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Category Archives: Uncategorized
On the 31st of January and the 1st of February 2022 former Deputy President Dr Phumzile Mlambo-Ngcuka launched a new initiative – the 2030 Reading Panel. The Chair (Dr Mlambo-Ngcuka) asked me to be the Secretary of the Panel and to write a Background Report documenting some of the research and evidence we have on reading outcomes in South Africa as well as interventions for which we have rigorous evaluations showing gains in learning outcomes. The full 2022 Background Report is available on the Reading Panel website and I will blog some of the main findings in another post.
In addition to the 2022 Background Report there are 13 Advisory Notes by a range of people working in the space of early grade reading in South Africa:
It’s that time of the year again! I’ll be teaching my postgraduate Applied Economics of Education course at Stellenbosch University. The course runs from the 10th of August to the end of October 2021, with in-person lectures from 9:00-11:00 on Tuesdays and in-person STATA pracs from 11:00-13:00. The full syllabus can be found HERE doc. If you have a strong interest in the course and would like to apply to be an auditor please complete the Google Form which is inside the course outline. Every year there are a number of local and international auditors that enrich the course by their participation. Approved auditors can join in-person at Stellenbosch or electronically via Zoom. There are a limited number of spaces for auditors and those with a quantitative and/or postgraduate background will have preference. Note also that all auditors have to do the readings and hand in the weekly reading reflections as your price of entry! I’ve included the list of readings for each lecture below:
(1) Inequality in South African education
- *Spaull, N. (2019). Equity: A price too high to pay? In Spaull, N. & Jansen, J. (eds): South African Schooling: The Enigma of Inequality. Springer.
- Collini, S. (2021). Snakes and Ladders. London Review of Books. Vol.43 (17) April 2021.
- Pabón, F., Leibbrandt, M., Ranchhod, V., & Savage, M. (2021). Picketty comes to South Africa. British Journal of Sociology. 2021 (72) p.106-124
(2) Sampling, assessment, and trends over time
Much of the economics of education involves analyzing sample-based surveys of educational inputs and learning outcomes. Of particular importance are the four international assessments South Africa participates in which are TIMSS (Gr5 & 9 maths and science), PIRLS (Gr4 reading), SACMEQ (Gr6 maths and literacy) and TALIS (teacher survey). This session covers issues of inter-temporal comparability, how surveys sample schools, representivity, basic statistical concepts in sampling, interpreting results from cross-national surveys and some of the literature that has looked at this issues in SA and sub-Saharan Africa. This will also be useful for your pracs.
- *Van der Berg, S. & Gustafsson, M. (2019). Educational outcomes in post-apartheid South Africa: Signs of progress despite great inequality. In Spaull, N. & Jansen, J. (eds): South African Schooling: The Enigma of Inequality. Springer.
- *Spaull, N., and Taylor, S., (2015). Access to what? Creating a composite measure of educational quantity and educational quality for 11 African countries. Comparative Education Review. Vol. 58, No. 1. (optional extras: Taylor & Spaull, 2015 and Lilenstein 2018 for francophone West Africa)
- Singh, A. (2015) How standard is a standard deviation? A cautionary note on using SDs to compare across impact evaluations in education. Development Impact. World Bank. (Online). Available: [Accessed: 11 July 2018]
(3) Early grade reading in South Africa: What do we know?
- *Spaull, N. & Pretorius, E. (2019). Still falling at the first hurdle: Early grade reading outcomes in South Africa. In Spaull, N. & Jansen, J. (eds): South African Schooling: The Enigma of Inequality. Springer.
- *Ardington, C., Wills, G., Pretorius, E., Mohohlwane, N., & Menendez, A. (2021) Benchmarking oral reading fluency in the early grades in Nguni languages. International Journal of Educational Development 84 (2021)
(4) Education in the time of COVID-19 in South Africa
- *Ardington, C., Wills, G., & Kotze, J (2021, forthcoming). COVID-19 learning losses: early grade reading in South Arica. Manuscript for RISE conference.
- *Shepherd, D. & Mohohlwane, N. (2021). The impact of COVID-19 in education – more than a year of disruption. NIDS-CRAM Wave 5 Working Paper.
- Spaull, N. & Van der Berg, S. (2020). Counting the cost: COVID-19 school closures in South Africa and its impact on children. South African Journal of Childhood Education. Vol 10(11).
(5) Teachers and the budget in South Africa: The R200bn question
- *Spaull, N., Lilenstein, A., & Carel, D. (2020). The Race between Teacher Wages and the Budget – the case of South Africa 2008-2018. RESEP.
- