Implications of COVID-19 labour market shock for child and household hungers in South Africa: Do social protection programs protect?'

Food insecurity in South Africa: To what extent can social grants and consumption of wild foods eradicate hunger?

PurposeHousehold food insecurity in South Africa is a pervasive public health challenge. Although its link to chronic health conditions is well established, its relationship to mental illness, particularly major depression, is not well-understood. Despite KwaZulu-Natal Province being the epicenter of the drug-resistant tuberculosis (MDR-TB) epidemic, and having the largest share of poverty in South Africa, this relationship remains unexamined. This study investigated the association between major depressive episode (MDE) and household food insecurity among individuals with MDR-TB.MethodsWe enrolled and interviewed 141 newly admitted microbiologically confirmed MDR-TB inpatients at a specialized TB hospital in KwaZulu-Natal Province, South Africa. Logistic regression models were fitted to assess the relationship between MDE and household food insecurity, while accounting for socio-demographic status (e.g., age, gender, education, marital status, social grant status, income, and preference for living in one’s community).ResultsThe prevalence of MDE and household food insecurity was 11.35% and 21.01%, respectively. MDE was significantly associated with household food insecurity (aOR 4.63, 95% CI 1.17–18.38). Individuals who are female (aOR 6.29, 95% CI 1.13–35.03), young (aOR 8.86, 95% CI 1.69–46.34), have low educational attainment (aOR 6.19, 95% CI 1.70–22.59) and receive social grants (aOR 7.60, 95% CI 2.36–24.48) were most at risk of household food insecurity.ConclusionsMDE in individuals with MDR-TB was significantly associated with household food insecurity, independent of socio-economic status. Although MDR-TB is not exclusively a disease of the poor, individuals from socio-economically disadvantaged backgrounds (e.g., female, young adults, low education, and social grant recipients) were more likely to experience household food insecurity. Our study underscores the need to address the co-occurring cycles of food insecurity and untreated MDE in South Africa.

The world experienced an unprecedented health shock (COVID-19) which caught everyone by surprise, and destabilized many sectors, especially the agri-food sector. This unpleasant situation caused upset in the food production and distribution chain, and continues to threaten the attainment of Sustainable Development Goal 2 which underscores zero hunger in society. Many people in South Africa were disproportionately affected with severe consequences on their livelihood activities, food security status, health status, and general welfare conditions; and as a result, social relief intervention was put in place or expanded. This study examined the factors influencing rural households’ food security status among the recipients of social relief grants in rural areas of South Africa. The study used a secondary dataset from Wave 5 of National Income Dynamics Study - Coronavirus Rapid Mobile Survey (NIDS-CRAM). The research applied descriptive statistics to describe the respondents’ socio-economic characteristics, and pattern of income flow. Food Insecurity Access Scale was employed to investigate the respondents’ food security status, while multinomial logistic regression was used to explore the determinants of food security. The results showed that the majority of the respondents were black (99%), female-headed (54.15%), dwelling in flats (74.01%), with secondary education (88.6%), and heavily dependent on government grants (58.61%). Also, most households were food secure (71.69%) during the pandemic. Moreover, households headed by men were more food secure (62.84%) compared to the ones headed by the female counterparts (37.08). Multinomial regression estimates revealed that formal education (p<0.1), employment status (p<0.05), dwelling type (p<0.01), as well as household size (p<0.01) significantly determined rural households’ food security status. The study concluded that social relief grants significantly reduced the food insecurity situation among the rural households in South Africa, and recommended that the government should ensure the continuation of the social relief of distress grant to the vulnerable people who are mostly domiciled in the rural areas, especially women who are disproportionately affected by these health shocks. Key words: Covid-19, social grant, rural households, food security, South Africa

This article presents the results of the five waves of the National Income Dynamics Study – Coronavirus Rapid Mobile Survey (NIDS-CRAM) on food security between May 2020 and May 2021. Despite significant investments in social protection, food insecurity and household and child hunger remained stubbornly high. We conclude that given the protracted nature of the pandemic, slow economic recovery, household and child hunger have stabilised at higher levels than before the pandemic. The phasing out of emergency relief coupled with the constrained economic situation, are some of the reasons why levels of food insecurity and hunger are likely to remain high in the near future. Strict lockdown regulations also reduced employment and income from informal economic activities. Social support for vulnerable individuals and households remain an urgent priority. Continuing support targeted at households with children is particularly important given the dire consequences of enduring hunger for stunting, and on children’s long-term development.

