Evaluating access to a child-oriented poverty alleviation intervention in rural South Africa.
BACKGROUND
In April 1998, the South African government introduced the child-support grant as a poverty-alleviation measure to support the income of poor households and enable them to care for the child.


OBJECTIVE
This research aimed to measure equity of access to applications for the child-support grant in an area characterized by poverty. Three questions were addressed: (i) How does socioeconomic status affect the probability of a household applying for a child-care grant? (ii) What household and caregiver characteristics are associated with child-care-grant application? (iii) What barriers to access are experienced by households that do not apply for the child-care grant?


METHODS
The study population of 6,725 households with at least one age-eligible child was drawn from the Agincourt field site, a rural sub-district of South Africa. Data used were obtained from health and demographic surveillance, a child-grant questionnaire, and a household-asset survey. Descriptive cross-tabulations and multivariate logistic regression were used in the analysis.


RESULTS
Although these grants are intended as a pro-poor intervention, the poorest households are less likely to apply for grants than those in higher socioeconomic bands. Households in lower socioeconomic bands experienced barriers in accessing grants; these related to lack of official documentation, education level of the caregiver and household head, and distance from government service offices.


CONCLUSIONS
Enhancing access will require improved provision of birth certificates and identity documents, efficient coordination and service provision from a range of rural government offices, and creative methods of communication.
MRC/Wits Rural Public Health and Transitions Research Unit (Agincourt), School of Public Health, University of Witwatersrand, South Africa. rhian@agincourt.co.za
Rhian
R
Twine
Mark A
MA
Collinson
Tara J
TJ
Polzer
Kathleen
K
Kahn
D002648:Child; D002669:Child Welfare; D005191:Family Characteristics; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000209:etiology / Q000517:prevention & control; D011203:Poverty; D011632:Public Assistance; D012424:Rural Population; D012943:Social Security; D012959:Socioeconomic Factors; D013019:South Africa / Q000208:ethnology; D011795:Surveys and Questionnaires