A SOCIAL SECURITY RESPONSE TO ADDRESS THE NEEDS OF CHILDREN IN THE CONTEXT OF HIV/AIDS IN SOUTH AFRICA
Request to present submission at the parliamentary hearings on the
Committee of Inquiry Report
9th-10th June 2003
The recommendations presented in this submission were drafted following extensive research and consultation with a range of key stakeholders within the children’s sector, including:
Children, their caregivers, teachers, school principals, social workers, home based carers, magistrates, NGO and CBO staff, community volunteers, health workers, traditional healers and traditional leaders, academics, international development agencies, funding agencies and representatives from local, provincial and national government.
Sonja Giese or Helen Meintjes
HIV/AIDS programme
Children’s Institute
Ph: (021) 689 5404
082 870 7345
Fax: (021) 689 8330
Email: [email protected] [email protected]
1 Background
In August 2001 the Children’s Institute was awarded a tender from the National Department of Health, to conduct research to inform an improved and integrated response to the needs of children who have been orphaned and children who are living with terminally ill caregivers (children at immediate risk of being orphaned). The research report and recommendations presented to the Department in January 2003 were the culmination of 16 months of research, policy and legislative review and consultation .
The project was designed using an in-depth qualitative case study approach in 6 sites across 5 of South Africa’s provinces. Information was collected through interviews, focus groups, child participatory research activities, and observation with children, their caregivers and a range of service providers.
The research set out to explore the life experiences of children and their caregivers and to collect information about the factors that impact positively or negatively on support-seeking behaviour, access to services, and service delivery. One important component of the research was to explore the extent to which the children and their caregivers were able to access and benefit from social security, and the appropriateness and sustainability of the current social security system in responding to the needs of children in the context of HIV/AIDS.
This document begins with a brief description of the research findings in this regard before moving on to present a set of recommendations for improved social security provisions for children living in contexts of HIV/AIDS and poverty in South Africa.
2 Brief overview of research findings regarding social
security for children in the context of HIV/AIDS
2.1 The need for an improved social security system for poverty alleviation
Of the 118 households participating in this research,
- 23 households (just under 20%) received no regular income other than state grants.
- - A further 20 households (17%) had no regular income whatsoever, and relied entirely on erratic
piecework and the support of relatives and neighbours. Of these 20 households, 7 were those in
which children were in the care of sick caregivers, 2 consisted of children living without adults, and 3
were households of young siblings (in which the oldest sibling was 25 years old).
- The research identified several problems with the existing social security system in terms of its
ability to reach all vulnerable children. Some of these problems are discussed briefly below.
2.2.1 Children in the care of sick adults
2.2.2 In HIV/AIDS affected households, poverty is frequently exacerbated through loss of earning
capacity (as breadwinners became progressively sicker) and increased expenditure on
health care and funerals .
Sick adults typically face increased financial struggles to care for their children, sometimes juggling the need to provide immediate care for their children with the need for caregivers to stay healthy in order to provide more long term care. Our research repeatedly demonstrates that the period of a caregiver’s terminal illness is one during which children are prone to exacerbated vulnerability, emphasising a glaring gap in the current social security system.
The case of Caroline, below, aptly illustrates the point:
# Reluctant mobility
Caroline Mvusi has 3 children, Zola (13), Monwabisi (10) and Madoda (8). None of her children qualify for the Child Support Grant, only available to children below the age of 7 years . After becoming ill and losing her job she struggled to provide for them, and reluctantly resorted to sending 2 of the children to live with their paternal grandmother and the third to stay with an aunt. Caroline explains how, when she approached the social worker for help, she was told that her only option for accessing social security to support her children was to send them to live elsewhere, since they did not qualify for any further cash grant support while they were in her care. When the social worker suggested that she place her children in foster care she initially refused. "How can I give my own children to be fostered by other people when I am alive!" she exclaimed bitterly to the researchers. "If I was allowed to stay with my children and get their Foster Grant, I would not complain, but the social workers do not want me to foster my own children".
The research clearly demonstrates the need to put in place mechanisms that support ALL children, particularly in the context of the HIV/AIDS pandemic in which large numbers of children are rendered especially vulnerable by the terminal illness of their biological parents.
