This report is Phase Four of the Integrated Development Plan for Umtshezi. Phase Four integrates the objectives, strategies and projects identified to date. This phase the report (highlighted) is part of the IDP process as illustrated below.
Umtshezi IDP : Phase Four 1
This report contains Sectoral Plans for each of the following sectors:
; Poverty Reduction/Social
; Land Reform
; Economic (excluding Agriculture and Tourism)
Each of the Sectoral Plans, except the Finance Sector, contains:
; An Introduction
; The Sectoral Setting
; The Sector Vision And Applicable Objectives
; Strategies And Projects
The Financial Sector Plan contains a:
; Five-year financial plan
; Five-year capital investment programme
; Five-year action programme
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2. SECTORAL PLANS
A. HIV / AIDS
The AIDS pandemic in KwaZulu –Natal, and more specifically in the Umtshezi Local Authority area, presents the greatest challenges for the Integrated Development of the area. The AIDS pandemic has spread rapidly throughout South Africa since the first two deaths were reported in 1983. It is estimated that one million adults are currently infected in KwaZulu-Natal. (TRP Commission Report on Impact of HIV/AIDS, 2000) As illustrated in Figure 1 below, KwaZulu-Natal has the highest rate of HIV Infection in the country. As a result, the pandemic will affect every aspect of development. (Refer to Phase One Annexure III: Impact of HIV/ AIDS on Planning Issues in KwaZulu-Natal.)
FIG 1: NATIONAL AND PROVINCIAL PREVALENCE 1994-8
22,82519,918,220SOUTH AFRICA1614,414,215KWA ZULU-NATAL10,4Percentage7,610
Source: Town and Regional Planning Commission Report: The Impact of
HIV/ AIDS on Planning Issues in KwaZulu-Natal
2. SECTORAL SETTING
2.1 Status Quo Of The Sector
The AIDS pandemic in Umtshezi is very serious. During 2000, testing of pregnant women at antenatal clinics in the Umtshezi area indicated an infection rate of 64.7%. This is illustrated in Figure 2 overleaf.
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FIG 2: PERCENTAGE HIV POSITIVE CLIENTS IN OKHAHLAMBA/
UMTSHEZI SUB DISTRICT
% of HIV Positive Clients
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
59.3% 69.6% 61.2% 64.6% 69.6% 74.2% 66.7% 56.9% 61.9% 71.8% 57.5% 63.3%
A total number of 1069 clients were tested during 2000 – This total
excludes Mnambithi sub-district – as they did not submit HIV/ AIDS
data for 2000.
Average of 64.7% of the Clients who were Tested for HIV were found
to be HIV Positive.
An average of 24.6% of clients come back to the Counselor for
Source: Annual Statistical Report – 2000, Uthukela District, DJ
HIV/Aids will have demographic, economic, social and developmental impacts. From recent studies, it is apparent that by the year 2005, 19.5% of the South African population will be HIV positive. These projections are based on modeling undertaken by the South African Insurance Industry, as illustrated in Figure 3.
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FIG 3: HIV/AIDS DATA 1997 – 2005 FOR SOUTH AFRICA
1997 1998 1999 2000 2001 2002 2003 2004 2005
2127906 2597926 3053222 3474845 3870873 4235374 4577189 4886566 5161047 #HIV +
87097 114368 143698 173018 200597 226073 249536 271255 291087 #HIV +
17629 24647 32713 41508 50471 59064 67079 74492 81361 AIDS
14089 19115 24733 30649 36499 42032 47172 51932 56325 AIDS
60410 96125 147056 216817 308837 425490 567686 734208 921394 Orphans
Note: Adult is 15 to 59 years, children are 0 to 14 years; Orphans are
children from 0 to 14 years who have lost their mother due to AIDS
Source: Town and Regional Planning Commission Report: The Impact of
HIV/ AIDS on Planning Issues in KwaZulu-Natal
2.1.1 The demographic impacts in Umtshezi will include changes in:
; Mortality (death) and Morbidity (illness)
; Life Expectancy
; Population size and growth
; Dependency Ratios
; The number of Orphans in the Community.
i. Mortality and Morbidity
An increase in Mortality and Morbidity is expected, which will slow the
population growth rate, but which is not likely to result in a negative
population growth. The population structure will change with higher
death rates amongst those in their reproductive years and those less
than five years of age, as illustrated in Figure 4.
