The State of the Population in the Western Cape Province potx

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This volume is compiled and funded by the Department of Social Development,
Western Cape Provincial Government
Published by HSRC Press
Private Bag X9182, Cape Town, 8000, South Africa
www.hsrcpress.ac.za
First published 2008
ISBN 978-0-7969-2226-7
© 2008 Human Sciences Research Council
Copyedited by Robyn Arnold
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Tables vii
Figures x
Acknowledgements xiii
Acronyms and abbreviations xv
฀ Introduction฀ 1

Ravayi Marindo
1฀ Western฀Cape:฀an฀overview฀ 7฀
Cornie Groenewald
2฀ ฀Population฀and฀planning฀in฀the฀Western฀Cape:฀฀
a฀policy฀review฀ 25฀
Shahid Solomon
3฀ ฀Under-five฀mortality฀in฀the฀Western฀Cape฀
province฀ 47฀
Nancy Stiegler
4฀ ฀Adult฀mortality฀in฀the฀Western฀Cape:฀฀
an฀example฀from฀Cape฀Town฀metro฀ 65฀
Nesbert Zinyakatira
5฀ ฀Levels,฀trends฀and฀determinants฀of฀child฀
maltreatment฀in฀the฀Western฀Cape฀province฀ 97฀
Andrew Dawes and Catherine L Ward
6฀ ฀Population฀ageing฀in฀the฀Western฀Cape฀
province฀ 127฀
Bärbel Haldenwang
7฀ ฀Foreign-born฀and฀non-citizen฀populations฀in฀
the฀Western฀Cape฀(1996–2006):฀a฀demographic฀
overview฀ 151฀
Ravayi Marindo
8฀ ฀Population,฀HIV/AIDS฀and฀the฀provision฀of฀
health฀care฀in฀the฀Western฀Cape฀ 175฀
Najma Shaikh
9฀ ฀Population฀and฀education฀in฀the฀Western฀
Cape฀ 197฀
Jean Baxen
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10฀ ฀Population฀and฀development฀interrelationships:฀

global฀perspectives฀ 221฀
Sam Gaisie
Conclusion฀ 239฀
Ravayi Marindo and Siyanda Saki
Contributors฀ 242
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vii
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Table 1.1. Surface area and population of the Western Cape, by district municipality
(1996 and 2001) 8
Table 1.2. Comparison of population numbers and growth between the Western Cape
and South Africa (1996, 2001 and 2007) 11
Table 1.3. Estimated migration into and out of the Western Cape (2001–2006 and
2006–2011) 12
Table 1.4. Population estimate for the Western Cape (2007) 17
Table 1.5. Population, by population group, for South Africa and the Western Cape
(1996, 2001 and 2007) 19
Table 1.6. Language composition for South Africa and the Western Cape, by district
municipality (2001) 20
Table 2.1. High-level targets of the Western Cape PGDS (2006–2014) 37
Table 3.1. Period life table for the Western Cape 51
Table 3.2. Probability of dying, by generation 52
Table 3.3. Survivals per 1 000 births, by generation 53
Table 3.4. Infant mortality and under-five mortality rates in the Western Cape
(1997–2004) 54
Table 3.5. Neonatal infant mortality rate in the Western Cape, by period (2006) 55
Table 3.6. Neonatal infant mortality rate in the Western Cape, by period (2007) 55
Table 3.7. Distribution of dead infants, by period, during first month of life per 100
neonatal deaths in the Western Cape (2006) 55
Table 3.8. Distribution of dead infants, by period, during first month of life per 100

neonatal deaths in the Western Cape (2007) 56
Table 3.9. Proportion of dying babies (less than one year old), by weight (2006 and
2007) 56
Table 3.10. Proportion of infant deaths per 1 000 live births in the Western Cape, by
health facility sector (2006) 57
Table 3.11. Proportion of infant deaths per 1 000 live births in the Western Cape, by
health facility sector (2007) 57
Table 3.12. Proportion of infant deaths, by medical institution, in the Western Cape per
1 000 live births at each institution (2006) 57
Table 3.13. Proportion of infant deaths, by medical institution, in the Western Cape per
1 000 live births at each institution (2007) 58
Table 3.14. Distribution of deliveries, by place of delivery, per 100 deliveries in the
Western Cape (2006) 58
Table 3.15. Distribution of deliveries, by place of delivery, per 100 deliveries in the
Western Cape (2007) 58
Table 3.16. Distribution of infant deaths in South Africa, by reason of death and age
period (1995–1996) 59
Table 3A1. Lexis diagram: live births and deaths in the Western Cape (1998–2004) 63
Table 4.1. Completeness of adult death registration (2001) 74
Table 4.2. Mortality rates between the ages of 15 and 60 (
45
M
15
) for females 87
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viii
Table 4.3. Mortality rates between the ages of 15 and 60 (
45
M
15

