Section 27 (1) of the South African Constitution provides that everyone has the right to have access to health-care services, including reproductive health care. Section 27 (3) also provides everyone with the right not to be refused emergency medical care. In addition to these rights that are specified for everyone, children have extra protection in that Section 28 (1) (c) provides that “every child has the right to basic health care services”.
South Africa is currently the country with the largest number of people living with HIV in the world. Many children are HIV positive or have become ill and died due to AIDS. The majority of children are infected before and during the birth process and some later through breastfeeding. Children may also become infected through sexual intercourse, including sexual abuse.
Adult HIV prevalence is critical for children, since children born to HIV-positive mothers are at risk of being born HIV positive or contracting HIV after birth, unless adequate and appropriate interventions and resources are available.
This indicator refers to the number of children under 15 years starting antiretroviral treatment (ART) in a particular year. Access to ART for children has improved substantially over the past six years but varies significantly between provinces.
The majority of HIV-positive children in South Africa are infected in-utero, during birth, or as a result of breast-feeding. The roll-out of the 'prevention if mother-to-child transmission' programme (PMTCT) has expanded dramatically in recent years, with the proportion of pregnant women receiving HIV tests increasing from 7% in 2001/02 to 81% in 2007/08.
The child mortality indicator focuses on two indices of childhood mortality, the Infant Mortality Rate and the Under-five Mortality Rate. Both are valuable indicators of early childhood mortality and the two are strongly related.