The experience of cash transfers in alleviating childhood poverty in South Africa: mothers' experiences of the Child Support Grant.
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SUBMITTER: Zembe-Mkabile W
PROVIDER: S-EPMC4536939 | biostudies-other | 2015
REPOSITORIES: biostudies-other
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Project description:OBJECTIVE:Cash transfer programmes targeting children are considered an effective strategy for addressing child poverty and for improving child health outcomes in developing countries. In South Africa, the Child Support Grant (CSG) is the largest cash transfer programme targeting children from poor households. The present paper investigates the association of the duration of CSG receipt with child growth at 2 years in three diverse areas of South Africa. DESIGN:The study analysed data on CSG receipt and anthropometric measurements from children. Predictors of stunting were assessed using a backward regression model. SETTING:Paarl (peri-urban), Rietvlei (rural) and Umlazi (urban township), South Africa, 2008. SUBJECTS:Children (n 746), median age 22 months. RESULTS:High rates of stunting were observed in Umlazi (28 %), Rietvlei (20 %) and Paarl (17 %). Duration of CSG receipt had no effect on stunting. HIV exposure (adjusted OR=2·30; 95 % CI 1·31, 4·03) and low birth weight (adjusted=OR 2·01, 95 % CI 1·02, 3·96) were associated with stunting, and maternal education had a protective effect on stunting. CONCLUSIONS:Our findings suggest that, despite the presence of the CSG, high rates of stunting among poor children continue unabated in South Africa. We argue that the effect of the CSG on nutritional status may have been eroded by food price inflation and limited progress in the provision of other important interventions and social services.
| S-EPMC4727456 | biostudies-literature
Project description:Food security and good nutrition are key determinants of child well-being. There is strong evidence that cash transfers such as South Africa's Child Support Grant (CSG) have the potential to help address some of the underlying drivers of food insecurity and malnutrition by providing income to caregivers in poor households, but it is unclear how precisely they work to affect child well-being and nutrition. We present results from a qualitative study conducted to explore the role of the CSG in food security and child well-being in poor households in an urban and a rural setting in South Africa. SETTING:Mt Frere, Eastern Cape (rural area); Langa, Western Cape (urban township). PARTICIPANTS:CSG recipient caregivers and community members in the two sites . We conducted a total of 40 in-depth interviews with mothers or primary caregivers in receipt of the CSG for children under the age of 5 years. In addition, five focus group discussions with approximately eight members per group were conducted. Data were analysed using manifest and latent thematic content analysis methods. RESULTS:The CSG is too small on its own to improve child nutrition and well-being. Providing for children's diets and nutrition competes with other priorities that are equally important for child well-being and nutrition. CONCLUSIONS:In addition to raising the value of the CSG so that it is linked to the cost of a nutritious basket of food, more emphasis should be placed on parallel structural solutions that are vital for good child nutrition outcomes and well-being, such as access to free quality early child development services that provide adequate nutritious meals, access to adequate basic services and the promotion of appropriate feeding, hygiene and care practices.
| S-EPMC5922468 | biostudies-literature
Project description:ObjectiveThis study investigated associations between adverse childhood experiences (ACEs) in early childhood (at ages 9 months and 3 years) and adiposity trajectories of children/adolescents from age 5 to age 17, and the potential interaction between ACEs and poverty on adiposity trajectories.MethodsData from the UK Millennium Cohort Study was used. Eight commonly studied ACEs and poverty were measured when the child was aged 9 months and 3 years. ACEs were considered as a cumulative score and as individual experiences. Linear-mixed effect models were employed, modelling BMI and fat mass index (FMI) trajectories from age 5 to 17 (main outcome), adjusting for covariates and stratified by sex. Interactions with poverty were also tested. The sample sizes were 7282 and 6912 for BMI and FMI sample respectively.ResultsCumulative ACE score was associated with steeper increase in BMI and FMI among boys with 3+ ACEs (BMI: β = 0.13, 95% CI: 0.02-0.24; FMI: β = 0.09, 95% CI: 0.01-0.19). For individual ACEs, parental depression was associated with steeper increase in BMI/FMI trajectories in both sexes (BMI: boys: β = 0.15, 95% CI: 0.07-0.23, girls: β = 0.13, 95% CI: 0.05-0.20; FMI: boys: β = 0.09, 95% CI: 0.03-0.15, girls: β = 0.09, 95% CI: 0.02-0.16). In addition, parental separation and physical punishment were associated with steeper increase in BMI/FMI trajectories among girls (BMI: parental separation: β = 0.25; 95% CI: 0.06-0.44, physical punishment: β = 0.14; 95% CI: 0.03-0.26; FMI: parental separation: β = 0.20; 95% CI: 0.03-0.37, physical punishment: β = 0.12; 95% CI: 0.02-0.22). No interaction effect had been found between ACEs and poverty on the adiposity trajectories.ConclusionsA complex relationship between ACEs in early childhood and adiposity trajectories for children/adolescents was found, highlighting the different effects of specific ACEs and sex differences in the association.