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FIG 4: ANNUAL MORTALITY BY AGE: 1996
0%% of People Dying Per Year
5 - 9 years
10 - 14 years
30-34Source: Town and Regional Planning Commission Report: The
Impact of HIV/ AIDS on Planning Issues in KwaZulu-Natal 35-39
ii. Life Expectancy 50-54
An HIV Positive woman may pass the infection to the foetus during 55-59
gestation or to the newborn child during delivery or through 60-64
breastfeeding. The Town and Regional Planning Commission Report: 65-69
The Impact of HIV/AIDS on Planning Issues in KwaZulu-Natal indicates 70-74
that between 13% and 45% of children born to infected mothers, will be 75-79
infected themselves. Most of these children will develop AIDS and die 80+before they reach five years of age. Life expectancy at birth is significantly lower for those infected by the virus, and child and young adult deaths are increasing. AIDS is lowering levels of life expectancy dramatically.
The AIDS pandemic is likely to accelerate the decline of the fertility rate in South Africa. The reasons for this are the death of women prior to their childbearing years, a physiological reduction of fertility by the HIV infection and AIDS and an increase in AIDS awareness and female empowerment and the concomitant increase in the use of condoms.
iv. Population Size and Growth
The Town and Regional Planning Commission Report: The Impact Of HIV/AIDS on Planning Issues in KwaZulu-Natal, states that negative population growth is unlikely to occur unless there are very high levels of HIV infection coupled with an accelerated decline in fertility. However, as outlined in 1.1 and 1.2.3, it is evident that both of these factors are
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present, and that KwaZulu-Natal could be facing negative population
v. Dependency Ratio
This Ratio is the number of dependants (usually children less than fifteen
years old and adults over the age of sixty four) per one hundred adults of
productive age, which is between fifteen and sixty four years of age.
According to the Town and Regional Planning Commission Report, AIDS
does not have a significant impact on the Ratio, as the increase in young
adult deaths is more or less balanced by the increase in child deaths.
However, AIDS does have a negative impact on the dependency
situation, in that the number of widows and widowers increases and
when parents die, children remain to be cared for by grandparents and
members of the extended family and the community at large. It will
become increasingly difficult for extended families and communities to
cope with all these children.
One of the most serious impacts of the AIDS pandemic is the creation of
AIDS Orphans, whose parents have died of the disease, often after a
lengthy illness. This is causing the apparent increase in the number of
child-headed households in the more densely populated rural areas such
as Cornfields and Thembalihle. This phenomenon becomes evident at
the Regional Hospital, when children of six and seven years old are seen
bringing their younger siblings for treatment.
2.1.2 Economic Impacts
The AIDS pandemic will impact on various levels of the local economy. At the household level, increasing medical costs and the loss of income from the patient, have the most impact. Further income is lost if other family members have to take leave from productive activities in order to care for infected family members.
Various economic sectors, such as Agriculture and Manufacturing are also impacted on by the AIDS pandemic. The economy of Estcourt / Wembezi is predominantly focused on the Manufacturing and Government services sectors. These sectors contributed 60% to the economy of the District in 1997. (SA Stats.) In the Manufacturing sector, such as at the Nestle and Eskort Production Plants, increased leave for workers and the death of workers will have implications for the production process. The practise of employers not providing care or treatment for workers will have to change. In the Emnambithi area of the Uthukela District, Dunlop is considering a policy of Prevention and Treatment for its workers. Although such policies and programmes are expensive in the short term, they will, in the long term, have a positive effect on the local economies of the District.
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The Agricultural sector is also important in Estcourt, contributing 9.7% to the local economy, In Weenen, approximately half of the economic activity (47%) is as a result of the Agricultural sector. This sector, in terms of commercial and subsistence agriculture, is vulnerable to the impact of AIDS. The loss of workers, particularly at key times during the year, can have a significant impact on output. In the Weenen area, Labour Tenants who work for farmers in return for accommodation only, are particularly vulnerable, as they have no income or support with which to face the ravages of the pandemic.
2.1.3 Social Implications
The demographic and economic impacts discussed above, will have, and are already having, serious social consequences. Communities are faced with the loss of their productive members, increased dependency, household economic strain and a rapid increase in the number of orphans. As children without adequate parenting and support, they are at a greater risk of developing anti-social behaviour and of being less productive members of society. The care of orphans, in terms of their physical, emotional and social well-being, must receive special attention. Social Welfare will need to reassess the provision of housing, orphanages and cemeteries. The provision of educational facilities and health facilities will also need to be reassessed and specific support programmes will have to be developed to cater for the unique consequences of the AIDS pandemic.
