Rural–urban inequalities amplified by COVID-19: evidence from South Africa

Visagie, Justin; Turok, Ivan

doi:10.1080/23792949.2020.1851143

Cited by 59 publications

(40 citation statements)

References 14 publications

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“…In three of our geographies, the economic shock was distributed similarly across the pre-pandemic wealth spectrum. This aligns with similar findings from national studies in Malawi, Nigeria, Ethiopia, Uganda and South Africa [ 24 , 27 , 29 , 31 ]. However, it diverges from findings in urban Ethiopia, [ 28 ] rural Uganda [ 30 ] and in Nigeria [ 39 ].…”

Section: Discussionsupporting

confidence: 91%

“…Similarly, a study in rural communities in Uganda found that the negative economic effects were actually larger among households that were wealthier at baseline [ 30 ]. An analysis in South Africa found that the initial income effects were similar in urban and rural areas, but that urban areas experienced income and employment recovery at a higher rate, widening urban-rural inequality [ 31 ].…”

Section: Introductionmentioning

confidence: 99%

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The wealth gradient and the effect of COVID-19 restrictions on income loss, food insecurity and health care access in four sub-Saharan African geographies

et al. 2021

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Introduction While there has been considerable analysis of the health and economic effects of COVID-19 in the Global North, representative data on the distribution and depth of social and economic impacts in Africa has been more limited. Methods We analyze household data collected prior to the COVID-19 pandemic and during the first wave of COVID in four African countries. We evaluate the short-term changes to household economic status and assess women’s access to health care during the first wave of COVID-19 in nationally representative samples of women aged 15–49 in Kenya and Burkina Faso, and in sub-nationally representative samples of women aged 15–49 in Kinshasa, Democratic Republic of Congo and Lagos, Nigeria. We examine prevalence and distribution of household income loss, food insecurity, and access to health care during the COVID-19 lockdowns across residence and pre-pandemic wealth categories. We then regress pre-pandemic individual and household sociodemographic characteristics on the three outcomes. Results In three out of four samples, over 90% of women reported partial or complete loss of household income since the beginning of the coronavirus restrictions. Prevalence of food insecurity ranged from 17.0% (95% CI 13.6–20.9) to 39.8% (95% CI 36.0–43.7), and the majority of women in food insecure households reported increases in food insecurity during the COVID-19 restriction period. In contrast, we did not find significant barriers to accessing health care during COVID restrictions. Between 78·3% and 94·0% of women who needed health care were able successfully access it. When we examined pre-pandemic sociodemographic correlates of the outcomes, we found that the income shock of COVID-19 was substantial and distributed similarly across wealth groups, but food insecurity was concentrated among poorer households. Contrary to a-priori expectations, we find little evidence of women experiencing barriers to health care, but there is significant need for food support.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

The wealth gradient and the effect of COVID-19 restrictions on income loss, food insecurity and health care access in four sub-Saharan African geographies

et al. 2021

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“…Employment dropped sharply after lockdown was imposed, but by October 2020 the overall employment rate appeared to have recovered, although not for women or respondents with low levels of education. The provision of increased government support, including top-ups for existing unconditional grants (which ended after October) and the new, temporary Social Relief of Distress grant for working-aged adults with no other sources of support appeared to aid households, particularly those in rural areas [32]. However, the withdrawal of these grants has caused concern.…”

Section: Introductionmentioning

confidence: 99%

Protective Behaviors and Secondary Harms Resulting From Nonpharmaceutical Interventions During the COVID-19 Epidemic in South Africa: Multisite, Prospective Longitudinal Study

