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Chronic Child Poverty and Health Outcomes in South Africa Using a Multidimensional Poverty Measure

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Abstract

In this paper, I examine the differences in health outcomes between children residing in poor and non-poor households. In order to identify household poverty, I make use of the framework of multidimensional poverty as introduced by Alkire and Foster (Journal of Public Economics, 95(7–8), 2011). I follow the poverty status of children (defined as individuals aged 18 years or younger) over the period 2012- 2017, using the last three waves of the South African National Income Dynamics Study (NIDS). I find great disparities in health outcomes among children depending on the classification of the household as being poor or non-poor. In addition, children residing in households which are chronically poor (i.e. are observed to remain in poverty over time) have worse health outcomes than children residing in households which move in and out of poverty, pointing towards the negative effects of poverty traps. Finally, I rely on the previous work conducted by Wagstaff et al. (Journal of Public Health, 94(5), 726-736, 2004) to explore some of the household circumstances which may alleviate or exacerbate socio-economic child health inequalities in South Africa. These include access to the labour market, maternal education, water and sanitation, and social norms (which include the prevalence of female-headed households and the decision-making power of women in the household).

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Notes

  1. South Africa is one of the most unequal countries in the world in terms of income and access to public services (Leibbrandt et al., 2011; von Fintel & Richter 2019).

  2. Alkire and Roche (2012) emphasise the importance of a multidimensional approach to measuring poverty, especially when measuring child poverty. Taking a multidimensional approach to measuring poverty provides policy makers with more information on the depth of the poverty as well as the indicators that children are most deprived in and accordingly warrant the most attention.

  3. The main reason for this is that the NIDS data does not lend itself to the development of a child-centered multidimensional poverty index.

  4. Internationally, the development of multidimensional poverty measures specifically tailored to measure the needs and wants of children has become quite prevalent. Child-centred multidimensional poverty measures have also been applied to children living in various circumstances, including Bhutan (Alkire et al., 2016), Afghanistan (Trani et al., 2013), Darfur (Trani & Cannings, 2013), Columbia (Garcia & Ritterbusch, 2015) and Australia (Callander et al., 2012).

  5. As indicated above, I define children as being all individuals who were 18 years or younger in 2017.

  6. Although chronic multidimensional poverty can be measured using the duration approach, i.e. where a separate cut-off is applied to ascertain whether a child was chronically multidimensionally poor or not, here I rely on the simpler method of identifying a child as chronically poor if he or she were observed to reside in a poor household in all three time periods.

  7. It should be noted that the last two items were only asked in the third wave in 2012, and not in the last two waves.

  8. I base this conclusion on the lower levels of poverty intensity found in NIDS in previous studies, when using the full sample (and not only children), for example Finn et al. (2013).

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Acknowledgements

The author gratefully acknowledges comments from Ronelle Burger and Mosima Ngwenya, as well as an anonymous referee. This project was funded by the South African Department of Science and Innovation–National Research Foundation (DSI-NRF) Centre of Excellence in Human Development.

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  1. Department of Economics, Stellenbosch University, Stellenbosch, South Africa

    Marisa von Fintel

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von Fintel, M. Chronic Child Poverty and Health Outcomes in South Africa Using a Multidimensional Poverty Measure. Child Ind Res 14, 1571–1596 (2021). https://doi.org/10.1007/s12187-021-09817-0

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