New study again proves worth of social grants in South Africa
Doubters of social grants, hear ye, hear ye: an extensive three-year study by academics from Oxford, Wits, UCT, UKZN and University College London provides more evidence that South Africa’s social grant system is both necessary and effective. In this case, the study’s findings report that child-focused cash transfers can reduce the incidence of HIV by lowering the prevalence of risky sexual behaviour, particularly among adolescent girls. By REBECCA DAVIS.
South Africa’s “bloated welfare state” tends to attract a great deal of disapproval from the chattering classes. Part of what drives this is the number of urban myths in circulation about the abuse of the social grant system: that teenagers fall pregnant in order to access child support grants, for instance; or Sky News’ egregious claim that South African women deliberately drink alcohol during pregnancy in order to subsequently claim a disability grant for the child.
When the Daily Maverick debunked that one, we quoted African Centre for Migration & Society researcher Marlise Richter: “Research has consistently found a correlation between social grants and positive childhood development.”
The new study, published in renowned journal The Lancet Public Health, shows now that there is also a correlation between social grants and reduced instances of risky sexual behaviour among adolescents: particularly the taking on of a ‘sugar daddy’ who swaps food, money or school fees for sex. The study, led by the University of Oxford’s Dr Lucie Cluver, interviewed South African adolescents between 10 and 18 years old, living in both urban and rural districts, between 2009 and 2012.
The reason for targeting young people in the study is because they are at the heart of sub-Saharan Africa’s HIV landscape. Of the 1,8 million new HIV infections in 2011, the report records, 41% were in people aged between 15 and 24 – and the prevalence rate was three times higher in girls than in boys.
Social grants available for children in South Africa are twofold: the child support grant (R280 per month in 2012) is available to the primary caregivers of children who earn below a certain amount per month. The take-up of this grant is far more extensive than the second form, the foster child grant (R770 per month), which is available to the primary caregivers of children legally in their care.
Of the four districts chosen for the study, two were rural and two were urban, within Mpumalanga and the Western Cape. All had an antenatal HIV prevalence of more than 30%, based on the national HIV testing of pregnant women.
All in all, 3,401 adolescents were interviewed over 2009-2010 and then again over 2011-2012, and asked questions about risky sexual behaviour. Types of risky sexual behaviour included transactional sex (having sex in exchange for food, shelter, transport or money); “age-disparate sex” (having a sexual partner more than 5 years older than the adolescent); unprotected sex (not always using condoms); having two or more partners in the past year; and sex while drunk or after using drugs.
The results showed that there were correlations between types of risky sexual behaviour engaged in. In other word, participants who had age-disparate sex were more likely to have transactional sex than those who didn’t. Participants who had transactional sex were more likely to have had sex while drunk or after taking drugs than those who didn’t have transactional sex. Participants who had age-disparate sex were also more likely to have had multiple sexual partners. “All risky behaviours increased with age, for both girls and boys”, the study notes.
The researchers found that receiving a social grant resulted in a reduction in certain types of risky sexual behaviour. In households not receiving any child grants, for instance, 5.5% of girls had had transactional sex in the past year, as compared with 2,5% of girls in households which did receive a grant. When researchers returned a year or more later, those figures stood at 6.2% and 2.7% respectively. In households which hadn’t received any child grants, 4.3% of girls had begun an age-disparate sexual relationship in the past year. In houses which were given such a grant, that figure dropped to just 1.2%.
Dr Cluver explained the significance of the findings to the Daily Maverick in simpler terms. “The most striking finding is that our social grants are reducing HIV risk behaviour for teenage girls,” Cluver said. “Girls who get a child support grant or foster child grant are half less likely to have transactional sex (in exchange for food, school fees or money) and two thirds less likely to have a boyfriend who is 5 or more years older than them. These are major HIV-infection risks, and parts of the reason why our Minister of Health says that ‘sugar daddies’ are one of the greatest risks to girls today.”
Such ‘sugar daddies’ are more likely to be HIV-positive, Cluver notes, and young girls are less likely to be able to negotiate condom use with them. “This is part of the reason why we see up to five times the rates of HIV in teenage girls compared to teenage boys,” Cluver said, citing a Human Sciences Resource Council report from 2012.
It’s important to note that social grants are not a comprehensive magic bullet here. The study found that receiving a grant did not significantly affect the likelihood of participants to have had unprotected sex, multiple sexual partners, or sex while drunk or after taking drugs. “So [social grants] don’t stop teenagers from doing stupid teenage stuff,” Cluver summed up. The study also found that most of the significant effects of social grants on sexual behaviour are limited to female adolescents. For boys, access to grants were associated with a slightly reduced incidence of multiple partners, but not sustainably so. There were “no other significant effects” for the sexual behaviour of boys.
“[Social grants] do reduce this one key risk – getting this small amount of monthly money for the whole household means that girls don’t have to choose their sexual partners through economic need,” Cluver said.
It’s also significant that the study identified no adverse effects of cash transfers for adolescents (whereas in Malawi, for instance, there were short-term increases in risky sex for men given cash transfers in a trial). The study reports: “Given the strong evidence of nutritional, educational, and other benefits of child-focused cash transfers, it is encouraging to identify no harmful effects on risky sexual behaviours in this sample”.
For Cluver, one of the most striking findings of the study was the debunking of the popular understanding of the relationship between young girls and sugar daddies.
“When you read in the newspapers about sugar daddies, it’s often talked about like it’s a lifestyle choice that girls make: they want luxuries or cellphones or nice clothes,” Cluver said. “But these findings really tell us something different. That if we give a small amount of regular money for survival, girls will choose not to have a sugar daddy. If we really want to reduce HIV incidence for our teenage girls, we can't just tell them not to take risks. We have to make it possible for them to do so.”
With this further evidence of the utility of social grants in hand, Cluver says it’s essential to work harder to make sure that eligible children are accessing the grants. “Although a huge amount of work has been done on this, a Children’s Institute report last year found that 30% of eligible children are not getting a grant, and these are likely to be the most vulnerable to HIV infection.”
It’s Cluver’s belief that the grants should be scaled up, not down. “We already know from a UNICEF study last year that these grants improve education and child development,” she says. “Now we know that they can also protect teenagers from HIV.” DM
- Child-focused state cash transfers and adolescent risk of HIV infection in South Africa: a propensity-score-matched case-control study, in The Lancet;
Photo: A mother washes clothes as an African National Congress (ANC) election poster is seen on the shack she and her family live in at Waterworks, an informal settlement outside Soweto May 9, 2011. REUTERS/Siphiwe Sibeko