Population policy south africa
policy of south africa
Published on: Mar 4, 2016
Transcripts - Population policy south africa
FLOW OF PRESENTATION:
NEED FOR AN EXPLICIT POPULATION POLICY
PAST POLICY AND PLANNING
THE CURRENT PARADIGM
FERTILITY & CONTRACEPTION
MORTALITY & MORBIDITY
(MNCWH) & NUTRITION
GOALS & OBJECTIVES
The population of South Africa -53,139,528
0.73% of the total world population.
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
Focus on Sustainable human development- Population as the driving force + ultimate
Improving education and health conditions;
promoting sexual and reproductive health (including family planning) and reproductive
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
MAJOR NATIONAL POPULATION CONCERNS-MAJOR NATIONAL POPULATION CONCERNS-
1.the pressure of the interaction of population, production and consumption patterns on
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
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 causes
6.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
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
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.
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
Unintended pregnancies- 39% (among 49.1 mn pregnancies in 2008)
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
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.
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
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
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
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 Africa
To reduce the maternal mortality ratio and neonatal, infant and child mortality rates by at least 10% by
· To empower women, and to ensure universal access to reproductive health services
· To improve the nutritional status of all mothers and children.
Strategy 1: Address inequity and social determinants of health
Strategy 2: Develop a comprehensive and coordinated framework for MNCWH & Nutrition service
Strategy 3: Strengthen community-based MNCWH & Nutrition interventions
Strategy 4: Strengthen provision of MNCWH & Nutrition services at PHC and district levels
Strategy 5: Strengthen delivery of MNCWH & Nutrition services at district hospital level
Strategy 6: Strengthen the capacity of the health system to support the provision of MNCWH &
Strategy 7: Strengthen human resource capacity for delivery of MNCWH & Nutrition services
Strategy 8: Strengthen systems for monitoring and evaluation of MNCWH & Nutrition interventions
310 per 100,000
live births (2008)
270 per 100,000
14 per 1000 per
12 per 1000 live
40 per 1000 live
36 per 1000 live
56 per 1000 live
50 per 1000 live
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
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 centers
Decline 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 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
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
1990 14661 4694 9967
1991 12245 4153 8092
1992 9262 4181 5081
1993 9996 8152 1844
1994 6398 10235 -3837
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
•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-
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)
• 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.