Food insecurity in urban South Africa is situated in both historic and contemporary factors. This article argues that there is a need to reimagine and reconceptualise national, socio-ecclesial and theological responses to urban food insecurity in South Africa. We contend that the global and enduring nature of food insecurity is indicative of the violence of hunger and poverty and can be viewed as structural violence. While the church has since its inception been involved in feeding the hungry, the structural and systemic nature of food insecurity requires more nuanced theological responses and reflections. As a prophetic voice, the church and theological reflection and action are important partners in conversations, dialogue, measures and interventions geared towards the eradication of hunger and food insecurity in urban South Africa. A descriptive and evaluative method of enquiry was adopted in order to identify the historic structural and systemic factors that perpetuate food insecurity in South Africa. This article concludes that social inequality, economic disenfranchisement and poverty are as a result of structural inequalities that amount to structural violence inflicted on the most vulnerable of society.

Household food insecurity in South African suburban low-income households is a major challenge. Research outcomes that will inform decisions on effective solutions towards reducing household food insecurity in South Africa are essential. The purpose of this study was firstly to determine the food security status of households and the skills of household members in Ward 60 of the Nelson Mandela Bay Municipality in the Eastern Cape Province in South Africa. Secondly, it was also to determine the association between the socioeconomic and demographic variables of the households and their level of food (in-)security. The study employed a mixed method of both qualitative and quantitative methodologies, comprising a qualitative Community-Based Participatory Action Research (CBPAR) methodology and a quantitative household food security survey methodology. A household food security survey was employed using a questionnaire that was based on the Household Food Insecurity Access Scale (HFIAS). The questionnaire was used to collect data from 170 randomly selected households. The data analysis used the HFIAS score and logistic regression analysis. The results show 6.1% of households as food secure, 3.05% as mildly food insecure, 13.4% as moderately food insecure, and 77.4% as severely food insecure. The results also show that a significant unemployment rate, a reliance on social grants, and absence of income seriously impact the extent of household food insecurity. The results show a significant association between the household food security and the variables of unemployment, income, and gender. The regression analysis results suggest that gender, household size, age, employment, and household income influence household food security. The results of the household skills show that the households had a variety of skills. These results can help to inform decisions by the government, local municipalities, NGOs, and other stakeholders towards designing effective solutions for enhancing household food security.

We analyze fertility preferences among women at risk of pregnancy with children ages five or younger as a function of two food security metrics: perceptions of household hunger and child stunting (height for age z scores ≤ -2.0) in order to convey a robust picture of food insecurity. We use data from the 2016 Tanzania Demographic and Health Surveys to analyze this research question. Multinomial generalized logit models with cluster-adjusted standard errors are used to determine the association between different dimensions of food insecurity and individual-level fertility preferences. On average, women who experience household hunger are 19% less likely to want more children compared to women who do not experience household hunger (AOR: 0.81, p = 0.02) when controlling for education, residence, maternal age, number of living children, and survey month. Adjusting for the same covariates, having at least one child ≤ 5years old who is stunted is associated with 13% reduced odds of wanting more children compared to having no children stunted (AOR: 0.87, p = 0.06). In the context of a divided literature base, this research aligns with the previous work identifying a preference among women to delay or avoid pregnancy during times of food insecurity. The similarity in magnitude and direction of the association between food insecurity and fertility preferences across the two measures of food insecurity suggest a potential association between lived or perceived resource insecurity and fertility aspirations. Further research is needed in order to establish a mechanism through which food insecurity affects fertility preferences. Individual fertility preferences are sensitive to dynamic multi-level factors in a woman's life. While qualitative research has explored the effect that food insecurity and associated resource constraints have on fertility preferences, results are conflicting. Here, we quantitatively examine how individual woman's fertility preferences associate with two measures of food insecurity and qualitatively compare the associations across food insecurity measures. We establish that two food insecurity measures- household hunger and child stunting- capture similar populations and have similar associations with fertility preferences. This is a critical step forward in understanding the dynamic relationship between resource availability, child well-being, and fertility preferences.

