The Government of Botswana
For Our Children: National Summary Report on Follow-Up to the World Summit for Children
National Summary Report on Follow-up to the World Summit for Children: Botswana
Table of Contents
Table of Contents...... 2
Foreword...... 3
A. Introduction and Background:...... 4
B. Process Established for the End-of-Decade Review...... 5
C. Action at the National and International Levels...... 5
D. Specific Actions for Child Survival, Protection and Development: ...9
E. Lessons Learnt...... 13
F. Future Action...... 13
Annex 1: World Summit for Children Indicators...... 14
2 Foreword
The Government of Botswana is pleased to have this opportunity to present the results of its national End-of-Decade Review of the National Programme of Action for the Children of Botswana to the Secretary General of United Nations.
Undertaking this review process has been a worthwhile experience in itself. It has provided an opportunity not only to see how far we have progressed, but also to re-examine, among other things, the effectiveness and adequacy of the existing institutional mechanisms and arrangements necessary for implementation, monitoring and co-ordination. It has enabled us to critically appreciate our achievements as a developing nation, with respect to the significant improvements we have made in a number of areas, in particular literacy, sanitation, provision of safe drinking water and protection of children. This is all with a view to intensifying efforts to at least sustain what has been gained.
Over the past decade infant and under five mortality rates had been in steady decline, resulting in significant progress in the health and survival of our children. We, however, note the recent increase in infant and under-five mortality rates. This is likely to be the result of the impact of the HIV/AIDS epidemic, which has reversed the significant gains we had made in these critical areas.
We have already put in place a number of multi-sectoral programmes and structures, as part of the response to this crisis. Our intention is to continue to intensify our efforts towards fighting the spread of HIV/AIDS as well as mitigating its impact. Special measures to protect children from HIV/AIDS are a vital part of our strategy. To this end, plans are being instituted to protect the HIV negative cohort of young people to maintain this status. This is consistent with our national aspiration to have no new HIV infections by 2016.
This is an aspiration, which requires concerted and co-ordinated efforts by all stakeholders. In this regard, we recognise the partnership and collaboration between the Government of Botswana and UNICEF, and indeed the entire United Nations family. The Government of Botswana will continue to nurture this relationship.
We are looking forward to the outcome of the United Nations Special Session on Children in September 2001, to provide a global framework for strengthening future actions, at both international and national levels.
3 National Summary Report on Follow-up to the World Summit for Children: Botswana
A. Introduction and Background:
1. The Government of Botswana was among the many that participated at the World Summit for Children (WSC), in 1990. The Government’s delegation was led by the then President, His Excellency, Sir Ketumile Masire. His Excellency, on behalf of the Republic of Botswana, signed the World Summit for Children Declaration, in May 1992. This event signalled the beginning of renewed efforts towards safeguarding the welfare of all the children in Botswana.
2. As part of its outcome, the Summit formulated a global Programme of Action from which countries were encouraged to develop their own country-specific Programmes of Action. Consequently, Botswana developed a National Programme of Action for Children (NPA) of Botswana.
3. The process was started through a national meeting in September 1992, convened and spearheaded by an inter-ministerial group to develop an outline for the National Programme of Action. Four working groups were formed on the basis of the following thematic areas: children and women in difficult circumstances; child and maternal health; education for all; and nutrition, food and economic security.
4. The working groups reviewed the Summit global goals and adapted them to Botswana’s current situation, needs and capacities. By mid-November 1992, a draft NPA was completed, with preliminary cost estimates. A summary of the report was then presented at the OAU/ICAAC in Dakar Senegal in November 1992. In February 1993, the working groups reconvened to finalise the report but the final report was only published in December 1995.
5. The “decade” for the National Programme of Action for Children of Botswana covers the period 1993-2003. A deliberate effort was made that the NPA’s period coincides with the National Development Plan Eight (NDP 8) period. This was to ensure that the NPA goals were in synergy with the objectives of the NDP 8, such that children’s issues were at the centre of the country’s development agenda throughout the implementation period of the plan.
