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ARTICLES

Precarity of Subsistence: Social Reproduction Among South African Nurses

 

ABSTRACT

The concept of precarity extends beyond insecure wage work into the conditions of social reproduction: supporting dependents can expose even securely employed, relatively well-paid workers to precarity. Qualitative data from public hospital nurses in Johannesburg reveal how responsibility for social reproduction can contribute to precarity among women in some contexts. This study maps nurses’ household networks to obtain a conservative estimate of dependency. Excerpts from interviews demonstrate how responsibilities are converted into precarity through household networks across different marital statuses, household structures, and ages.

HIGHLIGHTS

  • Securely employed, professional women may have precarious lives.

  • Familial dependency can induce precarity among black women employed in nursing in South Africa.

  • South African nurses were distressed prior to the COVID-19 pandemic.

  • Gendered value systems and norms contribute to precarious subsistence.

  • Universal basic income could mitigate micro-level crises of social reproduction.

JEL Codes:

ACKNOWLEDGMENTS

I gratefully acknowledge the study participants.

SUPPLEMENTAL DATA

Supplemental data for this article can be accessed online at https://doi.org/10.1080/13545701.2022.2123950 and at 10.6084/m9.figshare.19566016.

Notes

1 Conventionally tasked with financial support, men may experience precarity, as Franco Barchiesi (Citation2011) documents; but the articulation of precarity is gendered because gender norms dictate that women remain responsible for reproductive labor.

2 The apartheid government’s racist terminology distinguished between four populations groups: “African,” “Coloured,” “White,” and “Indian.” Barchiesi uses the term “black” to refer to the groups oppressed during the apartheid era: “African,” “Colored,” and “Indian” (Citation2011: 259). I use the term “black” to describe the seventy-one participants in the study, seventy of whom were “African” and one of whom identified as “Coloured.” Where I cite statistical agencies or research that uses population group terminology, the word “African” is used for consistency with the source.

3 See also Elena Moore (Citation2013) and Hatch and Posel (Citation2018).

4 All personal information that would allow the identification of any person(s) described in this article has been removed.

5 Barchiesi (Citation2011) underscores how a narrow focus on employment limits insight into precariousness as a social reality for black workers in South Africa and finds that even relatively high salaries can be too low to meet basic needs.

6 Lifetime prevalence of domestic violence was 24.6 percent in South Africa. Rachel Jewkes et al. note that tolerance of violence reflects popular thinking that it is “normal” and reflect “ideas about gender which legitimate the use of force by men in establishing hierarchical control over women” (Citation2002: 1605).

7 I lack space to examine the determinants of unemployment, which are largely historical, macroeconomic, and structural.

8 Only Coloured men (3.9 household members) and women (3.7) have similarly sized households as black women (3.8; StatsSA Citation2020b: 54). Men’s households are more likely to have multiple adults and earners than women’s households. Over 40 percent of African and Coloured households are headed by women, which suggests dependency among Coloured women may also induce precarity (StatsSA Citation2020b: 49). Nonetheless, there are a number of persistent differences in household structure, employment, and spending that influence or reflect dependency. Black African women are less likely to marry and less likely to co-reside with their spouse when they do compared with Coloured women (Jhamba and Mmatli Citation2016: 177; StatsSA Citation2020b: 48). They are more likely to be unemployed (34.5 and 23.7 percent – unexpanded definition), and almost twice as likely to have no employed household members (43.2 and 24.8 percent; StatsSA Citation2020b). Further, Coloured households have average income and expenditure that is higher than that of black households (StatsSA Citation2017). Coloured female-headed households spent R88,540 on consumption in 2015; African female-headed households spent R58,016 (StatsSA Citation2018). Less than half of African children live continuously with their mother compared to 75 percent of Coloured youth (Marteleto et al. Citation2016), but black African women’s responsibility for childcare may be stronger than it is among women in other population groups (Hatch and Posel Citation2018). These data suggest that black African women’s households and household networks differ in important ways from those of Coloured women and that precarious subsistence may be useful in considering variation across demographics.

9 Mothers and fathers both pay costs for 6.8 percent of children; other combinations cover the remaining children.

10 The study was approved by the Human Research Ethics Committee at the University of the Witwatersrand [H19/08/05] and the Institutional Review Board [IRB 14/15-61] of Whitman College.

11 See Supplemental Online Appendix for details.

12 It is possible that those who returned the diaries reported transfers more consistent with initial reporting than those who did not return them. In such a case the direction of bias regarding remittances is unknown. Research suggests support might be overreported. Where the diaries varied from initial reporting (variation>R250), transfer expenditure was overreported and underreported. In one case with substantial variation, a nurse reported the large amount she sent or spent but had excluded smaller transfers like buying airtime for mobile phones, which added up to R56, another R650 on daycare for children in the other household, and R200 on utilities for the other household.

13 All but two were husbands, one was a fiancé, and one was a boyfriend.

14 Technically, the nurse was Zulu and her husband was a Venda, but an “In our culture” explanation of women’s duties was given by several nurses, including at least two who described it as a difference between black and white “cultures.” It is unclear whether, how, or if there was variation across husbands’ or wives’ ethnicities.

15 Dictionary, not clinical, definition.

16 Some homes were joint bond, meaning both partners build wealth, so I do not interpret paying for housing as having a third effect of men building wealth in this asset while women do not. A joint bond does not, however, eliminate leverage/threat power as case of Nurse B demonstrates.

17 An earlier calculation identified this figure as 5.24 (Cohen and Venter Citation2020). That figure accidentally excluded four male sibling dependents under the age of 18.

18 I calculate dependency by summing the number of dependents a nurse supported and putting that number over one, which represents the nurse and her salary, to produce a dependency ratio. If the top number were four, it would mean the nurse supported four people in addition to herself.

19 Income pooling would imply sharing of financial resources and drawing from a common pool for household necessities that are used or consumed in common, not a Beckerian, single utility function household. With income pooling Nurse A and her husband might put their income together and withdraw for a payment, and this could mean they would make contributions to the payment proportional to their earnings, for example, if income were pooled entirely and Nurse A earned more than her husband, a greater proportion of the payment would be made using her earnings by withdrawing money from the pool.

20 Recipients of the OAP and disability grant are excluded to be consistent with the exclusion of earners with non-zero incomes; the exclusion does not imply that the OAP provides adequates income.

21 This figure includes five “mother’s children” (nurses’ siblings). Two of the three fathers of the five had passed away and one had never been involved with the family; therefore, these children belonged to the nurses’ mothers, not her parents.

22 Others expressed the opposite desire, to have their children live with their mother. Nurse A was one of them. Her older child had lived with the nurse’s mother until her mother passed away.

23 In South Africa, other women, particularly some Coloured women, are likely to experience precarity of subsistence, but history and context suggest substantive differences in its articulation and contributing factors.

Additional information

Notes on contributors

Jennifer Cohen

Jennifer Cohen, PhD Economics, is Associate Professor in the Department of Global and Intercultural Studies at Miami University and holds a joint appointment in Ezintsha, a research institute located in the Reproductive Health and HIV Institute, Faculty of Health Sciences at the University of the Witwatersrand in Johannesburg. She has conducted extensive fieldwork with nurses employed in the public healthcare system in Johannesburg. Her research focuses on paid work and unpaid reproductive labor, particularly among women of color who are healthcare workers in the US and in South Africa.

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