DRAFT THE DEVELOPMENT OF A SPATIAL FRAMEWORK TO IMPROVE SERVICE DELIVERY TO ORPHANS AND OTHER CHILDREN MADE VULNERABLE BY HIV/AIDS IN KWAZULU-,

Susan Erskine Research Fellow at the Health Economics and HIV/AIDS Research Division, based at the University of KwaZulu- Natal, South Africa

One of the most tragic consequences of the HIV/AIDS epidemic is the large number of children who become orphaned. Current approaches for delivering social services to these children and their caregivers are often haphazard, partly because those responsible for service delivery lack the research data and analytical tools to understand the extent of the need for services. The project is driven by this need; to develop an understanding of orphans and other vulnerable children (OVC), where they are, how best to reach them and who is currently working for their welfare.

GIS was used to develop a spatial framework for the management of support to OVC in KwaZulu-Natal (KZN), South Africa. This framework is capable of showing the likely spatial distribution of OVC, interacts with a database of organisations supporting OVC and makes use analytical and management tools to show spatially the varying levels of access children have to services and some of the obstacles they face in trying to gain access.

INTRODUCTION

One of the most tragic consequences of the HIV/AIDS epidemic in South Africa is the close to 2 million children who will become AIDS-orphans by 2015 (ASSA 2000 Model) and the countless others whose lives are made even more precarious as they or their family members encounter the epidemic. The devastating consequences for many children have been masked by the time-lag between the time of infection with the HI Virus and the onset of adult morbidity and eventual mortality and by the existence of traditional social security systems in which extended families routinely take care of children as the need arises. However, the scale of adult morbidity and mortality has reached such proportions that in many areas familial obligations and community support systems are fast reaching saturation point.

Current state and Non-governmental Organisation (NGO) approaches for the delivery of social services to these children and their caregivers are often haphazard, resulting in a number of children being missed. This is partly because those responsible for meeting the needs of children often lack the research data and analytical tools which could provide them with an understanding of the scale and extent of the need for services within a target area, both now and into the future; “As things stand, we do not have sufficiently developed and integrated child information systems and data collection strategies to permit reasonably accurate and sufficiently disaggregated descriptions of the state of South African Children” (Dawes, Richter and Bray, no date). This is problematic because “…orphan need will almost always outstrip available resources…” (Kezaala and Bataringaya, 1998, pp 2). And because if the targeting of interventions is not based on accurate and appropriate information it “… tends to happen by chance, or is subjected to political decision thereby defeating the humanitarian intent of reaching out to the most needy…” (Kezaala and Bataringaya, 1998, pp 2).

The project is driven by this gap in service delivery allocation. It aims to begin to fill the gap by developing an understanding of the rapidly growing number of orphans and other vulnerable children (OVC) within KZN, including where they are, how best they can be reached and who is currently working for their welfare.

An overview of AIDS in KwaZulu-Natal

Within KwaZulu-Natal (KZN) there is a large degree of variation in HIV prevalence rates. When the epidemic emerged in KZN in the early 1990s, the areas with the higher prevalence rates were associated with the major transport routes linking the provinces harbours with the rest of the sub-continent as well as areas of severe poverty. The epidemic is now so generalised that the effects of transport nodes and poverty is less pronounced. HIV prevalence rates throughout the province are high, ranging from 20% to 44% (figure 1 below).

Figure 1: HIV prevalence rates by Health District, KwaZulu-Natal

The KZN AIDS epidemic has not yet peaked and it is thought that at the height of the epidemic just over 1.8 million people will be infected by HIV. In the absence of effective treatment this will result in the premature death of 1.5 million adults over the following 6 years (ASSA 2000 Model) and an estimated 500 000 children who will lose one or both parents to AIDS.

CONCEPTUALISING THE SPATIAL FRAMEWORK

Why a spatial framework?

South Africa may not be as rich in spatial information as other parts of the world, but crucial baseline information such as that obtained in the Population Census and basic state service provision is available. However, for the most part these data sets remain largely unmapped, in their raw format and in isolation from each other and, therefore, have limited use as decision making tools. Our aim was to take the various levels of data and provide a framework in which they would interact and provide decision makers with useful information.

The motivation for using a spatial framework was simple. GIS has the capacity to link or integrate information that is difficult to associate other than spatially. GIS also allows decision makers to use combinations of mapped indicators to build and analyse new variables (as shown in figure 2 below). This is important because the concept of ‘child vulnerability’ has many dimensions and is therefore often best represented by a number of indicators. The flexibility of GIS, which allows users to select which elements of vulnerability they wish to consider in relation to other general information about the area, would overcome the inability of many current approaches to planning and implementing services that fail to consider the complexity or the geography of the OVC problem. We argue that without this holistic view, including demand or need and accessibility to existing services interventions, the targeting and distribution of support will remain inequitable with some areas remaining excluded. Ensuring decision makers have tools that enable them to visualise the distribution of OVC and a methodology for assessing the distribution of OVC support services in relation to the spatial pattern of need provides planners with a rational basis for locating additional OVC support.

Employment status of household head

Age appropriate education level

Water source

Economic

Dependency Ratio

Mother alive <15 years

Health care services

Reference grid

No. of children <15 years

Figure 2: Arrangements, relations and displays Note: The variables represented in the above figure were some of the indicators of child vulnerability selected from variables contained in the 2001 Population Census by delegates representing NGOs and the department of Education and Social Development at a Technical Consultation Meeting in April 2004.

The specifications of the framework

The spatial framework needed to provide two key sets of information; firstly, where are the children and how are they distributed throughout the province. OVC are considered to be a dynamic group and geographically mobile which makes them a particularly difficult group to track. Therefore, being able to pinpoint the exact location of any child at a particular point in time would be difficult and not especially useful. We decided to develop a profile of the province indicating the areas where OVC were most likely to occur based on a number of indicators of child (and household) vulnerability.

Secondly, all the current services providers needed to be mapped which required the spatial framework to interact with a purpose built database of organisations developed using ACCESS. A backdrop of basic infrastructure was used to enable later analysis of access assuming that roads and other transport routes would enhance access to services.

In order to be able to respond to a variety of management needs, the spatial framework needed to provide data at various spatial scales. This allows managers to consider only their area of operation or the broader context of the province. The basic demographic information from which areas of likely occurrence of OVC was drawn the 2001 South African Population Census. This data set was made available by Statistics South Africa in September 2003 and allows mapping to take place at a variety of scales, ranging from sub-place names (grouped enumerator areas) to the 11 district councils (see figure 3 below).

Figure 3: Differing spatial scales at which the 2001 South African Population Census can be mapped (Source: 2001 Census and EduAction)

Basic outputs and some practical applications

There are a number of indicators of child vulnerability and users could adapt the spatial framework to highlight variables of particular concern to them. An obvious starting point was to establish the number of children aged less than 15 years whose mother was no longer alive (see figure 4 below).

Figure 4: Percentage of children aged 0 – 14 years reporting in the 2001 Census that their own biological mothers were no longer alive (Source: 2001 Census and EduAction)

Our exploratorative research into child vulnerability found no universal standard or ‘vulnerability index’ such as the Human Development Index, yet poverty appeared to be a common denominator. Therefore a Socio-economic Deprivation Index was created using three criteria:  Economic Dependency Ratio. A measure of the number of dependents per employed person and the level of economic activity within the local population.  Average years of education obtained by adults. This indicator was selected because infant mortality and low educational status (particularly of women) are correlated.  Percentage of households with electricity used as an indication of service delivery within communities and economic circumstances.

Umkhanyakude DC

Amajuba Zululand DC DC

Umzinyathi DC Uthukela DC uThungulu DC

iLembe Umgungundlovu DC DC eThekwini Legend Sisonke District Councils DC Local Councils Ugu Socio-economic Index 0.04 - 0.26 (Least Deprived) DC 0.26 - 0.46 0.46 - 0.64 0.64 - 0.94 (Most Deprived)

Figure 5: Socio-economic Deprivation Index (Source: Census 2001 and EduAction)

Maps such as those created above can be analysed in conjunction with maps depicting the distribution of state services (primarily those delivered by departments of education, health and social development) and NGO services. For example in the figure below, NAFCI clinics (clinics involved in the National Adolescent Friendly Clinic Initiative), places of safety and youth skills training facilities have been highlighted.

