Background:
The advent of the COVID-19 pandemic in South Africa and across the globe posed special challenges and implications for low-income families with children. In this study we explored the experiences of primary caregivers of children receiving a South African social assistance programme, the Child Support Grant (CSG), during lockdown in Cape Town, South Africa, and sought to understand whether and to what extent the underlying logic of cash transfers such as the CSG speaks to the pitfalls of the social protection paradigm and the potential for moving closer to a transformative social policy approach.
Methods:
We conducted 26 telephonic qualitative interviews with primary caregivers of recipients of South Africa’s CSG that were part of a longitudinal cohort study assessing the impact of the CSG on child nutritional status and food security.
Results:
Even though primary caregivers of the CSG and their children and households were already living in precarity before the pandemic, COVID-19, and particularly the hard lockdown, worsened their social, economic and living conditions, especially as regards hunger and food insecurity.
Conclusion:
Low-income women bore the brunt of the pandemic in their roles as mothers, providers and homemakers. The pandemic has highlighted the inadequacies of the social protection paradigm that underlies the design of cash transfers such as the CSG, which has a narrowed focus on chronic poverty and vulnerability. It has also highlighted opportunities to shift to a transformative social policy framework that incorporates production, redistribution, social cohesion, adequacy and protection.
The Village Savings and Loan Association (VSLA) model is currently being employed in Uganda for deepening financial inclusion and poverty reduction. Despite its focus on women’s empowerment, concerns have arisen of an under-representation of women on VSLA leadership committees. Human rights-based, economic, and social justice arguments support active participation of women on VSLA leadership committees. The study sought to identify, explicate and characterise the barriers and facilitators to women in VSLA leadership. An exploratory study design using qualitative methods was selected to address the research objectives. Forty-nine focus group discussions were undertaken, featuring both VSLA members and non-members. VSLAs for inclusion in the study were randomly selected from within four regions of Uganda, stratified by: mature (>2 years old) versus new (<2 years old). The study exposed a diverse array of barriers and facilitators to women in VSLA leadership positions, revealing the influence of individual, material, institutional and social factors, in addition to social norms and gender characteristics, on women in VSLA leadership. The findings revealed that the design of interventions to achieve fair representation of women in leadership positions should be informed by an understanding of the different types, relative strengths, support for/against, and intersectionality of the factors impacting women in VSLA leadership.
This commentary discusses the ways in which the welfare system has responded to the financial and housing needs of Ukrainian citizens coming to the UK since the Russian invasion of Ukraine on 24 February 2022. The focus is on two key areas of policy: social security and housing. The article considers the revised eligibility criteria for welfare benefits and two policies which can provide accommodation: the Ukraine Family Scheme, which allows applicants to join family members in the UK, and the Ukrainian Sponsorship Scheme (known as ‘Homes for Ukraine’) which allows Ukrainian nationals to come to the UK if they have a sponsor who can provide accommodation for at least six months. It provides a comparison of the provision for Ukrainian refugees and the standard asylum system in the UK.
This article concludes that although the UK government quickly introduced emergency provisions for newly arrived Ukrainians which go beyond the scope of support for many other groups moving to the UK, significant areas of concern are evident, with risks that these will increase in future months and years. These concerns centre on discrepancies between the two policies which provide accommodation, risk of exploitation, homelessness caused by the breakdown in provision, and complexity in the welfare benefit system.
This chapter examines the regional impact of the COVID-19 economic crisis. Through analysing ONS data it examines regional trends in furlough rates, unemployment rates, and wage levels. The chapter shows that the negative economic impacts of the pandemic were higher in the North. Productivity costs to the UK economy from higher COVID-19 mortality (Chapter Two), mental health morbidity (Chapter Three) are calculated and it is found that the North was disproportionately affected. The chapter also explores the differing levels of COVID-19 restrictions and finds harsher lockdown restrictions were experienced in the North.
Why and how do policymakers initially sceptical of policy innovations from abroad eventually transfer them to their own countries? Focusing on Chile’s reforms to combat business cartels in 2009 and 2016, this article answers that question. Policy diffusion and transfer literatures maintain that coercion, competition, learning or emulation could account for foreign inspirations in policymaking. However, these literatures overplay the role of coercion and emulation in policy transfer to countries in the global south, and have difficulty distinguishing between different mechanisms in empirical studies. To address these limitations, I suggest analysing three intermediate causal steps in policy transfer: first, policymakers’ motivations in initiating policy reforms, second, their reflections on how the foreign-inspired model responds to the policy problem at hand, and third, their reflections on the fit between the foreign model and domestic conditions. Through process-tracing of two anti-cartel reforms in Chile, I find that policymakers introduced foreign-inspired policy measures to combat business cartels through a process of learning from other countries and international organisations, rather than coercion or emulation. Learning was evident in three ways. First, in the initiation of the reform, as policymakers responded to a clearly identified policy problem; second, in policymakers’ careful reflection on how the foreign-inspired model responded to these problems; and third, in the adjustments made to fit the foreign model to domestic conditions. The analysis demonstrates the utility of analysing intermediate causal steps in policy transfer, and of paying more attention to local actors and political processes.
This chapter concludes by reflecting on what can be done to reduce health inequalities. Drawing on international case studies of when inequalities in health have been reduced, this chapter outlines what public policy response is needed now to reduce regional health inequalities so that they do not increase for future generations and in any future pandemics.
This chapter describes the pre-pandemic context of inequalities in health and wealth in England. It provides a brief historical overview of the North–South regional health and economic divide. This chapter also introduces the reader to the core concepts and theories which underpin the rest of the book including: the deprivation amplification thesis, intersectionality, and the syndemic pandemic concept. It discusses common approaches in the field of health geography to understanding place-based health inequalities, including: compositional, contextual, relational and political economy approaches. It concludes by providing a summary for each of the following chapters of the book.
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Whilst the COVID-19 pandemic affected all parts of the country, it did not do so equally. Northern England was hit the hardest, exposing more than ever the extent of regional inequalities in health and wealth.
Using original data analysis from a wide range of sources, this book demonstrates how COVID-19 has impacted the country unequally in terms of mortality, mental health and the economy.
The book provides a striking empirical overview of the impact of the pandemic on regional inequalities and explores why the North fared worse.
It sets out what needs to be learnt from the pandemic to prevent regional inequality growing and to reduce inequalities in health and wealth in the future.
This chapter examines regional trends and inequalities in the ‘parallel pandemics’ of mental health, hospital pressure, and long COVID. Using mental health survey data, NHS prescribing data, NHS hospital data, and official estimates of long COVID prevalence, the chapter shows that these three parallel pandemics have been regionally unequal with worse outcomes in the North. In addition, the analyses reveal stark intersectional inequalities in self-reported mental health by ethnicity and gender in the North.
This discussion chapter places the results from the empirical analyses in Chapters Two–Four within the wider conceptual and empirical context. It sets out how the regional inequalities in health and wealth that have been identified during the pandemic reflect longer-term health divides across the country. Drawing on the conceptual material outlined in the introductory chapter, this chapter reflects on how, through the concepts of the syndemic pandemic, intersectionality and of deprivation amplification, COVID-19 had such an unequal regional impact.
