhood development 419 Indicators for monitoring childhood disability 445 Indicators for monitoring specific difficulties of learning 451 Free download from www.hsrcpress.ac.za Indicators for monitoring street children 455 Indicators for monitoring child labour, trafficking and commercial sexual exploitation 461 Indicators for monitoring child abuse and neglect 469 Indicators for monitoring children in statutory care 487 Indicators for monitoring children in conflict with the law 503 Indicators for monitoring orphans and children made vulnerable by HIV/AIDS 527 Appendices Appendix 1 Convention on the Rights of the Child 537 Appendix 2 South African Constitution: the Bill of Rights 554 Appendix 3 African Charter on the Rights and Welfare of the Child 566 Appendix 4 Key terms associated with indicators and monitoring 580 Appendix 5 Characteristics of effective indicators for child rights and well-being 582 Appendix 6 Summary of South African data on child health indicators 583 Appendix 7 South African EMIS indicator domains 587 Appendix 8 Indicators for juvenile justice as developed by UNICEF 592 Appendix 9 UNICEF recommended indicators for orphans and other children made vulnerable by HIV/AIDS 593 References 595 Contributors 635 Index 639 Free download from www.hsrcpress.ac.za Tables and figures Tables Table 1.1 Goals for child well-being and well-becoming, and their indicators 26 Table 2.1 Millennium Development Goals and indicators that apply to child rights and well-being 30 Table 5.1 Millennium Development Goals and indicators that apply to child health 95 Table 5.2 Infant, under-five mortality and neonatal mortality rates, South Africa, 1998 97 Table 5.3 Predicted changes in South African infant mortality rates, 1998–2002 97 Table 5.4 Leading underlying causes of death among children aged 0–14 years, South Africa, 1997–2001 (expressed as percentage of all deaths) 98 Table 5.5 The anthropometric status of children aged 1–9 years, South Africa, 1999 101 Table 5.6 South African child health-related data sources 105 Table 8.1 Adapting the UNESCO indicator approach 158 Table 9.1 Articles of the South African Constitution (SAC), CRC and AC relating to key rights domains 161 Figures Figure 2.1 A conceptual framework for a rights-based approach to monitoring child well-being 45 Figure 3.1 A multidimensional conceptualisation of child poverty 61 Figure 9.1 The uneven pace of child development with rapid progress at different times in different domains 171 Figure 15.1 Children’s movement into care 301 Figure 15.2 Processes and outcomes following needs and risk assessment 302 Figure 16.1 Overview of child rights architecture 331 vi • monitoring child well-being Free download from www.hsrcpress.ac.za Foreword South Africa has a proud history when it comes to the struggle for child rights. It was young black South Africans, many of them children, who played a leading role in the country’s liberation. The denial of children’s rights under apartheid, and the brutal treatment of those who resisted, spawned a deep child rights consciousness in those who were to make the new state, as well as a commitment to putting children first so as to ensure their well-being and positive development. The South African Bill of Rights is unique in granting children in South Africa specific rights that are aligned with international instruments such as the United Nations Convention on the Rights of the Child (CRC) and the African Charter on the Rights and Welfare of the Child (AC). Law reform in the interests of children has followed these developments and Save the Children has played its part in supporting these developments. As this piece is written, the first section of the new Children’s Act has been approved by Parliament, and subsequent sections over which provinces have authority will now be dealt with by the House of Provinces – the nation’s second legislative chamber. All these developments are to be celebrated. However, it remains the case, as this book will show, that the majority of children in South Africa still face serious threats to their survival, health, development and participation. More than 50 per cent live in poverty, and infant mortality is reversing past gains as AIDS takes its toll. Significant numbers of children are affected by abuse and violence, and services intended to assist them are stretched beyond the limit. In spite of massive injections of funding, the education system still fails to produce good outcomes in areas such as literacy and mathematics – both key areas for child and national development. It is not sufficient for children’s rights to be legislated. We need to know how well the country is doing in meeting its obligations to children. That requires indicators and a system for monitoring the situation of children that is rigorous, rights oriented and evidence-based. Both the CRC and the AC require countries to report in this regard but, more important than international surveillance, the country needs to monitor its progress in regard to the well-being and development of children. Indeed, this has been a major focus of the South African government’s call for improved monitoring of both the situation of children and of service delivery. This volume is dedicated to supporting that process. It provides a framework for monitoring the situation of children, the quality of the environments in which they live and grow, as well as their access to services and their quality. Save the Children has supported the research and publication of this volume in partnership with the Child, Youth, Family and Social Development Research Programme of the Human Sciences Research Council of South Africa. It has been a long road over several years, with contributions from