6. The Programme articulates various mechanisms and structures for its co-ordination and monitoring. At national level, the National Council on Population and Development (NCPD) is the main co-ordinating body for monitoring and implementation of the NPA through a National Task Force. Unfortunately, the development of these mechanisms and structures got lost in the process when the NCPD was formulating the National Population Policy and related instruments. While the plan was such that, the Population Policy would provide the policy and the institutional framework for the co-ordination of the implementation of the NPA, the Policy was only approved in August 1997, while its National Implementation Plan of Action and other related instruments were finalised end of 1999. The timing of these developments had not been properly synchronised. Due to this, the development of the planned District Programmes of Action and the conduct of the Mid-Decade Review of the Programme in 1995 did not materialise. Despite these failures, co-ordination of this Programme still remains one of the key responsibilities of the NCPD in the remainder of the NPA period.
7. This End-of-Decade Review has, however, revealed that even without the envisaged co- ordination, sectors have undertaken a number of activities in the NPA within the framework of their NDP 8 sector development programmes. This is mainly because the NPA goals were integrated in NDP 8 and thus implemented as part of the Ministries’
4 sectoral programmes. But the fact that the implementation was uncoordinated between sectors has resulted in the NPA being less effective than it would otherwise have been.
B. Process Established for the End-of-Decade Review
8. The Review process was co-ordinated by the Government of Botswana/UNICEF Joint Planning and Co-ordinating Committee. UNICEF in collaboration with Government engaged the services of a consultant to consolidate all the information collected and compiled into this Review report. To facilitate the process, a Reference Group chaired by the Population Secretariat in the Ministry of Finance and Development Planning was formed to oversee the review. The Reference Group comprised implementers and other stakeholders from Government Ministries and the Non-governmental Organisations. Its major responsibility was to ensure that appropriate information was made available for analysis, to provide technical guidance on the content of the report, to review and approve the reports. The Government of Botswana/UNICEF Joint Planning and Co-ordinating Committee provided the policy guidance on the contents of the report.
9. The main sources of information for the review were sector reports from Ministries, interviews with key Government officials and findings of the Botswana Multiple Indicator Survey of October 2000 (MIS2000) conducted by the Central Statistics Office. The MIS collected data that was specifically to measure progress made towards achieving the NPA quantitative goals. Its preliminary results were disseminated at a national workshop in December 2000. The survey was co-funded by Government and UNICEF.
10. Efforts were made to ensure the participation of children in the review process. But due to time constraints, planned participatory activities, such as essay-writing competitions and radio call-in programs for children could not be undertaken.
C. Action at the National and International Levels i) The Degree of Priority accorded to Children’s Programmes 11. The Government of Botswana accords priority to children’s programmes, as shown by the established co-ordination/implementation mechanisms and structures, the annual budgetary allocations, etc. This may be evidenced by the fact that the NPA is being co- ordinated by the National Council on Population and Development (NCPD). The NCPD is a high level policy-advisory body to Government, on population and development matters, including children’s issues. It reports to Cabinet through the Minister of Finance and Development Planning. The NCPD is served by a Secretariat headed by a Director.
12. The NPA has been integrated into NDP programmes and is being implemented as an integral part of the sectoral programmes of Ministries. The NPA goals have, therefore, not only influenced the national development agenda, but are also at the centre of the national development priorities. Apart from the scheduled reviews, the monitoring of the NPA programmes has largely been done as part of the existing mechanisms, such as the annual project reviews and National Development Plan Eight Mid-term Review.
13. The Government of Botswana acceded to the Convention on the Rights of the Child (CRC) in March 1995, with a reservation on the definition of a child. The country’s Initial Report to the United Nations Committee on the Rights of the Child (UNCRC), which was due in April 1997, is yet to be submitted. To date, however, a draft final report has been produced and comments from stakeholders are being incorporated. The delay in submitting the report is attributed to the lengthy but necessary consultative process within Government and with other stakeholders in the Non-Governmental sector. The report is
5 National Summary Report on Follow-up to the World Summit for Children: Botswana
expected to be ready for submission to the UNCRC in the first quarter of 2001. Although, little was done to ensure wider understanding of the CRC, various pieces of legislation are being reviewed to, inter alia, harmonise them with the CRC. Such pieces of legislation include the Affiliation Proceedings Act and the Children’s Act.
14. The social services sector has on average received a significant share of the Government budget since 1994/5 to 2000/2001. The sector has over the period received about 40 percent of total (recurrent plus development) government budget. There has also been a slight increase in this share to 42 percent in the 2001/2002 budget. During the 1994/5 - 2000/01 period, health and education were allocated approximately 70 percent of the sector’s budget and about 74 percent in the 2001/2002 budget.
