Poverty,HIV/AIDS and the old age pension in Bhambayi,Kwazulu-Natal,South Africa

To date the international community has tended to direct HIV prevention programmes, treatment, care and supportive services to young adults and children, with little concern about the impact on older people. Since empirical evidence on the socioeconomic impact of HIV/AIDS on households with older persons is lacking, this paper attempts to fill this gap, using data from a household-based survey conducted in Bhambayi, a mixed formal and informal settlement north of eThekwini, KwaZulu-Natal. The findings highlight the links between the uptake of the South African old age pension, poverty and HIV/AIDS in households with older persons. The paper makes recommendations for both government and non-governmental organisations in respect of community-based support systems for such households affected by HIV/AIDS.     

Livestock as a buffer against HIV and AIDS income shocks in the rural households of Zimbabwe

The objective of this study was to determine the extent to which households use livestock sales to mitigate the impact of HIV/AIDS income shocks. Using survey data from the Muzarabani and Bindura districts of Mashonaland Central Province in Zimbabwe, the econometric analysis indicated that livestock, particularly poultry and small stock, play a significant role in smoothing income fluctuations due to HIV/AIDS. Cattle sales compensate for 71 per cent of income shortfalls due to HIV/AIDS. About 90 per cent of HIV/AIDS-afflicted households, headed mainly by women or children, used poultry and goats as consumption-smoothing strategies when faced with negative income shocks. Government and other stakeholders were advised to support the use of small stock as a strategy for coping with HIV/AIDS economic shock in female- or child-headed households in rural areas.     

Child-headed households in South Africa: What we know and what we don't

Household structures in many countries in Africa have been drastically changed by the HIV/AIDS epidemic. Traditionally, orphans were absorbed by members of the extended family but today this safety net no longer works so well and many children are left to fend for themselves. The South African Government recognises the problem, but views differ on the effectiveness of the programmes for assisting these children. This article looks at what is known and what needs further research. It is known that child-headed households do exist in South Africa and that children living in these households are vulnerable. What is not known is the prevalence of these households and how to deal with the children's psycho-social problems. The article argues that the definition of child-headed households needs to be refined if we are to understand the extent of the problem. This will facilitate assessment of the programmes established for these children.     

艾滋病对我国社会经济影响

基于对我国艾滋病流行较为严重的五个省份进行的问卷调查,对比分析了931户感染者家庭和995户非感染者家庭的相关数据。研究发现,艾滋病对感染者个人及其家庭造成了极大的影响,如导致家庭结构改变、就业机会减少、劳动收入下降、医疗支出明显增大;同时也引发一系列社会经济问题,如贫富差距加大、性别不平等加剧、贫困家庭儿童教育机会减少及社会歧视扩大。最后提出了缓解艾滋病造成影响的对策建议。     

Working with community health workers to improve nutrition in rural KwaZulu-Natal

Addressing the health problems of disadvantaged communities requires innovative strategies in a situation of resource constraints. A community-based participatory intervention was undertaken in southern KwaZulu-Natal, using 18 local community health workers (CHWs). A baseline survey was conducted by each CHW, who visited five households to investigate factors affecting nutrition. After a training programme of monthly nutrition workshops, CHWs shared this information with local community members by visiting households and holding community meetings. After six months, a second questionnaire administered by CHWs investigated householder perceptions of the intervention. Data from the initial survey served as a basis for the content of the nutrition intervention by CHWs to improve health by influencing dietary practices. Factors affecting nutrition that were investigated included dietary practices, breastfeeding, sanitation, source of water and food gardens. CHWs learnt from this nutrition intervention and spread this information among their communities, suggesting a useful role for CHWs in implementing health-promoting initiatives.     

The KwaZulu-Natal Income Dynamics Study (KIDS) third wave: methods,first findings and an agenda for future research

The panel study known as the KwaZulu-Natal Income Dynamics Study (KIDS) has been extended by a new wave of data collection conducted in 2004. This third wave of the study interviewed 865 households containing core adult members from 760 of the households contacted in 1993. It also conducted interviews in next-generation households that have split off from the parental households and in the current households of children who have been fostered out. The study finds that the proportion of people aged 20–44 dying between the second and third waves was nearly three times the proportion dying between the first two waves. The pattern of income distribution is one of increasing poverty and inequality since 1993, although the partial reversal of these trends in the post-1998 period is hopeful, as are signs of relative prosperity among those who established independent next-generation households. In addition, access to services has improved.     

