Addressing Care Challenges in South Africa: Insights from UNRISD Project

1. The UNRISD Project on thePolitical Economy of Paid & Unpaid Care Work:The South African country study Francie Lund University of KwaZulu-Natal, and WIEGO network Working with Debbie Budlender Community Agency for Social Enquiry (CASE) Presentation at WIDe Conference, Basel, June 2009

2. A granny in Durban, looking after grandchild while working in a street market in the traditional herbs and medicines sector

3. UNRISD project in South Africa Holds the potential for: • Making more visible the links between economic and social policies • Bringing the totality of women’s work to the surface • Seeing the links between paid and unpaid care work • Through the combination of quantitative and qualitative research

4. South Africa • 48 million people • Middle income country • Steep poverty and inequality, with marked racial, gender-based and spatial features • High unemployment rates

5. Family/ household composition Of children under 17: • 35 percent live with both mother and father • 40 percent live with mother not father • 20 percent live with neither biological parent Of all households: • 35 percent comprised of children and middle generation – but this is supposedly ‘the norm’ of a nuclear family • 21 percent have three or more generations present

6. Burning problems and questions about care • Apartheid legacy of disruption of family life • High unemployment rates for women and for men, and especially for women • Exceptionally high HIV&AIDS rates SO: • What types of intervention could address the growing needs for care, especially of all children, and of middle generation adults with HIV&AIDS?

7. How do different agencies react and cope: households • No evidence of withdrawal of girl children from school • Extended families absorb kin children and sick people • Positive role of state pension for elderly people

8. The state • Unconditional and non-contributory cash transfers: Old Age Pension (OAP) and to a lesser extent the Disability Grant, allow care, shape care, enable younger women to go and seek work, keep girl children in school for longer • Child Support Grant too small to be able to see impact on care • ARV therapy provision – now received by about 700 000 people – is shaping care: for people with AIDS, by household members, and by Home Based Care workers; also by nurses and other paid carers

9. The market • Nurses move from government to private sector – and emigrate to UK, Australia, New Zealand, Canada • Nurses from SADC and elsewhere immigrate to South Africa • Growth in private market for low paid care • Are domestic workers (largely African women) doing more skilled care work, with no recognition or compensation?

10. International agencies • HIV&AIDS may be ‘crowding out’ funding for other health issues • Much positive support for cash transfers – how long will this last? May last longer because of global financial crisis? • Much focus on child headed households and human trafficking – these are problems, but may not be priority in terms of intensity

11. Non governmental organisations (NGOs)Community based organisations (CBOs)Faith based organisations (FBOs) • Absolutely crucial formal and informal support to households, much of it unrecognised and unregistered • Incoherent government policy as to where they fall in the ‘continuum of care’ and how to support them • A wider range of NGOs, CBOs and FBOs now receive government subsidies to provide HBC. A minority have clear programmes and support structures for the HBCs.

12. Household-based care programmes • Wide variety of interventions, mainly in departments of health, and of social development • On the whole ungendered, with ‘community’ standing for women doing unpaid care work • ‘Continuum of care’ – ‘community’ has no clear policy for support – compare with MUCH poorer African countries such as Uganda and Tanzania where there is more active support for community workers and volunteers • HBC programme in public works programme: • Appalling rates of ‘pay’ (just over a dollar a day), and care workers get paid much less than men (and some women) get paid in non-care public works programmes (Budlender and Parenzee) • No clear planned progression into other forms of work • BUT it provides some women with opportunities to enter labour market as low paid care workers

13. In absence of access to health services, or to support from HBC, who does the caring? • Unpaid care work by household members, overwhelmingly women, and especially grannies, who pay out of pocket (often from state pensions) to do the care work better – • Transport to clinics, cleaning materials, special food, bed linen, medication • They work with no informed support service, and with ill household member who often will not declare status and will not go for testing • ARV therapy is likely to increase the numbers of those who go for voluntary testing

14. Effective measures to challenge gender inequality? – the longer haul • Argue with figures (for example from UNRISD care project): - Somewhat influential: Time spent by women compared to men on unpaid care work: (246 cf 89 minutes a day); women in households with no children spent more time on care of children than men living in households with own children - More influential: Unpaid care work as fraction of GDP : range between 11 percent and 30 percent, depending on method used (median wage of all employees, or median wage of domestic worker) - Even more influential: How many jobs could be created • Analyse the totality of women’s work, and keep the distinctions between the categories very clear • Paid and unpaid market work • Formal and informal paid work • Unpaid care work