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Social Grants, Welfare, and the Incentive to Trade-Off Health for Income among Individuals on HAART in South Africa

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Abstract

South Africa’s government disability grants are considered important in providing income support to low-income AIDS patients. Indeed, anecdotal evidence suggests that some individuals may opt to compromise their health by foregoing Highly Active Antiretroviral Treatment (HAART) to remain eligible for the grant. In this study, we examined the disability grant’s importance to individual and household welfare, and the impact of its loss using a unique longitudinal dataset of HAART patients in Khayelitsha, Cape Town. We found that grant loss was associated with sizeable declines in income and changes in household composition. However, we found no evidence of individuals choosing poor health over grant loss. Our analysis also suggested that though the grants officially target those too sick to work, some people were able to keep grants longer than expected, and others received grants while employed. This has helped cushion people on HAART, but other welfare measures need consideration.

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Notes

  1. Not only did individuals continue to receive grants after commencing employment, but several individuals actually started receiving grants while engaged in steady wage or self-employment over the previous year (not shown here).

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Acknowledgments

We would like to thank the AIDS and Society Research Unit (ASRU) at the University of Cape Town for access to data from the HAART Panel Study and for research support. We would also like to thank Nathan Geffen, Elijah Paintsil, A. David Paltiel, Gustav Ranis, Jeremy Seekings, Jody Sindelar, T. Paul Schultz, T.N. Srinivasan, seminar participants at the University of Cape Town Center for Social Science Research, the Center for Interdisciplinary Research on AIDS at Yale University, the Global Citizenship: Research Implications workshop, and the International Health Economics Association 7th World Congress, as well as two anonymous referees, for helpful comments and suggestions. Funding for this research was provided by ASRU, the Whitney and Betty MacMillan Center for International and Area Studies at Yale University, and the William and Flora Hewlett Foundation. All errors are our own.

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Authors and Affiliations

  1. Washington University School of Medicine in St. Louis, 660 South Euclid, St. Louis, MO, 63110, USA

    Atheendar S. Venkataramani

  2. AIDS and Society Research Unit, University of Cape Town, Cape Town, South Africa

    Brendan Maughan-Brown & Nicoli Nattrass

  3. Division of Health Policy and Administration, Yale University School of Public Health, 60 College St, New Haven, CT, 06520, USA

    Jennifer Prah Ruger

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  1. Atheendar S. Venkataramani
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Correspondence to Atheendar S. Venkataramani.

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Venkataramani, A.S., Maughan-Brown, B., Nattrass, N. et al. Social Grants, Welfare, and the Incentive to Trade-Off Health for Income among Individuals on HAART in South Africa. AIDS Behav 14, 1393–1400 (2010). https://doi.org/10.1007/s10461-009-9642-y

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