) for males 89
Table 4A1. Female average completeness ratios for adults aged 15+ (1996–2004) 92
Table 4A2. Male average completeness ratios for adults aged 15+ (1996–2004) 92
Table 4A3. Age and sex mortality rates for Cape Town (1996–2004) 93
Table 5.1. Summary of key research studies and reports in the public domain relevant
to child maltreatment in the Western Cape (2000–2005) 107
Table 5.2. Sexual assault incidence rates per 1 000 children, aged 0–13 years, by health
region 111
Table 5.3. Children’s Court Inquiry (CCI) incidence rates, per 1 000 children
(2002–2005) 113
Table 5.4. The elements of a protective environment (UNICEF) 117
Table 6.1. Age composition of the Western Cape population, by sex and population
group (1996 and 2001) 129
Table 6.2. Population ageing indices of the Western Cape, by population group (1996
and 2001) 132
Table 6.3. Median age and life expectancy at age 65 years of the Western Cape
population, by sex and population group (1996 and 2001) 133
Table 6.4. Projected population of the Western Cape, by population group (2005–
2025) 137
Table 7.1. Population density in the Western Cape district municipalities (1996, 2001
and 2007) 154
Table 7.2. Foreign-born population in the highest immigration countries in the world
(1990s–2000s rounds of censuses) 158
Table 7.3. Foreign-born population, by province of enumeration and country of birth
(2001) 160
Table 7.4. Foreign-born population in the Western Cape, by racial group (2001) 161
Table 7.5. Foreign-born population in the Western Cape, by country of birth and
district municipality (2001) 163
Table 7.6. Non-citizen population in the Western Cape, by country of citizenship
(2001) 164

Table 7.7. Non-citizen population in the Western Cape, by gender and citizenship
(2001) 165
Table 7.8. Demographic indicators (2001) 170
Table 8.1. HIV prevalence, by locality type, in the Western Cape (2005) 179
Table 8.2. HIV projections for the Western Cape (2006–2010) 184
Table 8.3. Projected AIDS orphans in the Western Cape (2006–2011) 184
Table 9.1. National profile of total learner, teacher and school ratios, by type of
school 199
Table 9.2. Number and type of schools, teachers and learner–teacher ratio in the
Western Cape (2006) 200
Table 9.3. Learners in the Western Cape, by phase (2006) 200
Table 9.4. Learners in the Western Cape, by grade (2006) 201
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Table 9.5. Proportional indicators of educational levels in the Western Cape (1995 and
2002) 202
Table 9.6. Western Cape and total South African population, by racial group
(2001) 202
Table 9.7. Source of water supply 203
Table 9.8. Source of energy supply 204
Table 9.9. Sewage disposal 204
Table 9.10. Site security 204
Table 9.11. Employment status of communities (2001) 206
Table 9.12. Highest level of education among those aged 20+ years 206
Table 9.13. Annual household income (2001) 206
Table 9.14: Occupation, by geographical location (2001) 207
Table 9.15. Type of housing unit (2001) 207
Table 9.16. Toilet facilities (2001) 208
Table 9.17. Main water supply (2001) 208
Table 9.18. Energy source for cooking (2001) 208