scholars, government stakeholders and many others. The system designed and presented here is unique foreword • vii Free download from www.hsrcpress.ac.za in going beyond monitoring child status or outcome. It is designed to monitor the performance of duty-bearers as well – a crucial component of a monitoring system that seeks to bring about change in children’s lives and development. This is a reference work. Unlike other multi-authored collections, the editors have ensured that the chapters are all aligned to the indicator framework presented in Chapter 2, making for a coherent system across all the domains covered in this comprehensive volume. Eva Carhall Regional Representative, Southern Africa Regional Office, Save the Children Sweden viii • monitoring child well-being Free download from www.hsrcpress.ac.za Preface Background Perhaps the first question to ask of a book of this nature is, why do it? The answer is simply that if we want to know how our children are doing and the extent to which our policies and interventions are making a difference to their well-being and outcomes, we need a conceptually grounded and evidence-based approach. South Africa has never had a consistent and comprehensive approach to monitoring the situation of children. The primary objective of the volume is to fill this gap. We set out with our many collaborators (see Acknowledgements) to develop a conceptual framework and recommendations for a comprehensive set of indicators for monitoring the well- being of children (including adolescents) 1 and to contribute to the development of reliable indicator data at all levels of government. Our approach is of course not the final word. Indeed, other conceptual frameworks exist from which we can learn and which can be compared with what we have developed here. The indicators we recommend are not fixed. Indicator systems are dynamic – they must respond to change in the policy and research environments as well as in society at large. Policy-making is an ideological business. People in government who develop policies and programmes are guided by the political ideologies of the day, whether these be neo-liberal, social democrat or socialist. The same applies of course when it comes to making law and policy for children and families. The United Nations Convention on the Rights of the Child (CRC – see Appendix 1 in this volume) is an unashamedly ideological instrument that seeks to change the way in which the world conceptualises childhood and the manner in which State Parties to the Convention provide for the survival, health, social security, protection and development of children. The very act of fixing the end of childhood at 18 years in the CRC and the South African Constitution is an ideological rather than a technical move. The many changes to law and policy for children in South Africa since the end of apartheid are the product of the strong child rights ideology that took root in the period following the Soweto youth uprising of 30 years ago. These changes were consolidated in the development of a National Programme of Action for children in the mid-1990s, the ratification of the CRC, and the inclusion of specific children’s rights in the Constitution. Most recently, the Children’s Act (No. 38 of 2005) and the associated Children’s Amendment Bill (No. 19 of 2006), and the Child Justice Bill (No. 49 of 2002), are examples of a legislative programme that foregrounds children’s rights and a particular ideology of childhood – an ideology that carries with it an image of what childhood should be like as well as provisions for the reciprocal obligations of the state in making this childhood possible (see chapters 1 and 2 in this volume). preface • ix Free download from www.hsrcpress.ac.za During the apartheid era, policies for children and conceptions of childhood were grounded in racist ideology. Notoriously, black children were considered to need far less support for development than white children – mainly because their capacities were regarded as inferior – hence the provision of inferior and separate education for black children. The post-apartheid constitutional order ensures the rights of all children to the same dignity and equality within a single approach to childhood. Enormous strides have been taken by government to improve children’s situation. This volume takes its ideological cue from the child rights ideology that is rooted in the South African Constitution, the CRC and the African Charter on the Rights and Welfare of the Child (AC – see Appendix 3 in this volume). In taking a rights-based approach we make clear that it is not just the status of children (or child outcomes) that is important to measure, but also the contexts within which children grow and develop. For it is only through looking carefully at how these contexts shape child outcomes that we learn where intervention is needed (where and how action should be taken). A key element of that context is the policy environment. As will be seen, the indicators developed for all the domains covered in the volume include both the policy environment and children’s developmental contexts. The timing of this initiative is important. We are a new democracy in rapid social and economic transition with many challenges for children and those who care for them – particularly in the spheres of education, poverty and the HIV/AIDS epidemic. These conditions will have a major impact on family and community well-being, and the ability of these structures to provide the basic conditions for child survival and the promotion of positive child outcomes. Under such conditions, data to inform targeted service and programme provision will become increasingly important. At the same time, the new