The South African disability grant: Influence on HIV treatment outcomes and household well-being in KwaZulu-Natal

This paper explores the implications of the disability grant for household members' well-being and adults' success on ART (antiretroviral therapy). It uses case studies based on data from an in-depth qualitative study of 10 households in KwaZulu-Natal. Receipt of the disability grant ensured that the basic needs of the HIV-infected adult could be met by other household members, especially when the grant was received when the person first met the qualifying criteria and in conjunction with ART. Where treatment was effective, HIV-infected adults were able to make substantial contributions to the well-being of other members in addition to the financial support provided by the grant itself. Thus, early access to financial support in conjunction with commencing ART may lead to improved health outcomes and reduce poverty and vulnerability associated with illness in poor households. This synergistic relationship between social welfare and treatment may in turn contribute to greater cost-efficiency.     

Improving food security in the rural areas of KwaZulu-Natal province,South Africa: Too little,too slow

Food insecurity is still remarkably high in the poorest areas of the KwaZulu-Natal province of South Africa. Many rural households struggle to have sufficient access to the food they need or prefer. This article explores the extent of food access insecurity and assesses the perceived impact on food security of an Empowerment for Food Security Programme that was launched in the Province in 2007. One of the programme aims was to improve agricultural practices in community gardens, home gardens and broiler production. Data were collected among 390 beneficiary households involved in these agricultural projects in 2010. Findings confirmed that experience-based food insecurity levels were still high, despite the agricultural support programme and the government income transfers. Nevertheless, respondents attribute an improved dietary diversity and better access to resources to the programme.     

HIV/AIDS AND POVERTY IN SOUTH AFRICA: A BAYESIAN ESTIMATION OF SELECTION MODELS WITH CORRELATED FIXED‐EFFECTS

In this paper, we estimate the causal impact of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) on monetary poverty using a panel database from South Africa. We treat endogeneity and selection problems associated with HIV/AIDS by a selection model that includes correlated fixed effects both in the level and in the participation equations, which are estimated simultaneously via original Bayesian methods. We model the consequences of the illness on both labour income and income transfers, and disentangle between urban and rural households. While no significant impact of HIV/AIDS on labour income is found because of households' recomposition, we find a substantial fall in received transfers among rural population and a dramatic increase in chronic poverty.     

THE ROLE OF SOCIAL GRANTS IN MITIGATING THE SOCIO‐ECONOMIC IMPACT OF HIV/AIDS IN TWO FREE STATE COMMUNITIES1

Social grants may play an important role in mitigating the impact of HIV/AIDS. Eligibility for these grants is driven in part by the increasing burden of chronic illness, the mounting orphan crisis and the impoverishment of households associated with the epidemic. This article investigates the role of social grants in mitigating the socio‐economic impact of HIV/AIDS in South Africa, using data from a panel study on the household impact of the epidemic. Social grants reduce inequality and decrease the prevalence, depth and severity of poverty in affected households. However, these transfers also have disincentive effects on employment, while non‐uptake is in some cases higher amongst the poorest.     

Shocks and rural livelihoods in the Okavango Delta,Botswana

This paper describes the impacts that three shocks in the Okavango Delta, Botswana, have had on rural livelihoods: the desiccation of river channels, animal diseases, and HIV/AIDS. Primary data was collected from five study areas, using formal questionnaire interviews and focus group discussions. The paper reveals the adverse effects on rural livelihoods. It describes the way households have been exposed to poverty and vulnerability and the various ways they have coped or adapted, such as by re-allocating their labour, liquidating their assets to cover medical expenses and funeral costs, reducing the area ploughed for crops, hiring labour, digging wells and switching from flood recession agriculture to dryland farming. The Botswana government has provided safety nets to help households cope, but this paper recommends that people's responses to these shocks should be taken into account in future policy and programme formulation.     