2.2.3 When a caregiver dies…
When a caregiver receiving a CSG, CDG or FCG dies, grants are automatically cancelled upon the registration of death, and new applications from replacement (adult) caregivers are required. In instances where households are heavily reliant on children’s grants for survival, the break in the financial support can significantly increase children’s vulnerability.
The death of a child’s adult caregiver (the grant recipient) can therefore result in interruptions in children’s receipt of social security benefits at a time when arguably they need them most
2.2.4 Children without adult caregivers
The fact that children’s grants are in practice provided only in the name of an adult so-called ‘primary caregiver’ or ‘foster parent’ entirely excludes children living without adults – thereby increasing these children’s vulnerability. In the absence of appropriate social security alternatives, in some instances social workers resort to placing children in the care of inappropriate adults.
2.2.5 Children living with HIV
For young children with HIV, disease progression is usually rapid and most HIV-infected infants die before their 5th birthday. Their illness is exacerbated by increased exposure to opportunistic infections and high rates of malnutrition. While the care dependency grant provides some material support to children with severe disabilities, it is yet to be officially extended to provide for the needs of HIV-infected children. The absence of support for caregivers of HIV-positive children is a significant gap in the national response to the impact of HIV/AIDS on children.
2.2.6 HIV/AIDS- exacerbated poverty
While most of the participants in the study described how they relied on support from neighbours / relatives, many expressed their concern that people are becoming less able to support one another as more and more households experience the loss of adults to HIV/AIDS. In other words, HIV/AIDS amplifies poverty way beyond those whom it directly afflicts, by increasing demands on ‘informal’ networks of support in heavily HIV/AIDS affected communities.
Given the socio-economic circumstances of households and neighbourhoods that were part of our study, it is not unexpected that poverty-related experiences were at the forefront of participating children’s and caregivers’ concerns. Whether children had experienced the death of a caregiver(s) or were living with terminally ill caregivers, whether adults were sickly or were caring for orphans, poverty-related difficulties were almost without exception the first that were highlighted by research participants across the sites.
Children who participated in group ‘resource mapping’ activities – a child participatory research tool – were encouraged, as the first step, to brainstorm and agree between themselves what they considered to be the biggest challenges they faced in their daily lives. This exercise was striking in its reflection of children’s poverty-related experiences as central to their circumstances and vulnerability.
All 8 children’s groups who participated in this activity named persistent hunger as one of their key problems. Other poverty-related concerns were their repeated struggles to pay school fees (mentioned by 7 groups) , lack of school uniforms and other clothing (all 8 groups), inadequate housing (4 groups), difficulty accessing water (3 groups), not having money for transport or health care when sick (2 groups) and insufficient blankets to keep warm in winter (2 groups). While a range of other difficulties were also raised by the children during these group activities, the overwhelming majority of needs, and those that were prioritised by the children, were poverty-related.
2.3 Some of the challenges to grant access
Social security grants, in particular the old age pension and the child support grant, play a vital role in sustaining households whose members are able to access the grants. However, the research highlighted several barriers to grant access.
Firstly, the research findings are unequivocal in demonstrating that improved human resource capacity is fundamental if the Department of Social Development wishes to meaningfully address the needs of vulnerable children in South Africa. Across every research site, service provision was hindered by a lack of social workers. Social workers spent most of their time dealing with applications for social security benefits, leaving very little time to deal with other areas of need. Despite this, they still reported massive backlogs in grant applications, mostly because the foster care grant was being used as a poverty alleviation grant in the absence of alternatives (see next section for more discussion on this) and social workers were spending time placing children in formal foster care with relatives so that these relatives could access the grant.
The research findings indicate further that a lack of clarity regarding eligibility criteria and the absence of standardised application procedures for the various grants results in haphazard administration of the grants, excessively long application periods, and in decreased uptake.
Research participants – both applicants and service providers – commented on the lengthy processes of grant application, and the repercussions of this for their daily survival. Smooth and efficient application processes are especially necessary in contexts in which people’s poverty is compounded by illness and death.