Table 9.19. Mode of transport (2001) 209
Table 9.20. Provincial HIV prevalence estimates among antenatal clinic attendees in
South Africa (2004–2006) 212
Table 9.21. Types of training and workshops on HIV/AIDS attended (2004) 215
Table 10.1. Population, GDP and productivity in 16 more developed countries (1870 and
1987) 229
Table 10.2. Key indicators of development related to population and economic
growth 231
Table 10.3. Population and economic growth in sub-Saharan African countries 232
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Figure 1.1. Western Cape province and its district municipalities 8
Figure 1.2. Total rainfall in South Africa (July 2005–June 2006) 10
Figure 1.3. Migration into and within the Western Cape, by district municipality
(1996–2001) 13
Figure 1.4. Migrants from other provinces to the Western Cape, by district municipality
(1996–2001) 14
Figure 1.5. Migrants within the Western Cape that moved to district municipalities
(1996–2001) 15
Figure 1.6. Growth of the Western Cape district municipalities (1996–2001) 16
Figure 1.7. Growth by population group in the Western Cape (1996–2001) 16
Figure 1.8. Age–sex pyramid for the Western Cape (2007) 18
Figure 1.9. Sex ratios by race for South Africa and the Western Cape (2006) 18
Figure 1.10. Educational status of population 20 years and older for South Africa and the
Western Cape (2006) 20
Figure 1.11. Unemployment status by province (2006) 21
Figure 1.12. Informal dwellings in South Africa and the Western Cape (2002–2006) 21
Figure 1.13. Poverty index by province (1996–2001) 22
Figure 3.1. Mosley/Chen model 49
Figure 3.2. Mosley/Chen model modified by Barbieri 50

Figure 4.1. Population distribution of the City of Cape Town (1996 and 2001) 70
Figure 4.2. Completeness of vital registration, by age (2001) and completeness trends in
Cape Town (1996–2004) 73
Figure 4.3. Age-specific mortality rates per thousand in Cape Town, by sex
(1996–2004) 75
Figure 4.4. Communicable mortality rates per thousand in Cape Town (1996–2004) 76
Figure 4.5. Non-communicable mortality rates per thousand in Cape Town
(1996–2004) 77
Figure 4.6. Injury mortality rates per thousand in Cape Town (1996–2004) 78
Figure 4.7. Ill-defined mortality rates per thousand in Cape Town (1996–2004) 79
Figure 4.8. Age-specific female and male mortality rates per thousand in the Central
health district (1996–2004) 80
Figure 4.9. Age-specific female and male mortality rates per thousand in the Eastern
health district (1996–2004) 81
Figure 4.10. Age-specific female and male mortality rates per thousand in the Khayelitsha
health district (1996–2004) 82
Figure 4.11. Age-specific female and male mortality rates per thousand in the Klipfontein
health district (1996–2004) 83
Figure 4.12. Age-specific female and male mortality rates per thousand in the Mitchells
Plain health district (1996–2004) 84
Figure 4.13. Age-specific female and male mortality rates per thousand in the Northern
Panorama health district (1996–2004) 85
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xi
Figure 4.14. Age-specific female and male mortality rates per thousand in the Southern
health district (1996–2004) 86
Figure 4.15. Age-specific female and male mortality rates per thousand in the Tygerberg
health district (1996–2004) 87
Figure 4.16. Female mortality rates between the ages of 15 and 60 (

45
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15
) for Cape Town
and its eight health districts (1996–2004) 88
Figure 4.17. Male mortality rates between the ages of 15 and 60 (
45
M
15
) for Cape Town
and its eight health districts (1996–2004) 89
Figure 5.1. The nested systems of an ecological approach to child maltreatment 102
Figure 5.2. A hierarchy of interventions to improve child protection linked to the eight
elements of the UNICEF protective environment 117
Figure 5.3. Formal child protection intervention: processes and outcomes following
needs and risk assessment 119
Figure 6.1. Population pyramids of the Western Cape population (2001) 131
Figure 6.2. Population pyramids of the Western Cape population (2025) 136
Figure 6.3. Projected age structure of the Western Cape population, by population
group (2005–2025) 137
Figure 6.4. Projected median age of the Western Cape population, by population group
(2005–2025) 141
Figure 6.5. Projected life expectancy at age 65 years of the Western Cape population,
by population group (2005–2025) 142
Figure 6.6. Projected ageing index of the Western Cape, by population group
(2005–2025) 143
Figure 6.7. Projected old-age dependency ratio of the Western Cape population, by
population group (2005–2025) 144
Figure 6.8. Projected potential support ratio of the Western Cape, by population group
(2005–2025) 144

