Disability, Cash Transfers and Family Practices in South Africa

Abstract

Relative to other low and middle-income countries, South Africa provides a generous set of cash transfers (social grants) targeted at people with disabilities. This article explores the influence of disability-related grants on family practices and configurations, care arrangements and household composition in the Western Province of South Africa. The article draws on the findings of two studies: 1) an ethnographic study of disability grant recipients and applicants in a low-income Cape Town community and; 2) a study of interactions between healthcare staff, disability grant applicants and their families. Findings show that disability grant income is shared within households and the contribution of a stable income provides opportunities for people with disabilities to exercise agency, be seen as valuable household members and secure care and support from other household members. However, conflicts may arise over how income is shared and may lead to the extortion, abuse and neglect of people with disabilities, particularly in cases of severe disablement. Given the lack of adequate social provisioning for those who are able-bodied and unemployed, disability also becomes highly valued in households and the potential suspension or cancellation of a grant can interfere with adherence to treatment. The study emphasises the influence of policy structures and economic conditions on household dynamics and care outcomes and contributes to the sparse international evidence-base on the role that disability welfare benefits play in household dynamics and care outcomes.