ñ ñ|x

ñ|x |xñ ñ ñ ñ "M|x "Ax| ñ ñ "M|x ñx| ñ ñx| x| ñ|x Region x| ñx| ñx| ñ ñ|x ñ|x ñ |x ñ ñx| Midlañ nds ñ x| ñ Region |x ñ|x ñ ñ |x |x Õ ñ ñ ñ ñ'K |x ñ ñ|x"A ñ|x ñ ñx| ñ ñx| ñ ñ|x ñ 'K ñ|x ñ Õ ñx| x| x| ñ ñx| |x 'K|x ñ ñ|x |x |x ñ |x|x ñ x 'K Pietermñ aritzburg | ñ ñ|x'K |x |x Õñ|x ñ |x Durban Region "M'Kñ|x ñ|x Õñ Õx| Region x| ñ x| |x |x ñ x ñ ñ | Legend |x Õ NAFCI Clinics ñ|x ñ ñ ñ Magistrates Courts |x Welfare Institutions |x ñ ñ Õ|x "A Rehabilitation x| Children's Home 'K Place of Safety "M Skills Training National Roads

Figure 6: Government-based child and youth orientated service provision

A critical resource for many impoverished households is the money obtained through the social welfare system. Data obtained from the Department of Social Development in 2003 was plotted to highlight areas in which welfare support might be limited (figure 7a below) and this was overlayed with a map of representing poverty (figure 7b below).

Maputa # Maputa # # Ingwavuma # Ingwavuma Umkhanyakude DC # # Paulpietersburg Paulpietersburg

Madadeni Ubombo KZ Madadeni # Zululand Ubombo KZ # Vryheid # # # # # # # # DC # # Nongoma # Amajuba DC # # Hlabisa # Hlabisa Nqutu Ulundi Nqutu # # Region # # # # # # # # Kwamsane Umzinyathi Kwamsane Midlands # # Ladysmith # DC Region Nkandla Melmoth Ladysmith Nkandla Melmoth # # # # Tugela Ferry # Enseleni # Tugela Ferry # # Enseleni # # Uthukela # # # Richards Bay # uThungulu # DC # Richards Bay Estcourt # DC # Estcourt # # # # # # # # # Stanger iLembe Umgungundlov# u # Stanger # # DC # DC # # # # Pietermaritzburg # # # # # # # # Pietermaritzburg # Durban eThekwini # # # # Pinetown # # Region # # Durban # Pinetow# #n Metro Umlazi# Region Durban # # # # Umbum#bulu# Chatsworth Um#lazi Legend Umbumbulu # Chatsworth Number of Child Support and Foster Care Grants # Legend # # 1 - 2000 # Number of Child Support # 2000 - 6000 # # Umzinto # 6000 - 12000 Bhongweni and Foster Care Grants # Sisonke DC # Umzinto # # Bhongweni # 12000 - 20000 paid in May 2003 Ugu DC Izingolweni # 20000 - 34000 # # # 1 - 2000 # # # Izingolweni District Councils # 2000 - 6000 # # # Municipalities # 6000 - 12000 Poverty Index 0.04 - 0.26 (Least Poor) # 12000 - 20000 0.26 - 0.46 0.46 - 0.64 # 20000 - 34000 0.64 - 0.94 (Most Poor) National Roads

Figure 7a: Distribution of welfare grants paid monthly (2003) Figure 7b: Grants paid and general poverty

These figures could be used by the Department of Social Development when organising campaigns around grant literacy and uptake as well as those NGOs whose core business it is to facilitate access to child targeted grants. The figure below, which highlights access to Magisterial Courts (necessary to obtain documentation necessary for grant applications) should be analysed in conjunction with the above figures in order to help determine whether low grant uptake in some areas is a problem of access or information.

A

B

Figure 8: Access to Magistrates Courts

The green areas in the map indicate areas of greater accessibility, while those areas in red indicate areas where gaining access to a court house may be more difficult and resource intensive (both in terms of time and financial resources).

When considered in conjunction with figures 7a and 7b above it is easy to see that some of the areas of greatest need (as indicated by darker shading of brown, indicating high levels of poverty), marked ‘A’ on the map, coincide with areas of low grant uptake and appear to have low access to magisterial court houses. In other areas of the province, for example the area marked ‘B’ in figure 8 above, high need (assumed because of the poverty levels) and low grant uptake are not associated with poor access and therefore other possible variables (such as lack of information) would need to be considered.

