A friend of mine, Emaceke, gave birth a couple of weeks ago. The baby came on quickly and she delivered at her home – on her knees. She didn’t seem to mind, or perhaps she was quite proud of her efforts. In discussing what I see as a heroic event, another colleague Zodwa explained that she had given birth in her kitchen by herself. She said she just instinctively knew what to do. I was shaking my head in disbelief at what the Swazi women thought was quite a normal circumstance. When I got back to my desk, I quite coincidentally received these stats:
| | World Summit for Children Indicators | MICS 2000 | SDHS 2006-07 |
| Knowledge of preventing HIV | Women who correctly state the 2 main ways of avoiding HIV infection | 49.5% | 91.5% |
| Knowledge of misconceptions of HIV/AIDs | Women who correctly identified 3 misconceptions about HIV/AIDs | 41% | 51.9% |
| Knowledge of mother to child transmission | Women who correctly identify means of transmission of HIV from mother to child | 47% | 75.8% |
| Attitude to people with HIV/AIDs | Women expressing a discriminatory attitude towards people with HIV/AIDs | 77.4% | |
| Knowledge of HIV testing | Women who know where to get a HIV test | 59.7% | 91.8% |
| HIV testing | Women who have been tested for HIV | 17.3% | 35.8% |
| Contraceptive prevalence | Married women aged 15-49 who are using a contraceptive method | 27.9% | 50.6% |
| Antenatal care | Women aged 15-49 attended at least once during pregnancy by skilled personnel | 79% | 97.1% |
| Childbirth care | Births attended by skilled health personnel | 70% | 74.3% |
| Birth weight below 2.5 kg | Live births that weigh below 2500 grams | 5% | 8% |
| Exclusive breastfeeding | Infants aged less than 4 months who are exclusively breastfed | 31.2% | |
| Timely complementary feeding | Infants aged 6-9 months who are receiving breast milk and complementary food | 60% | 76.5% |
| Continued breastfeeding | Children aged 12-15 months and 20-23 months who are breastfeeding | 76.6% (12-15) | 76.4% (12-15) |
| 24.8% (20-23) | 30.7% (20-23) | ||
| Under five mortality | Probability of dying before reaching age five | 122/1000 | 120/1000 |
| Infant mortality | Probability of dying before reaching age one | 87.7/1000 | 85/1000 |
| Underweight prevalence | Under-fives who are too thin for their age | 10% | 5.3% |
| Stunting prevalence | Under-fives who are too short for their age | 30% | 29% |
| Wasting prevalence | Under-fives who are too thin for their height | 2% | 2.9% |
| DPT immunization | Children immunized against diptheria, pertussis and tetanus by age one | 77.2% | 90.2% |
| Measles immunization | Children immunized against measles by age one | 72.3% | |
| Polio immunization | Children immunized against polio by age one | 80.2% | 85.9% |
| Tuberculosis immunization | Children immunized against tuberculosis by age one | 94.1% | ~ |
| Neonatal tetanus | One year old children protected against neonatal tetanus through immunization of their mother | 79.8% | 74.9% |
| Home management of illness (IMCI) | Under-fives reported ill during the last 2 weeks who received increased fluids and continued feeding | 15.5% | ~ |
| Care seeking knowledge | Caretakers of under-fives who know at least 2 signs for seeking care immediately | 17.4% | ~ |
| ORT use | Under-fives who had diarrhea in the last 2 weeks who were treated with oral rehydration salts or an appropriate household solution | 92% | 82.8% |
| Home management of diarrhea | Under-fives who had diarrhea in the last 2 weeks and received increased fluids and continued feeding during the episode | 6.9% | 11.1% |
| Care for acute respiratory infections | Under-fives who had ARI in the last 2 weeks and were taken to an appropriate health provider | 60.9% | 73% |
| Use of safe drinking water | Population who use a safe drinking water source | 51% | 63.9% |
| Sanitary means of excreta disposal | Population who use a sanitary means of excreta disposal | 72% | 56.5% |
| Preschool attendance | Children aged 36-59 months who are attending some form of organized early childhood education programme | 12% | 21.6% |
| Net primary school attendance | Children of primary school age attending primary school | 90.6% | 84.2% |
| Children reaching Grade 5 | Children entering Grade 1 who eventually reach Grade 5 | 93.5% | |
| Birth registration | Under-fives whose births are reported registered | 53.5% | 35.1% |
| Children’s living arrangements | Children aged 0-14 years in households not living with biological parent | 19.7% | |
| Orphans in households | Children aged 0-14 years who are orphans living in households | 2% - both parents | |
| 5.6%- one parent | |||
| Child labour | Children aged 5-14 who are currently working | 11.8% | ~ |
[1] Among women age 15-49 who have heard of AIDS, percentage expressing specific accepting attitudes towards people
with AIDS
[6] Percentage of children under the age of 15 who have a very sick parent OR live in a household where an adult has been very sick OR died in the past 12 months (vulnerable children)
These are from two quite separate studies, methodologically incomparable. But the person who compiled them thought she might like to compare them anyway, and I think they capture the state of things quite well.
74% of women in labour being attended to by skilled health personnel is, I suppose, pretty good for a middle-income country in Africa. But it is still a terrible state of affairs.
But what has this got to do with the Constitution?
I’m not sure, but my feeling is with a different constitutional structure, these sorts of problems would be less likely, or would be being more rapidly addressed. As it is, the following sections of the Constitution require duty bearers to enact laws for the assistance of women and children:
27(4) Motherhood and childhood are entitled to special care and assistance by society and the State.
27(6) Subject to the availability of resources, the Government shall provide facilities and opportunities necessary to enhance the welfare of the needy...
28(2) Subject to the availability of resources, the Government shall provide facilities and opportunities necessary to enhance the welfare of women to enable them to realise their full potential and advancement.
29(7) Parliament shall enact laws necessary to ensure that –
(a) A child has the right to the same measure of special care, assistance and maintenance as is necessary for its development from its natural parents (sic)...
(b) A child is entitled to reasonable provision out of the estate of its parents;
(c) Parents undertake their natural right and obligation of care, maintenance and proper upbringing of their children; and
(d) Children receive special protection against exposure to physical and moral hazards within and outside the family.
So, what have duty bearers done since the passing of the 2005 Constitution?
A full list of what the Government has done is not possible here: suffice to say that it does not seem that the policy or practice of the Government has been radically transformed by these new constitutional requirements.
As for parliament, well since 2005, I am aware of only two women-/child-friendly laws being passed: The Free Primary Education Act 2009 and the Child Trafficking Act 2010.
The Free Primary Education Act 2009 was passed under duress of the courts, and in violation (not fulfilment) of the constitutional requirement for free primary education. And the Child Trafficking Act 2010 was passed under very direct pressure from the government of the United States of America. Its benefit has been marginal at best, and downright damaging at worst. Marginal because the American obsession with trafficking is a somewhat middle-class concern in a country where 30% of children are orphans, there is a skeletal welfare system, and no free education. And damaging, as the State Department’s ‘ride in and take over the parliament’ approach has taken the momentum out of much more important bill, the Child Protection & Welfare Bill and the Sexual Offences & Domestic Violence Bill, and has increased the burdens of inertia within parliament, which tends to think it has now done its bit for children.
