This is one of the findings from a study, ‘€œThe Health of our Children in South Africa: Results from a national HIV prevalence population survey’€, released in Cape Town yesterday (13 May).

Almost 9 000 children up to the age of 18 were surveyed in 2008 in the nationally representative study.

According to the study 2,1 percent of children up to the age of two were HIV positive, whereas 3,3 percent of children up to the age of four were living with the disease.

The study also found that three million children had lost either one or both parents and that more boys than girls were being orphaned.  

The study recorded 1 899 000 paternal orphans, 713 000 maternal orphans and 419 000 double orphans.

Paternal orphans are as defined as children without fathers while those without mothers were referred to as maternal orphans. Children who have lost both parents are called double orphans.

 Researchers said the likelihood of being orphaned increased with age with a third of teenagers between the ages 15 to 18 years without one or both parents.

They noted a slight hike in the number of orphans (where one or both parents are absent) between the ages of two and 18 years (19.3%). This was compared to 15.6%  in 2002 and 14.4%  in 2005.

The study found that overall 96,5% of South African children attended school, but the picture changed with orphans with more than one in 10 (12.9%) receiving no schooling. The likelihood of the children attending school plummeted even further if the mother had died.

Most orphans were located in the Eastern Cape (23.2%) followed by KwaZulu-Natal with 19.4%. The Northern Cape and Western Cape had the least number of orphans. More orphans were located in rural areas.

One percent of children were reported to be heading households in 2008 a decline from 2.6% in 2005.

Researchers said one of the main impacts of HIV was the premature loss of young parents leaving their children orphaned. However, they said it was difficult to trace the parents’€™ cause of death.

The report also found that government’€™s programme to prevent babies from getting HIV from their mothers appeared to be working as fewer children under the age of two are now infected with the virus.

Less than one percent of Western Cape children were HIV positive whereas 4.5 percent of Mpumalanga’€™s children were HIV positive.

‘€œThis pattern could indicate a possible positive impact of the national prevention of mother-to-child HIV transmission (PMTCT) programme in the two years before the study took place,’€ said the researchers, who were drawn from a number of organisations including the Human Science Research Council (HSRC) and the Medical Research Council (MRC).

Girls aged 12 to 14 were far more likely to have had sex than boys in the same age group, with one in seven girls having had sex in comparison to one in 10 boys.

A quarter of the girls aged 12-18 years had most recently had sex with males who were five or more years older than themselves. Older male partners are more likely to be HIV positive.

Of the sexually active boys aged 15 to 18, over a quarter had more than two partners in the past year as opposed to one in 10 girls. However, condom use was reported to be high (92.1% among males and 83.9% among females).

Nearly all pregnant women in South Africa attended antenatal care clinics during pregnancy (97%), and most births took place in health facilities overseen by midwives.

‘€œYet maternal mortality remains high (at about 2,500 per year) and this suggests that challenges remain with the quality of health care provided,’€ notes the report.

National Minister of Health Dr Aaron Motsoaledi said his department was encouraged by the findings of the study.

He said the antenatal uptake was impressive and that one of the department’€™s priorities was to see more women seeking antenatal services earlier.

‘€œIt is noteworthy that there has been a very high level of uptake of antenatal services with a level of 97% being attained. Among our key policy priorities for the health sector for the upcoming period is increasing the percentage of pregnant women who book for antenatal care before 20 weeks gestation,’€ he said.

He said it was unfortunate that the country continued to have high rates of maternal deaths. Motsoaledi added that most of the maternal deaths were preventable sighting negligence in the part of health care providers as the most probable cause.

Although children also had good access to primary health care, fewer than 70% of children had routine immunisations other than BCG which is given at birth.

‘€œ(This) demonstrates a shortcoming of the primary health-care system to prevent and adequately manage disease among children,’€ notes the report.

It recommends that the Department of Health (DoH) ‘€œprioritises strengthening the primary health care system, particularly expanding the number and scope of work of community health workers to include high impact but low-cost child health and nutrition interventions’€.

Motsoaledi added that the study highlighted other issues that were of importance like immunisation and mixed feeding practices which ‘€œwere still a great concern’€. He said there was too much damage being done by the fact that more mothers were dependent on formula milk and opting out of breastfeeding.

‘€œBreastfeeding is by far the best method of feeding. Infant feeding formula milk should be banned altogether,’€ he said.

It also says that HIV testing should be routine for sick children and primary health care providers must be trained to ‘€œidentify HIV infections and to ensure timely referral and management of advanced HIV infection in children’€.

Some eight percent of children reported that male teachers tried to have sex with school girls. The report commends ‘€œthe initiative by the South African Council for Educators (SACE) to establish a website that publishes the names of teachers found guilty of sexual misconduct with pupils’€.

Although children aged 12 to 18 were found to have good access to broadcast and print media for AIDS communication, there was lower access to national AIDS communication programmes in rural areas, as well as among home language speakers of English, Afrikaans, Tsonga or Venda.

Over one in five boys (21.7%) aged 15-18 years were circumcised, mostly for traditional reasons. However, almost one-third of young men knew that male circumcision reduced HIV risk.

The survey was funded by the US Centers for Disease Control and Prevention (CDC) using funds from the US President’€™s Emergency Plan for AIDS Relief (PEPFAR) and the United Nations Children’€™s Fund (UNICEF). ‘€“ Health-e News.