NGOs play a critical role in providing services to OVC and their care givers and are more flexible in terms of their ability to respond to local needs. As of November 2004 the database contained detailed information on 274 agencies implementing child-related projects and programmes. Counselling, Training and Feeding Schemes were the most common projects implemented by NGOs (see figure 9 below).

Num ber of OVC Projects by Type

Training Street Shelter

School Bursaries Other

Medical Support

Home-based Care

Grant Aid

Fund Raising Fostering

Feeding Scheme Education

Daycare Centre

Counselling

Childrens Home

0 40 80 120 160 Number

Figure 9: Number of OVC Projects being implemented by Project Type

The bar chart (figure 10 below) and the map (figure 11) highlights how most of the projects are concentrated in three Local Council areas within KZN, namely the eThekwini Municipality, The Msunduzi and Hibiscus Coast. However this distribution of projects does not necessarily reflect the areas of greatest need. This does not in any way suggest that there is a surplus of services in anyone area of the province, indeed most NGOs indicated that they did not come close to meeting the demands for services in their areas of operation. Rather it highlights how many areas in KZN have limited or non-existent services, for example much of the Zululand Region.

Total support programmes for Orphans and Vulnerable Children (OVC) by Local Council Abaqulusi Dannhauser eDumbe Emnambithi-Ladysmith Endondakusuka Endumeni Ezingolweni Greater Kokstad Hibiscus Coast Hlabisa/ Impala Imbabazane Impendle Indaka Ingwe Jozini Kwa Sani Maphumulo Matatiele Mbonambi Mkhambathnini Mngeni Mooi Mpofana Msinga Mthonjaneni Mtubatuba Ndwedwe Newcastle Nkandla Nongoma Nquthu Ntambanana Okhahlamba Richmond The Big Five False Bay The KwaDukuza The Msunduzi Ubuhlebezwe Ulundi uMdoni Umhlabuyalingana uMhlathuze Umlalazi uMshwathi Umtshezi uMuziwabantu Umvoti Umzumbe uPhongolo Utrecht Vulamehlo

0 5 10 15 20 25 30 35

Number

Figure 10: Numbers of support programmes implemented by NGOs for OVC by Local Council(Note: eThekwini (Durban) , which has 104 projects has been excluded to enable a better comparison between areas where fewer projects are in operation.)

In#Ydumo Drop In Centre Manguzi Orphan Programme #Y Tholulwazi Uzivikele #Y Ntabayosinda OVC Programme Friends of Mosvold Hospital

#YIngwavuma Orphan Care Jozini Umhlabuyalingana

Sinothando Nezintandane #YOVC Project Lulisandla Kumtwana Orpha#Yn Care Project #Y Mduduziwethu OVC Care #Y Isiphephelo Sejuba HIV/AIDS Orphans Support Project Ubomb#Yo Drop-In Center #Y Makhanya Women's #Y Ubombo HIV Amajuba uPhongolo Orphanage Project Nakekelisizwe Network eDumbe Ubombo #YHIV/AIDS Project

