Associations of formal childcare use with health and human capital development for adolescent mothers and their children in South Africa: A cross‐sectional study

In this contribution, we focus on the influence of employment-supportive policies on the childcare strategies of a specific subgroup of mothers, namely, divorced mothers. As previous research has shown, the economic consequences of divorce are mitigated by the provision of formal childcare, allowing divorced mothers to combine work and care and thus achieve a decent level of economic well-being. Our main hypotheses deal with the interplay between formal and informal childcare systems. While the crowding-out hypothesis states that formal childcare provision relaxes the functions that used to be provided by informal networks, the crowding-in thesis postulates that mothers use a mixture of strategies in search of an optimal combination between formal and informal childcare. Using longitudinal data from the ECHP for 13 countries, we evaluate the influence of a variety of macro-level indicators referring to the formal and informal care provision on the use of different types of childcare after divorce. Our empirical evidence points at the existence of a crowding-in effect, be it in a specific way. We find that while the use of both formal and informal childcare is mainly driven by the available formal arrangements, social networks fulfil an important complementary role, enabling divorced mothers to increase their use of formal childcare. More specifically, we find that in countries with limited formal childcare provision, extended informal support results in an increased use of formal childcare. In welfare states with ample formal childcare, divorced women need less help from informal caregivers, although the latter are still essential for mothers in order to synchronize work and formal childcare.

Objective: we explore migrant-native differentials in the uptake of formal and informal childcare and whether this is induced by lower demand for childcare versus differential access to (in)formal childcare compared to natives. Background: The rise in female labour market participation in recent decades has challenged parents to negotiate work and family responsibilities and organise childcare. Belgium is among the European countries with the highest availability of formal childcare, but maternal employment and uptake of childcare are substantially lower in migrant populations. Methods: Combining linked microdata from the 1991 and 2001 censuses with contextual data on childcare availability at the municipality level, we use multinomial logit models to study childcare use and type of childcare arrangement among parents having a young child in 2001. As access to childcare and maternal employment are mutually endogenous, we use estimated employment opportunities. Results: We find considerable migrant-native differentials in childcare use, as well as substantial differences between first and second generation migrants. Second generation mothers of Turkish, Moroccan and Eastern-European background are less likely than natives to use childcare, and more likely to rely on informal arrangements if childcare is used. Controlling for socio-demographic characteristics and differential availability of (in)formal childcare largely accounts for differences in childcare use, but Turkish and Moroccan women remain less likely to use care and first generation Turkish mothers remain more likely to use informal care as opposed to formal childcare. Conclusions: While differences in socio-demographic characteristics, labour market opportunities and availability of (in)formal care provide a partial explanation, partial migrant-native differentials in childcare use persist for specific groups, suggesting that other factors inhibit the uptake of formal childcare.

Numerous studies have explored the influences of family policies, such as formal childcare use, and migration on fertility, with mixed findings. However, limited research has examined how formal childcare use (or the lack thereof) affects both fertility intentions and behaviours among native and migrant women. This study uses Italy as a case study, where the familistic welfare system creates challenges in work–family reconciliation and female workforce participation, particularly for migrant women facing precarious jobs and higher fertility. This results in employment disparities between migrant and native women, especially among mothers. Using the 2012 Birth Sample Survey from the Italian National Institute of Statistics, we address two research questions: (i) Does formal childcare use for one child positively influence mothers' fertility intentions and behaviours to have another? (ii) Does this effect vary according to migration background? We apply multinomial logistic regression models to analyse the relationship between mothers' fertility intentions and behaviours and childcare use by migration background, migratory generation, and partner's nationality. Our results show that mothers using formal childcare—either stable or occasional—are more likely to have positive fertility behaviours than those with unmet needs, with differences by migration background. Among mothers using formal care, natives show higher positive short-term fertility intentions than migrants, while natives with unmet childcare needs are less likely to have another child than migrants. While formal childcare has limited effect on fertility, unmet childcare needs emerge as a crucial factor, highlighting the need for policies addressing broader socio-economic and cultural factors shaping fertility decisions.