Service provision for street-based traders in Pietermaritzburg,KwaZulu-Natal: comparing local findings to lessons drawn from Africa and Asia

South Africa's informal economy absorbs approximately one-quarter of the labour force of 15 million people and is therefore the fastest growing sector of employment. Street-based trading constitutes a major subsector within the informal economy and is continuously expanding through unrelenting proliferation of survivalist micro-enterprises. However, few organisations that support enterprises are accessible or appropriate to survivalist and informal sector micro-enterprises. Interviews were conducted with 98 Pietermaritzburg street-based traders and ten KwaZulu-Natal service providers to determine service provision requirements. The results are compared with findings of four international studies. The findings suggest that for survivalist enterprises to benefit from entrepreneurial education and training services, obstacles with regard to South African traders' understanding of entrepreneurship and cultural limitations to enterprise growth should be overcome. Service institutions also require incentives to serve the informal sector, as well as the capacity to design and deliver appropriate services.     

Does South Africa need trade promotion organisations?

This article analyses one aspect of export promotion that has come to be an important mechanism for public sector implementation of export promotion, namely trade promotion organisations. Drawing on the export experiences of firms in the KwaZulu-Natal province of South Africa, we explore the possible role of a trade promotion organisation (TPO) in efforts to promote exports. Based on this, we conclude that services that may be offered by a TPO are already offered by a combination of private and public sector service providers; that the barriers to export growth in KwaZulu-Natal firms have little, if any, relationship to TPO services; and that, based on this evidence, there seems to be no case for public sector investment in TPOs. We do, however, find some weaknesses in export service provision, and suggest some policy changes in this regard.     

Supply and Demand for Livestock Credit in Sub-Saharan Africa: Lessons for Designing New Credit Schemes

Based on analysis of credit supply in Ethiopia, Kenya, Uganda and Nigeria, it is shown that public credit institutions do not have sufficient funds to meet the demand for livestock credit and cannot mobilize savings from their clients or other commercial sources for one reason or another. In addition, available credit does not reach those who need it the most and with whom it could have the greatest impact due to the application of inappropriate screening procedures and criteria to determine creditworthiness. The analysis of demand based on borrowing and nonborrowing sample households using improved dairy technology, it is shown that not all borrowers borrowed due to liquidity constraint while some borrowers and some nonborrowers had liquidity constraint but did not have access to adequate credit. Logistic regression analysis show that sex and education of the household head, training in dairy, prevalence of outstanding loan and the number of improved cattle on the farm had significant influence on both borrowing and liquidity status of a household, though the degree and direction of influence were not always the same in each study country. Based on the findings it is suggested that combining public and commercial finance could solve the problem of inadequate credit supply while inventory finance to community level input suppliers and service providers might help in getting credit to worthy and needy smallholders at lower cost than providing credit to smallholders directly.     

关于居家养老及其服务的思考

居家养老是人们基于传统家庭养老功能的弱化和社会化机构养老的缺陷而做出的新的养老选择,它有节省开支、提高老年人生活质量、减轻家庭成员压力、促进社区自身建设和发展等方面的优势。要从建立现代养老保障制度、构建老年社区支持网络、培育专业化养老服务机构和人员、改进社区服务、完善评估机制、加大政府的主导力度等方面加强实施。     

The challenges facing empirical estimation of household food (in)security in South Africa

This paper sets out to describe current principle theoretical positions in food security research, describe and compare empirical South African food security studies with key international methodologies and pose research challenges for food security research in the country. Scant available food security studies for South Africa seem to indicate that food insecurity and hunger exist and are likely to increase due to increasing food price trends, greater reliance on cash food purchases and spiralling vulnerability as a result of HIV/AIDS morbidity and mortality. Empirical research is urgently needed to determine the coping strategies of households under ‘normal’ conditions, identify vulnerable households, and monitor the impact of various shocks and stresses on household food security.     

A situational analysis for the implementation of the National School Health Policy in KwaZulu-Natal

The South African National School Health Policy was launched in 2003 to improve pupils' health by linking school visits by nurses and other health providers with the intersectoral collaboration required for health promoting schools. In KwaZulu-Natal, the policy required that various parties collaborate in order to ensure the successful implementation of the policy. This study examines the status of provincial departments and district level groups and their capacity to contribute to this partnership. It is a situational analysis that includes interviews, a questionnaire and focus group discussions. The results reveal issues that need addressing before the policy can be successfully implemented, including staffing, transport for the School Health Teams and further training of these teams and the teachers. Given the health issues faced by South Africans, especially the quadruple burden of disease, it is imperative that the School Health Policy be comprehensively implemented in KwaZulu-Natal.     

