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The impact of social policies on well-being and health : three studies from South Africa
Thesis (PhD)--Stellenbosch University, 2025.
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| Format: | Thesis |
| Language: | English |
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Stellenbosch : Stellenbosch University
2025
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| _version_ | 1867613792058212352 |
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| access_status_str | Open Access |
| author | Khumalo, Tsepang Juliet |
| author2 | Von Fintel, Marisa |
| author_browse | Khumalo, Tsepang Juliet Von Fintel, Marisa |
| author_facet | Von Fintel, Marisa Khumalo, Tsepang Juliet |
| author_sort | Khumalo, Tsepang Juliet |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (PhD)--Stellenbosch University, 2025. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/134658 |
| institution | Stellenbosch University (South Africa) |
| language | English |
| last_indexed | 2026-06-10T12:41:46.341Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2025 |
| publishDateRange | 2025 |
| publishDateSort | 2025 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/134658 The impact of social policies on well-being and health : three studies from South Africa Khumalo, Tsepang Juliet Von Fintel, Marisa Burger, Ronelle Stellenbosch University. Faculty of Economic and Management Sciences. Dept. of Economics. Income maintenance programs -- South Africa Economic assistance, Domestic -- South Africa Social policy -- South Africa Child welfare -- Government policy -- South Africa Adolescence -- Economic aspects -- South Africa UCTD Thesis (PhD)--Stellenbosch University, 2025. Khumalo, T. J. 2025. The impact of social policies on well-being and health: Three studies from South Africa. Unpublished doctoral dissertation. Stellenbosch: Stellenbosch University [online]. Available: https://scholar.sun.ac.za/items/296fc914-4ed8-43ce-8d88-59638c40dc61 ENGLISH SUMMARY: Vulnerable individuals are often trapped in a cycle of poverty and poor health that could span generations. The debate about the types of interventions that can effectively break this cycle continues. This dissertation contributes to this debate by showing that the design and implementation of social policies at critical life stages can break or reinforce this cycle through their indirect impact on health. It examines the effect of three social policies, each aimed at a different phase of the life cycle, on the well-being and health of vulnerable individuals in South Africa. Chapter 2 examines the impact of the cessation of South Africa’s child support grant on the mental health of adolescents. The child support grant programme was launched in 1998 as an unconditional cash transfer given to low-income households. Since its launch, the age limit for eligibility has repeatedly been extended. The grant lapses at the end of the month when the beneficiary reaches this age limit. We exploit this age cut-off point for eligibility using a regression discontinuity design. Using nationally representative data from the National Income Dynamics Study (NIDS), we find that the cessation of the child support grant increases the depressive symptoms of the beneficiary. The results of the mechanism analysis suggest that the observed increase in depressive symptoms is mediated by the pressure to participate in the labour market and dropping out of school. These findings shed light on the unintended consequences of withdrawing financial support from vulnerable populations, especially when this withdrawal occurs at a critical stage of life such as adolescence. In South Africa, this occurs as adolescents exit the school system and face the country’s extremely high youth unemployment rates. Chapter 3 examines the impact of a programme that provides free housing on mental health. To address rapid rural-urban migration and housing poverty, the South African government provided and subsidised more than 5 million houses to vulnerable individuals. The allocation of these free brick-and-mortar houses was based on waiting lists. We exploit this quasi-random allocation of the houses and use a staggered difference-in-differences approach to estimate the effect of receiving housing on mental health. The chapter uses data from NIDS. We find that receiving formal housing decreases depressive symptoms, with stronger effects observed among individuals who moved from an informal home compared to those who moved from a formal house. Mediation analysis suggests that these effects are primarily driven by improved access to basic sanitation and adequate water. Chapter 4 investigates whether an emergency policy that temporarily banned alcohol improved health outcomes at birth. In response to the COVID-19 pandemic, the South African government temporarily banned the sale and transport of alcohol to limit social gatherings and free hospitals of alcohol-related trauma cases to prepare for possible hospitalisation related to COVID-19. We use the sudden and unexpected alcohol ban as a natural experiment to examine its effect on birth weight in the Western Cape province of South Africa. Using recorded births from 2017 to 2024 of women participating in the Building Healthier Communities (BHC) study, we find that in utero exposure to the alcohol ban in the first trimester of pregnancy had a significant and large impact on birth weight. These results suggest that, given the high levels of alcohol consumption and prenatal alcohol exposure in South Africa, stringent alcohol policies