Legend Christelike Maatskaplike DC Diens (CMD), Newcastle A#YIDS Action Team Ntababomvu Clinic Utrecht Child and Family Welfare Amajuba District Youth Council Salvation Army - Northern KZN - Abaqulusi project #Y Ekuseni Youth Development Centre St. Anthony's Children's Hom e Inkululeko Child Care Rosary Clinic Inkululeko Siyathuthuka-Orphan Project Umkhanyakude #Y Sekusile Youth Club Utrecht OVC Projects #Y#Y #Y Child Care Newcastle Crisis Centre #Y#Y #Y Siyathuthuka-Bhekisizwe Creche Them balihle Children's #Y Ma#Ydadeni Catholic Chruch #Y#Y Foster Parents Shelter Make It Better Programme, Child and Family Diversion Groups, Youth in Prison Welfare DC District Councils Newcastle Child and Family Welfare - Newcastle Abaqulusi Zululand Nongoma The Big Five Lethimpilo Youth Organisation Municipalities #Y False Bay Dannhauser DC Urban Areas Endumeni Vusimpilo Support Siphuthando and #YCare Project Drop In Centre Philani Drop In #Y Centre #Y Hlabisa/ Duduza Care Centre Nquthu Ulundi Isandla Sethu Impala Duduza Health Care Centre #Y Koningsdal Child and Ithembalesizwe Emnambithi- Drop In Centre Ladysmith Umzinyathi Youth#Y Care Centre #Y Mthonjaneni Community Resource Centre Mtubatuba Mpilonhle Drop Mthonjaneni Melmoth Network Amadlelo Aluhlaza Comm unity In Centre Thubalethu Preschoo P roject Child Care Based Or ganisation #Y DC ABS Construction-HIV/AIDS Orphaned project #Y Abasizi - Terminally ill Child and Family Welfare #Y#Y Melmoth HIV-A IDS Programmes Trust Mbonambi Society - Steadville #Y NGK Morester Children Home Nkandla #Y KwaZulu-Natal Help Ministers Institute and Ladysmith Emnambithi Mthonjaneni Community Development Sakhisizwe Child and Family Local Council #Y Welfare Society - Phakamani Zululand Hospice/ Indaka Ntambanana #YGoelem a #Y Msinga Nkwenkwe Rural Bergville Wellbeing Orphan Project Tugela - CSP Development Centre Richards Bay Family Care #Y#Y Sinozwelo Drop In #Y #Y #Y #Y Thandukuphila CB O #YEthemeni Care Centre Okhahlamba ADP Zimele Project Centre uThungulu #Y#Y Uthukela #Y #Y Nkosinathi HIV /AIDS CMD Khayalethu Leaders of Tomorrow Project #YDoors of Hope (Empangeni) Children's Home Okhahlamba Salvation Army uMhlathuze DC DC Senzokuhle C.B.O. Network Ngoboyolwazi Early Childhood Developm ent #Y Umtshezi St. Joseph Tugela#Y AIDS P rogramme Trust #YSukuma Community Thubelihle Creche #Y Khomanani Campaign Child#Yren's Home Holy Cross Aids Project Orphanage Pilot Project AIDS Hospice Child and Family Welfare #Y #Y Estcourt Hospice B eth-Hatlaim Umlalazi #Y Children's Hom e #Y Lethusizo Child Child and Family #Y Protection Project Welfare Izingane Zethu #Y#Y Greytown Children's Home #Y Intervention Imbabazane Mandini Drop In Centre Mooi Maphumulo #Y Mpofana Umvoti Khayalempilo Endondakusuka #YDrop In Centre Lethukukhanya Community Development Programme Greenfields #YKusasalethu Project Umgungundlovu Place of Safety #Y#Y Women's Club iLembe #Y Vianney #YChild and Family Welfare Childen's Enduduzweni Home Drop In Centre uMshwathi #Y Ndwedwe DC DCHowick Hospice #Y Association See Piietterrmarriittzzburrg Lethukukhanya Project The KwaDukuza IInssett #Y#Y Dare Care Centre Mngeni Umgeni AIDS Ndwedwe Welfare Child and Family Welfare #Y Centre District Office #Y Boy's Town-Tongaat #Y#Y Youth Centre Impendle #Y #Y#Y#Y #Y Fait h in Action Baitul A man KwaNomusa #Y #Y #Y#Y#Y#Y#Y #Y#Y#Y#Y Orphan P roject Ch ildren's Home Child an d Fa mily Welf are Pre-School #Y Abalindi Da ycare Centre #Y #Y#Y #Y#Y BhambayiY ##YSettlem ent Project Inqaba Yokucash a Abalindi Ch ildren's Home Children 's Orphanage Edendale Hospice Inanda Commun ity Health Centre #Y Phoen ix Community Association God's