Figure 7.1. Population distribution by population group (race) in the Western Cape and
South Africa (2007) 153
Figure 7.2. Map of the Western Cape and its district municipalities 154
Figure 7.3. Foreign-born persons from Africa and Europe, by province (2001) 159
Figure 7.4. Foreign-born population in the Western Cape, by sex and race (2001) 162
Figure 7.5. Age-sex pyramids of the non-citizen population of the Western Cape
(2001) 166
Figure 7.6. Spatial distribution of the non-citizen population in the Western Cape district
municipalities (2001) 168
Figure 7.7. Distribution of the non-citizen population in Cape Town, by citizenship
(2001) 168
Figure 7.8. Age-sex pyramids for the Western Cape native population and non-citizen
population (2001) 169
Figure 8.1. HIV prevalence among antenatal clinic attendees in the Western Cape
compared with South Africa (1990–2006) 177
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xii
Figure 8.2. HIV prevalence in the Cape metropole, by health district (2001 and
2006) 178
Figure 8.3. HIV prevalence in non-metropolitan areas of the Western Cape (2001 and
2006) 179
Figure 8.4. National HIV prevalence, by age and sex (2005) 180
Figure 8.5. HIV prevalence, by age group, in the Western Cape (2000–2006) 180
Figure 8.6. HIV prevalence among the group aged 15–24 years in the Western Cape
(2001–2005) 182
Figure 8.7. Top 10 causes of premature mortality years of life lost (YLL) for Cape Town
(2004) 183
Figure 8.8. Age-standardised death rate for TB, HIV+TB and HIV in Cape Town, by area
(2001 and 2004) 183
Figure 8.9. TB incidence and HIV prevalence in the Western Cape (1997–2006) 186

Figure 8.10. Trends in the enrolment of antiretroviral patients in the Western Cape (April
2004–May 2007) 191
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xiii
This book would not have been possible without the support of the Department of
Social Development (DSD), Western Cape Provincial Government. The Director for
Research and Population Development, Mr Gavin Miller, suggested the title of the
report and provided support at every stage of the project from its conceptualisation,
ensuring that funds were available, signing submissions and suggesting some of
the authors. Without him, the book would not have become a reality. My sincere
gratitude goes to him.
I am also indebted to Statistics South Africa for providing much of the data on which
the studies are based.
I am very grateful for having Koleka Lubelwana, Sharon Follentine, Mr Juan Smith
and all the other senior managers in the Western Cape DSD as my leaders and
colleagues and wish to thank them for their support and belief in my ability.
It has been an honour to work with my eminent co-editors, Prof. Cornie Groenewald
and Prof. Sam Gaisie.
I wish to thank the authors for their ability and hard work, for submitting chapters
on time and for their patience with my endless demands. I feel honoured to have
worked with this group, and thank them for trusting me with their intellectual
property.
I would like to thank the reviewers; Dr Benjamin Häefele, Crystal Prince and Leigh
Johnson, for taking the time to read and comment on some of the chapters.
I am grateful for the support of specialists who did the first stage of proofreading and
styling – Peter Nortje and Neall Fourie; and David Green and Lindsay Redcliffe for
designing policy briefs.
Last but not least, my gratitude goes to my family in Germany, Zimbabwe, Australia
and Botswana for their unconditional support.
Dr Ravayi Marindo

Cape Town, June 2008
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xv
45
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Number of deaths per thousand
AIDS Acquired immune deficiency syndrome
ANC African National Congress
ART Antiretroviral therapy
AsgiSA Accelerated Shared Growth Initiative for South Africa
ASSA Actuarial Society of South Africa
BBBEE Broad-based black economic empowerment
BEE Black economic empowerment
BMR Bureau of Market Research
BOD Burden of Disease Research Unit
CCI Children’s Court Inquiry
CD4 Cluster of differentiation 4
CPR Child Protection Register
CPU Child Protection Unit
CRC United Nations Convention on the Rights of the Child
DoE Department of Education
DoH Department of Health
DPLG Department of Provincial and Local Government
DSD Department of Social Development
EC Eastern Cape
ECD Early childhood development
ECOSOC United Nations Economic and Social Council

ELRC Education Labour Relations Council
EPWP Extended public works programme
FET Further Education and Training
FS Free State
G Gauteng
GDP Gross domestic product
GDPR Regional gross domestic product
GET General Education and Training
GNI Gross national income
GNP Gross national product
HBC Home-based care
HIV Human immunodeficiency virus
HSRC Human Sciences Research Council
ICD International Causes of Death
IDP Integrated development plan
IMR Infant mortality rate