15. Furthermore, Government, in collaboration with UNICEF has reviewed various pieces of Children’s legislation such as the Affiliation Proceedings Act, the Adoption Act and the Children’s Act. The Children’s Act was reviewed to, inter alia, make specific provisions for orphans and children affected by HIV/AIDS. To-date, Government has developed a Short Term Plan of Action (STPA) for orphans to cater for the immediate needs of orphans, while developing a long-term one. Among the major outcomes of the STPA was the development of a minimum package of assistance comprising material and non- material needs of orphans.
16. 16. There is evidence of emerging political commitment to the prioritisation of HIV/AIDS and the mitigation of its impact on children. Currently, the Government of Botswana contributes over 80 percent of the budget for the HIV/AIDS programmes. The amount of resources allocated to HIV/AIDS programmes by Government increased significantly in 1999 as new programmes were put in place. Since then, the Government has made an annual allocation of P16.5 million (US$3.6 million) to the Prevention of Mother to Child Transmission of HIV (PMTCT); P27 million (US $5.9 million) for Community Home Based Care Programme (HBC); P24 million (US$5.2 million) to the Orphans Care Programme.
17. Following discussions with resident UN Agencies under the Theme Group on HIV/AIDS on the systemic co-ordination weaknesses of the national response to the epidemic, the Government has reviewed its mechanisms. As a result of this process, the National AIDS Council (NAC) has been reconstituted with a view to strengthening it and His Excellency, the President of Botswana, now chairs it. A National AIDS Co-ordinating Agency (NACA) has been established to co-ordinate all HIV/AIDS programmes and activities in the country, in view of the multi-sectorality of the epidemic. It also serves as the Secretariat to NAC through the Minister of Health. A special Parliamentary Select Committee has also been established to lead advocacy on HIV/AIDS.
ii) The Role by Families and Civil Society in Support of the NPA 18. The Government of Botswana has established fora where Non-Governmental Organisations (NGOs) and Community Based Organisations (CBOs) and the society at large contribute to national policy development. However, their collaboration with Government is still uncoordinated and fragmented. Due to the low levels of funding for NGOs and CBOs and Government’s inevitable commitment to social responsibility since Independence, Government has been the main provider of social services in Botswana thus rendering the potential role of NGO and CBO weak. The sector’s potential has therefore not been fully exploited. The NGO/CBO base is, however, still narrow and weak to provide complementary service delivery. Furthermore, there is still no agreed upon common framework for NGO/Government collaboration.
19. However, the potential the Government/civil society partnership has for programme planning and implementation, is fast gaining credibility among all stakeholders. The major challenge facing Government is to facilitate the development and strengthening of NGOs/CBOs to have the capacity of delivering some of the social services.
6 20. The potential role the media can play in this area of children welfare has not been fully exploited. There has generally been a weakness in the media activities targeted at children. Despite this, mobilisation of the media has increased over the years. The coverage of HIV/AIDS issues, especially by the print media and the radio, has intensified over the past 3 to 5 years. Issues of rape, child-abuse, etc are frequently reported on. There has, however been no co-ordinated or programmatic approach to media participation. This is an area that needs to be further developed. New private radio stations are being established, a new national television station is now in operation; these provide opportunities that should strengthen and widen the use of the media for IEC.
iii) Mechanisms for Monitoring Social Indicators relating to the well being of Children. 21. The Central Statistics Office, a Department of the Ministry of Finance and Development Planning has a well-established programme of regular statistical surveys, which includes inter-censal demographic surveys, family health surveys, literacy surveys, annual statistical reports based on administrative enquiries, etc. These surveys, in particular the family health surveys provide a wide range of information on children, such as infant and under 5 mortality, fertility rates, immunisation coverage, morbidity rates of childhood diseases. Process indicators, such as health service use and quality of care for pregnant women have been regularly monitored through the established routine statistical systems. Routine information systems such as sentinel surveillance reports have been established to monitor indicators, such as, HIV prevalence among pregnant women, and STD prevalence among men.
