Putting Children First: Identifying solutions and taking action to tackle poverty and inequality in Africa. Addis Ababa, Ethiopia, 23-25 October 2017 This three-day international conference aimed to engage policy makers, practitioners and researchers in identifying solutions for fighting child poverty and inequality in Africa, and in inspiring action towards change. The conference offered a platform for bridging divides across sectors, disciplines and policy, practice and research.

1. Aislinn Delany
Putting children first: Identifying Solutions and Taking Action on Child
Poverty and Inequality in Africa
Addis Ababa, 24 October 2017
Towards comprehensive social
protection for children in South
Africa

2. Starting point – Constitutional rights
• Founding values of dignity,
equality
• Section 27 provides for socio-
economic rights
• The state must take reasonable
measures, within available
resources, to achieve progressive
realisation of these rights.

3. Starting point – Constitutional rights
• Section 28 provides for a set of
children’s rights – including
economic and social rights
• Every child has the right to basic
nutrition, shelter, basic health care
services and social services
• Clear role for social protection
policies in realising these rights
• Formalised in legislation and policy

4. So what do we know about the need for
social protection for children?
• Children are disproportionately affected
• Child income poverty has decreased, but still high
• Inequalities persist – legacy of apartheid policies

5. Child poverty has decreased, but remains high
Source: Statistics South Africa (2004 - 2015) General Household Survey 2003 - 2014. Analysis
by Katharine Hall & Winnie Sambu, Children’s Institute, University of Cape Town.
0
10
20
30
40
50
60
70
80
90
100
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
%ofchildrenlivingbelowthepovertyline
Child income-poverty rates, 2003 - 2015
Upper-bound
poverty line
Lower-bound
poverty line
Food poverty line

6. Children are most affected by poverty
Source: Statistics South Africa (2017)
Poverty headcount by age (UBPL: 2006, 20009, 2011, 2015)

7. Unemployment rates have not decreased
Source: Statistics South Africa (2008 – 2017) Quarterly Labour Force Survey, Q1 2008 - Q2 2017.
Pretoria: Stats SA.
Unemployment trends (population 15-64 years, 2008 – 2017), by sex
0
5
10
15
20
25
30
35
2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
%15-64yrswhoareunemployed
All Women Men
31% of
children live
in households
in which no
adult is
employed

8. Inequalities amongst children persist
Dimension of deprivation Poorest 20% Richest 20%
Inadequate water 49% 3%
Inadequate sanitation 35% 3%
Inadequate housing 30% 3%
Overcrowding 25% 2%
No electricity 15% >1%
Child hunger 20% >1%
Not living with mother 31% 8%
No living mother 7% 1.5%
Travel 30 mins + to nearest clinic 32% 4%
Source: Statistics South Africa (2015) General Household Survey 2014. Pretoria: Stats SA.
Calculations by Katherine Hall & Winnie Sambu, Children’s Institute, UCT.
Run along
spatial, race
and gender
lines

9. So what is in place for children in South Africa?
End March 2017
0
2,000,000
4,000,000
6,000,000
8,000,000
10,000,000
12,000,000
14,000,000 1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Care Dependency Grant: 145,000
Foster Child Grant: 440,000
Child Support Grant: 12 million
Numberofchildgrantsinpayment
Growth of grants for children (1998 – 2017)

10. • Online birth registration available at health
facilities
• Free health care for pregnant women &
children <6
• National school nutrition programme
• No fee schools; school fee exemptions
• Housing subsidy; and free basic services
Programmes to support access to services
Social
services
for all
who
need
them

11. So what are the gaps and challenges?
The low value of the child support grant
Lowest levels of take-up are found amongst infants
The CSG was intended as part of a broader package of services,
but the policies and programmes are not coordinated and in
practice families have difficulties accessing them.
The eligibility criteria for the care dependency grant remain
based on a medical model of disability – this excludes poor
children whose disabilities require the use of support services but
do not meet the criteria for the medical assessment
There is no social assistance for those aged 18 – 59 years (with
the exception of the disability grant)

12. So what are the gaps and challenges?
Foster care system has been used to provide (income) support to
orphaned children in the care of relatives – led to a significant
increase in the demand for foster care placements and placed
enormous strain on the child protection and social welfare
services. Many children are unable to access the foster child
grant timeously
There is widespread inequality in access to quality healthcare
and insurance. Contributory schemes cover a relatively small
proportion of population, leaving many poor households
vulnerable to risks or shocks.
The system is fragmented in terms of planning and service
delivery; split across multiple government departments.