# A house "covered in darkness…"
"I am afraid that all my children will turn 7 before receiving this money!", exclaimed 26-year-old Foneka who is responsible for the care of her own 3 children, her sister’s 2 children and her 2 younger siblings since the death of their mother 2 years ago. It cost her R40 to get to the social services offices in Umzimkulu town in order to apply for the Child Support Grant for her youngest children - and that was many months ago. "It is better to be a child," said Foneka, "so that you know nothing. The way things are going you just feel like putting your hands on your head and crying out loud. As you look at your own home you ask the question why should it have problems that are bigger than everyone else’s? Since my mother died this house is covered in darkness".
Documentation requirements presented difficulties for research participants, especially where demands were made by social services for paternal documents. Research participants cited repeated trips to Home Affairs offices (to obtain documents) as an obstacle, which in the case of rural areas frequently required costly and time-consuming journeys . The story of Babalwa Nxumalo, below, illustrates some of the challenges:
# Organising documents where there are none
Babalwa Nxumalo (28) lives in a one-roomed hut at the end of a winding footpath far from the main road that makes its way through Ingwavuma. She cares for her own 3 children as well as 3 children orphaned by the death of her husband’s sister. Her husband lives in Johannesburg and, now that he has lost his job, he seldom returns home and never sends money to help support his own or his sister’s children. The only income to the household is the 2 Child Support Grants that Babalwa gets for her youngest children and the R10 she earns "on good days" by selling home grown beans, catching fish or working in other people’s fields. "It is hard to raise these children," Babalwa said with resignation.
Ten-year-old Njabulo had to repeat Grade 1 this year because she could not pay his school fees. Babalwa said this makes her feel terrible because she "looks like a failure". The community health workers advised Babalwa to go to the social worker to apply for Foster Grants for her sister-in-law’s children. The problem, however, she said, is that the children do not have birth certificates and she does not have their mother’s death certificate or know the identity or whereabouts of their fathers. "It is a big problem" she said, because in order to verify the children’s identity, she would have to take her local induna with her to the social workers. However, he demands R150 for this service and, she added, "you must also pay for transport for him and also buy food for him while we are standing in a queue." However, this is impossible for her to do, she says, and besides, she may have to go more than once to the social workers, who are a R30 journey away.
At times she thinks of leaving the children and going back to her parent’s home, "but," she says, "my conscience blames me all the time. I don’t know what they would do without me…".
Requirements to produce documents or proof of whereabouts of biological fathers provided a number of research participants with unsurmountable barriers to accessing grants . Grandmother Mrs Mbuli (68), who cares for her 2 young grandchildren after the death of her daughter, exclaimed in frustration:
"When you go to the social workers to ask for support to bring up your children, they ask you for the father’s death certificate. If the father is alive they say you must open a case against him so that he can be forced to pay maintenance. How can you open charges against someone you do not know? My daughter fell pregnant from a man she met in Port Shepstone. She had gone there to work. How will I know him? I don’t know this man … who shall I say I am looking for?"
The research demonstrates how difficulties of access to grants are exacerbated by the HIV/AIDS pandemic – particularly for children who are subjected to the loss of multiple caregivers and/or who live in households without adults.
2.4 Questioning the appropriateness of the foster care grant as a poverty alleviation mechanism
Given the lack of alternative poverty alleviation mechanisms available to the caregivers of children over the age of 9 years, and the fact that the value of the Foster Grant is more than 3 times that of the CSG, it is hardly surprising that across all of the research sites, facilitating legalised foster care placements for orphan children was by far the most widespread response on the part of social workers and NGOs in dealing with children who had lost parents. In each and every case, social workers and programme staff identified the opportunity to assist people living in poverty through the provision of Foster Care Grants. A manager in an NGO providing statutory social work services explained their approach to placing orphaned children in foster care: "We see it as our poverty alleviation programme. It’s a long-term route, but I think the only route at the moment available to us to ensure the children’s needs are being met".