Agricultural growth multipliers for two communal areas of KwaZulu-Natal

Expenditure data were collected from 99 households in two rural areas of KwaZulu-Natal. District and wealth group expenditure analyses suggest a less-than-proportional increase in the demand for tradable farm commodities, and a more-than-proportional increase in the demand for non-tradable farm commodities following a 1 per cent increase in household expenditure. Expenditure on non-farm tradables (imported consumer durables) showed the greatest potential for demand growth, with expenditure elasticities ranging from 1,75 to 2,59. An increase of R1,00 in household income is predicted to add an additional 28 cents (multiplier of 1,28) to the local economy. The study estimates relatively weak growth linkages. However, even relatively weak growth linkages could lead to much needed new income and employment opportunities in the local farm and non-farm sectors if the constraints limiting agriculture, and hence broad-based growth in rural incomes, are alleviated. Agriculture-led growth in South Africa requires public investment in both physical and institutional infrastructure to reduce transaction costs and risks in all markets, thus encouraging greater participation by local entrepreneurs and private sector investors. In addition, the roles, functions and services offered by extension agents should be extended to promote collective marketing, facilitate land rental contracts and provide training, technical and business support for farm and non-farm entrepreneurs.     

HIV/AIDS Knowledge and Behaviour: Have Information Campaigns Reduced HIV Infection? The Case of Kenya*

Abstract: AIDS continues to have a devastating effect on developing countries, particularly in sub‐Saharan Africa. The lack of a proven effective vaccine to stop HIV transmission has led to much of public policy putting an emphasis on information campaigns in order to reduce HIV‐prevalence. In this paper we examine the impact of HIV/AIDS‐knowledge from two sides. First, we examine to what extent the campaigns have been successful at inducing the expected behavioural change with regards to HIV‐related attitudes. Second, we examine the impact of HIV/AIDS knowledge on HIV status. The basic policy issue can be expressed as follows: even if individuals have acquired sufficient and necessary information on the basic facts about AIDS, factors such as innate risk attitudes or cultural background could undermine the effects of the campaigns. Using the Kenya Demographic and Health Survey (2003) we elicit empirical evidence on the relation between declared HIV/AIDS‐knowledge, behavioural attitudes related to HIV/AIDS situations and the relation between knowledge and observed HIV‐status. Overall, our empirical findings suggest that information campaigns have been effective at equipping the adult population in Kenya with the required knowledge to avoid becoming HIV‐positive. However, when HIV‐status is measured objectively we find that the relation between correctly declared attitudes and actual behaviour is only statistically significant for females who have arrived into sexuality late enough to benefit from such campaigns: it is for these females that the impact of the information campaigns has been to statistically reduce the probability of becoming HIV positive, as intended. In the case of males we find that there is no statistical relation between either knowledge or timing of the information campaigns and a positive HIV status. Nevertheless, another important finding refers to the selection bias induced by males who are sampled randomly but decline to take the HIV test. The consequences of this bias are twofold; first, the estimated policy parameters for males should be interpreted with caution, but more importantly, estimating the population level HIV‐prevalence for Kenyan males based on the DHS implies underestimating the true and unknown prevalence rate. Our analysis controls for individual characteristics, selection bias and endogeneity effects, thus allowing us to make inferences for the full population and with regards to policy implementation.     

Which eligible households get grants? Demographic correlates of receipt in South Africa

Since Apartheid, the South African government transformed and expanded the social grants system to improve the well-being of its vulnerable populations. Despite increased efforts, a sub-section of the grant-eligible population is not reached. Too little is known about the factors that contribute to grant receipt, especially for the household as a whole. This article examines the household and community characteristics associated with grant receipt among poor households in KwaZulu-Natal. We add to previous work by assessing grant receipt at the household level, examining receipt of the two major grants and analysing correlates in a multivariate framework. While associations with grant receipt are complex and varied, we find higher grant receipt (especially the Child Support Grant) among more disadvantaged households. We also find that characteristics across multiple domains are needed to best distinguish household grant receipt. We discuss theoretical implications for models of grant receipt and practical implications for improving grant access.