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ISDM Integrated service delivery model
Jipsa Joint Initiative on Priority Skills Acquisition
KPA Kilimanjaro Programme of Action for African Population and Self-reliant
Development
KZN KwaZulu-Natal
L Limpopo
M Mpumalanga
MDG Millennium Development Goals
mm
3
Cubic millimetre

MRC Medical Research Council
MSM Men who have sex with men
MTEF Medium-term expenditure framework
MTSF Medium-term strategic framework
NBD National Burden of Disease
NC Northern Cape
NGO Non-governmental organisation
NHI Non-accidental head injury
NSDP National Spatial Development Perspective
NSP National Strategic Plan
NTC National Technical Certificate
NW North West province
OECD Organisation for Economic Cooperation and Development
PEP Post-exposure prophylaxis
PERO Provincial Economic Review and Outlook
PGDS Provincial Growth and Development Strategy
PMTCT Prevention of mother-to-child transmission
PPP Purchasing power parity
RDP Reconstruction and Development Programme
RDS Respiratory distress syndrome
RHRU Reproductive Heath and HIV Research Unit of the University of the
Witwatersrand
SA South Africa
SADC Southern African Development Community
SADHS South African Demographic and Health Survey
SAPS South African Police Service
SCOPA Standing Committee on Public Accounts
SIP Strategic infrastructure plan
SMME Small, medium and micro enterprises
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StatsSA Statistics South Africa
STD Sexually transmitted disease
STI Sexually transmitted infection
TB Tuberculosis
TBVC Transkei, Bophuthatswana, Venda and Ciskei
TFR Total fertility rate
UNICEF United Nations Children’s Fund
USAID US Agency for International Development
VCT Voluntary counselling and testing
WC Western Cape
WHO World Health Organisation
WPPA World Population Plan of Action
YLL Years of life lost
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1
Introduction
Ravayi Marindo
The main purpose in writing the State of the population in the Western Cape province
report is to bring together various topics on population and development in order to
evaluate and monitor the progress of the Western Cape province in implementing the
national population policy (DSD 1998).
By using official statistics, the report aims to create awareness of the role of
population in the development process, the usefulness and importance of official
statistics and the intersectoral nature of population. Population is central to
sustainable development; it is both a response variable and an impacting variable.
For policy-makers, decision-makers and planners, understanding population is critical.
Ultimately, all decisions, policies and plans must aim to improve the quality of life of
all people and populations. The syllable ‘demo’ in the word ‘demography’ means ‘the

people’. Without understanding the state of the population or the variables impacting
and impacted on by population, how can we adequately plan a better life for people?
From the perspective of the Department of Social Development, the state of the
population report identifies and highlights variables that reflect vulnerability at
population level. What makes population vulnerable? In the context of this report, the
following are identified and highlighted:
• Thepopulationhistoryoftheprovince,whichdeterminescurrentpopulation
growth and dynamics, the numbers of people in various racial groups and
where they are settled, the distribution of resources and the policies and
frameworks.
• Thelevels,trendsanddeterminantsofchildandadultdeathandmortality,
especially the identification of those at high risk, highlighting the limitations
imposed by the data.
• Thelevels,trendsanddeterminantsofchildmaltreatment,identifyingfactorsthat
increase the risks of child maltreatment and highlighting the need for more data.
• Theinevitabilityofpopulationageing,creatingpopulationvulnerability,
highlighting that the levels, trends and determinants of ageing and social service
requirements point to the vulnerability of the provincial population.
• TheprevalenceandincidenceofHIV/AIDSinfectionsandthechallengesof
implementing prevention measures that actually have positive impact.
• Thedemographiccharacteristicsofnon-citizenpopulationsandtheirimpacton
the native population; their unacknowledged characteristics, which can create
certain needs within the population.
• Thepoliciesandframeworksusedintheeducationalsector,inspatialplanning,
in development planning and in integrating population and development.
The focus on vulnerability played a critical role in the selection of topics covered in
the report. This approach justified the exclusion of fertility from the report. Although
teenage childbearing is an indication of vulnerability, childbearing in general in any
population is not necessarily a negative event. Data limitations led to the exclusion
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
2
of two critical topics from the report, namely migration and poverty. The reliance on
census data resulted in data limitations, which made the writing of these two chapters
problematic.
The report addresses a number of national and provincial mandates that are critical
to development in South Africa. Firstly, in addition to its role in monitoring and
evaluating the implementation of the South African population policy, the report
contributes to realising the constitutional goal that ‘Everyone has the right of access
to any information held by the state’ (South African Constitution, Act No. 108 of 1996:
chapter 2, article 32 (1)(a)). By bringing together data and information on population
and development in the Western Cape, this report is an attempt by the Department of
Social Development to create awareness and provide information to stakeholders.
Secondly, quite closely related to article 32 is the Department of Social Development’s
integrated service delivery model (ISDM). Emanating from a vision of creating a
self-reliant society, the ISDM is a framework that aims to provide a ‘comprehensive
network of social development services that enable and empower the poor, the
vulnerable and those with special needs’ (DSD 2007: 6). The framework identifies
four levels of intervention – awareness and prevention, early intervention, statutory
intervention and re-integration.
By providing population information for the Western Cape province, this report
addresses the first level of intervention, which is creating awareness. By bringing
together various population development issues, the report creates awareness of the
role of population in influencing sustainable development.
The report therefore addresses the integrated service delivery model by providing
population information and creating awareness of the role of population in
development and service delivery.
The third mandate is related to the United Nations (UN) Millennium Development
Goals (MDGs), to which South Africa is a signatory. The MDGs were adopted by UN
member states in 2000. This report on the state of the population in the Western Cape