In order to qualify for a Foster Grant caregivers have to apply, through a court of law, to formally foster the children in their care and placements in foster care are made for a maximum period of 2 years at a time, with a renewal process necessary in order to continue the placement. Turnover time was said to vary in the urban sites from roughly 6 months to 18 months, depending on social work and court backlogs and on whether people had the correct supporting documents (a frequent problem). In the rural sites, where there were no dedicated Children’s Courts and only a few hours per week (if that) allocated to children’s cases, the process could take even longer. For example, in Umzimkulu social workers reported a backlog of 140 foster care applications, with 7 social workers sharing 1 car (needed to conduct home visits to potential and current foster parents), and only 1 magistrate in the area who conducts roughly 3 Children’s Court enquiries per month. In Ingwavuma, 3 social workers serviced a population of over 110 000 people with a court that considered children’s issues once a week. In one of the courts in greater Tzaneen, 4 social workers vie for hearings while the magistrate only grants time to children’s issues from 7.45 am to 9 am on a Friday. At the time of the research one of the social workers had 14 foster placements fully prepared but had been unable to obtain a hearing in 5 months.
Once the foster placement is eventually approved by the magistrate, social workers are required by law to monitor the placement, write regular reports on the child’s progress and justify the extension of the placement every 2 years. "You can imagine," explained a social worker from Durban: "if we place a 2-year-old, or a 9-month-old baby in foster care, we will have to write those reports until that child has finished school. We’ve got a file open and we’re going into volume 2 and volume 3 of the file for the entire time of the child’s life…so imagine what that means for us!"
Social workers in all 6 research sites spoke about how time-consuming the processing and monitoring of foster placements is but how, in the absence of alternative poverty relief for children, the processing of foster placements was necessarily prioritised.
Given the lengthy processes involved in processing foster care placements, social workers in the sites were not able to fulfil a number of their other designated roles: they were – in the main - rarely able to meet the needs of the children of whose circumstances they were aware, let alone make any effort to identify other children who may be vulnerable. Thus, in general the Department’s goals of early identification and support of OVC were left unattained.
The application of foster care placements to the majority of orphans (as proposed by the Department of Social Development) detracts from the crucial role that such placements are intended to perform in protecting children who have experienced abuse and neglect. The huge numbers of applications for fostering of orphans will undoubtedly further clog up an already overburdened system, making access more difficult for those who most need the protection that it offers.
Furthemore, the ethics of the State providing support to poor relatives to care for children without providing adequate and equal support to poor biological parents is questionable. Such a system is nothing short of inequitable.
It is therefore crucial that the foster care system be strengthened in order to better accommodate children who do require the State to intervene in their care arrangements. In addition, an alternative, equitable social security mechanism that is able to reach the large numbers of poor children in South Africa needs to be urgently instituted.
Partly as a result of HIV/AIDS, children in South Africa are likely to increasingly find themselves in circumstances that make them vulnerable to basic rights violations. This fact demands a shift in the current administrative requirements for the various grants, and for serious consideration to be paid to the structure of the social security system itself. Socio-economic security is a right granted to children by the South African Constitution. It is the State’s duty to deliver on this, and to make adequate provision for children who find their lives upturned by the HIV/AIDS pandemic.
3 Recommendations for a social security response to addressing the needs of children in the
context of HIV/AIDS in South Africa
The Children’s Institute believe that the recommendations that follow in this section are progressively achievable. Furthermore, many good and appropriate policy initiatives to address service provision for children are already in place in South Africa. In all instances, the recommendations attempt to contribute to and build upon these initiatives and to address gaps.
3.1 A basic package of services and support
Given the fact that most children in South Africa live in poverty and that the vulnerability of children experiencing orphanhood is most frequently poverty-related, we recommend instituting a basic package of services and support for all children in South Africa. This package of services and support would need to be integrated into broader poverty reduction mechanisms, including employment strategies, income-generating schemes and community development projects.
The proposed package comprises both direct and indirect benefits.
