The budget for the Directorate: Child and Youth Health for the 2005/06 financial year is R9 526 000.

The breakdown is as follows:

- Office of the Director: R1 629 000

- Child Health: R2 062 000

- Youth & Adolescent Health R1 929 000

- EPI R3 906 000

The amount of R5 335 000 has been set aside for Compensation of Employees, and is included in the above-mentioned amount.

The total budget for the Comprehensive HIV and AIDS Care, Management, Treatment and Support Plan for Children amounts to R2 281 000.

The total budget for the HIV and AIDS – Youth Programme amounts to
R1 941 000.

Because of unplanned/unforeseen circumstances, it is often necessary to shift money within the Directorate to meet the demands of the other Sub-directorates, e.g. during disease outbreaks.

Several activities have been planned, aimed at reducing the morbidity and mortality rates of children under 5-years, thereby improving their quality of life.

The main activities are grouped as follows:

• Training of health care professionals and community caregivers on child health issues
• Meetings, workshops and conferences
• Provincial child health support visits
• Health facility surveys (monitoring & evaluation)
• Policy development and dissemination workshops
• Inter-sectoral collaboration activities
• Development of IEC materials
• Awareness campaigns

• Reorientation and sensitization of health workers on Youth Friendly Services
• Supporting provinces in National workshops, meetings, etc.
• Intra- and Inter-departmental collaboration activities on youth related issues
• Implementation of Peer Education in all provinces
• Develop Health Regulations on Traditional Circumcision
• Finalization and dissemination of National Strategy on Prevention of Teenage Pregnancy
• HIV and AIDS prevention, care and support
• Support the people infected and affected by HIV and AIDS
• Developing, purchasing and dissemination of identified Information Education and Communication (IEC) material specific for young people

• High staff-turnover

Although training is done, all provinces experience high staff-turnover. After investing on time, money and effort, the trained practitioners leave the services for other areas. This defeats the objective of saturating districts with adequately trained personnel to increase the quality of services rendered.

• Lack of provincial budget for child health

Most of the provinces do not have a dedicated budget for child health. Reliance on donor funding and/or funding from the NDoH, defeats the objective of availability and sustainability of services.

• Lack of transport

In most of the provinces, district level supervision is curtailed by lack of transport. Post IMCI Case Management training, e.g. supervision and support are crucial to re-enforce quality care standards. This is not possible due to lack of transport.

• Poor intra-departmental and inter-sectoral collaboration

Collaborative efforts between all relevant role-players in child health care are disjointed, e.g. IMCI / EPI / Nutrition, PMTCT, Child Abuse and Neglect, Child Labour, etc. Gradual improvement is however observed, as role players realise the need to defeat fragmentation and duplication of services.

• Biennial health facility surveys

Due to lack of funds and/or capacity, provinces are not able to carry out the health facility surveys as recommended by WHO and the NDoH. Conducting province specific health facility surveys creates an opportunity to identify good practices, as well as implementation areas that require improvement.

• Slow progress in the implementation of the School Health Policy

Although provinces have commenced with implementation of this policy, very few submit quarterly reports as expected. This makes it difficult for the Sub-directorate to table evidence-based progress reports.

• IEC material

Mostly developed in English. A need has been identified for translation into other official languages.

• Some provinces are undergoing restructuring thus there is minimal interaction between National and Provincial offices, e.g. KwaZulu Natal and Western Cape Provinces
• Shortage of staff and staff turnover, trained people leave services and vacancies not filled readily thus delay progress
• Some provinces do not have a dedicated person the manage the Youth Health Programmes, thus hindering progress in implementation of Youth Friendly Services and other youth health programmes,
• Lack of Specialist Technical support – Post for Medical Officer Health has been vacant for more than 3 years.
• Reporting and monitoring of youth health programmes/ activities at provincial level: No mechanism in place to inform the National office on activities taking place at provincial level.
• Lack of information as data elements are not included in the Minimum Data Set for the District Health Information System, e.g. the teenage pregnancy rate
• Lack of dedicated budget to support implementation of Youth Health programmes, e.g. Youth Friendly Services and stipends for Peer Educators.

