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Children and caregivers get valuable support through collaborative research project

Children and caregivers get valuable support through collaborative research project
This 100-litre pot of curry has been a lifeline for the adults and children who gather daily on The Battlefield in Lavender Hill, Cape Town during lockdown. (Photo: Brenton Geach)

Close to two-thirds of children in South Africa live in poor households that struggle to meet basic needs for nutrition, clothing and shelter. These challenges impact on learning and progression; for many, the consequences of these struggles extend far beyond childhood.

Dr Sadiyya Haffejee is a senior researcher at the CSDA, a registered psychologist and mum of two. Her work focuses on children, youth and family risk and wellbeing. She is a board member at Kids Haven CYCC, where she also manages the therapy centre.

Tania Sani is a community development social worker who has a master’s degree in social work. She was part of developing, piloting and implementing the community coaching role for the SmartStart Early Learning programme and is passionate about leveraging community stakeholder resources in social services delivery.

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Bonga is nine years old. He lives with his mother Anna, who is unemployed. Anna loves Bonga so much, but sometimes struggles to give him all that he needs. Bonga is now in Grade 1 and has difficulty reading and sometimes he goes to school hungry. Anna knows he needs help, but doesn’t know who to approach for assistance and what to do first. 

Bonga and Anna’s story isn’t unusual. Close to two thirds of children in South Africa live in poor households that struggle to meet basic needs for nutrition, clothing and shelter. As in Bonga’s case, these challenges impact on learning and progression; for many, the consequences of these struggles extend far beyond childhood.

Extant research shows that exposure to childhood adversity can manifest in poor mental and physical health outcomes, poor school performance and high drop-out rates, and may have negative long-term impacts.

On paper, South Africa’s children are guaranteed a range of support and care. Their rights are enshrined in the Constitution: sections 27, 28 and 29 of the Bill of Rights outline children’s rights to basic education, health, food, care and social assistance. But, like Bonga, we know that millions of children’s daily realities differ greatly from the protections promised by the Constitution. Poor collaboration and cooperation between key sectors such as health, welfare and education — meant to serve children and families — compounds this situation. As a result, children at risk and in need of support slip through the cracks.

To address this fragmentation, the Centre of Social Development in Africa (CSDA) at the University of Johannesburg, and our partners, have convened a Communities of Practice (CoP) Project. The aim is to promote collaboration across different sectors to better understand the complex and multiple needs of children and to develop innovative solutions to promote child wellbeing. Collaborative, interdisciplinary partnerships are increasingly being promoted by scholars, practitioners and development organisations and have been applied successfully in health sectors and in countries in the Global North.

The target group for this project is children in the foundation years of schooling (Grades R and 1). Targeted interventions in nutrition, health and education at this developmental stage could result in positive outcomes for children, families and communities. 

A primary step in this project was the assessment of a sample of children from five low-resourced areas in Johannesburg. A Child Wellbeing Tracking Tool was developed by the CoP team for the purpose of identifying children at low, medium and high risk across key domains of child wellbeing including health, nutrition, education, safety and mental health. 

The first wave of research for the CoP Project was recently completed, and some of the findings are troubling.

Some worrying numbers

Prevalence of running out of money to buy food, weekly household hunger and weekly child hunger in South Africa over the four waves of NIDS-CRAM 2020/2021 (all households with children in them). (Source: Van der Berg et al. (2021) using NIDS-CRAM Wave 4, weighted)

A total of 162 children participated in the first wave of research. We found that many children live in precarious environments where 65% of primary caregivers are unemployed and 40% report having no source of income aside from the Child Support Grant. An alarming 61% report they don’t have enough money to cover their basic needs. 

Although 96% of children attend school regularly, 16% are reported by parents as not progressing with their schoolwork and a worrying 36% are afraid to go to school. Teachers report that 33% of children have difficulty learning and 78,5% have difficulty sitting long enough to learn. 