22. Relevant information for purposes of monitoring has been disaggregated by age, sex and location. There are however some problems with regard to the timeliness and depth of analysis of some of the statistical series, thus limiting their usefulness as a guide for policy development and review.
23. An appreciable achievement of the existing mechanisms has been their responsiveness to information needs as defined by emerging critical issues affecting children. For instance, the upcoming 2001 Population and Housing Census will include some questions on orphanhood. This is expected to become a permanent feature of our population censuses. This will also provide a reliable frame for subsequent in-depth research studies on this subject.
24. Other monitoring activities supported and sustained include the production of the Botswana Human Development Report, which is a collaborative effort between the Government of Botswana and the United Nations Development Programme (UNDP). This report has attracted a lot of media coverage and public debate since its inception. iv) Arrangements for Responding to Natural Disasters and Man-made Calamities 25. In August 1996, the Government of Botswana approved a National Policy on Disaster Management and established a National Disaster Management Office in the Office of the President two years later in 1998. The key responsibility of the National Disaster Management Office is to build disaster preparedness in the country, to formulate an integrated and effective disaster management system and co-ordination across the disaster spectrum. This system is anchored on a disaster management spectrum comprising preparedness, prevention, mitigation, response, relief, recovery, rehabilitation and reconstruction. It is intersectoral and involves communities. In 1993, the Government formed a National Committee on Disaster Preparedness, principally to increase co-ordination and improve effectiveness in the management of disasters.
26. Other natural disasters such as animal diseases, veldt fires, pest infestations, etc. are already catered for within existing ministerial programmes. For example, drought management is co-ordinated by the Rural Development Council. The Council has technical and operational committees, such as, the Inter-Ministerial Drought Committee which receives its technical inputs from the National Food Security Monitoring Group, the Grain Reserve
7 National Summary Report on Follow-up to the World Summit for Children: Botswana
Monitoring Group and the Early warning Technical Committee, as well as District Drought Committees and District Development Committees.
27. Despite the existence of a policy and its related structures, the 1999-2000 flood situation which inflicted a heavy toll on social and economic development, affecting about 90 percent of the country, showed that Botswana needed to urgently strengthen its disaster management systems. Government has, however, in 2001/2002 allocated 9 percent of the Development Budget to Floods Disaster Relief, which mainly includes repair and reconstruction of roads.
v) Relevant Research and Development 28. Botswana is one of the first countries in Africa to pilot the Prevention of Mother–to-Child Transmission (PMTCT) of HIV. This operations research project was piloted over two years in two cities since April 1999. Lessons learnt from the pilot project are being used to inform the phased scaling up of the programme to national coverage. As a result the PMTCT services have now been integrated into routine antenatal care services.
29. As the HIV epidemic increased and its impact gradually became more evident, so did the need for new research in certain critical areas. Consequently, the Government in collaboration with UNDP and Development Partners carried out a number of research activities. These include research studies on the socio-economic impact of HIV/AIDS in Botswana. Some of the major ones are:
The Macro-economic Impact of HIV/AIDS Epidemic in Botswana; The Impact of HIV/AIDS on the Health Sector; Review and Evaluation of HIV/AIDS for an Expanded National Response to the HIV/AIDS Epidemic in Botswana; An Impact Assessment of HIV/AIDS on Current and Future Population Characteristics and Demographics in Botswana; The Impact of HIV/AIDS at the Household Sector; The Impact of HIV/AIDS on the Education Sector; and The Botswana Human Development Report 2000: Towards an AIDS-free Generation.
30. The findings from these studies will not only contribute to the growing literature on HIV/AIDS in Botswana, but will also guide programming and policy development and review. It is expected that few as they are, they will stimulate additional sector specific research for more targeted interventions.
8 D. Specific Actions for Child Survival, Protection and Development: Report on Progress made to date on NPA Goals.
Goal 1a: To reduce non-HIV related infant mortality rates by one third to 30 per 1000 by the year 2003.
Goal 1b:To reduce non-HIV related under-five mortality rates by one third to 38 per 1000 births by the year 2003.
31. Child survival indicators are deteriorating from their 1991 levels. We have lost the positive trends witnessed in the 1971-81 and 1981-91 intercensal periods, despite progressive gains in access to health services. Infant mortality rates have stayed around 37 per 1 000 live births for the past ten years (BFHS II & III). Under-five mortality rates have similarly stagnated at around 48. The results of the Multiple Indicator Survey show an increase in Infant Mortality and Under-Five Mortality Rates from 38 and 48, in 1996 to 57 and 75 in 2000, respectively.