addresses three of the MDGs:
• MDG2:Achieveuniversalprimaryeducation(addressedinchapter9).
• MDG4:Reducechildmortality(addressedinchapter3).
• MDG6:CombatHIV/AIDS,malariaandotherdiseases(addressedinchapter8).
These particular chapters provide information on levels and trends, thereby giving
readers some idea of how far South Africa has progressed in addressing the MDGs, as
well as critically evaluating some of the factors that might impede the achievement of
MDG targets. The chapters also identify the gaps to be addressed if the targets are to
be met.
A fourth mandate emanates from the iKapa Elihlumayo growth and development
strategy for the Western Cape, which may be considered to be a 2014 vision of
a sustainable ‘Home for All’ in the province. It addresses the need for shared
growth and integrated sustainable development, improved economic and social
opportunities, greater equality, and better access to assets, resources and healthy
living environments.
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3
The state of the population report addresses four of the 11 iKapa strategies:
• Provincialspatialdevelopmentframework.
• Humancapitaldevelopmentstrategy.
• Socialcapitalformationstrategy.
• Burdenofdiseaseandhealthcare.
Spatial development framework
The spatial development framework identifies the areas where growth is taking place
and where it should take place in the future in terms of a sustainable development
paradigm. The state of the population report provides a clear description of where
population is growing in the province. Since population is one of the drivers of
development, the report provides critical information that informs the provincial
spatial development framework.

