Children and South Africa s Budget

Children and South Africa s Budget

Children and South Africa s Budget 1. Macro context 2. Health 3. Education 4. Social Development

1. MACRO CONTEXT South Africa

Key message 1 The nearly 20 million children in South Africa account for more than a third of the country s population of approximately 55 million. Population growth is about 1.6% per year. With GDP per capita of R73,061 in 2015, South Africa is an upper middle income country. GDP is growing at less than 1% per year lower than both inflation (6%) and population.

Key Message 2 South Africa does not have a single official poverty line. However, all measures indicate that children are more likely than adults to live in poor households. Food inflation is higher than overall inflation.

% Poverty lines (2011 Rand) 70 62.8 60 53.2 55.7 50 45.5 40 36.2 38.7 30 20 20.8 21.0 10 0 Food poverty Lower bound Upper bound Upper bound population Upper bound children Rebased 2015 estimates 2014 estimates Statistics South Africa University Cape Town

Key Message 3 The main source of government revenue is taxation. In 2015/16, taxation stood at 27% of GDP. If government had fully adjusted tax brackets for inflation every year since 1990, the tax: GDP ratio would now be about 29% because more people would be paying tax, and the income of the wealthiest has increased faster than inflation.

Key Message 4 Provincial budgets are especially important for children because provinces bear the main responsibility for delivery of education (other than tertiary), health and social development services. In 2016/17 provinces receive 42.9% of all nationally collected revenue. Provinces receive a block grant (the equitable share) determined by a formula, and conditional grants for specified purposes.

National transfers to provinces R million 120000 100000 17489 80000 18839 79600 87898 60000 10243 58060 7120 40000 20000 6816 22995 48709 6987 33450 3749 7043 28062 10749 41062 10863 0 EC FS GT KZN LIM MPU NC NW WC Equitable share Conditional grants

Key Message 5 The three social sectors education, health & social protection each receive a substantial share of the consolidated (national and provincial) budget. However, debt service costs require almost as much funding as social development, with each at about 10% of the combined national and provincial budgets. It will cost government R148 billion to pay interest on its debt in 2016/17.

Composition of consolidated budget, 2016/17 Function R bn % of total Basic education 228.8 16% Health 168.4 12% Social development 167.5 11% Defence, public order & safety 181.5 12% Other 563.4 39% Allocated expenditure 1309.6 89% Debt service costs 147.7 10% Contingency 6.0 0% Consolidated expenditure 1463.3 100%

2. HEALTH

Key Message 1 The primary health care share of combined provincial budgets has increased steadily over time, and inequities in allocations between provinces are smaller than ten years ago. However, in 2016/17 primary health care still accounts for less than a third (29%) of total provincial health budgets.

Provincial primary health care budgets 45% 1600 40% 40% 1400 35% 30% 25% 29% 27% 26% 31% 30% 33% 32% 25% 29% 1200 1000 800 20% 15% 600 10% 400 5% 200 0% EC FS GT KZN LIM MPU NC NW WC RSA 2016/17 PHC per uninsured 0

Key Message 2 The health component of the formula for the equitable share may not adequately reflect the needs of the poorest children. The weights used in the formula are based on use of health care by children from wealthier households with medical aid cover. The health needs of children from poor households who are the target of public health are likely to differ from those of children in wealthier households.

Key Message 3 In 2014, 78% of children were likely to be treated at public health facilities when ill. The percentage was 96% for the poorest children but only 14% for children in the wealthiest households. A quarter of children who use public health facilities have travel time of half an hour or more to reach the facility, rising to 40% in rural areas.

Distance of children from health facilities 100% 90% 89% 80% 75% 70% 60% 50% 40% 30% 22% 20% 10% 9% 0% Public 3% Private 1% < 30 min 30-89 min 90+ min

Key Message 4 For the nine provinces combined, the HIV and AIDS subprogramme allocation increased from R9 277 million in 2012/13 to R15 684 in 2016/17. Children, alongside adults, have benefited enormously from the roll-out of antiretrovirals and prevention of mother-to-child transmission However, in 2016 more than half of HIV-infected children under 15 years of age are still not receiving treatment.