Although South Africa has an adequate food supply nationally, household level food insecurity is still prevalent. One well-known social security intervention, the South African social grant programme, aims to provide financial relief to food-insecure households. However, there is lack of empirical evidence on how deep and broad the food security impact of this programme has been. Employing data from a nationally representative sample and using the instrumental variable method, the study examines this issue by measuring the resilience these households have towards vulnerability to food insecurity. The findings revealed that households receiving social grants are vulnerable to food insecurity. Chronic food insecurity prevails in rural-dominated provinces, while urban-dominated provinces mostly have transient food insecurity. Although this programme targets the poor, its unintended negative impact on economic activities would require policy priority. People with disabilities, female-dominated rural households, and environmentally friendly economic activities should all be prioritised in policy.

Food insecurity impacts childhood nutritional status, physical and cognitive development, and increases lifetime risk for chronic disease. Previous South African studies have examined hunger at the sub-national level without a specific focus on children and adolescents. This study determines the national prevalence of childhood food insecurity, from birth to adolescence, and identifies factors associated with hunger within the household. Individual and household-level data were extracted from the South African National Health and Nutrition Examination Survey (SANHANES-1). Prevalence of food insecurity was assessed using the Community Childhood Hunger Identification Project (CCHIP) index. Multinomial logistic regression analyses were conducted on all households (with and without children) to determine the predictors of food insecurity, with additional analyses adjusting for child dependency and sociodemographic characteristics of household heads in households with children. Of 5 098 households surveyed, 68.6% had children and adolescents present (0-19 years). Of these households, 32.5% (95% Confidence Interval [CI]: 29.5-35.7) were experiencing hunger and 26.3% (95% CI: 23.9-28.8) were at risk of hunger. Among all the households, significant associations for experiencing hunger were the presence of children and adolescents: Adjusted Odds Ratio (AOR) = 1.68 (95% CI: 1.12-2.53); being female-headed: AOR = 1.53 (95% CI: 1.21-1.94) and informally-located; AOR = 1.6 (95% CI: 1.07-2.43). Of the racial groups, having a non-African household head, Coloured: AOR = 0.29 (95% CI: 0.19-0.44) and White/Indian/Asian: AOR = 0.12 (95% CI: 0.04-0.33) conferred lower odds of experiencing hunger; and, the household head having secondary/tertiary education conferred lower odds of experiencing hunger; AOR = 0.40 (95% CI: 0.28-0.56) as well as being at risk of hunger; AOR = 0.69 (95% CI: 0.52-0.92). Receiving social grants, pensions, or remittances more than doubled the odds of experiencing hunger; AOR = 2.15 (95% CI: 1.49-3.09). After adjusting for child dependency in households with children, having at least one older child (age 15-19 years old) did not change the odds of food insecurity. In summary, only 41% of South African households with children and adolescents were food secure. The associations between household head sociodemographics, household location and size on household food insecurity indicate a need for multi-sectoral interventions to bolster sustainable food systems for households with children and adolescents and to improve public protections for female-headed, African-headed and informally-located households dependent on social grants.