Human capital development strategy
The chapter on population and education (chapter 9) discusses some aspects of early
childhood development and basic and primary education, highlighting certain of the
constraints to achieving good quality education for all in the Western Cape. To further
highlight the challenges of human capital development, the state of the population
report discusses the impact of HIV on the education sector.
Social capital formation strategy
How is the province’s population growing? How diverse is the provincial population?
Where do the foreign-born and non-citizen populations come from? How numerous
are they and where are they settled? What is contributing to the population growth
rate of provincial cities and towns? All these questions linked to the human capital
formation strategy are addressed in the state of the population report.
Burden of disease and health care
Three chapters in the report address issues related to the burden of disease, two from
a mortality perspective (chapters 3 and 4) and one from a health-care perspective
(chapter 8). The chapters begin by providing useful data and then highlighting the
increasingly critical challenges created by changing population dynamics and their
impact on the burden of disease, as well as the challenges of ensuring the provision
of quality health care for all the diverse populations of the Western Cape in the face
of HIV/AIDS.
South African population policy
The population policy provides a comprehensive and multisectoral framework for
addressing population issues that are critical to achieving sustainable development.
The report addresses the following major concerns raised by the population policy:
• Thelimitedsystematicuseofpopulationdatainimplementing,monitoring
and evaluating development plans and programmes for the entire population
(chapter 2).
• Highratesofinfantandchildhoodmortality(chapter3).
• Highratesofadultmortality(chapter4).
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
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• Populationageing(chapter6).
• Risingincidencesofsexuallytransmitteddiseases,especiallyHIV/AIDS
(chapter 8).
This short summary contextualises the report within both national and provincial
mandates. Although the report does not cover all aspects of population and
sustainable development, it provides a starting point and a broad base for policy-
makers, as well as anyone interested in population, to begin a critical discussion of
the role of population in sustainable development and service provision.
Brief summaries of the chapters in the report
Prof. Cornie Groenewald (in chapter 1) gives a demographic overview of the Western
Cape province, focusing on the population dynamics of population growth, fertility,
mortality and migration. He mainly uses census data and sets the context for the
other chapters in the report.
Shahid Solomon (in chapter 2) writes that South Africa provides one of the most
striking examples of politically inspired planning in Africa. His chapter focuses on the
various frameworks and policies that drive both development planning and spatial
planning. His overview discusses the policy changes that occur when a country
moves from interventionist to democratic planning. He also discusses the population
legacy of apartheid planning, and concludes by stating that although much has been
achieved post 1994 to integrate population into planning, there is further need for
the following: making the link between population and planning more managerial,
tackling departmentalism with outcome measurement, and building and strengthening
the population research capacity of local government.
Although the Western Cape generally experiences lower child and adult mortality
than other provinces in South Africa, indications from the data suggest that both child
and adult mortality have increased in the recent past. Nancy Stiegler (in chapter 3)
uses vital registration data to show that child mortality has been increasing since
1998. She also uses other studies published in the Western Cape to provide a profile

of children at high risk of child mortality. Using registration data from the City of
Cape Town, Nesbert Zinyakatira (in chapter 4) presents findings showing that adult
mortality has also been on the increase in recent years. He identifies locations that
are at risk of high adult mortality. Both authors independently conclude that the
increases in child and adult mortality could be attributed to increasing HIV/AIDS
deaths.
Prof. Andrew Dawes and Dr Catherine Ward’s chapter (chapter 5) provides
considerable background information on the various local and international
policies, frameworks, rights and other legal instruments for protecting children from
maltreatment. Despite limitations in the data, the authors are able to use existing
data to indicate that the problem of child maltreatment is a matter of concern in the
Western Cape and to suggest ways in which the Department of Social Development
could address the problems of child maltreatment through its 10-year strategy. More
than any other chapter in the report, this chapter demonstrates that reliable data are
critical for making sound policy decisions influencing the well-being of children in
the province.
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5
Ageing is unavoidable and prevalent among all the population groups of the Western
Cape. In her chapter on ageing (chapter 6), Dr Bärbel Haldenwang discusses the
demographic drivers of ageing and shows, through an analysis of data as well as
projections by the Actuarial Society of South Africa (ASSA), the various indicators of
ageing, both at present and in the future. In the sections on service provision, she
discusses the increasing need for social and retirement pensions, health-care services,
housing and living arrangements. She concludes that ‘population ageing in the
Western Cape province is a demographic reality; it is pervasive, profound, enduring
and largely irreversible. The social and economic impact of population ageing should
be regarded as both an opportunity and a challenge’. The benefits of ageing include
the wealth of skills and experience that can be brought to the workplace, public life

and the family.
Dr Ravayi Marindo (in chapter 7) presents demographic indicators of non-citizen and
foreign-born populations in the Western Cape. Using census data, she shows that the
proportion of non-citizen population is quite small, but nevertheless has a significant
impact because of its concentration in the City of Cape Town. Her data analysis
shows that the non-citizen population differs demographically from the native South
African population. Non-citizens from Africa tend to be young males, suggesting
labour migration, while non-citizens from Europe tend to be both male and female,
and over the age of 60 years, suggesting retirement migration. She concludes that the
socioeconomic implications of the characteristics of the non-citizen population mean
that the Western Cape is experiencing a double socio-demographic burden – that
of creating employment for young, able-bodied black African males, as well as the
burden of increasing numbers of aged persons through retirement migration.
Dr Najma Shaikh (in chapter 8) gives a comprehensive account of the status of the
HIV/AIDS epidemic in the Western Cape, starting with a history of the epidemic
in South Africa. She then presents HIV-prevalence rates for the whole country and
for the Western Cape and highlights HIV-prevalence levels by metropolitan health
districts. The chapter also considers age and gender differences related to HIV
incidence and HIV/AIDS-related mortality. Dr Shaikh uses the 2003 ASSA model
of the impact of HIV/AIDS and ends with a detailed account of the health sector’s
response to the epidemic, in which she discusses the prevention strategies of
community mobilisation, condom use, voluntary counselling and testing, prevention
of mother-to-child transmission, life skills and peer education, antiretroviral therapy,
post-exposure prophylaxis and sexually transmitted infections.
Dr Jean Baxen (in chapter 9) focuses on the impact of HIV/AIDS on the education
sector. She begins by presenting the national frameworks, policies and legal
instruments that guide South African schools. Data from the Department of Education
are then used to identify and highlight the factors that influence education in the
Western Cape, including learner–teacher ratios, types of schools and learners by
grade. She gives a broad overview of school funding and access to schooling. Her