HIV prevalence & ART coverage 50% 3.5% 46.2% 45% 40% 35% 30% 25% 1.8% 2.1% 2.3% 2.5% 2.7% 2.8% 2.9% 3.0% 3.0% 2.9% 25.4% 2.8% 33.0% 38.9% 2.7% 43.5% 2.6% 2.4% 3.0% 2.5% 2.0% 20% 1.5% 18.8% 1.5% 15% 12.8% 1.0% 10% 5% 0% 8.2% 4.6% 2.4% 0.0% 0.2% 0.3% 0.5% 0.9% 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 0.5% 0.0% ART coverage HIV prevalence

Key Message 5 If all children under five years of age without medical aid made four visits to clinics and all pregnant women made four antenatal visits, the costs would account for 39% of the total primary health care budget excluding funds for HIV and AIDS. In reality, young children make more than four visits on average to public health services.

4 visits per annum as % of PHC-HIV 50% 45% 40% 3% 4% 3% 4% 3% 3% 35% 4% 3% 30% 2% 3% 25% 20% 15% 43% 41% 31% 41% 39% 37% 29% 32% 29% 36% 10% 5% 0% EC FS GT KZN LIM MPU NC NW WC RSA Child health Antenatal

Mean visits per year to clinics, 2015 6.0 5.6 5.4 5.3 5.0 5.0 4.7 4.5 4.5 4.5 4.7 5.0 4.0 3.0 3.1 2.8 2.3 3.3 2.8 2.6 3.1 2.6 3.0 2.8 2.0 1.0 0.0 EC FS GP KZN LIM MPU NC NW WC RSA All <5 years

Key Message 6 In 2012, 26.9% of boys and 25.9% of girls aged 0-3 years were found to be stunted. Health s dedicated funding for nutrition is equivalent to only 4% of education s funding for the National School Nutrition Programme. However, health is responsible for the youngest children, for whom nutrition has the most severe and long-lasting negative impact.

3. EDUCATION

Key Message 1 Significant investment in education: 16% of 2016/17 consolidated budget expenditure goes to basic education. High enrolment rate in primary and secondary schools, but poor learning outcomes: 58% of Grade 4 leaners could not read for meaning and 29% could not read at all. In 2016, per learner allocations are: R12 231 for primary R15 718 for secondary.

Per learner allocations for public schools 18000 16000 14595 15794 14529 15274 14630 14000 12000 11886 12087 13230 12844 12051 13335 12512 12048 12985 12096 12081 10000 8000 6000 4000 2000 0 FS GT KZN LIM MPU NC NW WC Primary Secondary

Key Message 2 Many educators in South Africa lack the necessary skills and knowledge. Available evidence suggests that spending per educator on teacher development averaged only R1 625 in 2015/16. However, provinces record spending on teacher development in different ways. Also, a range of donors fund teacher development off-budget.

Teacher development per educator 3500 3201 3000 2500 2516 2652 2554 2236 2000 1870 1625 1500 1372 1000 500 560 451 0 EC FS GT KZN LIM MPU NC NW WC RSA

Key Message 3 National government s records suggest that in 2016/17 provinces allocated less for learner and teacher support materials (LTSM) than in 2013/14, even before adjusting for inflation. In some provinces the amount for LTSM is included in the transfers to public schools that manage their own funds. For these schools the LTSM spending is hidden, because it is not recorded separately from the rest of the transfer to the school.

Allocation for LTSM per learner, 2015/16 500 479 450 400 370 350 300 250 247 244 235 209 200 150 155 157 129 139 100 50 0 EC FS GT KZN LIM MPU NC NW WC RSA

Key Message 4 There is substantial variation across provinces in funding of Grade R. North West allocates more than double what Limpopo does. For the country as a whole, the Grade R per learner amount is only about two-fifths of the primary school amount.