Food insecurity impacts childhood nutritional status, physical and cognitive development, and increases lifetime risk for chronic disease. Previous South African studies have examined hunger at the sub-national level without a specific focus on children and adolescents. This study determines the national prevalence of childhood food insecurity, from birth to adolescence, and identifies factors associated with hunger within the household. Individual and household-level data were extracted from the South African National Health and Nutrition Examination Survey (SANHANES-1). Prevalence of food insecurity was assessed using the Community Childhood Hunger Identification Project (CCHIP) index. Multinomial logistic regression analyses were conducted on all households (with and without children) to determine the predictors of food insecurity, with additional analyses adjusting for child dependency and sociodemographic characteristics of household heads in households with children. Of 5 098 households surveyed, 68.6% had children and adolescents present (0–19 years). Of these households, 32.5% (95% Confidence Interval [CI]: 29.5–35.7) were experiencing hunger and 26.3% (95% CI: 23.9–28.8) were at risk of hunger. Among all the households, significant associations for experiencing hunger were the presence of children and adolescents: Adjusted Odds Ratio (AOR) = 1.68 (95% CI: 1.12–2.53); being female-headed: AOR = 1.53 (95% CI: 1.21–1.94) and informally-located; AOR = 1.6 (95% CI: 1.07–2.43). Of the racial groups, having a non-African household head, Coloured: AOR = 0.29 (95% CI: 0.19–0.44) and White/Indian/Asian: AOR = 0.12 (95% CI: 0.04–0.33) conferred lower odds of experiencing hunger; and, the household head having secondary/tertiary education conferred lower odds of experiencing hunger; AOR = 0.40 (95% CI: 0.28–0.56) as well as being at risk of hunger; AOR = 0.69 (95% CI: 0.52–0.92). Receiving social grants, pensions, or remittances more than doubled the odds of experiencing hunger; AOR = 2.15 (95% CI: 1.49–3.09). After adjusting for child dependency in households with children, having at least one older child (age 15–19 years old) did not change the odds of food insecurity. In summary, only 41% of South African households with children and adolescents were food secure. The associations between household head sociodemographics, household location and size on household food insecurity indicate a need for multi-sectoral interventions to bolster sustainable food systems for households with children and adolescents and to improve public protections for female-headed, African-headed and informally-located households dependent on social grants.

BackgroundSouth Africa is rated a food secure nation, but large numbers of households within the country have inadequate access to nutrient-rich diverse foods. The study sought to investigate households’ physical and economic access and availability of food, in relation to local context which influences households’ access to and ability to grow food which may affect the dietary quality. We sought to understand self-reported healthy diets, food insecurity from the perspective of people who experienced it, barriers to household food security and perceptions and feelings on food access as well as strategies households use to cope with food shortages and their perceptions on improving household food security.MethodsFocus group discussions were conducted along a rural–urban continuum in three South African towns situated along an agro-ecological gradient. Participants were asked about their knowledge of healthy diets, factors influencing their food consumption, their perceptions regarding food insecurity, barriers to food security, coping strategies and solutions to improve access to nutrient-rich foods.ResultsA total of 91 people participated in 11 focus groups, with 76% females. The majority of participants aged between 31 and 50 years. Participants were knowledgeable about healthy diets but had limited access to it hence consumed monotonous diets. The perceptions provided insights into the pressing issues of inadequate access to food, food insecurity, coping strategies and ideas on improving food security. The majority of participants reported on experiencing food insecurity and female-headed households, unemployed and orphaned children were most vulnerable. Focus group participants highlighted the complexity of the food system in their communities which relies on own production, collecting from open spaces, donations and to a larger extent purchase, in the context of unemployment, low income, water and land shortages as well as theft.ConclusionThe results provide a significant contribution from a needs assessment perspective from the communities, identify “hidden” constrains in household food access and provide effective future solutions for improving food security in the communities. Government should assist with capacity building, employment creation and providing resources (especially, land and water) for communities to practise agriculture which they all agreed can improve food security.