3.1.1 Direct benefits in the form of cash transfers
a) We recommend a universal income support mechanism, such as a basic income grant, as the most appropriate and equitable mechanism for improving the status of poor households and thereby addressing the needs of vulnerable children in the context of HIV/AIDS.
b) Phasing in a universal income support mechanism: Given resource constraints, and in line with the progressive realisation principle in the Constitution, we recommend the implementation of a universal child support grant (or extension of the age of eligibility of the existing CSG to 18 years) as the first step towards the roll-out of a universal income support mechanism.
c) These recommendations concur with those made by the Taylor Committee of Inquiry (Committee of Inquiry, 2002).
3.1.2 Indirect benefits
Indirect benefits to be included in the basic package of services and support should include:
a) Free and accessible primary and secondary education at state schools (including reception year) for all children - not subject to the granting of a school fee exemption and including subsidised uniforms.
b) Free and accessible registration of births and deaths and the processing of identity documents (including the provision of photographs).
c) Nutritional support through the urgent development of a national food security strategy, including the strengthening and expansion of existing programmes such as feeding schemes through schools and early learning centres, micronutrient supplementation, food fortification, the distribution of food parcels and agricultural support programmes.
d) Full access to free basic health care for all children and, where possible, a review of the triaging system to ensure compliance with the principle of ‘putting children first’.
3.1.3 Phasing in a basic package of services and support ~ a needs- based approach
Until such time as a ‘package’ of direct and indirect benefits is available to all children in South Africa, we recommend that the package be provided - with immediate effect - to the most vulnerable, and we suggest the following provisions for determining who is "most vulnerable":
a) Eligibility for the package of services should be determined on the basis of a single needs-based assessment. At present caregivers applying for benefits such as school fee exemptions, exemptions from payment of health care fees, and child support grants, are subject to multiple application processes. These processes are often inaccessible and intimidating for the applicant and time-consuming and costly for the applicant and the service providers involved. Children and/or their caregivers applying for the recommended package should be eligible for the full range of exemptions and support services based on a single needs-based assessment.
b) The package should be weighted towards the provision of services and support that are of direct benefit to the child, thereby reducing opportunities for misappropriation of support intended to benefit children and the likelihood of children being perceived and exploited as a route to resources.
3.2 Formal foster care as a service response
Core to the Department’s response to the impact of HIV/AIDS on children is an intention to roll out the Foster Grant to reach the large and increasing number of orphans in South Africa. Our research suggests that this is an inappropriate response to the poverty related needs of these children.
a) We recommend against the use of foster grants to address the poverty- related needs of children experiencing orphanhood, and argue that money be allocated instead to addressing poverty through more accessible poverty alleviation mechanisms, such as a universal child support grant, and through a ‘package’ weighted towards the provision of services and support that are of direct benefit to the child.
b) We recommend that the amount of the universal child support grant be increased so as to reduce the discrepancy between the child support grant and the foster care grant.
c) We further recommend that the foster care system be strengthened in order to accommodate children who do require the state to intervene in their care arrangements and to monitor their care, e.g. children needing protection from abusive home circumstances or young children in the care of very elderly caregivers with no additional adult support in the household.
d) Essential components in strengthening the foster care system include the following:
i) Increasing the number of social workers as well as the resources available to social workers so as to enable them to process applications effectively and to monitor and support foster parents.
ii) In many areas, courts are difficult to access and only allow a limited time for children’s issues per month, creating a bottleneck in the processing of foster placements. The Department of Justice needs to address this issue as a matter of urgency by increasing the number of commissioners and/or the time allocated to children’s issues. Child commissioners could benefit from training in child development and other related issues so as to be well placed to make informed decisions regarding what is in the best interests of the child.
iii) There is also a need to increase awareness among magistrates of the purpose of foster care and the circumstances in which a foster placement is essential.vi)
3.3 Special provisions for HIV-positive children
The Taylor Committee of Inquiry is unclear in their recommendations as to whether the Care Dependency Grant be extended to children with chronic illnesses, including HIV/AIDS.