13. Considering comprehensive social security –
and social protection
Early 20th century
European-style social
security measures
introduced
1996
Lund Committee
recommends the child
support grant to replace the
biased state maintenance
grant. The CSG was
introduced in 1998.
2002
Taylor Committee of Inquiry
into Comprehensive Social
Security – recommends a
comprehensive social
protection package
2012
National Development Plan
lays out the strategy for
eliminating poverty and
reducing inequality by 2030 –
calls for social protection floor
to be defined
2016
Government releases
Comprehensive Social Security
discussion document – based on
2012 policy positions
Parallel discussions of policy
reforms for social assistance

14. Taylor Committee – comprehensive social
protection package
Application Key components
Income poverty
(provision of basic
income/income support)
Universal (a) Basic income grant
Child support grant
Maintained state old age grant
Capability poverty
(provision of access to
certain basic services, often
referred to as social wage)
Universal/eligibility
criteria (b)
Free and adequate publicly-provided healthcare
Free primary and secondary education
Free water and sanitation (lifeline)
Free electricity (lifeline)
Accessible and affordable public transport
Access to affordable and adequate housing
Access to jobs and skills training
Asset poverty
(income-generating assets)
Universal/eligibility
criteria (c)
Access to productive and income-generating assets
such as land and credit
Access to social assets e.g. community
infrastructure
Special needs Eligibility criteria Reformed disability grant, foster care, care
dependency
Social insurance Eligibility criteria Cover for old age, survivors, disability,
unemployment, health needs

15. Comprehensive Social Security paper (2016)
Pillar 1: Social assistance
(non-contributory,
poverty alleviation)
• Child support grant
• Foster child grant
• Care dependency grant
• Disability grant
• Older persons grant
• War veterans grant
• Social relief of distress
Pillar 2: Social insurance
(contributory,
mandatory)
• Unemployment Insurance
Fund (UIF)
• Compensation Funds
• Road Accident Fund (RAF)
• National Health Insurance
(NHI)
• National Social Security
Fund (NSSF)
Pillar 3: Private
insurance (contributory,
supplementary)
• Pension & provident funds
• Retirement annuities
• Group life schemes,
collective investment
funds, endowments funds
etc.
Source: Presentation by Brenton van Vrede on the Comprehensive Social Security Discussion
Document at workshop on expanding social assistance for children, Cape Town, 16-17 May 2017.

16. What does the government paper propose?
Social assistance
• Expand social assistance by phasing out the means test all dependent
children, the elderly and those with disabilities are eligible for benefits
• Align social assistance entitlements with the personal income tax system
Social insurance
• Establish a National Social Security fund to that provides pensions and life
insurance to the whole workforce
• Improve unemployment benefits for those already eligible for UIF
Strengthen links between non-contributory & contributory systems
• Create a consolidated department to oversee existing responsibilities of
Departments of Social Development, Labour, Health, Transport
• Establish integrated service delivery points (social security agencies and
labour centres to share facilities and infrastructure)

17. What does the government paper propose?
• Promote more effective linkages between social security measures
and labour active labour market policies
• Aligning the proposed social security reforms with the National Health
Insurance in progress
What does it mean for children?
• Very little direct mention of children
• Reforms:
• Phasing out means test for CSG and CSG
• Providing survivor benefits through NSSF so that children of a deceased
worker receive income until they complete their education

18. What does it not address?
There is little reference to social protection, including the call for
the social protection floor in the National Development Plan
It does not provide evidence for why phasing out the means test is
the most effective policy choice in meeting the NDP goals of
eliminating poverty and reducing inequality by 2030
It does not refer to the challenges relating to the foster care
system or the proposed CSG-based reform that is intended to
address them – or other reforms under discussion.

19. What does it not address?
Little mention is made of links to basic services or social welfare
services
It does not address in detail the social assistance gap for
unemployed adults; rather, “employment creation, training and
improved access to new job opportunities are the most important
vehicles for support to this target group” (IDTT, 2016:14).
When CSG beneficiaries turn 18, they find themselves without income
support – just when they face the expenses of further education and
job searches in a context of stubbornly high youth unemployment
In the absence of work or social security to support adults to meet
their own needs, the grants provided for children are invariably shared
across households

20. Making social protection work for children in
South Africa
1. Reviewing the amount of the existing child support grant
2. Enabling early access to social protection interventions
3. Improving synergies and coordination with other programmes,
policies and sectors
4. Strengthening and adequately funding social welfare services
5. Strengthening coordinated support for children with disabilities
6. Investigating increased social protection for unemployed and
low-income adults

