Connecting cash with care for better child well-being


All children have the right to survive, grow and develop but also the right to thrive and participate, to be safe, loved and cared for by empowered and informed caregivers/parents.

With wide, largely historic, socio-economic inequalities between children and communities, and high rates of violence and other vulnerabilities for children, South Africa is a land of contrasts. The country has excellent laws and policies, one of the most well-developed social assistance systems for children on the continent, and almost universal access to basic social services. Successes include 12,7 million children whom are enrolled and benefit from child grants, access to universal primary and secondary education, access to health services with 96% of children fully immunized, and the births of 92% of children are registered. It is noteworthy that all these critical services are paid for and provided by a democratically-elected government.

However, South Africa faces persistent challenges, with 65% of children living below the poverty line, a 27% adult and 59 % youth unemployment rate. In addition, 78% of learners in Grade 4 of primary school cannot read for meaning, and 27% of the country’s children under five are stunted. In addition, the 2016 Optimus Study estimates that 26% of adolescents have experienced physical abuse by an adult in their lifetime and one in four adolescents reported experiencing at least one (or more) forms of sexual abuse in their lifetime.

So why, after such a substantial investment by the state and non-state actors, is the well-being of children still lagging?

Evidence continues to show us that elevated levels of pervasive economic hardship, inequality and unemployment are the drivers of intergenerational poverty, violence and abuse of which often women and children carry the brunt. During apartheid, many families were torn apart, people were oppressed and experienced violence as either victims or witnesses. Millions of women continue to carry the brunt of child care, both financial and emotional, and live in a situation of distress. Children are often primary and secondary victims of these elevated levels of poverty, unemployment, violence and abuse in their homes and in other places where they should be most safe, including their schools. We also know that cash alone is not enough.

Cash alone is, however, not enough to improve the well-being of a child living in a context of multiple deprivations in disadvantaged families. Financial support can contribute to the material needs of children such as housing, clothing, education cost and food but cannot contribute to the social, cognitive and psychological needs of the children. Research supported by UNICEF,  demonstrates that complementary family-strengthening interventions to families at risk with children on the grants more holistically address the psychosocial, system and structural risks these households face.

Through the Child Support Grant (CSG), the state knows where these children are, their gender and age and the profile of the family. All these children have a name and identity with a birth certificate. This is an enormous opportunity, which enables government to create linkages for these children to other social services.

Evidence shows that cash works. An external evaluation of the Child Support Grant (CSG) conducted in 2010 provided the data that the CSG had a positive impact on poverty reduction in households and led to improved nutrition and increased school attendance of the children. An additional study conducted by Lucy Cluver in 2016 showed that child-focused grants, combined with free schooling, teacher support, the school-feeding scheme and parental monitoring were associated with reduced HIV-risk behavior incidence.

Cash Plus is a global commitment by UNICEF, which views South Africa as an important country where this can happen as it will lead to enhanced access to services. UNICEF is advocating for the CSG Plus Policy -that is currently in development- to include a component of cash-plus-care to improve children’s well-being and enhance their access to other social services. UNICEF also advocates for intensified budgeting for social service professionals and calls on all stakeholders – Government, corporate, High-Net Individuals, philanthropies and foundations –  to accelerate the investment in prevention and early intervention programmes to ensure children’s well-being in families at risk is mitigated.

The Isibindi programme shows that the intervention of child and youth care workers in child grant beneficiary households leads to reduced risks, improved learning outcomes – with an average 70% matric pass rate for Isibindi-supported children –  improved child budgeting and enhanced access to services.

This Sihleng’imizi Family Programme was built on the established Sinovuyo Teens Parenting initiative which resulted in more involved parenting, less parenting stress, more social support for caregivers, more household savings, more financial self-efficacy and reduced substance abuse amongst adolescents and caregivers.

Through these early interventions programmes, UNICEF believes that change is possible and that caregivers can create a nurturing environment for children and change behavior in the best interest of their children despite the socio-economic challenges of poverty and unemployment. UNICEF calls for cash transfers and care to be integrated as part of the broader social welfare services. One child at a time.


Mayke Huijbregts is the Chief Social Policy and Child Protection, UNICEF South Africa.