Ubu hle Benanda Orga nisation #Y##Y #Y Health Cen tre - P.C.H.C Golden AGAPE - Child Care #Y# ##Y #Y #Y#Y Child Prote ction Programme Acre #Y and Child Support Ekusizaneni The Msunduzi #Y Ch ildre n's Home #Y Yout h Proj ect - Love Life Clouds of Hope Hillcrest & Molweni The V al le#Yy #Y #Y Trust #Y Child and eThekwini AIDS Care Cent re #Y #Y #Y #Y Family Welfare Makaphutu Childre n's V i#Yllag#Ye #Y #Y #Y #Y Khululeka #Y See Durban #Y #Y #Y #Y#Y#Y#Y#Y#Y#Y#Y#Y Richmond Day Care #Y #Y #Y#Y#Y#Y#Y#Y #Y#Y#Y#Y#Y#Y#Y#Y Kwa Sani and Support Centre #Y #Y #Y#Y #Y Inset Ingwe #Y Mkhamba- Chatsworth Hos pice#Y Chri stelike Maatska plike Child and Family Welf are #Y#Y#Y#Y #Y Diens - C.M. D thnini Arren Benev olent Children's Hom e#Y #Y #Y#Y Sinosizo Home Base Care Umlazi Place of Safety St Monica Children's Home Richmond Health Care & #Y #YSt Au gustine Church Information Centre Izandla Zothando Boy's Town - V erulam #Y #Y Thandokuhle C#Yreche #Y#Y #Y#Y Greater Friends of S t Apollinaris Khul akahle Iso Lase Adams - OVC project Day Care Centre #Y Ikhambi Project Child and Family Welfare Kokstad Owambeni Masakhane Organisation #Y PMB Inset: #Y ; Northdale Ubuhlebezwe Vulamehlo Chase Valle y Pietermaritzburg Children' s Home Planned Parenthood Assoc A mandawe Child Lawyers for Human Rights Community Chest Welfare Centre of SA - Highflats and Family Welfare #Y#Y #Y Surre y Farm Nhlangwini Isu Labasha Project Child and Family #Y Hlengabantu Sisonke Welfare #Y Community AIDS Child & Family Welfare - AIDS Orphans Project Northdale Project African E nterprise Woodlan ds #Y Matatiele Child Welfare Mo ntrose Matatiele Advice Centre Hilton Athlone Y# Aids Orphan P roject DC The Early Childhood uMdoni Community Based Development Centre Sacred Heart PMB Agency for Christian Christelike Maatskaplike Children's Home Rehabilitation Training #Y Matatiele Diens - C.M.D Umzumbe #Y Natal Kinderhuis Social Awareness #Y# #Y #Y# #Y K hanyiselani #Y#YChild and Family Welfare Khul'Ugqame Creche Association #Y#Y Ekuphileni Project Clarendon ; Development Trust Home of Comfort UguSibusisweni Day Care Centre Port Shepstone Child & Family Care S ociety #Y Sobantu Christelike Maatskaplike Diens - C.M.D Goelama District Aid Forum #Y Izingane Zethu Intervention Programm e Cross Roads Children Home Siyafundisana Organisation Boughton #Y# South Coast Hospice-Daycare Centre St. Martin's ;#Y #Y Life Line and Rape Crisis - PMB uMuziwabantu Children's Home Ziphakamise Welfare Organisation Khayalethu Street Pietermaritzburg OsindDisweniC Daycare Center Zulu Creche-Day South Coast Place of Safety Children' s Project #Y ##Y Usozolwethu Organisation Msunduzi Hospice #Y #Y #Y Natalse Christelike Vrouevereniging Murchison Hospital -#Y Care Centre #Y #Y Kingfisher Hospice Association Fountain of Life AIDS Resource Centre #Y#Y#Y#Y Y# #Y #Y#Y #Y Practical Ministries Willowton Ntokozweni Village #Y Prestbury #Y#Y Scottsville for the Vulnerable#Y Mass Junction South Coast Hospice Children's #Y Maduleni Pelham Zamakulunge Creche #Y Programme & Memory Box project Community Child Care Com mittees Project North #Y Zamukuphila Day Care Centre Day Care Centre Thandanani Association #Y ##Y Child and Family Welfare Place of Restoration #Y Philane Centre Cluster Home Action Group (CHAG) Community Care Project, Bethany House Camp' s Drift Ezingolweni Duduza Orphans Home Centre Hayfields Mpumuza Children in Distress - C.I.N.D.I #Y Access to Justice Hibiscus Coast Youth for Christ - KZN for Women & Children Mason's Mill Msunduzi #Y Joseph Baynes Ekujabuleni Children's Home Childrens Home #Y S.O.S . Children's Village #Y Ashdow n Mk onde ni I ndustrial Area