We recommend the following provisions for HIV-positive children:
a) That the eligibility for the Care Dependency Grant be needs-based and that the Grant not target only those children with severe disabilities in permanent home care. Eligibility criteria for the CDG need to be reviewed to include children with special needs as a result of a chronic illness, including HIV/AIDS.
b) Primary level health care facilities need to be better equipped to offer testing, treatment, care and support to children who are HIV-positive or who are suspected to be HIV-positive.d) e) Additional support for HIV-positive children and their caregivers to be considered include improved health outreach and home based care services for children, transport vouchers to hospitals, additional nutritional supplements and basic equipment required to care for a sick HIV-positive child at home. f) 3.7 Provisions for HIV-positive caregivers3.8 The most effective way of reducing the burden of increasing numbers of orphans on services is by providing treatment, care and support to HIV-positive adults to enable them to maintain independence and care for and financially support their children for as long as possible, and to curb further orphanhood and vulnerability in South Africa.
c) The provision of antiretroviral therapy (ART) in the public sector is a crucial step towards decreasing the numbers of children who will be made vulnerable as a result of deaths due to AIDS.b) c) For those cases where ART is not available or where the treatment has failed, eligibility criteria for the adult disability grant need to be reviewed to ensure that HIV-positive adults are able to access the grant at a stage of their illness where they are still able to benefit from it. Once again, eligibility should be needs-based and applications for the grant should be fast-tracked for adults in the late stages of AIDS.d) We therefore support the Taylor Committee’s recommendation that people with chronic illnesses (including HIV/AIDS) be eligible for the adult disability grant.
d) The prevention of mother-to-child transmission of HIV is a core component of a response to the needs of children who have been orphaned and who are at risk of being orphaned. The research suggests that PMTCT programmes have potential benefits beyond preventing the transmission of the virus. In particular, the programme provides HIV-positive caregivers with much needed support, provides children born to HIV-positive mothers with nutritional supplements and fosters a health care environment that is more conducive to monitoring and supporting OVC.f) g) Nutritional support, through the proposed national food security programme, should be available as part of a comprehensive health plan to maintain the health of HIV-positive children and adults.h) i) Income-generating projects need to be supported where appropriate. There is a need to provide these programmes with professional as well as financial support so as to ensure their effectiveness and sustainability.j)
3.4 Addressing hunger
In light of the widespread and severe hunger documented in this research, we recommend:
a) The development of a national food security strategy to co-ordinate and guide a national response to hunger and to ensure comprehensive and sustainable food security for all children.
b) Existing programmes aimed at addressing malnutrition and hunger need to be strengthened. These include school-based feeding schemes, the clinic-based protein-energy malnutrition scheme, the distribution of food parcels, vitamin A supplementation and the distribution of milk formula to HIV-positive mothers.
c New initiatives are also required to supplement what already exists. These could include community-based feeding schemes such as soup kitchens, communal gardens, school gardens, contracting community workers to take responsibility for feeding children living without adults or living with very sick caregivers, the wider distribution of food vouchers (limited to staples), and the development and expansion of income-generating and home food production schemes. In this respect, collaboration between the three departments targeted in this document (Health, Education and Social Development) and the Department of Agriculture is urgently needed.
3.5 Improving the administration of and access to social security grants and social relief of
distress
Much of the responsibility for service provision for vulnerable children is placed on the Department of Social Development. The following recommendations are proposed for making Social Development services more accessible and appropriate to vulnerable children and their caregivers:
a) Social workers are scarce and have limited resources at their disposal to deal with the increasing numbers of children made vulnerable through HIV/AIDS-related illness and death. There is a need to make additional social services staff available to process grants and to create enabling legislation for the devolution of certain functions – currently the responsibility of social workers – to accredited individuals (such as home- and community-based carers and auxiliary social workers) and/or non-governmental organisations.
b) Lack of transport emerged as a major barrier to service delivery among social workers. Transport needs to be made available to social workers so that they are able to perform the functions for which they are responsible.
c) Social workers and other social services staff need nationally consistent regulations and guidelines on which to base discretionary decisions regarding grant eligibility, particularly in the case of children or young adult siblings living without adults.
d) The research showed the need for a Social Development departmental awareness campaign for the benefit of social workers, which informs them as to the correct documentation required to access grants. The research documented instances of social workers demanding the death certificates of fathers who may have been absent for many years and have never played a significant role in supporting a child’s welfare. The application process is often stalled because social workers tell caregivers that they are not eligible for assistance without the death certificates of both the child’s parents.