political order has the potential to present far more developmental opportunities for children as systems of delivery are strengthened and developments in health, education and social services proceed. It is therefore equally important to monitor whether these initiatives are reaching children and households and the extent to which the situation is improving as desired in policy goals. Finally, Cabinet has charged all levels of government with monitoring policy and delivery. In our view, the monitoring system must ensure that the state and its officers are held accountable for responsibilities as duty-bearers in regard to the legislative and policy environment they have constructed for children. In this regard, we require indicators and an approach to monitoring the situation of children that can ascertain whether initiatives of the state are: • Effective – they have the outcomes intended, promote children’s rights in line with the Constitution and other relevant instruments, and are doing more good than harm; • Efficient – are using limited public resources to best effect; and •Service orientated – to meet citizens’ needs and expectations for children’s well- being and development. This volume seeks to contribute to such a venture. x • monitoring child well-being Free download from www.hsrcpress.ac.za [...]... for monitoring children’s rights in South Africa That would be a task for child rights lawyers and related specialists, which we are not Rather, it is well-being that is the primary focus, and the volume presents a rights-based approach to monitoring child well-being Where the rights base enters the picture is when indicators are developed to monitor government’s delivery of services to which children... comprehensive approach to monitoring children in statutory care The statutory care indicators are designed both to track the numbers of children involved, and the quality of services and care they receive This section of the volume draws strongly on the Child Justice and the Children’s Act (No 38 of 2005), and the associated Children’s Amendment Bill (No 19 of 2006) to inform indicators for monitoring the performance... take into account the need to measure child outcomes as well as the contexts that support or challenge children’s development, and the provisions for children through law, policy and, ultimately, services Type 1: Child status indicators These measure the status of the child Examples include child mortality, reading ability, immunisation status, and whether the child has been a victim of abuse Type... Equality CHAOS Confusion, Hubbub and Order Scale CHILD Child Health Indicators of Life and Development CIS Canadian Incidence Study CJB Child Justice Bill CLAP Child Labour Action Programme CPA Criminal Procedure Act CPR Child Protection Register CRC UN Convention on the Rights of the Child CRS Census Replacement Survey CSA Correctional Services Act CSG Child Support Grant DAP developmentally appropriate... of a European Union (EU) system for monitoring children’s well-being and well-becoming that draws on the CRC (Bradshaw et al., 2005) Apart from the use of the CRC to hold governments to account on the situation of their children, at a country level, monitoring initiatives seek to provide data to influence policy development Without good data on the well-being of children and the quality of their developmental... foundation for the volume It has two main components First, a brief history of attempts to establish a child well-being monitoring system for South Africa is outlined Thereafter, the conceptual foundations that underpin child well-being and rights monitoring systems are reviewed Monitoring the situation of children in South Africa: from past to present The apartheid years Free download from www.hsrcpress.ac.za... dynamics and did not have a significant child component However, referring to malnutrition, Wilson and Ramphele (1989) noted that there had been no nationally co-ordinated reports on this threat to child well-being for over 20 years – this despite many independent scholarly reports attesting to the seriousness of the problem in 6 • monitoring child well-being black children For example, the inquiry reported... 6–14-year-old children [Bray, 2002]) These gaps remain because there is no state policy (or practice) to routinely survey issues of specific importance to child development outcomes and child monitoring Moreover, South Africa lacks both an integrated child information system and the data collection strategies necessary to supply reasonably accurate and sufficiently disaggregated data on children The children’s... State obligation (see Chapter 2 in this volume for a discussion of child rights monitoring in relation to the CRC) The ORC has recently undergone restructuring, and there are currently proposals under discussion for improving the oversight of children’s rights It is proposed that 8 • monitoring child well-being a National Advisory Council on Children’s Rights is established in the ORC with structures to... dearth of child- focused researchers in the country (Richter & Dawes, in press), the climate is currently more favourable than it was ten years ago Since that time, we have seen an increase in research on relevant aspects of child well-being and child rights Several separate but complementary initiatives relating to monitoring children’s rights are under way, including the Government-Wide Monitoring . indicators: monitoring child rights and well-being at small-area level 73 Catherine L. Ward SECTION II Child survival and health domain 5. Monitoring child. 373 Indicators for monitoring child health 379 Indicators for monitoring child and adolescent mental health 393 Indicators for monitoring child injury morbidity