| S-EPMC9492536 | biostudies-literature
Project description:Child cash transfers are increasingly recognised for their potential to reduce poverty and improve health outcomes. South Africa's child support grant (CSG) constitutes the largest cash transfer in the continent. No studies have been conducted to look at factors associated with successful receipt of the CSG. This paper reports findings on factors associated with CSG receipt in three settings in South Africa (Paarl in the Western Cape Province, and Umlazi and Rietvlei in KwaZulu-Natal).This study used longitudinal data from a community-based cluster-randomized trial (PROMISE EBF) promoting exclusive breastfeeding by peer-counsellors in South Africa (ClinicalTrials.gov: NCT00397150). 1148 mother-infant pairs were enrolled in the study and data on the CSG were collected at infant age 6, 12, 24 weeks and 18-24 months. A stratified cox proportional hazards regression model was fitted to the data to investigate factors associated with CSG receipt.Uptake of the CSG amongst eligible children at a median age of 22 months was 62% in Paarl, 64% in Rietvlei and 60% in Umlazi. Possessing a birth certificate was found to be the strongest predictor of CSG receipt (HR 3.1, 95% CI: 2.4 -4.1). Other factors also found to be independently associated with CSG receipt were an HIV-positive mother (HR 1.2, 95% CI: 1.0-1.4) and a household income below R1100 (HR1.7, 95% CI: 1.1 -2.6).Receipt of the CSG was sub optimal amongst eligible children showing administrative requirements such as possessing a birth certificate to be a serious barrier to access. In the spirit of promoting and protecting children's rights, more efforts are needed to improve and ease access to this cash transfer program.
| S-EPMC3534520 | biostudies-literature
Project description:To estimate the effects of weather conditions on welfare globally, cross-country comparisons need to rely on international poverty lines and comparable data sources at the micro-level. To this end, nationally representative household surveys can offer a useful instrument, also at the sub-national level. This study seeks to expand the existing knowledge on the determinants of poverty in Africa south of the Sahara (SSA), examining how long-term climatic conditions and year-specific weather shocks affect expenditure per capita. We take advantage of a novel and unique dataset combining consumption-based household surveys for 24 SSA countries -representative of more than half of the African population and two thirds of SSA- and geospatial information on agro-climatic conditions, market access and other spatial covariates of poverty. To our knowledge, it is the first time that a welfare-based, multidisciplinary, micro-level dataset with such wide spatial coverage has been assembled and examined. Our analysis relies on a linear and spatial model at the household- and district-level, respectively, both controlling for socio-economic, demographic, and geographic confounding factors. Results are consistent across econometric approaches, showing that living in more humid areas is positively associated with welfare, while the opposite occurs living in hotter areas, as existing literature shows. Flood shocks -defined as annual rainfall higher than one standard deviation from the 50-year average- are associated to a 35% decrease in total and food per-capita consumption and 17 percentage point increase in extreme poverty. On the other hand, extreme shortages of rain and heat shocks show an uncertain effect, even when estimates control for spatial correlation between welfare and weather conditions using the spatial error correction model. Given the heterogeneous effects of climatic events across SSA macro-regions, local-specific adaptation and mitigation strategies are suggested to help bringing households on a sustainable path.
| S-EPMC6853414 | biostudies-literature
Project description:BackgroundIn South Africa, HIV/AIDS remains a major public health problem. In a context of chronic unemployment and deepening poverty, social assistance through a Disability Grant (DG) is extended to adults with HIV/AIDS who are unable to work because of a mental or physical disability. Using a mixed methods approach, we consider 1) inequalities in access to the DG for patients on ART and 2) implications of DG access for on-going access to healthcare.MethodsData were collected in exit interviews with 1200 ART patients in two rural and two urban health sub-districts in four different South African provinces. Additionally, 17 and 18 in-depth interviews were completed with patients on ART treatment and ART providers, respectively, in three of the four sites included in the quantitative phase.ResultsGrant recipients were comparatively worse off than non-recipients in terms of employment (9.1 % vs. 29.9 %) and wealth (58.3 % in the poorest half vs. 45.8 %). After controlling for socioeconomic and demographic factors, site, treatment duration, adherence and concomitant TB treatment, the regression analyses showed that the employed were significantly less likely to receive the DG than the unemployed (p < 0.001). Also, patients who were longer on treatment and receiving concomitant treatment (i.e., ART and tuberculosis care) were more likely to receive the DG (significant at the 5 % level). The qualitative analyses indicated that the DG alleviated the burden of healthcare related costs for ART patients. Both patients and healthcare providers spoke of the complexity of the grants process and eligibility criteria as a barrier to accessing the grant. This impacted adversely on patient-provider relationships.ConclusionsThese findings highlight the appropriateness of the DG for people living with HIV/AIDS. However, improved collaboration between the Departments of Social Development and Health is essential for preparing healthcare providers who are at the interface between social security and potential recipients.