Goal 2: Reduce maternal mortality rate by half from 300 to 150 per 100,000 live births by the year 2003.
32. There is no current data to measure progress made through this indicator. Some rough estimation, using indirect methods were made, based on the 1991 Population Census figures. These estimates showed significant regional variations in the maternal mortality rates as follows: 678 in Chobe, 601 in Ngamiland South, in Ghanzi and 464 per 100,000 in Barolong. These rates suggest a high national rate of no less than 300 maternal deaths per 100,000 live births in 1991.
33. With the current high prevalence of HIV/AIDS, it would not be surprising if this rate was higher than estimated in 1991. In the absence of immediate plans to conduct a survey to directly measure maternal mortality, the 2001 Population Census will be the only source to update these estimates.
Goal 3a: To reduce malnutrition among children under five to half of the 1990 levels (for moderate malnutrition from 15 percent to 7 percent) by the year 2003.
34. The MIS shows that 12.5 percent of children in Botswana were malnourished and that 10.1 percent of these children were moderately malnourished. This represents a slight increase from 12.8 percent in 1996. Despite this increase, these rates had been in steady decline since the 1978 rate of 25 percent. It however appears that, we have been unable to half the 1990 levels of malnutrition.
35. Although, there is no difference between sexes, there are significant disparities across age groups. Malnutrition rates immediately deteriorate as soon as children are two years and above; which is the time children are weaned or receive complementary feeding and hence prone to infectious diseases.
36. There are significant differences between urban and rural, and between districts. The malnutrition rate for urban areas is 11.5 percent, well below the national average, while it is 13.6 percent for rural areas, well above the national average. Although, the sub-sample sizes in some of the districts are too small to provide conclusive evidence, there is indication that there are significant disparities between districts. They range from 7.0 in Gaborone to 30.6
9 National Summary Report on Follow-up to the World Summit for Children: Botswana
percent in Ghanzi. It is also noted that the harder-hit districts are the poorer and more remote ones.
Goal 3b: To bring about the virtual elimination of severe malnutrition for children under five by the year 2003.
37. The National Programme of Action reports a severe malnutrition rate of approximately 1.0 percent in 1993, for children under five years of age. The MIS estimates this rate at 2.4 percent in the year 2000. The estimate shows no difference between sexes, but a slight disparity between urban (2.0%) and rural areas (2.9%). Of all the districts, Ghanzi has the highest level of severe malnutrition rate at 16.3 percent. It is not immediately obvious why urban centres such as Selibe-Phikwe (5.9%) and Lobatse (4.0%) have rates higher than some of the purely rural districts, such as Kgalagadi and the North East. The reliability of these district estimates is, however, uncertain due to low sample sizes.
Goal 4: To increase access to a safe water supply from 68 percent to 98 percent for rural households by the year 2003.
38. According to the MIS results, there has been an improvement in the proportion of rural households having access to safe water supply from 68 percent in 1993 to 90.5 percent in 2000. It is estimated that 99.7 percent of urban households have access to safe water supply, while the national estimate is 96.5 percent.
39. There is still some way to go towards achieving this goal but given the current national efforts in this area, the 98 percent target for the year 2003 is likely to be have been achieved by then. The main constraint has been the declining yields of boreholes induced by persistent droughts and diminishing water sources due to contamination and overloading. This is likely to be exacerbated by the proliferation of settlements, due to the revised National Settlement Policy’s reduction of the settlement population threshold from 500 to 250.
Goal 5: Increase access to facilities for sanitary means of excreta disposal from 41 percent to 70 percent of rural households by the year 2003.
40. The MIS indicates that there has been substantial improvement in rural households’ access to sanitary means of excreta disposal. It is estimated that about 59.8 percent of rural households have sanitary means of excreta disposal. The corresponding urban proportion is 97 percent. There is a large urban-rural gap in favour of the urban households.