Background: Cancer is a rising public health concern in South Africa, with varying incidence and prevalence trends between provinces. Objectives: This study aimed to investigate the approach to estimating and ranking common cancers in South Africa's Eastern Cape and Mpumalanga provinces through a patient survey in three referral hospitals. Methods: A quantitative cross-sectional design was employed from 1 April 2022 to 31 July 2022. A total of 425 patients were recruited to participate in this study. Patients were purposively sampled. Pretests were conducted to determine the reliability and validity of the instruments. Data were coded in Microsoft Excel and Stata; version 18 was used for data analysis. Ethical principles were observed and ensured throughout the study. Results: The results show the highest prevalence as breast cancer with 37.65% representing 160 cases, followed by cervical cancer with 19.06% (81 cases), and prostate cancer with 12.00% (51 cases). Conclusions: This study provided valuable insights into the prevalence and distribution of common cancers in the Eastern Cape and Mpumalanga provinces of South Africa based on data collected from patients across three referral hospitals.

The article focuses on the use of childcare for preschool-age children in 13 European countries with different models of maternal employment. Employing a comparative approach it relates care arrangements to family policy measures. Childcare policies and practices in post-communist countries (the Czech Republic, Bulgaria, Hungary, Poland, Slovakia, and Slovenia) are compared in a wider European context and specifically to various countries representing the principal types of welfare state and family policy strategies in Europe (the United Kingdom, Germany, Austria, Italy, France, Spain, and Sweden). The article focuses on parental leave schemes, parental employment, and formal childcare and takes into account informal childcare, which in many countries is crucial to achieving a work-life balance. The authors' findings reveal that the use of informal childcare is not directly related to either the length of paid parental leave or maternal employment. Informal childcare, which in most cases is provided by grandparents, is used on a weekly basis for at least thirty per cent of preschool-age children in all the post-communist countries studied except Bulgaria. However, similarly high levels of informal childcare were also found in the United Kingdom, Italy, and Austria. Gendered moral rationalities based on cultural norms play an important role in division of childcare in each European state.

Rural hospital beats the odds in South Africa

Over the past few decades there has been a dramatic increase in maternal employment and, as a result, an increase in the use of non-maternal childcare in the early years. The purpose of this longitudinal study was to examine, in a large representative English sample, the influence of different forms of childcare on children's behavioural and emotional development around the age of school entry. A sample of 991 families, originally recruited when the children were 3 months old, was assessed around school entry age at 51 months. The main outcome variable was the children's emotional and behavioural functioning, measured by questionnaire completed by both mothers and teachers. A range of repeated assessments were carried out at different time points, including direct observation of the quality of maternal caregiving and observations of the quality of non-parental care, and amount of time spent in different forms of care. The strongest and most consistent influences on behaviour and emotional problems were derived from the home, including lower socio-demographic status, poorer maternal caregiving, parental stress/maternal mental health problems, as well as child gender (being a boy). Non-parental childcare had small effects on child outcome. One finding that did emerge was that children who spent more time in group care, mainly nursery care, were more likely to have behavioural problems, particularly hyperactivity. These findings suggest that interventions to enhance children's emotional and behavioural development might best focus on supporting families and augmenting the quality of care in the home.

This article explores the origins of Fingo (Mfengu) identity in South Africa's Eastern Cape. While observers have generally understood the Fingo as an ethnic group, this article argues that Fingo-ness developed out of a lifestyle and worldview that emphasised agriculture and trade, and rejected established systems of Xhosa authority. The participation of men in farming activities, as well as attempts to engage in trade outside the control of chiefs, constituted a significant break with social practice by those who identified as Fingo, who, in challenging widely accepted standards of Xhosa-ness, were perceived by many Xhosa (and especially Xhosa chiefs) as anti-social and supernaturally dangerous. The idiom of witchcraft therefore became essential in marking out the distinctions between Fingo and Xhosa identities. While the 1835 frontier war saw the movement of the Fingo into the Cape Colony, the contours of Fingo-ness had already been established in the context of Xhosaland.

