Health and education closely entwined

At the Mail & Guardian and Save the Children South Africa Critical Thinking Forum in Johannesburg this week, discussions focused on whether role players in the South African market are delivering on their promise to ensure the successful implementation of the 2030 Agenda for Sustainable Development. The spotlight was on the provision of education and healthcare to children.

Well-known journalist and media personality Xolani Gwala was the moderator for the evening.

“No child should be left behind. So while we are proud of South Africa, are we building a country that our children will be proud of? Are we confident that the future we are building for our children is one that is best suited to their needs?” he said.

Independent researcher Dr Kristina Bentley provided a review of research findings on the implementation of the Social Development Goals (SDGs). This research was commissioned by Save the Children South Africa.


“We were tasked to do a three-fold report. First, it would craft the contribution of South Africa to the Save the Children global report on sustainability. Secondly, it would provide guidance to the Save the Children South Africa advocacy programme. And finally, the research investigated how the National Development Plan (NDP) is integrated and aligned with the vision for 2030,” she said.

According to Bentley, the Millennium Development Goals (MDGs) are very clear in their objectives. 

These are largely about access and are easy to quantify. On the other hand, the SDGs are much greater in number and more complicated in terms of their holistic vision of development. From a qualitative perspective, this makes the SDGs much more difficult to measure.

“In carrying out the research, we focused on two things. On the one hand, we examined the SDGs as they related to the quality of education and on the other, how they related to the quality of healthcare, in particular around the preventable deaths for children under five years old. Globally, this is a good indicator of the state of healthcare in a country. As such, the intention was not to draw out individual SDGs but rather look at them as interdependent upon each other. In South Africa, there has been a major shift from access to quality in the development agenda. Unfortunately, the reality is that access is still not ideal, particularly when it comes to children with disabilities and them receiving quality education.”

Taking responsibility

For her, there is a shifting of institutional responsibility around children’s rights and education. On the healthcare side, she pointed out, MDG 4 focuses on reducing the mortality rate. And while it is unclear the extent to which the country has met this already, she feels that we might be closer than many think. With MDG 3 paying much more attention to higher standards focused on quality of healthcare, these two goals and their associated policies address HIV, pneumonia, and diarrhoea, which are the major diseases impacting on children.

“Our research shows that advocacy around exclusive breastfeeding for first six months of child’s life is the most important area to focus on. This might sound like a deceptively simple solution. However, mothers and healthcare professionals need to understand the importance of this message. Breastfeeding is difficult. It is not only time-consuming, but mothers are battling social issues when breastfeeding in public. 

Without treating the matter as a public health issue, the country will not be able to get exclusive breastfeeding to take root. Our research sample shows that it is currently sitting at 8%, so there clearly is a lot more work to be done in this regard.”

Dual standards

Concerning education, Bentley said that the country has a dual system in place.

“The top 25% of our schools perform on a standard that is comparable to the best in the world. Unfortunately, the majority of children receive primary education that simply does not prepare them for the secondary level of education. This creates a problem of learner retention and there is a high drop-out rate in high school as a result.”

Sanitation at schools

Preceding both healthcare and education is sanitation, said Bentley. “If children do not have a place to wash their hands after going to the toilet, they are far more vulnerable to disease. They are likely to get sick and not attend school. So the question should be on how do we close the gap in this dual system of education and resolve such a basic issue? 

School infrastructure is a national problem and already the focus of quite a lot of advocacy. Sanitation is possibly the most accessible aspect of the problem. By addressing this, we can improve both health and education aspects of the country.”

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