The South African disability grant: Influence on HIV treatment outcomes and household well-being in KwaZulu-Natal

Abstract

This paper explores the implications of the disability grant for household members' well-being and adults' success on ART (antiretroviral therapy). It uses case studies based on data from an in-depth qualitative study of 10 households in KwaZulu-Natal. Receipt of the disability grant ensured that the basic needs of the HIV-infected adult could be met by other household members, especially when the grant was received when the person first met the qualifying criteria and in conjunction with ART. Where treatment was effective, HIV-infected adults were able to make substantial contributions to the well-being of other members in addition to the financial support provided by the grant itself. Thus, early access to financial support in conjunction with commencing ART may lead to improved health outcomes and reduce poverty and vulnerability associated with illness in poor households. This synergistic relationship between social welfare and treatment may in turn contribute to greater cost-efficiency.

Keywords:

• antiretroviral therapy
• disability grant
• HIV/AIDS
• KwaZulu-Natal
• social security systems

Acknowledgements

This research was conducted while L Knight was a PhD student at the London School of Hygiene and Tropical Medicine. The research was funded by a UK Economic and Social Research Council (ESRC) postgraduate studentship linked to an ESRC/Department of International Development funded research project (grant number RES-167-25-0076). The authors are grateful to the Africa Centre for Health and Population studies for logistical and administrative support. Comments on a draft of the paper were provided by the facilitators of a SANPAD-funded Writing for Scientific Publication workshop. An early version of this paper was presented at the 4th SA AIDS Conference in 2009.

Notes

⁴1 USD = 8.17 ZAR (on average) in 2012.

⁵Verbal autopsies analyse symptoms to determine cause of death and are particularly useful where cause-of-death data are poor (Herbst et al., 2011).

⁶1 USD = 8.25 ZAR (on average) in 2008.

⁷A stokvel is an informal communal savings or rotating credit union.

⁸These are households where the members have disclosed their status to one another and in some cases to people outside the household.