41. Despite this large urban-rural disparity, most of the districts (inclusive of their urban villages) have, however, individually surpassed this goal. The only districts, which are below the target of 70 percent, are Ngamiland (55%) and Ghanzi (66%). This suggests that an improvement in these districts, which does not compromise the same service to the other districts, would significantly increase the proportion of rural households, well above the 60 percent average. The district estimates are, however, to be interpreted with caution due to low sub-sample sizes.
42. The national estimate is 84 percent, indicating a significant improvement over the 55 percent in 1991 (CSO-1991 Population and Housing Census).
10 Goal 6: Secure universal access to and improvement of the quality and relevance of basic education by the year 2003.
43. There has been an improved access to basic education since 1991 from 75 percent to 85.7 percent of children aged 6-13 years in the year 2000. This represents 84 percent males and 86 percent females. There is, however a significant difference in the corresponding proportions for urban at 89 percent, while rural stands at 81 percent.
44. To strengthen efforts for increased access to basic education, the Botswana College of Distance and Open Learning has been established for out-of school education, thus promoting life-long learning. Some of the achievements aimed at increasing access to education for children with special needs include: the establishment of a new deaf unit at secondary school level; integrating special education in the regular system; and modifying the primary level curriculum for the deaf.
45. The launching of the new Botswana Technical Education Programme and the Gaborone Technical College during the year 2000, provides new and enhanced opportunities for young people to prepare themselves for the world of work in both the formal and informal sectors of the economy. This programme offers courses in entrepreneurship, communication and computer skills, as part of the response to the urgent need to expand the training of technicians and technologists.
46. Significant progress has been made towards achieving certain education targets set in the Revised National Policy on Education (RNPE) of 1994. The transition rate from primary school level to junior secondary school level continues to be maintained at 100 percent, while that from junior to senior secondary school is expected to reach 49 percent upon completion of the ongoing upgrading programme by the end of 2001.
47. Regarding the part of the goal on the improvement of the quality and the relevancy of basic education, Government continues to review the entire education system, including the revision of the curriculum for the ten-year Basic Education Programme. These improvements include, linking the three-year junior secondary school curriculum to the world of work and increase its practical orientation, the infusion of Population-Life Education dimensions, such as HIV/AIDS, and the reduction of primary class sizes from 45 to 35 students per class by the year 2003.
48. To further enhance the quality of education, the Government continues to invest in human resources. For example, the Diploma in Primary Education has been successfully phased in teacher training and the qualifications of a significant number of college teacher training lecturers have been upgraded to Masters Degree level between 1997 and early 2000. Teacher training institutions are also being expanded.
Goal 7: Significantly reduce adult illiteracy by the year 2003.
49. The 1993 Botswana Literacy Survey reported that rates for adult illiteracy were 31.1 percent, translating to 33.1 percent male and 29.1 percent female. Compared to previous rates, a significant increase in literacy rates over the past 12 years has been achieved. In 1981, rate of illiteracy (using educational attainment as a proxy) was estimated at 66 percent.
50. The Literacy Survey estimated that the highest age specific illiteracy rates were among the older age groups, with a rate of 88 percent for the 65 years and over. On the other hand, the younger age groups had lower illiteracy rates ranging from 9.8 to 50.8 percent, for age groups 15-19 and 50-54 years, respectively. The high literacy rates among the younger age groups imply current improved literacy rates in the older age groups. This coupled with
11 National Summary Report on Follow-up to the World Summit for Children: Botswana
current high primary school attendance (85% in 2000) among children (6-13 years), should result in lower than illiteracy rates among the adult population.
51. The improvement in rates of literacy between 1981 and 1993, with a doubling in literacy levels (and assuming that there has been no slippage since then), indicates that this goal is well on track for success.
52. The Department of Non-Formal Education in the Ministry of Education is charged with the responsibility of administering the national literacy programme. It is currently working on the development of an Adult Basic Education course with a view to making it equivalent to the Primary School Leaving Education.
Goal 8: To promote early childhood development with emphasis on family and community involvement by the year 2003.
53. In 1996, the pre-primary Unit was operational within the Ministry of Education. The Day Care Centre Policy of 1980, which is important in the development of early childhood, has been reviewed. In its place, an Early Childhood Development Policy has been drafted and is currently under-going consultation within the Ministry. This policy will provide standards and monitoring systems for the private sector operated day care centres and pre-primary schools.