e) More could be done to encourage the uptake of social grants and to improve knowledge and awareness of user rights through collaborative partnerships with other service providers:j)
i) Social institutions such as churches and other religious groups, traditional leaders, etc. have a role to play in assisting people to access grants.
ii) Social services / NGOs should be more immediately available to newly identified HIV-positive caregivers at or near health facilities. This would place health staff in a much better position to persuade HIV- positive caregivers to seek immediate assistance.
iii) Selected home-based carers and community volunteers could be trained to assist social workers with identifying people eligible for social assistance and to assist in the process of applying for grants.
iv) Social workers should be available to schools as part of a team of professionals, including school psychologists and nurses.
v)
f) User knowledge of grants and procedures for application of grants needs to be improved. An ongoing campaign is needed, directed at caregivers, children and the elderly, to increase awareness of the services and support available.
g) Given the fact that most poor children are not accessing the available grants, we recommend and support initiatives to fast-track the registration of children and the processing of grants to reach a desirable target over a given period of time.
h) Caregivers and children are often unable to access the required documents from Home Affairs – such as children’s birth certificates, caregivers’ death certificates and identity documents. The Department of Home Affairs needs to address this issue urgently, through:
i) Exploring options for alternative forms of proof of identity,
ii) The possible devolution of registration functions to accredited organisations,
iii) Increased human resource and technical capacity at Home Affairs offices, and
iv) Increased numbers and activities of mobile Home Affairs units.
i) Systems need to be put in place to assist children living without adults, children living with young adult siblings, and children who assume caregiving responsibilities for other children or for sick/elderly adults, to access social grants and services. Possible avenues to be explored in this regard include the use of schools as vehicles through which children can be identified, supported and monitored, the use of household mentors to assist children and young adults to access and manage social grants, and the expanded role of social relief of distress to provide these households with support on a regular and longer term basis.
i) Mechanisms need to be put in place to ensure that the grant follows the child and that it is not terminated, as is currently the case, when the child’s caregiver dies.
j) There needs to be some consideration given to making pay points safer as they are currently being targeted by criminals.
k) Systems need to be put in place to ease the burden on elderly caregivers of applying for grants and collecting grants on a monthly basis. For example, social workers could meet with groups of elderly caregivers at clinics to provide information and process grant applications. The payment of child grants to elderly caregivers could be linked with the payment of old-age pensions.
l) Monitoring mechanisms need to be in place to ensure compliance with regulations regarding the administration of social grants and social relief of distress.
aa) There needs to be serious consideration given to reorganising the provision of social relief of distress and increasing the capacity of the system for its delivery.
bb)
i) The procedures and documentation required to access Social Relief of Distress need to be relaxed in order to make it more accessible to the people who need them most.
ii) Clarity is needed for social workers and administrative staff on who qualifies for social relief of distress.
Iii) Social Relief of Distress should not be issued for a limited period of 3 months only and should be available for longer periods of time for those in greatest need.
Giese S, Meintjes H, Croke R and Chamberlain R (2003). Health and Social Services to Address the Needs of Orphans and Other Vulnerable Children in the context of HIV/AIDS – research report and recommendations. Children’s Institute and National Department of Health.
The full research report and recommendations will soon be released by the Department for distribution. If you would like a copy of the document, please contact [email protected] or [email protected].
Footnotes
See Steinberg et al (2002).
Note that all names used in this document have been changed to protect the identity of research participants.
The research was conducted prior to the extension of the CSG to children aged 9. The activity was conducted with 8 groups of children (involving a total of 37 children) in the research sites.
The group which did not raise school fees as a concern was that of 4 boys who were living at their school in an old classroom, with support from the principal, teachers and school governing body.
For example, for residents of Ingwavuma the nearest Home Affairs office at which documents could be obtained was located in Hluhluwe, roughly 200 km away from the ‘town’ centre of Ingwavuma.
The 1995 South African October Household survey figures highlight the absurdity of provision of support having paternal documents as a prerequisite: the survey documented that at the time 42% of children under 7 years old were living only with their mother (Budlender, 1998).