can lead to positive unintended consequences, benefiting the well-being of future generations beyond immediate targets. AFRIKAANSE OPSOMMING: Kwesbare individue is dikwels vasgevang in ’n siklus van armoede en swak gesondheid wat oor geslagte heen kan strek. Die debat oor watter tipe ingrypings die siklus doeltreffend kan verbreek, duur voort. Hierdie proefskrif lewer ’n bydrae tot die debat deur aan te toon hoe die ontwerp en implementering van maatskaplike beleid op kritieke lewensfases hierdie siklus of kan verbreek of kan versterk, deur hul indirekte impak op gesondheid. Dit ondersoek die uitwerking van drie maatskaplike beleide—elk gerig op ’n ander fase van die lewensiklus—op die welstand en gesondheid van kwesbare individue in Suid-Afrika. Hoofstuk 2 ondersoek die impak van die beeindiging van Suid-Afrika se kindertoelae op die geestesgesondheid van adolessente. Die kindertoelae-program is in 1998 bekendgestel as ’n onvoorwaardelike kontantoordrag aan lae-inkomste huishoudings. Sedertdien is die ouderdomsperk vir kwalifikasie herhaaldelik verhoog. Die toelae verval aan die einde van die maand waarin die begunstigde hierdie ouderdomsperk bereik. Ons benut hierdie ouderdomsafsnypunt vir kwalifikasie deur ’n regressie-diskontinuiteitsontwerp te gebruik. Deur gebruik te maak van nasionaal verteenwoordigende data van die National Income Dynamics Study (NIDS), vind ons dat die beeindiging van die kindertoelae die begunstigde se depressiewe simptome verhoog. Die resultate van die meganisme-analise dui daarop dat die waargenome toename in depressiewe simptome bemiddel word deur die druk om aan die arbeidsmark deel te neem en om skool te verlaat. Hierdie bevindinge werp lig op die onbedoelde gevolge van die onttrekking van finansiele ondersteuning aan kwesbare groepe, veral wanneer hierdie onttrekking plaasvind tydens ’n sensitiewe lewensfase soos adolessensie ’n kwessie wat grotendeels oor die hoof gesien word in die literatuur. Hoofstuk 3 ondersoek die uitwerking van ’n program wat gratis behuising verskaf op geestesgesondheid. Om die groeinde landelike-na-stedelike migrasie en behuisingsarmoede in die land aan te spreek, het die Suid-Afrikaanse regering meer as vier miljoen huise aan kwesbare individue verskaf en gesubsidieer. Die toekenning van hierdie gratis baksteen-enmortier huise was gebaseer op waglyste. Ons benut hierdie kwasi-ewekansige toekenning van die huise en gebruik ’n gefaseerde verskil-in-verskille-benadering om die effek van behuising op geestesgesondheid te skat. Die hoofstuk maak gebruik van data uit NIDS. Ons vind dat die ontvangs van formele behuising depressiewe simptome verminder, met sterker effekte onder individue wat van ’n informele woning getrek het in vergelyking met die wat van ’n formele huis getrek het. Medieringsanalise dui daarop dat hierdie effekte hoofsaaklik gedryf word deur verbeterde toegang tot basiese sanitasie en voldoende water. Hoofstuk 4 ondersoek of ’n noodmaatreel wat alkohol tydelik verbied het, gesondheidsuitkomste by geboorte verbeter het. In reaksie op die COVID-19-pandemie het die Suid-Afrikaanse regering tydelik die verkoop en vervoer van alkohol verbied om sosiale byeenkomste te beperk en hospitale van alkohol-verwante trauma-gevalle te bevry ter voorbereiding op moontlike hospitalisasie weens COVID-19. Ons gebruik hierdie skielike en onverwagte alkoholverbod as ’n natuurlike eksperiment om die impak daarvan op geboortegewig in die Wes-Kaap provinsie van Suid-Afrika te ondersoek. Deur gebruik te maak van geboorterekords van 2017 tot 2024 van vroue wat aan die Building Healthier Communities (BHC) studie deelgeneem het, vind ons dat in utero-blootstelling aan die alkoholverbod in die eerste trimester van swangerskap geboortegewig verhoog het. Hierdie resultate dui daarop dat, gegewe die hoe vlakke van alkoholverbruik en prenatale blootstelling aan alkohol in Suid-Afrika, streng alkoholbeleide positiewe onbedoelde gevolge kan he wat die welsyn van toekomstige geslagte bevorder, bo en behalwe die onmiddellike beleidsdoelwitte. Doctoral 2025-12-22T09:49:33Z 2025-12-22T09:49:33Z 2025-12 Thesis https://scholar.sun.ac.za/handle/10019.1/134658 en Stellenbosch University xvi, 142 pages : illustrations, maps, includes annexures application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Income maintenance programs -- South Africa Economic assistance, Domestic -- South Africa Social policy -- South Africa Child welfare -- Government policy -- South Africa Adolescence -- Economic aspects -- South Africa UCTD Khumalo, Tsepang Juliet The impact of social policies on well-being and health : three studies from South Africa |
| title | The impact of social policies on well-being and health : three studies from South Africa |
| title_full | The impact of social policies on well-being and health : three studies from South Africa |
| title_fullStr | The impact of social policies on well-being and health : three studies from South Africa |
| title_full_unstemmed | The impact of social policies on well-being and health : three studies from South Africa |
| title_short | The impact of social policies on well-being and health : three studies from South Africa |
| title_sort | impact of social policies on well being and health three studies from south africa |
| topic | Income maintenance programs -- South Africa Economic assistance, Domestic -- South Africa Social policy -- South Africa Child welfare -- Government policy -- South Africa Adolescence -- Economic aspects -- South Africa UCTD |
| url | https://scholar.sun.ac.za/handle/10019.1/134658 |
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