| S-EPMC4459666 | biostudies-literature
Project description:BackgroundPrevious research on the association between maternal HIV status and child mortality in sub-Saharan Africa was published between 2005-2011. Findings from these studies showed a higher child mortality risk among children born to HIV-positive mothers. While the population of women with disabilities is growing in developing countries, we found no research that examined the association between maternal disability in HIV-positive mothers, and child mortality in sub-Saharan Africa. This study examined the potential compounding effect of maternal disability and HIV status on child mortality in South Africa.MethodsWe analyzed data for women age 15-49 years from South Africa, using the nationally representative 2016 South Africa Demographic and Health Survey. We estimated unadjusted and adjusted risk ratios of child mortality indicators by maternal disability and maternal HIV using modified Poisson regressions.ResultsChildren born to disabled mothers compared to their peers born to non-disabled mothers were at a higher risk for neonatal mortality (RR = 1.80, 95% CI:1.31-2.49), infant mortality (RR = 1.69, 95% CI:1.19-2.41), and under-five mortality (RR = 1.78, 95% CI:1.05-3.01). The joint risk of maternal disability and HIV-positive status on the selected child mortality indicators is compounded such that it is more than the sum of the risks from maternal disability or maternal HIV-positive status alone (RR = 3.97 vs. joint RR = 3.67 for neonatal mortality; RR = 3.57 vs. joint RR = 3.25 for infant mortality; RR = 6.44 vs. joint RR = 3.75 for under-five mortality).ConclusionsThe findings suggest that children born to HIV-positive women with disabilities are at an exceptionally high risk of premature mortality. Established inequalities faced by women with disabilities may account for this increased risk. Given that maternal HIV and disability amplify each other's impact on child mortality, addressing disabled women's HIV-related needs and understanding the pathways and mechanisms contributing to these disparities is crucial.
| S-EPMC8099123 | biostudies-literature
Project description:BACKGROUND:Health professionals are striving to improve respectful care for women, but they fall short in the domains of effective communication, respectful and dignified care and emotional support during labour. This study aimed to determine women's experiences of childbirth with a view to improving respectful clinical care practices in low-risk, midwife-led obstetric units in the Tshwane District Health District, South Africa. METHODS:A survey covering all midwife-led units in the district was conducted among 653 new mothers. An anonymous questionnaire was administered to mothers returning for a three-days-to-six-weeks postnatal follow-up visit. Mothers were asked about their experiences regarding communication, labour, clinical care and respectful care during confinement. An ANCOVA was performed to identify the socio-demographic variables that significantly predicted disrespectful care. Six items representing the different areas of experience were used in the analysis. RESULTS:Age, language, educational level and length of residence in the district were significantly associated with disrespectful care (p ? 0.01). Overall, the following groups of mothers reported more negative care experiences during labour: women between the ages of 17 and 24 years; women with limited formal education; and women from another province or a neighbouring country. Items which attracted fewer positive responses from participants were the following: 46% of mothers had been welcomed by name on arrival; 47% had been asked to give consent to a physical examination; and 39% had been offered food or water during labour. With regard to items related to respectful care, 54% of mothers indicated that all staff members had spoken courteously to them, 48% said they had been treated with a lot of respect, and 55% were completely satisfied with their treatment. CONCLUSION:There is a need to improve respectful care through interventions that are integrated into routine care practices in labour wards. To stop the spiral of abusive obstetric care, the care provided should be culturally sensitive and should address equity for the most vulnerable and underserved groups. All levels of the health care system should employ respectful obstetric care practices, matched with support for midwives and improved clinical governance in maternity facilities.
| S-EPMC5689145 | biostudies-literature
Project description:The aim of this study was to compare the transcriptional response to TB in regions of different incidence / prevalence.
2010-08-11 | GSE19442 | GEO
Project description:Adverse childhood experiences (ACEs) have detrimental intergenerational health consequences; however, mechanisms require elucidation. We test the associations among mothers’ ACEs, mothers’ prenatal anxiety and depression symptoms, and DNA methylation (DNAm) in maternal prenatal blood and infant umbilical cord blood. Maternal ACE score was associated with higher prenatal depression (β= 0.84, p=0.004) and anxiety (β = 1.36, p=0.02) symptoms and lower rates of secure attachment at 3 months (OR= 0.52 p=0.003). Prenatal depression (OR= 0.92, p=0.194) and anxiety (OR= 0.94, p= 0.072) were not correlated with infant attachment. Results from the regression of epigenetic age acceleration in maternal prenatal blood on maternal ACE score were: β =0.49, p= 0.09. Regressing epigenetic age in cord blood on prenatal depression yielded: β = -0.10, p=0.07 and on anxiety yielded β =-0.05, p=0.07. No CMR was associated with maternal ACE score at the FDR-corrected p<.05 level. ACE-associated DNAm variation was enriched for genes related to nervous and reproductive systems development. ACEs may affect the next generation through maternal mental health, infant attachment, and DNAm.
2024-12-13 | GSE282533 | GEO