Research delineates two epidemiological categories among HIV-positive adolescents: those who contract the virus sexually and those who inherit it as infants. In this article, we are interested in how tacit inferences about adolescents' mode of infection contribute to their experiences of HIV-related blame, and their ability to achieve care, in their intimate, everyday settings. The analysis arises from ethnographic research with 23 HIV-positive adolescents living in South Africa's Eastern Cape. From these, we draw particularly on the narratives of four HIV-positive teenage girls and their HIV-positive mothers. The article explores the social stakes entailed in ascriptions of adolescents' mode of infection, particularly in terms of how blame was allocated between mothers and daughters. It further considers how these families have sought to negotiate repudiation and thereby sustain intergenerational care. The article furthers limited research on the life projects and dilemmas of this HIV-positive adolescent cohort.

We investigate the effect of providing information about the benefits to children of attending formal child care when women intend to use formal child care so they can work. We postulate that the reaction to the information differs across women according to their characteristics, specifically their level of education. We present a randomized experiment in which 700 Italian women of reproductive age with no children are exposed to positive information about formal child care through a text message or a video, while others are not. We find a positive effect on the intention to use formal child care and a negative effect on the intention to work. This average result hides important heterogeneities: the positive effect on formal child care use is driven by high-educated women, while the negative effect on work intention is found only among less-educated women. These findings may be explained by women's education reflecting their work-family orientation, and their ability to afford formal child care.

In this contribution, we examine whether and why there is a gap in the use of formal childcare services between immigrant and native families across 21 European countries. We focus on three sets of potential determinants: (1) social class, education and labour market position; (2) immigrant-specific factors such as norms in the region of origin, citizenship acquisition and length of stay in the country of residence; and (3) contextual factors such structural constraints impeding access to childcare and traditional norms on motherhood in the region of origin. Drawing on data from the 2010 ad hoc module of the EU Labour Force Survey, we find evidence for an immigrant-native gap in formal childcare use. Adjusted for social class position, education and maternal employment, immigrant families are less likely to use childcare compared to native families across European countries. However, there are important cross-country differences in the size of this gap. The study also provides evidence for immigrant-specific explanations: acquiring citizenship and staying longer in the country of residence increases the probability to use childcare, while the strength of traditional norms in the region of origin reduces the probability to use childcare. Finally, we find that structural barriers to childcare use negatively affect childcare use for both native and immigrant families. Removing barriers to childcare use in terms of availability and affordability will benefit everyone.

The history of South Africa's Eastern Cape continues to attract considerable attention. Recent scholarship suggests that the Royal Engineers, as one of the executive arms of imperial colonisation, played a significant role in the colonisation and development of the eastern frontier of the Cape Colony. This article seeks to contribute to the discussion by examining the importance of surveying and mapping in underpinning and extending the colonial State in what is now the Eastern Cape. It attempts to disentangle and assess the impact of the activities of the Royal Engineers and other military officers. It briefly examines African responses to surveying and the construction of fortifications; and attempts to unravel the respective roles of imperial and colonial agencies in surveying, mapping, and construction of fortifications and establishment of towns.