#Y Imbali Cle land Durban Inset: ; Kwadabeka Broadway Earlsfield Chi ldren First Kloof Family Literacy Project Child and Fami ly Welfare-Sibusisiwe Newlands Kenville ; St C lement Home Clermont Community Resource Centre - C.C.R.C Based Care Christel ike Maatskaplike Diens - C.M.D East Khulani Chil dren's Shelter #Y#Y #Y Bl essed Gerard's Children's Home #Y Doctors for Life Bl essed Gerard's Pre-primary and Cresh #Y Christian Medical Fellowship Y# of South Afri ca - C.M.F.S.A Bl essed Gerard's Malnutrition Cli nic #Y Bl essed Gerard's Bursary Funds Training and Resource Beachwood Clermont ; in Early Education #Y

Reservoir Hills Tennyson House Shelter Orphans (Vul nerable Chil dren) #Y ; Khayalethu Response Project Pinetown #Y

Excelsior Place of Safety SA National Council for Berea Stamford Hill #Y AIDS Foundation of SA - A.F.S.A Westmead Chi ld & Fami ly Welfare Family Care - Protection of Chi ldren Westville Highway Hospice #Y Zwelethu Education Development #Y Sinosizo H.B.C.Programme and Family Support Servi ces #Y #Y ; ; St. Phil omenas Chi ldren's Home #Y #Y Si nikithemba C hristian Durban Childrens Society St Vincent's Children's Home St Thomas Home for Children Care Centre #Y #Y #Y #Y#Y#YDiocese Of Natal - HIV/AIDS Programme Islamic Medical Association #Y Save a Child/ Sindisa Ingane#Y #Y#Y #YHIV Help-Line - Durban #Y Association for Physically Chall enged #Y Christelike Maatskaplike SA Red Cross Society Diens - C.M.D #Y Dept. of Housing Sakhultsha Schools Lifeskills Courses#Y #Y Nati onal Association of People Living with HIV/AIDS Westvil le Youth Cenre #Y Mariannhill As-Salaam Child ; Boy's Town#Y Open Door Community HIV/AIDS Support Centre Isibi ndi - Circles of Care Care Project #Y #Y #Y Crime Reduction in Schools Project Amaqhowe Care Centre - Durban Children's Home #Y #Y #Y #Y Childrens Rights C entre Ithemba Lethu Survivors of Violence #Y ##Y #Y (Orphaned Babies Project) Diakonia Counci l #Y The Ark Christian Ministries of Churches #Y Dram aide Queensburgh Build Environment Support Group - B.E.S.G#Y#Y #Y Medical Care Development International Society for Family Health - SFH Nagina ; Feed the Babies Fund #Y Ithemba Lethu (HIV/AID S Prevention Projects) Ethelbert Children's Home Dept of Paediatri cs and Chil d H ealth Centre Cave Rock Chatsworth Bayhead

; #Y

Figure 11: Distribution of NGOs and projects providing OVC support services in KwaZulu-Natal as of May 2004 By combing the density of children aged 0 to 14 years with information of orphaning to the Socio-Economic Deprivation Index a map was produced to show lower, moderate of high potential vulnerability. The distribution of OVC support Projects was overlayed to produce figure 12 below.

#Y #Y #Y

#Y Jozini Umhlabuyalingana

#Y #Y Umkhanyak#Yude #Y

#Y#Y DC uPhongolo #Y Utrecht eDumbe #Y #Y

A#Y#Y#Y#Ym#Y ajuba DC #Y #Y #Y #Y#Y#Y Zululand Newcastle The Big Five Abaqulusi DC Nongoma False Bay #Y Dannhauser Endumeni #Y #Y #Y Hlabisa/ Nquthu Ulundi Impala #Y Umzinyathi Emnambithi- #Y Mt#Yubatuba Ladysmith DC #Y #Y#Y #Y#Y#Y Indaka Mthon#Y janeni Mbonambi #Y Ntambanana #Y #Y Uthukela Msinga Nkandla #Y #Y #Y #Y #Y#Y DC uThungu#Yl#Yu #Y Okhahlamba #Y Umtshezi #Y DC #Y#Y uMhlathuze #Y #Y #Y Umlalazi #Y #Y #Y #Y#Y#Y Imbabazan#Ye Mooi Umvoti Maphumulo #Y Mpofana Endondakusuka #Y iLembe #Y#Y #Y #Y Umgungundlovu DC#Y uMshwathi #Y D#YC The KwaDukuza Nd#Yw#Y edwe Mngeni #Y #Y #Y #Y #Y Impendle #Y #Y #Y#Y #Y#Y#Y#Y#Y#Y #Y #Y#Y#Y #Y #Y #Y #Y #Y#Y #Y The Msunduzi #Y #Y#Y#Y #Y #Y #Y #Y eT#Yhekw#Y ini #Y#Y #Y#Y #Y#Y #Y#Y#Y #Y #Y#Y #Y #Y #Y #Y#Y#Y#Y#Y#Y#Y Richmond #Y #Y#Y #Y#Y#Y#Y#Y Metr#Y#Y#Yo#Y#Y#Y Kwa Sani Ingwe #Y #Y Mkhamba- #Y#Y#Y#Y #Y #Y #Y #Y#Y thnini #Y#Y Legend Greater #Y #Y #Y #Y#Y #Y #Y #Y #Y Kokstad #Y OVC Support Projects Ubuhlebezwe #Y #Y Vulameh#Ylo #Y District Councils #Y Sisonke DC Matatiele uMdoni Local Councils #Y #Y Umzumbe #Y#Y #Y Composite Vulnerability Index Ugu DC uMuziwabantu #Y Lower Vulnerability #Y #Y#Y#Y #Y #Y#Y#Y #Y #Y #Y#Y #Y Moderate Vulnerability Ezingolweni Hibiscus Coast High Vulnerability