2.1.4 Implications for Development
Development is not only about economic growth and GDP per capita. Development includes concern about the distribution of income, standard of living, life expectancy and infant and child mortality. These variables are particularly susceptible to the ravages of the AIDS pandemic and many of the development gains made by communities will be reversed, worsening the plight of their members. AIDS is a major obstacle to the reduction of poverty and inequality. In order to plan for the effective development of Umtshezi, care must be taken when using past norms and standards. These may need to change as a result of the pandemic. The Town and Regional Planning Commission Report: The Impact of HIV/AIDS on Planning Issues in KwaZulu-Natal, has developed a checklist in this regard, as illustrated in Annexure III of the Phase One report
3. SECTOR VISION AND APPLICABLE OBJECTIVES
The Vision and Objectives for addressing HIV/AIDS as one of the Priority Issues, is as follows:
To rapidly reduce the HIV/AIDS Infection Rate in Umtshezi.
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From the Phase Two report the following interrelated objectives apply to this sector:
; To reduce the levels of HIV infection in Umtshezi to below 5% by the
; To provide access to appropriate levels of basic services to all families
in Umtshezi by 2006
; To provide quality services to the community of Umtshezi.
; To have no prejudice against the disabled, sick, aged and
handicapped in Umtshezi.
4. STRATEGIES AND PROJECTS
The strategies and projects were derived in Phase Two per Priority Issue. The different objectives, strategies and projects applicable to this sector from a range of the Priority Issues are illustrated below.
(Reference numbers are derived from Figure II in Phase Two)
ISSUE 8: HIV/AIDS Objectives Strategies Projects No No No 8/1 To reduce the levels of 8/1/1 Through changing of sexual 8/1/1a Establish community-driven HIV infection in Umtshezi practices. HIV programmes. to below 5% by the year 8/1/1b Establish Public Private 2006 Partnerships to assist business in “Prevent and Treat” programmes. 8/1/1c Establish support for HIV infected people through Rural service Centres. 8/1/1d Involve Traditional Leaders, Business Leaders and Senior Municipal Officials in Prevention and Treatment Campaigns.
ISSUE 3: BASIC SERVICES Objectives Strategies Projects No No No 3/1 To provide access to 3/1/1 Through the maintenance of 3/1/1a Clinic maintenance appropriate levels of basic existing clinics Cornfields. services to all families in 3/1/1b Clinic maintenance Umtshezi by 2006. Wembezi 3/1/1c Clinic maintenance Sahlumbe.
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3/1/1d Forderville Clinic expansion and equipment upgrade. 3/1/1e Central Clinic expansion and equipment upgrade.
3/3 To provide quality 3/3/1 Through maintaining existing 3/3/1B Upgrading of Health services to the community infrastructure, replacement of Administration equipment of Umtshezi equipment and providing appropriate new services.
ISSUE 9: ATTITUDES Objectives Strategies Projects No No No 9/1 To have no prejudice 9/1/1 Through providing 9/1/1a Organise and disseminate against the disabled, sick, information to build literature for changing aged and handicapped in knowledge and attitudes towards the sick, Umtshezi understanding disabled and aged. 9/1/1b Support the production of plays and events aimed at changing attitudes. 9/1/1c Establish empowerment programmes for the sick, disabled and aged.
Further rationale on some of the above projects is provided below:
Project No 8/1/1a: The changing of sexual practices, by means of Community-driven HIV/AIDS Programmes.
Public Sector funding should be allocated directly to Local Authorities, for allocation to these Community-driven programmes. There is an urgent need for the development of a reliable local database on HIV Infection Rates, including information on levels of infection, sectors of society infected, geographic areas most affected and effective approaches to the reduction of HIV Infection Rates.
In Uganda, the Infection Rate has decreased from over 20% to less than 5%. This success has been attributed to the change in sexual practices brought about by Community Programmes and strong moral and religious norms. The average number of sexual partners per person in Uganda has reduced by two thirds. This sharp change in sexual practices has occurred as a result of Community-driven Programmes. Despite Kenya and Tanzania having higher usage of condoms than Uganda, these countries have retained very high infection rates. It appears that there are lower infection rates in areas where Community Programmes exist, than in areas where there is a greater use of condoms as a result of Public Sector awareness campaigns. Commentators have attributed Uganda‟s success to the involvement of communities in the HIV/AIDS Programmes.
At present, there is a nationwide lifestyle awareness campaign, known as “loveLife”, which is aimed at twelve to seventeen year olds. In an article on page six of The Sunday Times Lifestyle Magazine of 10 February 2002, this age group is described as “the „ground zero‟ of HIV/AIDS infection in South Africa.”
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