IntroductionAdolescent girls and young women, including adolescent mothers, in Southern Africa have high HIV seroconversion and transmission. We need to know which risks drive HIV infections, and what can reduce these risks.MethodsWe interviewed 1712 adolescent girls and young women (11–23 years), including 1024 adolescent mothers who had conceived before age 20 and had a living child, from two health municipalities of South Africa's Eastern Cape Province between March 2018 and July 2019. Recruitment was through multiple community, school and health facility channels. Associations between adolescent motherhood and seven HIV risk behaviours (multiple sexual partners, transactional sex, age‐disparate sex, condomless sex, sex on substances, alcohol use and not in education or employment) were investigated using the generalized estimating equations method for multiple outcomes specified with a logit link and adjusting for nine covariates. Using the same model, we investigated associations between having enough food at home every day in the past week (food security) and the same seven HIV risk behaviours. When we found evidence of moderation by HIV status, we report stratum‐specific odds ratios.ResultsMean age was 17.51 years (SD: 2.54), 46% participants were living with HIV. Compared to non‐mothers, adolescent mothers had lower odds of alcohol use (AOR = 0.47, 95% CI = 0.29–0.75), but higher odds of multiple sexual partners (AOR = 1.93, 95% CI = 1.35–2.74), age‐disparate sex (HIV‐uninfected AOR = 1.73, 95% CI = 1.03–2.91; living with HIV AOR = 5.10, 95% CI = 2.98–8.73), condomless sex (AOR = 8.20, 95% CI = 6.03–11.13), sex on substances (AOR = 1.88, 95% CI = 1.10–3.21) and not in education/employment (HIV‐uninfected AOR = 1.83, 95% CI = 1.19–2.83; living with HIV AOR = 6.30, 95% CI = 4.09–9.69). Among non‐mothers, food security was associated with lower odds of multiple sexual partners (AOR = 0.45, 95% CI = 0.26–0.78), transactional sex (AOR = 0.32, 95% CI = 0.13–0.82) and not in education/employment (AOR = 0.48, 95% CI = 0.29–0.77). Among adolescent mothers, food security was associated with lower odds of transactional sex (AOR = 0.17, 95% CI = 0.10–0.28), age‐disparate sex (AOR = 0.66, 95% CI = 0.47–0.92), sex on substances (AOR = 0.51, 95% CI = 0.32–0.82), alcohol use (AOR = 0.45, 95% CI = 0.25–0.79) and not in education/employment (AOR = 0.56, 95% CI = 0.40–0.78).ConclusionsAdolescent motherhood is associated with multiple vulnerabilities to HIV infection and transmission. Social protection measures that increase food security are likely to reduce HIV risk pathways for adolescent girls and young women, especially adolescent mothers.

To examine associations between childcare type and nutrition and oral health indicators. Cross-sectional data extracted from a longitudinal birth cohort. Parent-completed FFQ and questions regarding oral health and childcare use. The associations between childcare type, classified into four groups: parent care only (PCO), formal childcare only (FCO), informal childcare only (ICO) or combination of care (F&I), and nutrition and oral health indicators were examined. Home and childcare. Families with children aged 3 years (n 273) and 4 years (n 249) in Victoria, Australia. No associations were observed between childcare type and core food/beverage consumption or oral health indicators. For discretionary beverages, compared with children receiving PCO at age 3 years, children in FCO or F&I were less likely to frequently consume fruit juice/drinks (FCO: adjusted OR (AOR) 0·41, 95 % CI 0·17, 0·96, P = 0·04; F&I: AOR 0·32, 95 % CI 0·14, 0·74, P = 0·008). At age 4 years, children receiving FCO or ICO were less likely to consume sweet beverages frequently compared with children receiving PCO: fruit juice/drink (ICO: AOR 0·42, 95 % CI 0·19, 0·94, P = 0·03; FCO: AOR 0·35, 95 % CI 0·14, 0·88, P = 0·03) and soft drink (ICO: AOR 0·23, 95 % CI 0·07, 0·74, P = 0·01; FCO: AOR 0·14, 95 % CI 0·03, 0·76, P = 0·02). Associations between childcare type and discretionary beverage intake were observed. Investigation into knowledge, attitudes and activities in formal and informal childcare settings is required to explore different health promotion practices that may influence nutrition and oral health.

Connecting streams of feminist and comparative social policy literature, this article investigates stratification in maternal employment and childcare use along class, contractual, and gender lines across six countries (Denmark, France, Germany, Italy, Sweden, and the United Kingdom) and five family policy models. Detailing the different stratifying factors that intervene in the relation between maternal employment and childcare use offers a concrete analysis of the complex link between social reproduction and work. Employing multivariate regressions and EU-SILC (2007–2018) data, it provides an intersectional perspective to the literature. First, we observe a process of formalization in childcare use with a parallel reduction of nonformal care for couples; this process is slower for single mothers. Second, we document a paradox in relation to the social investment approach: the relation between childcare use and maternal employment is stronger in countries that recently expanded childcare to modify their male-breadwinner orientation, but in these countries childcare use is more stratified along class/contract types, a concern for the outcomes of social investment strategies outside of Scandinavia. Being out of work, being in a lower social class, fulfilling domestic tasks and/or care activities, and having an atypical contract negatively correlates with childcare use in most countries. Third, households where partners have more similar earning levels use childcare to a greater extent. The article also provides models employing different dependent and independent variables, alternative family structures, full and part-time work, formal and nonformal childcare, and rich country details.