54. Part of the intention behind this policy is to encourage parents to place children into some form of early childhood educational programme. At present only about 9 percent of children between the ages of 36-59months attend some form of pre-primary education. The major challenge the Government is facing however is to ensure that all children have access to early childhood education facilities. Most if not all, existing pre-primary education facilities, are owned by the private sector and therefore are very expensive for an average Motswana.
Goal 9: To improve protection of children in especially difficult circumstances and tackle the root causes leading to such situations by the year 2003.
55. The Government has allocated a significant budget of P39 million towards its newly started Orphan Care Programme. This programme offers a specialised social safety net for all orphans in the form of a monthly high-protein food-basket for each orphaned child.
56. To date 29,000 orphans have been registered into the programme. Specially appointed Programme Co-ordinators in each of the districts are continuing to locate and register orphans into this programme and this is expected to be fully computerised by mid-2001. The numbers of AIDS orphans projected for the year 2000 is estimated to be 65,000 (UNDP), so there are clearly many more to locate.
57. Data from the Multiple Indictor Survey indicates that 12 percent of all children aged less than 14 years had one or both biological parents dead. Another 23.6 percent of children (ages 0-14 years) surveyed were at the time of the survey not living with a biological parent.
58. Government has been made significant efforts to increase the number of facilities for children with special needs. In 1993, there were 20 such facilities, by the year 2000, there were 35 in operation. Government also provides handicapped children with assistive devices free of cost.
59. This goal is quite broad and requires a more detailed level of qualitative analysis than time permits.
Goal 10: Promote widespread understanding and observance of the Convention on the Rights of the Child (CRC) by the year 2003.
12 60. In a move towards aligning Botswana law more closely with some of the provisions of the CRC, a number of laws are under review. The Children’s Act and the Adoption Act are currently being reviewed. The Affiliation Proceedings Act was recently amended (1999) to ensure a higher level of child maintenance support payments to single parents/guardians. A draft review of the CRC has been developed by Government, and is currently being discussed. The CRC is also being translated into Setswana for a mass audience. Very little has however been done to promote wide spread understanding and implementation of the CRC.
E. Lessons Learnt
61. The prevalence of HIV/AIDS in the general population has increased from 13 percent in 1996 to 19 percent in 1999. In addition, rates of infection amongst the sexually active age group (15 to 49 years) are estimated to have increased from 23 to 29 percent over the same time period. Given this situation, the National Programme of Action sub-goals of reducing non-HIV related infant and under-five mortality need to be reformulated to take account of HIV/AIDS. Even moreso, with our current measurement methods, it is difficult if not impossible, to distinguish non-HIV related mortality. The National Programme of Action goals should be reviewed to make them more focused and measurable.
62. A more enhanced co-ordination of the implementation of the National Programme of Action for Children is essential.
63. The National Programme of Action for Children should have in-built mechanisms for a meaningful involvement of children at all levels of the programme implementation and process in a meaningful way.
64. Contrary to popular believe, the MIS survey has revealed that adequate knowledge about HIV/AIDS is low among the general population.
65. With these high rates of HIV prevalence, the problem of orphanhood is most likely to increase.
F. Future Action
Recommendations under consideration by the Government of Botswana:
66. More needs to be done to disseminate appropriate information on HIV/AIDS. Furthermore, IEC activities targeted at positive behaviour change should be strengthened. These should address critical issues including men and adolescents’ participation, and women’s vulnerability factors in the fight against HIV/AIDS.
67. Continue to build on the momentum developed from this review process, to promote the achievement of the NPA goals by 2003, and develop a greater level of action in all sectors on behalf of children.
68. Establish a dedicated multi sectoral structure (with participation of Children and NGOs) to advise on children’s issues. This structure would meet regularly over the course of the next 5 years.
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69. Improve the National Programme of Action co-ordination and monitoring mechanisms.
70. Promote understanding of the National Programme of Action by senior level policy and decision-makers to strengthen its place in the national development agenda.
71. With better co-ordination and role clarity, it is hoped that a final review will be done at the end of Botswana’s NPA in 2003, in time to ensure input into the Government’s next national planning cycle
72. Improve wide spread understanding and implementation of the CRC, using opportunities such as the emergence of new private radio stations, a television station, etc.
73. .
