Apartheid-style neglect of children continues in democratic South Africa, with millions lacking a proper home, healthcare and schooling.

So says a report, a collaboration between the UN Children's Fund (Unicef) and the SA Human Rights Commission, released yesterday. It details how the country fails the most vulnerable.

The report said that 64%, or 11.9million of the country's 18.6million children, live in poverty, and four out of 10 children live in households in which none of the adults work.

About 1.7million children lived in shacks, 1.4million relied on rivers or streams as their main source of water, and 1.5million had no toilet in their home.

African children were 18 times more likely to grow up in poverty and 12 times more likely to experience hunger than white children.

The worst-hit areas of "multiple deprivation" were still former homelands, said the report, which drew on data from the Statistics SA general household survey and other surveys.

Children are failed primarily by the health and education systems.

"Most" causes of death of children under five were avoidable; and 61% of all child deaths were due to "health system failures" - inadequate care by doctors and nurses working at clinics and hospitals.

The growth of one in five children is stunted by chronic malnutrition, and 100000 children who need antiretroviral drugs did not get them.

Immunisation against diseases such as measles, polio and hepatitis fell to as little as 45% of the 1994 levels.

In education, 582000 children of high school age were not at school - 28% of them because their parents could not afford school fees.

The report said one in six pupils aged 14-18 was still in primary school because of a late start or failure to gain promotion. Failure rates were extremely high, with almost one in five pupils repeating grade 10 or grade 11.

Aida Girma, Unicef's representative in South Africa, said the situation was similar to that in other developing countries, where "millions of the world's most disadvantaged, vulnerable and marginalised children" are left behind.

Human Rights commissioner Lindiwe Mokate said she hoped the government would take action on the findings disclosed in the report.

SOME OF THE REPORT'S TROUBLING FINDINGS

• "Most" of the causes of death of children under five are avoidable, and 61% of all child deaths are due to "health system failures" - poor treatment by doctors and nurses at clinics;

• Immunisation coverage across the country for killer diseases, including polio, hepatitis, measles, whooping cough, diphtheria and tuberculosis, has decreased to as little as 45% in some areas compared to 1994;

• Only 54% of the HIV-positive children who should be on antiretroviral treatment are receiving it;

• More than 270 babies and their mothers die after birth on average a day, mainly due to HIV/Aids, and the maternal mortality rate has increased by 80% since 1990;

• 582000 children who should be attending high school are not - 28% don't have the money for fees and 15% because "education is useless";

• Almost half of all children admitted to orphanages and places of safety were neglected or abandoned by their parents. The remainder were abused, orphaned, living or working on the streets, or had parents or guardians who were too sick to care for them. Only 1% were in trouble with the law. About 4000 cases of child neglect or abuse are reported to the police each year; and

• Of 56500 children who were victims of violent crime in 2009-2010, 27417 were raped or molested. Of those, 29% were aged between 0 and 10.