Figure 12: Areas of high vulnerability that coincide with low or non-existent support for OVC (Source: Census 2001 and EduAction)

The resulting spatial framework is capable of showing the likely spatial distribution of OVC within KZN, interacts with a purpose-built database of organisations supporting OVC and uses of a suite of analytical and management tools to improve co-ordination of OVC programmes within the province.

USING THE SPATIAL FRAMEWORK AS A MANAGEMENT TOOL

Map illiteracy and a reluctance to think spatially are two of the challenges for any project aimed at providing decision makers with a geographically grounded management information system. Indeed, at a technical consultation meeting held with decision makers from the departments of education and social development it was the first time many of the delegates had even seen the census data represented as a series of maps. However, delegates at this meeting responded well recognising their potential to inform decision making.

In addition, for this spatial framework to reach its full potential as a management tool it has to be an interactive tool. Unfortunately, finding a central location from where the spatial framework can be accessed and interacted with has had political implications. As a result the outputs thus far have been limited to paper products and limited interactive capabilities associated with generating predefined reports and maps within the ACCESS database. This has meant that much of our explorative work with multi-criteria analysis and possible suites of decision support tools remains incomplete. We feel that the spatial framework, in its current form, has not reached its full potential as a management tool as it fails to make use of some of the more powerful functions of GIS including a variety of predicative modelling techniques.

MOVING FORWARD

The next step will be to refine the tools and ensure they are accessible to policy makers. A methodological framework for replicating the process is currently being developed to extend the project into a second South African province, the Western Cape. In trying to learn from our experience in KZN, we have turned the process around. In KZN we designed a prototype spatial framework in consultation with a number of stakeholders on the ground which was subsequently taken to policy makers. Our experience has been that while policy makers appear excited by the capacity the spatial framework has to assist them in planning and implementing OVC support services, that’s where it ends. In the Western Cape we have begun to meet with the relevant policy makers first, and hope this will ensure that the spatial framework has a ‘home’ before its refinement of the database and management tools begins with key stakeholders.

ACKNOWLEDGEMENTS

This paper is drawn from numerous presentations and other project outputs prepared by the author in conjunction with Daniel Wilson (EduAction) and his input is duly acknowledged. Much of the technical explorative work was done with guidance from the GeoData Institute (Southampton University), a partnership which was facilitated by a British Council Higher Education Link Programme grant. The Rockefeller Brothers for project funding and ongoing support to replicate the model on other provinces. Finally, to all the NGOs who contributed their details to this project – siyabonga.

REFERENCES

ASSA, 2000 AIDS and Demographic Model of the Actuarial Society of South Africa as downloaded July 2004 from www.assa.org.za

Dawes, A., Richter, L., Bray, R., Muswana, M., Essau, S. and Bentley, K., No date: Child and adolescent indicators project summary accessed via www.hsrc.ac.za/resaerch/npa/CYFD/projects/20030331_6.html on 9 July 2003.

Kezaala, J., and Bataringaya, J. 1998: The practicalities of orphan support in East and Southern Africa: planning, and implementation of multi-sectoral social services for children and child careers. Presented at CINDI Conference in Raising the Orphan Generation, Pietermaritzburg 9 -12 June 1998.