paper identifies various household indicators that affect the educational outcomes
of learners, including poverty, employment status, annual household income,
occupation, type of housing unit, toilet and water supply, energy and mode of
transport.
At the level of the individual child, Dr Baxen identifies risk factors that lead to poor
performance, including the incidence of child hunger, substance and alcohol abuse,
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HIV prevalence, educator attrition and mortality, and poor access to social services.
She ends the chapter by discussing the implications for population development and
education, addressing issues of quality, progress and accountability, education needs
and priorities, and going beyond the issue of physical access to education.
‘Demographic variables are both determinants and consequences of development’,
states Prof. Sam Gaisie in his chapter on population development from a global
perspective (chapter 10). Using data and information from United Nations reports,
Prof. Gaisie shows that understanding the interrelationships between population and
development is not limited to population issues, but enhances knowledge about
the economic and social development of a country. The chapter places South Africa
within the global context.
References
DSD (Department of Social Development) (1998) Population Policy for South Africa. April
1998. Pretoria: DSD
DSD (Department of Social Development) (2007) Overview of 10 year integrated delivery
plan 2007–2017, Western Cape. Deepening democracy and empowerment. May, Cape
Town
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7
Western Cape: an overview
Cornie Groenewald

Introduction
This chapter provides an overview of the main features of the Western Cape province
and its current population, and serves as a background for in-depth analysis of
specific population aspects and their relation to development. The salient features
of population are described in the context of the location, physical features and
development status of the Western Cape vis-à-vis the rest of South Africa. The
dynamic aspects of population are described, where possible, by comparing data
over time and across space and social groupings and pointing out trends, differences
and similarities. Official data sources, produced by the South African statistics office
(StatsSA) and similar public offices, were used. Data that had already been processed
and published, whether in print or electronic format, were mostly consulted, and the
author’s own calculations were applied sparingly.
Location and population
The Western Cape is one of nine provinces that make up the Republic of South
Africa. It is located in the south-western part of the country and is the southernmost
part of the continent of Africa. Before 1994, under the apartheid regime, it formed
part of the Cape Province. After 1994, the Cape Province was divided into three new
provinces, namely the Western Cape, Eastern Cape and Northern Cape. The current
Western Cape province is now bordered by the Atlantic Ocean to the west and south-
west, the Indian Ocean to the south and south-east, the Eastern Cape to the east, and
the Northern Cape to the north.
The province has a land surface of 129 307 km² (StatsSA 2006)

and an estimated
population of 5 278 585 according to the Community Survey conducted by Statistics
South Africa in 2007, which also gives a population density of 40.8 persons per
square kilometre (StatsSA 2007d). The south-western parts, surrounding the City
of Cape Town, accommodate most of the population and display higher density
ratios. With a growth rate of 5.3% in 2004, the Western Cape outperformed the
national South African economic performance of 4.5% (PERO 2006). The land surface

represents 10.6% of the nation’s total surface area and 10.9% of the population. The
Western Cape’s contribution to national gross domestic product (GDP) in 2004 was
14.56% (PERO 2006).
The province is divided into a single metropolitan area (the City of Cape Town)
and the five district municipalities of West Coast, Central Karoo, Overberg, Eden
and Cape Winelands. The five district municipalities are in turn divided into 24 local
municipalities. The area, population and densities of these district municipalities are
given in Table 1.1 for the years 1996 and 2001.
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