Social Assistance Needs of Children with Chronic Health Conditions: A Comparative Study of International and South African Eligibility Assessment Instruments

Abstract

The efficacy of the current instrument to assess the social assistance needs of children with chronic health conditions in South Africa is questioned. To develop an improved assessment instrument for South African use, this instrument was pitted against two international social assistance assessment instruments, the United Kingdom (UK) Disability Living Allowance (DLA) and the Australian Child Disability Assessment Tool (CDAT). A purposive sample of 18 children representing six types of disability and chronic illnesses was selected, and all three assessment instruments were used to assess the needs of these children. A juxtaposition of the outcomes of the assessment instruments revealed significant differences. The South African instrument deemed the majority (56%) of the sample ineligible for assistance. On the contrary, significant majorities were deemed eligible for assistance in terms of the U.K. (94%) and Australian (89%) instruments. The study recommended that a holistic approach to need assessment be adopted in the design of a more appropriate assessment instrument for South African use.

KEYWORDS:

• Social assistance
• assessment instruments
• need assessment
• child disability
• childhood chronic illness

Notes

The financial assistance of the Children's Institute, University of Cape Town toward this research is gratefully acknowledged. The authors wish to thank Ms. Teresa Guthrie (formerly University of Cape Town) and Dr. Colleen Adnams (University of Cape Town) for their contributions to this research.

1. A form of social security.

2. Chronic health condition is used as an umbrella term for children with long-term health conditions or impairments. For the purposes of this study it refers specifically to children with disabilities and chronic illnesses.

3. Approximate 2008 value USD 1 = R 9.

4. The primary health condition as identified by the selected categories and a secondary health condition.

5. The social model refers to the social and economic conditions that might result from impairment.

6. The LAQ is a functional assessment instrument that was reviewed in the study. It focuses on the impact of disability.

7. Levels of need due to the health conditions are identified, and children with high rates of need are initially prioritised for benefits.

8. For example, subsidised transport services or medical services.