“BIRTH TO TWENTY”: A STUDY OF HEALTH AND DEVELOPMENT ACROSS THREE GENERATIONS

Abstract

ISEE-418 “Birth to Twenty” started in 1989 as a longitudinal birth cohort study of children's health and development, during a period of rapid social and political change in South Africa. The period of the study has overlapped also with sweeping demographic and health transitions. More than 70% of the original cohort of children and their families in Soweto-Johannesburg have been followed up for 15 years, and the first child in the third generation was born late in 2004. The project has examined a broad range of influences on children's health and wellbeing including socio-economic status, family and school support, and access to services. Currently, the focus of the study is on determinants of risk for sexual and reproductive health and early indications of non-communicable diseases. This paper describes the mobility of children in an urban environment, from data collected during annual and biennial data collection waves, as well as a survey of 5 501 children attending more than 600 schools in the Gauteng area. All these children were born within the 7-week cohort enrolment period in 1990. Close to half of the children surveyed at schools are in-migrants to the area, from neighbouring towns, from other provinces in South Africa, as well as from the southern African region. However, in-migration and circular migration between urban and rural areas are only two aspects of children's mobility. Other aspects, more difficult to determine, are residential moves with family, long-term and short-term stays with relatives and neighbours, and travel between home and school. Children's movements are difficult to track and to interpret. Some mobility is designed to achieve benefits for children; for example, when families send children to live elsewhere as a strategy to gain access to better education or more resources in a household. However, other moves that children make compromise their care and protection. Given the implications that mobility has for a broad range of policies designed to benefit children, the paper makes recommendations on how children's movements can be tracked and what supports need to be in place to ensure that high levels of mobility do not jeopardise children's health, education and development.