In terms of food and nutrition, 33% of children sometimes or often go to bed hungry and 37% live in homes where there isn’t enough food. 

From a health perspective, 17% of children have health concerns that prevent them from going to school regularly and, although 96% of children have a ‘road to health’ vaccination card, 33% of children’s vaccinations are not up to date. 

In terms of safety, 67% of children have been exposed to violence, 75% have safety concerns and 8% have experienced abuse or neglect. It is interesting to note that teachers only reported evidence of abuse for 5,5% — this shows that abuse is not always visible and may go undetected.   

Researchers also assessed caregivers’ mental health and found that 55% reported symptoms of depression. 

Going beyond the numbers: A comprehensive intervention 

Now that we’ve assessed the children in our study and identified children at risk, we are implementing the intervention plan to ensure that children in need can access the help they need. 

To facilitate this process, and to ensure service delivery and effective collaboration, we have established and are coordinating a local level community of practice teams at each of our school sites. These local level CoPs draw on existing local resources while seeking to build capacity in communities. To this end, we have identified and included in each CoP, social workers, educational psychologists, community-based nurses/health workers, local NGOs and school governing body members working within the community and/or school. 

This will ensure that these key role players are working collaboratively with the school and identified caregivers to address the multiple vulnerabilities that children face — and, ultimately, to improve children’s wellbeing. Interventions include family strengthening, interventions to support numeracy and literacy, and referrals to appropriate health and mental health services and resources. 

A private social worker has been placed at each of the schools until the end of July 2021. Their role is to implement, with support from the researchers and teachers, contextually relevant intervention plans for the children and families who were flagged as requiring support, as well as to support and develop the local-level CoP groups. Social workers are conducting home visits, liaising with teachers and assessing the specific needs of each child who was identified as “at risk”.

Household and child hunger, and money for food, Wave 1 and Wave 2 (95% confidence intervals). Source: Bridgman et al., 2020)

Children and households who have indicated that they struggle to feed their children will be referred to schools for food parcels. Children who require assistance with language and maths comprehension will be supported by the UJ Maths and Language Education department. 

Through the local-level CoP groups in schools, children who were behind with their vaccinations were referred to local clinics so they can be appropriately vaccinated. Eye and hearing screenings have been arranged with community-based health facilities for children whose caregivers reported they were struggling in these areas.

Thirty children who were identified by both their teachers and caregivers as struggling with learning and schoolwork were assessed by a team of five educational psychologists linked to the UJ Education Psychology department. The assessments took place at schools and included teachers, caregivers and social workers who visited these families and supported them throughout the duration of the assessments. These assessments are currently being analysed and feedback is being provided to caregivers, teachers, local-level CoP groups and the Gauteng department of education’s psychology unit. Intervention plans for these 30 children will be developed by the school, the GDE and the CoP team once all stakeholders have received feedback. 

In addition, families who are identified as needing support and strengthening will be invited to participate in the CSDA’s Sihleng’imizi programme. It covers areas like communication, nutrition, budgeting and conflict resolution. 

The local-level CoP groups have proven to be a source of support for teachers: they not only offer assistance for the children at risk, but offer teachers an important space to discuss problems they notice among children in their classes. As a result, teachers and social workers have been able to identify different solutions to assist children and families with challenges. 

In addition, by including community-based NGOs in these local-level CoP groups, teachers broaden their resource base for other children and families who require support. NGOs, in turn, are given access to these schools and a platform to showcase their services to teachers, social workers and other CoP members. 

Our CoP project continues with a second wave of data collection, post intervention, planned for August 2021. Feedback thus far has been positive and encouraging. Through this collaboration and the creation of community networks, this CoP model offers opportunities to ensure that children, like Bonga, who are in need and at risk, are not left behind. DM/MC

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  • Jane Crankshaw says:

    Time for the DA to step in seeing the ANC won’t! Perfect opportunity to gain some traction with voters too! Do it bevore the Gift of the Givers do it and steal your thunder!

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