Yes, things are getting better in SA

Since the dawn of democracy, South Africa has made remarkable progress in improving the lives of its citizens. Health and education have been among the major priorities of government in addressing inequality, unemployment and poverty. So how have we done?

The minister of health recently conducted hearings on the National Health Insurance (NHI) green paper.

The NHI is a financing system that will ensure all citizens are provided with essential healthcare, regardless of their employment status or ability to make a direct monetary contribution to the NHI Fund.

For the first time since 1994, the empirical evidence shows that South Africa is making progress in improving the health status of its people.

Statistics South Africa and the Actuarial Society of South Africa note a gradual improvement in life expectancy from 2006 onwards, after a decline from 2001 to 2005. This could be a result of government measures to combat communicable diseases such as Aids and tuberculosis (TB).


The evidence shows a reduction in child mortality, with deaths from malnutrition and preventable diseases substantially reduced.

According to the Medical Research Council's rapid mortality surveillance report, the improvements in the infant and child mortality rate are also thanks to the wider availability of antiretroviral treatment and the increased prevention of mother-to-child HIV transmission.

The health department has the goal of improving child health and reducing infant and under-five mortality and morbidity. South Africa has done well in increasing the immunisation of infants under a year old, going from 63% in 1998 to 90.8% in 2011.

In 2005, South Africa was one of only four countries in the world with an under-five mortality rate higher than the 1990 baseline for the millennium development goals.

All models and data sources agree that over the past five years South Africa has achieved one of the fastest rates of child mortality reduction in the world. This is likely the result of fewer Aids deaths by the scaling up of programmes to prevent mother-to-child transmission and the expanded roll-out of antiretroviral therapy.

The government is committed to improving women's health and to reducing maternal and neonatal mortality and morbidity. The high rate of maternal mortality in South Africa is largely attributable to Aids-related infections.

Health
The government and the multisectoral South African National Aids Council have been working hard to minimise the spread of HIV through testing and counselling campaigns, the promotion of male and female condoms and medical male circumcision, as well as driving social change to promote health-seeking behaviour.

The South African research community is recognised in the global search for solutions to the epidemic.

There has been a stabilisation of the number of people living with HIV in South Africa, which had risen all through the 1990s. Prevalence among the youth levelled off between 2009 and 2012; South Africa will probably meet the millennium development goals targets here.

The national TB cure rate in South Africa has improved gradually. In 2010, for the first time, the rate passed the 70% mark, reaching 73% the following year. Case notification for all forms of TB has increased over the past decade, from 188 695 in 2001 to 389 974 in 2011.

The number of people defaulting on TB treatment declined from 13% in 2000 to 8% in 2011 – and to 6.1% in 2012.

Despite this improvement, there has been an uneven performance across districts. The data shows some districts with TB cure rates of less than 50%. These require sustained attention by the government, civil society and development partners.

Education
In education, major strides have been made both at early childhood development level and in reducing the number of people with no schooling. We have increased the number of citizens achieving matric. In the current political cycle, education is the first of five priorities and 12 outcomes.

Over time, the government has turned around dysfunctional and poorly performing schools by improving systems of accountability and service delivery at district, provincial and national level.

Early childhood development aims to help every child gain the knowledge, skills, attitudes and behaviours for life, learning, schooling and work.

The department of basic education is making progress in ensuring that access to Grade R is universal and that it provides quality programmes to compensate for socioeconomic deprivation and low rates of family literacy.

The percentage of children up to the age of four in early childhood development facilities increased by 18.4% between 2007 and 2011; for five-year-olds, the increase was 24.6% over the same period. The upward trend may be attributed to the implementation of the national integrated plan for early childhood development, developed by the departments of social development and basic education.

The government instituted measures to reduce pupil-teacher ratios, in line with international standards. The pupil-teacher ratio has stabilised over time, hovering at around 30:1, the figure in 2010, but remains a challenge

The government is committed to improving the quality of teaching and learning, with a focus on literacy and numeracy and improving performance in mathematics and science. This entails increasing access to quality materials and providing competent and professional teachers.

It also aims to increase the number of national senior certificate passes with mathematics. From 2008, the number of maths passes declined, until 2012, when there was a marginal increase of about 17 937 passes over the prior year.

Since maths literacy was introduced as a matric exam subject, there have been more pupils passing this subject than mathematics. Obviously, this is a cause for concern: mainstream maths is essential for admission into the engineering, natural and economic sciences.

This unintended policy consequence, often pursued by teachers and learners desperate to increase pass rate percentages, has long-term effects that require attention.

Over the years, the matric pass rate has steadily increased. The 2012 pass rate surpassed that of 2003, the highest since 1994. But the quality of matric, as indicated by the number of bachelor passes, is not increasing as rapidly as the overall matric pass rate.

Development Indicators 2012 (sixth edition) shows that adult literacy is increasing and that the percentage of university graduates with degrees in science, engineering and technology is picking up after a decline between 2008 and 2010.

More children are at school, learning. Black children now have access to quality basic education and many are taking up the post-matric training opportunities that have become available.

All in all, indications are that, as we move towards celebrating 20 years of democracy, South Africa is a better place today compared with 20 years ago.

Busani Ngcaweni works in the office of the deputy president. The views expressed here are his own.

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