In the last two decades, there have been a plethora of South African policies to promote safety. However, indications suggest that the policy response to violence is not coherently formulated, comprehensive, or evenly implemented. This study examines selected South African national legislative instruments in terms of their framing and definition of violence and its typology, vulnerable populations, and prevention. This study comprises a directed content analysis of selected legislative documents from South African ministries mandated to prevent violence and its consequences or tasked with the prevention of key contributors to violence. The legislative documents recognised the high levels of violence, confirmed the prioritisation of selected vulnerable groups, especially women, children, disabled persons, and rural populations, and above all drew on criminological perspectives to emphasise tertiary prevention interventions. There is a policy focus on the protection and support of victims and the prosecution of perpetrators, but near absent recognition of men as victims. The authors argue for the policy framework to be broadened from primarily criminological and prosecutorial perspectives to include public health contributions, and to enlarge the conceptions of vulnerability to include men alongside other vulnerable groups.
Values, Policies and Rights
Interpersonal violence has a grave effect on children: Violence undermines children’s future potential; damages their physical, psychological and emotional well-being; and in many cases, ends their lives. This report sheds light on the prevalence of different forms of violence against children, with global figures and data from 190 countries. Where relevant, data are disaggregated by age and sex, to provide insights into risk and protective factors.
The post-2015 development agenda will have at its core the sustainable development goals (SDGs). The SDGs are a set of universal goals covering a range of sustainable development issues. The challenge for the international community will be to match this agenda with adequate means to implement it. This translates into large financing needs. In its report issued in August 2014, the Intergovernmental Committee of Experts on Sustainable Development Financing estimated the investment requirements in different sectors. More recently, a group of multilateral development banks and the IMF have coined the term 'from billions to trillions' to characterise the financing demand. Globally, they estimate that achieving the proposed SDGs will require US$ 135 billion in ODA, and nearly 1 trillion in philanthropy, remittances, South-South flows and other official assistance, and foreign direct investment that needs to be used effectively for the SDGs.
The Co-facilitators of the Post-2015 Development Agenda talks have released what could be the near-final version of the Post-2015 Development Agenda. This will set the stage for the final round of hectic negotiations at the United Nations headquarters in New York in end July.
The “Outcome Document for the UN Summit to Adopt the Post 2015 Development Agenda: Draft for Adoption” attempts to resolve some of the still remaining thorny issues. However, whether and how quickly the Member States agree to the final document remains to be seen. The document is likely to undergo some changes as negotiations continue, and the final document will be adopted when there is consensus among member states.
The UN General Assembly is currently considering proposals for Sustainable Development Goals (SDGs). SDG 3, focusing on health, specifically includes universal health coverage (UHC) among its targets. The authors argue that while UHC is timely and important, its promotion also entails substantial risks. A narrow focus on UHC could emphasise expansion of access to health-care services over equitable improvement of health outcomes through action across all relevant sectors—especially public health interventions, needed to effectively address non-communicable diseases (NCDs). The challenge for policy makers is observed to be to not merely to improve clinical services, but to achieve equitable health outcome improvements through genuine integration of individual and population-level health promotion and preventative efforts with curative services. Future UHC evaluations should include assessments of the extent to which this integration is accomplished—with particular attention to the distribution of benefits across groups—and not, as major current work be limited to the clinical side.
Botswana has made good progress against the targets of the Southern African Development Community (SADC) Protocol on Gender and Development set for 2015, according to this report. However, President Ian Khama of the Republic of Botswana said that Botswana would not sign the SADC Gender Protocol because the government considers some its time frames unrealistic, and some of its measures to have serious resource implications that the state cannot guarantee. Progress is noted in the report on the health sector, with trained personnel delivering more than 90% of births and 84% of the population living within five kilometres of a quality health facility. However, the maternal mortality rate is noted to have increased and only 44% of the population access contraception. Although Botswana has one of the world's highest HIV prevalence more than 95% of HIV-positive pregnant women access the prevention of mother-to-child transmission programme. In spite of these achievements, this report also reveals obstacles for the country on the road to gender equality, including a failure to address contradictions between formal and customary laws, with the latter discriminating against women, especially widows and divorced women.
Almost two decades after adoption of the African Charter on Human and Peoples' Rights, the record of adherence to its provisions across the continent is mixed. Some countries have made notable progress, but others show persistent serious violations of human rights. African performance on human rights as spelled out in the Charter varies from one country to another. The author elaborates the situation in different countries on the continent against the rights set out in the Charter. The author concludes that Africa has a long way to go in the practice and upholding of human rights at out in the Charter. He urges that governments be made accountable to ensure that human rights are upheld.
Health systems have a crucial role in a multisector response to violence against women. Some countries have guidelines or protocols articulating this role and health-care workers are trained in some settings, but generally system development and implementation have been slow to progress. Substantial system and behavioural barriers exist, especially in low-income and middle-income countries. Violence against women was identified as a health priority in 2013 guidelines published by WHO and the 67th World Health Assembly resolution on strengthening the role of the health system in addressing violence, particularly against women and girls. In this Series paper, we review the evidence for clinical interventions and discuss components of a comprehensive health-system approach that helps health-care providers to identify and support women subjected to intimate partner or sexual violence. Five country case studies show the diversity of contexts and pathways for development of a health system response to violence against women. Although additional research is needed, strengthening of health systems can enable providers to address violence against women, including protocols, capacity building, effective coordination between agencies, and referral networks.
A mixed-methods study was conducted in four countries in sub-Saharan Africa to investigate the impacts of maternal death on families and children. The analysis identified gender as a fundamental driver not only of maternal, but also child health, through manifestations of gender inequity in household decision making, labour and caregiving, and social norms dictating the status of women. Focus group discussions were conducted with community members, and in depth qualitative interviews with key-informants and stakeholders, in Tanzania, Ethiopia, Malawi, and South Africa between April 2012 and October 2013. Findings highlighted that socially constructed gender roles, which define mothers as caregivers and fathers as wage earners, and which limit women's agency regarding childcare decisions, among other things, create considerable gaps when it comes to meeting child nutrition, education, and health care needs following a maternal death. Additionally, the findings show that maternal deaths have differential effects on boy and girl children, and exacerbate specific risks for girl children, including early marriage, early pregnancy, and school drop-out. The authors conclude that investment in health services interventions should be complemented by broader interventions regarding social protection, with a shifting of social norms and opportunity structures regarding gendered divisions of labour and power at household, community, and society levels.
Universal health coverage (UHC) means that all people receive the quality, essential health services they need, without being exposed to financial hardship. Moving towards UHC is a dynamic, continuous process that requires changes in response to shifting demographic, epidemiological and technological trends, as well as people’s expectations. But in all cases, countries need to integrate regular monitoring of progress towards targets into their plans. In May 2014, the World Health Organization and the World Bank jointly launched a monitoring framework for UHC, based on broad consultation of experts from around the world. The framework focuses on indicators and targets for service coverage – including promotion, prevention, treatment, rehabilitation and palliation – and financial protection for all. This report is the first of its kind to measure health service coverage and financial protection to assess countries’ progress towards universal health coverage. It shows that at least 400 million people do not have access to one or more essential health services and 6% of people in low- and middle-income countries are tipped into or pushed further into extreme poverty because of health spending.