Grade R per learner and % enrolled 10000 99% 9227 9000 87% 85% 8000 100% 90% 80% 7000 70% 6325 72% 68% 68% 72% 70% 6000 581061% 60% 5000 4000 4143 3410 53% 3630 3994 4575 4275 50% 40% 3000 30% 2000 20% 1000 958 10% 0 EC FS GT KZN LIM MPU NC NW WC RSA 0% Amount per learner % enrolled

Key Message 5 There are two grants for school infrastructure. 2012/- 13 2013/- 14 2014/- 15 2015/- 16 2016/- 17 2017/- 18 2018/- 19 Education infrastructure 5802 6643 7327 9354 9614 12780 13512 School infrastructure backlogs 1277 1956 2541 2047 2375 There has been some progress in funding school infrastructure, but more than half of Eastern Cape schools remain without adequate sanitation.

% of schools with basic utilities, 2009 & 2015 80% 70% 60% 50% 50% 40% 30% 29% 20% 18% 22% 20% 16% 10% 0% 2009 2015 2009 2015 2009 2015 No/unreliable water No/unreliable electricity Pit/bucket/no sanitation EC FS GT KZN LIM MPU NC NW WC RSA

4. SOCIAL DEVELOPMENT

Key Message 1 Spending on social grants accounts for 84% of the annual consolidated national and provincial social development budget. The three child grants together account for 36% of the consolidated amount. Welfare services are budgeted mainly by the provinces.

Key Message 2 The share of DSD provincial budgets allocated for services for children and families increased substantially, from 21% in 2009/10 to 38% in 2016/17. The share increased in all provinces except Free State.

Children & families as share of DSD budgets 50% 49% 45% 43% 40% 38% 37% 39% 37% 38% 35% 30% 27% 32% 27% 31% 30% 25% 20% 19% 20% 22% 18% 17% 21% 15% 15% 15% 10% 5% 0% EC FS GT KZN LIM MPU NC NW WC RSA 2009/10 2016/17

Children & families per child 1600 1400 1360 1200 1000 965 800 758 780 600 400 307 245 484 573 265 349 320 410 349 551 609 297 434 324 362 564 200 0 EC FS GT KZN LIM MPU NC NW WC RSA Per child Per poor child

Key Message 3 For all provinces combined, prevention and early intervention services account for only 18% of the children and families budget. All provinces except Gauteng plan decreases in the share going to these services over the period 2016/17 to 2018/19.

Prevention & early intervention allocations R million 4,500 4,235 100% 4,000 90% 3,500 80% 3,000 2,500 2,384 2,778 70% 60% 2,000 1,500 1,000 500-2,081 1,961 1,634 1,455 1,415 1,145 1,076 774 648 704 615 544 544 429 384 249 95 146 209 34 67 46 58 44 EC FS GT KZN LIM MPU NC NW WC 50% 40% 30% 20% 10% 0% DSD Children & families PEI services PEI % of children & families

Key Message 4 In 2016/17, the combined allocations for ECD across the nine provinces amounted to R2 285 million. This is almost as much as the total for prevention and early intervention services. Nevertheless, the ECD allocation is only just over a quarter of a reasonable measure* of need in the poorest households. *100% 4-years;75% 3-years; 50% 1-2 years; 25% <1 year

ECD as % of need 60% 55% 50% 48% 42% 43% 40% 37% 30% 27% 22% 20% 17% 16% 17% 10% 0% EC FS GT KZN LIM MPU NC NW WC Total

Key Message 5 The amount spent on child grants at R60 149 million in 2016/17 is nearly ten times as large as the R6 086 million spent on welfare services for children. In 2005, 5 648 800 children benefited from the child support grant (CSG) and 256 949 from the foster child grant (FCG). In 2015, the comparable numbers were 11 703 165 and 499 774 respectively.

% of children with grants by province 80% 75% 72% 70% 68% 66% 64% 62% 61% 60% 59% 50% 48% 42% 40% 30% 20% 10% 0% 4% 4% 3% 1% 3% 4% 2% 3% 2% 3% EC FS GT KZN LIM MPU NC NW WC RSA % with CSG % with FCG

For more information, please contact Yulia Privalova Krieger Deputy Representative ykrieger@unicef.org United Nations Children s Fund Equity House 659 Pienaar street, Brooklyn, Pretoria, 0181, P.O. Box 4884, Pretoria, 0001, South Africa www.unicef.org/southafrica United Nations Children s Fund October, 2016