• Support provinces on training on the 3 components of IMCI
• Provincial support visits done in KZN, Eastern Cape and North West Provinces. These visits are a perfect opportunity to observe the realities of the situation, learn lessons, identify areas of support and strengthen existing good practices.
• Support the Comprehensive HIV and AIDS Care, Management, Treatment and Support Plan for children in updating trained IMCI practitioners on the Comprehensive Plan for children
• Strong political support to prioritization of children’s issues on the national agenda, e.g. School Health Services, IMCI, EPI, Early Childhood Development, etc.
• Successful hosted the Inter-provincial IMCI co-ordinators as well as the Household and Community Component meetings
• Policies for child health related issues have been developed – awaiting approval by the National Health Council
• IEC material for the key diseases, e.g. diarrhoea have been developed and are currently used in all the provinces
• Implementation of the School Health Policy is gradually gaining momentum in the provinces
• Participation on the development of the National Integrated ECD Plan – as co-ordinated by the NDoE
• Participation in inter-sectoral activities on children’s issues e.g. National Children’s Day, Child Protection Week, Orphaned and Vulnerable Children, Child Labour, and Child Abuse and Neglect
• Participate in national, regional and inter-national conferences on child health issues e.g. the UN Study on Violence Against Children, and the Children’s Bill as co-ordinated by the Department of Social Development.

• Linked with Health Promotion and jointly conducted support visits to promote Healthy Lifestyles campaign during the youth month in Frances Baard District, Northern Cape;
• Continuous Intra-Departmental collaboration to maximize utilization of resources within the Department, e.g. working closely with HIV –Youth Programme, Health Promotion, Oral Health, Nutrition, Gender Focal Point, Women’s Health and Genetics and Mental Health,
• Participated in Inter-sectoral collaboration activities coordinated by external stakeholders to:

• Draw programme of action for Peer Education within the Department of Health,
• Developed a script on teenage pregnancy for a Child Survival video developed by Mindset Health

• Supported the National Youth Commission and sponsored 10 young people to attend the National Youth Economic Empowerment workshop from 11-17 June 2005 in Kimberley, Northern Cape,
• Developed promotional Information, Educational and Communication material on abstinence to raise awareness and market services available in our health facilities;

• Supported the Sub-directorate: Mental Health and Substance Abuse to collaborate with Eastern Cape and Mpumalanga Dept of Health to host an awareness campaigns on Drug Abuse and Illicit Trafficking on 21 and 25 June 2005 respectively;
• Successfully strengthened collaboration in seven out of nine provinces through the provincial road shows that were held early in 2004;
• Workshop on Life Skills Education done in collaboration with Department of Education;
• Site visits to funded Faith-Based Organisation rendering abstinence programmes
• Supported Western Cape training on Young Care Givers
• Facilitated quarterly Life Skills meeting for national and provincial partners
• Awarded an approved tender for translation of youth specific IEC material.

The expenditure for Directorate: Child and Youth Health are mainly for the following:

• Salaries for national officials
• Office furniture and equipment
• Travel and subsistence to the provinces
• Attendance of courses / training
• Courier services to deliver training materials, stool specimens, etc on time at various destinations
• Payment for meetings, conferences, etc.

Till the end of July 2005, the Directorate: Child and Youth Health has spent 28.47% of the total budget, and the HIV and AIDS - Youth Programme has spent 18.41% of the total budget.

The Sub-directorate: Youth & Adolescent Health collaborates and works closely with the HIV and AIDS - Youth Programme. The HIV and AIDS - Youth Programme funds some of the joint programmes that are done through collaboration because both units are targeting young people.

The Directorate: Child and Youth Health strives to actualise a rights-based approach in all interventions, as enshrined in the UN Convention on the Rights of the Child, as well as the Constitution of the Republic of South Africa.

The Directorate is committed to reducing morbidity and mortality rates from preventable causes (Millennium Development Goals). Since no single Directorate or Department can achieve this as an entity, the Directorate participates in intra-departmental as well as inter-sectoral interventions to ensure a holistic approach to child and youth care. Relevant NGO participation enriches community involvement / participation in improving health promoting behaviour at household level.

Care and protection of children and youth is everybody’s business – "It takes the whole village to raise a child".