21. 1. Review the amount of the child support grant
• The grant is well targeted at poor households, has a broad reach
and relatively simple administrative processes
• It has proven benefits for poor children; but these benefits are
necessarily limited by the small amount of the grant.
29% of children
still live below the food
poverty line
(Hall & Sambu, 2016)
27% of children
under five years are below
expected height for their age
(National Department of Health et al, 2016)
It is estimated that when the
full CSG is spent on food, a
caregiver is underspending
on nutritionally complete diet
for adolescent (10 – 13 years)
by one third
(PACSA, 2017)

22. 1. Review the amount of the child support grant
• Index the CSG to an objective measure that adequately takes into
account the cost of meeting a child’s needs
• Possible benchmarks include:
• Poverty lines
• Costs of feeding a child a nutritionally complete diet
• Consumer price index or food inflation etc.
• Linking the grant to a measure that takes inflation into account
would ensure that annual increases are not discretionary and the
real value is maintained.

23. 2. Enable early access to social protection
Early – and continued
– access to the CSG
is associated with
improved outcomes
Source: Hall K, Sambu W, Berry L, Giese S and Almeleh C (2017)
Integrating service
delivery mechanisms
would help to address
barriers.
• Online birth registration
is already available at
hospitals; enable grant
applications too
• Pre-register in third
trimester

24. 2. Enable early access to social protectionEssentialpackageofECDservices
Use ante-natal
and post-natal
screening to
determine
eligibility for care
dependency grant
Includes home
visits, food and
nutritional support
by community
health workers

25. 2. Enable early access to social protection
• The possibility of introducing a maternity
benefit for vulnerable pregnant women is
being debated
• Maternity benefits are available for women in
formal employment, but no such support is
available for unemployed women or those in
informal employment.
• Such a benefit could have important health
benefits for both mother and child – but
impacts depend on the design

26. 3. Strengthen synergies and coordination
• Strengthening synergies
• Simple mapping of the various forms of support available to children
and their caregivers from conception to young adulthood; formalising
and improving service delivery links; and communicating these links
widely
• Establishing integrated service delivery sites
• Improving data management and information systems
• The quality of services remains a challenge
• The child support grant was envisaged as part
of a broader basket of services, but in practice
one form of support does not necessarily
support access to another

27. 4. Strengthen and fund social services
• Children have a right to social (care and protection) services,
but they have historically been under-funded and human
resources (social workers) are stretched
• Review of the guiding document (white paper) for the
Department of Social Development recommended:
• Increased funding – government and non-profit organisations
• Implementing human resources reforms
• The defining of a social protection floor that explicitly delineates
entitlements to social welfare and community development
services, and allows for expansion of the services over time

28. 5. Strengthen social protection for children
with disabilities
• The care dependency grant is available for children with a
physical/mental disability receiving permanent care or support
services
• But the eligibility criteria continues to be based on a largely
medical model of disability, and excludes children with minor
disabilities or chronic illness
• Reforms were piloted but not implemented; need to be revived
• Additional support is required to ensure that children with
disabilities, particularly in rural areas, are able to access quality
education as well as any necessary support services and
assistive devices.

29. 6. Investigate increased social protection for
unemployed and informally employed
17 yrs 60 yrs or older
Child support
grant (R380)
Care dependency
grant (R1600)
Foster child
grant (R980)
Older persons
grant (R1 600)
Disability grant (R1600)
18 – 59 years
Unemployment rate: 27.7%
Expanded definition: 36.6%
0 yrs
Limited coverage of
social insurance, public
works programmes

30. 6. Investigate increased social protection for
unemployed and informally employed adults
• The national minimum wage agreement will go some way to
providing a minimum income for the working poor
• But social grants will continue to be shared across households
until the material needs of unemployed and informally employed
adults are met.
• By not providing for their needs, the social security system does
not acknowledge that women often carry a double burden of care
and financial support for children.
• Possibilities range from the basic income grant through to a work
seekers allowance or extending social insurance to those in
informal sector.
• Such initiatives would also contribute to reducing child poverty.

31. Conclusion
• South Africa has a substantial social assistance programme in
place, as well as many other elements of a comprehensive social
protection programme.
• However some gaps remain, both in groups that are not supported,
and in terms of the coordination and integration of these policies
and programmes.
• South Africa has taken a progressive realisation approach, but now
needs to ensure that the system is coordinated and
comprehensive approach – both at the level of policy development
and planning as well as in terms of service delivery – to better
promoting equitable outcomes for children.

32. Thank you
Support for this paper was provided by the Department of Paediatrics and
Child at the University of Cape Town and the Raith Foundation.