The Mail & Guardian and Save the Children South Africa hosted a Critical Thinking Forum in Johannesburg this week in which discussions concerned access to education and the provision of healthcare for children, in the context of the 2030 Sustainable Development Agenda.
Xolani Gwala, journalist, television presenter and radio DJ, was the moderator of a government panel that consisted of Khulekani Mathe, programme head for planning at the department of planning, monitoring, and evaluation; Carol Nuga-Deliwe, chief director of strategic planning, research, and co-ordination at the department of basic education; and Dr Yogan Pillay, deputy director-general at the department of health.
Gwala questioned the perception that there is a lack of co-ordination between government departments around the outcomes of the Millennium Development Goals (MDGs) in South Africa.
Mathe responded: “The MDGs present government with clear focus areas. Supplementing that are the Social Development Goals (SDGs) that make the goals clear that all role players need to fulfil. I feel that we have done reasonably well in terms of access to education and the health indicators. Despite the challenges that exist, there are signs of the country turning the corner. The big question is around the quality of the measures taken. Government departments are designed in silos and struggling to work together. This makes the quality discussion a more difficult one to crack.”
Nuga-Deliwe said that there has been a huge improvement in the education and healthcare sectors over the past two decades.
“We know the situation in these sectors and can see how far we have come. There is a certain amount of adherence to the National Development Plan (NDP) in terms of the outcomes achieved. The question is whether the institutional mechanisms are in place that make it more efficient to implement policies? This has been the real challenge. Integrating the SDGs into the NDP will not be a problem. But we need to translate how this is internalised and transact that in institutions for the public good.”
It is not always clear why the government is still struggling to achieve outcomes when the goals are so clear, the speakers said.
“There is concern around capacity and co-ordination at a high level. We know that large systems are not necessarily the most efficient, irrespective of whether they fall in[to] the public or private sectors. So we need to get these systems to be more efficient and work better with communities. But despite the challenges, there are schools performing well. We need to learn from them and see how to translate those successes into the larger systems,” said Pillay.
He said healthcare presents an equally difficult challenge: “Commentators call the SDGs senseless, dreamy, and garbled. And with more than 160 targets, they might be right. But with that being said, we know what needs to be achieved through the NDP. We know what our baselines are in health. But with the MDGs and SDGs having different targets, we need to agree on a set of goals and remain committed to achieving them. For us, the key thing is to make sure people do not get sick. We need to focus on preventable illnesses.”
Mathe believes that the issues are simple but that funds are the challenge. “It is not like South Africa has some sort of stash of cash that will appear next year. The reality is that development has to happen within a constrained resource envelope. Our economy is not growing, so we have to look at improving efficiencies. Unfortunately, there is a great deal of wastage in our system from procurement all the way through to the top.”
Increased efficiency may present a challenge for education, with more than 28 000 schools in South Africa, but Nuga-Deliwe said: “It is not difficult at all. We need to align ourselves, diagnose the weakness in education and all other issues. As a sector, we have to internalise and work towards achieving these outcomes. If we cannot do something as simple as this, then we really should not be working in this industry.”
Using legislative muscle
For Pillay, an important intervention like exclusive breastfeeding can benefit from more legislative intervention.
“While government can push, more work is also required from a societal level. We need employers and public places to increase areas where mothers can breastfeed their children. At Kalafong Hospital (in Pretoria) for example, we have a world-class breastfeeding programme that goes from antenatal to postnatal. So we need to be more agile and scale up such interventions,” he said.
Mathe said that the public and private sectors working together requires a degree of humility: “Both sides need to understand the different sets of challenges that exist, the constraints, and must work accordingly. Government is open to working with civil society on sustainable development plans. We just need to collectively understand the reality of the market and act in a way that improves the lives of our children.”