14 Annex 1: World Summit for Children Indicators
World Summit for Children Indicators 1988 1996 2000 Under-five mortality Probability of dying before reaching age five 53 48 75 rate(per 1000 live births) Childhood mortality Probability of dying between one and five 16 161 20 rate(per 1000 live births) Infant mortality Probability of dying before reaching age one 37 38 57 rate(per 1000 live births) Underweight Proportion of under-fives who are too thin for their age - 17 13 prevalence (%) Stunting prevalence Proportion of under-fives who are too short for their age - 29 23 (%) Wasting prevalence Proportion of under fives who are too thin for their height - 11 5 (%) Use of safe drinking Proportion of population who use a safe drinking water source - 771 97 water (%) Use of sanitary means Proportion of population who use a sanitary means of excreta - 551 84 of excreta disposal disposal (%) Antenatal care (%) Proportion of women aged 15-49 attended at least once during 92 94 97 pregnancy by skilled personnel Contraceptive Proportion of married women aged 15-49 In Union 33 48 43 prevalence (%) who are using a contraceptive method All women 30 42 43 Childbirth care (%) Proportion of births attended by skilled health personnel 78 87 95 Birth weight below Proportion of live births that weigh below 2500 grams - - 12 2.5 kg. Iodized salt Proportion of households consuming adequately iodized salt - - 61 consumption (%) Exclusive Proportion of infants aged less than 4 months who are exclusively - - 29 breastfeeding rate (%) breastfed Timely Proportion of infants aged 6-9 months who are receiving breast milk - - 57 complementary and complementary food feeding rate (%) Continued Proportion of children aged 12-15 months and 20-23 months who - - 53 breastfeeding rate (%) are breastfeeding (12-15) 10 (20-23)
DPT immunisation Proportion of children immunized against diphtheria, pertussis and 94 95 98 coverage (%) tetanus by age one Measles immunisation Proportion of children immunized against measles by age one 93 74 90 coverage (%) Polio immunisation Proportion of children immunized against polio by age one 92 94 98 coverage (%) Tuberculosis Proportion of children immunized against tuberculosis by age one 99 99 100 immunisation coverage (%) Children protected Proportion of one year old children protected against neonatal - - 72 against neonatal tetanus through immunisation of their mother tetanus (%) ORT use (%) Proportion of under-five children who had diarrhoea in the last 2 722 - 96
1 These figures were obtained from the 1991 Population and Housing Census.
15 National Summary Report on Follow-up to the World Summit for Children: Botswana
World Summit for Children Indicators 1988 1996 2000 weeks who were treated with oral rehydration salts or an appropriate household solution Home management of Proportion of under-five children who had diarrhoea in the last 2 - - 7 diarrhoea (%) weeks and received increased fluids and continued feeding during the episode Care seeking for acute Proportion of under-five children who had ARI in the last 2 weeks - - 15 respiratory infections and were taken to an appropriate health provider (%) Pre-school Proportion of children aged 36-59 months who are attending some 9 development (%) form of organized early childhood education program
Indicators for Monitoring Children’s Rights
Birth registration (%) Proportion of under-five children whose births are reported - - 65 registered Children’s living Proportion of children aged 0-14 years in households not living with - - 24 arrangements (%) a biological parent Orphans in household Proportion of children aged 0-14 years both dead - - 1.4 who are orphans living in households one parent dead 10.8 one or both dead 12.2
Indicators for Monitoring IMCI
Home management of Proportion (percent) of under-five children reported ill during the - - 26% illness (%) last 2 weeks who received increased fluids and continued feeding
Indicators for Monitoring HIV/AIDS
Knowledge of Proportion (%) of women who correctly state the 3 main ways of 67 preventing HIV/AIDS avoiding HIV infection Knowledge of Proportion (percent) of women who correctly identify 3 31 misconceptions of misconceptions about HIV/AIDS HIV/AIDS Knowledge of mother Proportion (percent) of women who correctly identify means of 57 to child transmission transmission of HIV from mother to child Attitude to people Proportion (percent) of women expressing a discriminatory attitude 69 with HIV//AIDS towards people with HIV/AIDS Women who know Proportion (percent) of women who know where to get a HIV test 46 where to be tested for HIV Women who have Proportion (percent)of women who have been tested for HIV 19 been tested for HIV
2 Percentage of children with diarrhoea treated by ORS and/or home solution
16