This article maps food insecurity in South Africa and plumbs the data to women-headed households at the municipal level. Local contexts provide a better understanding of people's experiences by studying the impact their geographical location has on their economic status, and the impact their raced and gendered identities have on that experience. Localised information could also ensure that more nuanced policies are developed to address inequalities. Food insecurity is a marker of exclusion and poverty in urban and rural areas across South Africa, but women are more likely than men to be food insecure, especially in the rural areas. Data are combined from Statistics South Africa's Income and Expenditure Survey and Community Survey (both 2008) to arrive at a more accurate assessment of food insecurity at municipal level in South Africa. The National Department of Agriculture places food insecurity at 50%, while this study argues that approximately 64% of households in South Africa are food insecure, a result which has policy implications. Our study also uses data that provide a more nuanced approach that shows provincial and municipal variations that are much higher than the national average, which should support provincial and local government policies that address food insecurity more effectively. The article also argues that due to male-biased economic, cultural and community practices, women-headed households are most food insecure. In light of this information, the article provides a nuanced understanding of women's food insecurity in the country. We offer policy recommendations on how women's food insecurity could be reduced in the areas where it is most prevalent. The importance of gender-sensitive development policies, localised contextual knowledge, and innovative strategies that would assist women in their efforts to become food secure, particularly in rural areas across South Africa, are highlighted.

Addressing the disproportionate burden of food insecurity in South Africa requires targeted efforts to help smallholder farmers to access markets. The purpose of this study was to assess determinants of market participation and its contribution to household food security. The secondary data used in this study were collected from 1520 respondents; however, 389 smallholder farmers participated in the market. The Household Food Insecurity Access Scale revealed that out of the total sample size, 85% of the households were food insecure while 15% were food secure. Gender of household head, receiving social grants and higher wealth index positively impacted market participation. Having a family member with HIV had a negative impact on market participation among smallholder farmers. The results from the extended ordered probit regression model showed that household size, having a family member with HIV and agricultural assistance had a positive and significant contribution to the household food insecurity situation of the smallholder farmers. On the other hand, the educational level of household head, ownership of livestock, age of household head, gender of household head, and having access to social grants had a negative and significant effect on the food insecurity status. Access to education and the market can improve household food security. Linking smallholder farmers, particularly women and aged farmers, to markets should form an intrinsic part of the government’s efforts to improve farming and food security and increase access to diversified food.

Empirical analysis on the impact of the COVID-19 pandemic on food insecurity in South Africa

Food insecurity and hunger are major challenges in many Ethiopian communities with repercussions on health and nutrition outcomes in vulnerable household members. Depending on the context, a combination of supply and demand factors, community and institutional factors may affect household food insecurity and hunger. Our objective was to determine the degree of household food insecurity and hunger, and examine the contribution of associated contextual factors, in two rural communities of Ethiopia, namely Halaba and Zeway, located in two adjacent regions of the country (SNNPR and Oromiya Regions, respectively). A sample of 630 households were randomly selected from the two districts, and levels of food insecurity and hunger were measured using the Household Food Insecurity Access Scale and Household Hunger Scale developed by Food and Nutrition Technical Assistant project (United States Agency for International Development). Multiple classification analysis was employed to explore the effects of key demand (e.g. household size, livestock) and supply (e.g. land size, wealth) factors and community (geographic location) as well as institutional (participation in food security programs) factors on food insecurity and hunger. Household food insecurity was unacceptably high in both districts (95% in Halaba & 67% in Zeway). Household hunger was 38% in Halaba and 18% in Zeway. Both food insecurity and hunger were significantly greater in Halaba (p<0.001), indicating an effect of geographic location. Both supply and demand factors were significant in determining household food insecurity and hunger ( p <0.01); however, supply factors such as women's access to land, land size and wealth had greater influence than the demand factors. Levels of food insecurity and hunger in both communities were very high and of serious concern. We recommend increasing the food supply, and its subsequent accessibility, for households through enhancing women's access to land, improving income through savings and wealth accumulation, introducing more inclusive programs for women's participation and reducing household work‐burden by significantly enhancing productivity of cultivable land. Support or Funding Information The research was supported by the International Development Research Centre (IDRC) and the Department of Foreign Affairs Trade and Development (DFATD), Government of Canada, through the Canadian International Food Security Research Fund (CIFSRF).