Harling¹,

Gómez‐Olivé²,

Tlouyamma³

et al. 2021

JMIR Public Health Surveill

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Background In March 2020, South Africa implemented strict nonpharmaceutical interventions (NPIs) to contain the spread of COVID-19. Over the subsequent 5 months, NPI policies were eased in stages according to a national strategy. COVID-19 spread throughout the country heterogeneously; the disease reached rural areas by July and case numbers peaked from July to August. A second COVID-19 wave began in late 2020. Data on the impact of NPI policies on social and economic well-being and access to health care are limited. Objective We aimed to determine how rural residents in three South African provinces changed their behaviors during the first COVID-19 epidemic wave. Methods The South African Population Research Infrastructure Network nodes in the Mpumalanga (Agincourt), KwaZulu-Natal, (Africa Health Research Institute) and Limpopo (Dikgale-Mamabolo-Mothiba) provinces conducted up to 14 rounds of longitudinal telephone surveys among randomly sampled households from rural and periurban surveillance populations every 2-3 weeks. Interviews included questions on the following topics: COVID-19–related knowledge and behaviors, the health and economic impacts of NPIs, and mental health. We analyzed how responses varied based on NPI stringency and household sociodemographics. Results In total, 5120 households completed 23,095 interviews between April and December 2020. Respondents’ self-reported satisfaction with their COVID-19–related knowledge and face mask use rapidly rose to 85% and 95%, respectively, by August. As selected NPIs were eased, the amount of travel increased, economic losses were reduced, and the prevalence of anxiety and depression symptoms fell. When the number of COVID-19 cases spiked at one node in July, the amount of travel dropped rapidly and the rate of missed daily medications doubled. Households where more adults received government-funded old-age pensions reported concerns about economic matters and medication access less often. Conclusions South Africans complied with stringent, COVID-19–related NPIs despite the threat of substantial social, economic, and health repercussions. Government-supported social welfare programs appeared to buffer interruptions in income and health care access during local outbreaks. Epidemic control policies must be balanced against the broader well-being of people in resource-limited settings and designed with parallel support systems when such policies threaten peoples’ income and access to basic services.

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“…Other survey data suggested that as many as 3 million people who had been employed in February were unemployed (either temporarily or permanently) in June (Kean and Armstrong, 2020). The initial job losses affected urban and rural areas alike, although there was a modest recovery in urban areas in mid-year (Visagie and Turok, 2021).…”

Section: The South African Case: Large-scale But Temporary Provisionmentioning

confidence: 99%

“…The new emergency grant social grant also reached more rural than urban households -but the ratio was far smaller than for existing grants. In other words, the emergency grant was less strongly directed at the rural poor (Visagie and Turok, 2021). It is likely that the emergency unemployment insurance was heavily oriented to urban areas, given the structure of employment and unemployment.…”

Section: The South African Case: Large-scale But Temporary Provisionmentioning

confidence: 99%

Pandemic, lockdown and the stalled urbanization of welfare regimes in Southern Africa

Gronbach

Seekings

2021

Global Social Policy

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While Covid-19 caused few fatalities across most of Africa – with the notable exception of South Africa – the indirect economic effects were substantial, especially in urban areas. International organizations encouraged governments to expand their provision, especially for the urban poor. South Africa extended temporarily its already considerable system of social protection and introduced new implementation systems. Elsewhere, governments that had hitherto appeared ambivalent about social protection resisted major reforms, even on a temporary basis. In Zambia, the government committed considerable resources to small farmers but ignored almost entirely cash transfers to the poor. Botswana provided food parcels but did not expand its social grant programmes. The shock of Covid-19 in Southern Africa did not prove to be a ‘critical juncture’: Powerful pro-reform coalitions did not form to shift governments onto new policy paths. National governments were generally reluctant either to introduce programmes that were targeted on the urban poor specifically or to allow countrywide emergency programmes to become permanent. The crisis thus did not lead to any clear ‘urbanisation’ of welfare regimes in the region, despite the disproportionate effect of the crisis on the urban poor.

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Rural–urban inequalities amplified by COVID-19: evidence from South Africa

Cited by 59 publications

References 14 publications

The wealth gradient and the effect of COVID-19 restrictions on income loss, food insecurity and health care access in four sub-Saharan African geographies

The wealth gradient and the effect of COVID-19 restrictions on income loss, food insecurity and health care access in four sub-Saharan African geographies

Protective Behaviors and Secondary Harms Resulting From Nonpharmaceutical Interventions During the COVID-19 Epidemic in South Africa: Multisite, Prospective Longitudinal Study

Pandemic, lockdown and the stalled urbanization of welfare regimes in Southern Africa

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