care means that the specific benefits and costs of unlinked care – where caregivers are not linked to or supported by any formal HIV/AIDS care programmes – are missed.
In both developed and developing countries, governments are concerned with different groups in need of care. In developed countries the concern of social policy makers is with the growing number of elderly people requiring care. Many of these governments have therefore attempted to
“strengthen the family’s capacity to care” (Daly & Standing, 2001, p. 8). In some developing countries, chiefly those in sub-Saharan Africa, the concern of governments has been with the increasing numbers of people with HIV/AIDS who require care, and community care policies have been placed centre-stage to this end. Almost all AIDS care in sub-Saharan Africa is home- based, and women are disproportionately responsible for this care (Urdang, 2006, p. 173). Yet, as noted in section 2.2, for the vast majority of AIDS-affected families care is ‘unlinked’ (Ogden et al., 2004). Urdang (2006, p. 177) argues for the valuation of the unpaid care work which
underpins the HIV/AIDS epidemic, and notes that if this is not done “governments will simply continue to allow this work to subsidise the national economy”, which is able to limit expenditure on care provision more generally as a result.
2.5 HOUSEHOLD STRUCTURE AND UNEMPLOYMENT IN SOUTH
households are nuclear and just over a third are extended. The population groups show
differences in living arrangements with Africans and coloureds most likely to live in extended family households (even more common among the least educated and poor), and whites and Indians most likely to live in nuclear family households. Extended households are more common in rural areas, while nuclear households are more common in urban areas. Eight out of ten households were occupied by family groups in 2001, indicating that the majority in South Africa live with family, while less than one of four households were occupied by non-relatives or a single person (Amoateng et al., 2007, p. 47).
Budlender and Lund (2008, p. 17) analyse the 2005 South African GHS and find that about a third of South African households consist of children and a middle generation (18-49 years), about a quarter are middle generation only, while about a fifth have three or more generations.
Moreover, only 35 percent of under 18 children are resident with both their biological parents, 39 percent are living with their mother but not father, and 22 percent are not living with either biological parent (Budlender & Lund, 2008, p. 16). For African children the pattern deviates most strikingly from a nuclear family norm. In fact a higher percentage of African children live with grandparents compared with other race groups, and African children are also more likely to live with a sibling or other relative (Amoateng et al., 2007). There is also a very high rate of childbirth out of marriage, and many fathers have limited involvement with their offspring (Budlender &
Lund, 2008).
Overall Amoateng et al. (2007) describe an increasing tendency towards complexity of
households especially among Africans. They note that families and households in South Africa are becoming more diverse, in line with rapid social, economic and political changes in broader society.
The (un)employment regime in South Africa is also quite distinct from that in many other countries. In all, the population that are not economically active totalled 32 percent of the working age population in 2005 (own calculations using Statistics South Africa, 2005, p. xvii).
The official unemployment rate, which classifies someone as unemployed only if they have taken
active steps in recent weeks to find work, was 26 percent in September 2004, but the expanded unemployment rate, which includes those who would prefer to work but are not actively seeking work because they have given up hope of finding it, was 40 percent. Both rates of unemployment have decreased slightly since 2003 to the present (Budlender & Lund, 2008; The Presidency, Republic of South Africa, 2008, p. 21). However, Bhorat and Oosthuizen (2006) point to the worrying development of a rapid rise in unemployment rates for those with completed secondary and tertiary education. These authors also show that for 1995 and 2002, and for those who had completed secondary and tertiary education, Africans were more often unemployed than any other race group (ibid, p. 168).
Sienaert (2008) describes labour market outcomes as the central determinant of poverty in South Africa. About one-third of the population lived on less than $2/day (or R174 per month) in 2000, according to Hoogeveen and Özler (2006, p. 64), and this figure is higher for Africans at 40 percent than for other race groups. These authors show that the sheer number of people that fall below this poverty line has increased – albeit marginally – for the country as a whole and for Africans (ibid, p. 65). Leibbrandt et al. (2006, p. 106) corroborate this finding: they document an increase in the population falling below the same poverty line, from 26 percent in 1996 to 28 percent in 2001. The persistent problem of inequality in South Africa must also not be forgotten.
Inequality has grown even wider in recent years to a Gini coefficient of 0.73 in 2001 (Leibbrandt et al., 2006, p. 101). Added to this are very high rates of HIV/AIDS, more of which shall be described in the following section, and it is evident that this is a quite particular context. All of this should be borne in mind when applying knowledge on care provision from a developed world context to a developing country setting, but especially when applying this knowledge to a context as specific as South Africa.
2.6 PROVISION OF HEALTH AND WELFARE SERVICES IN SOUTH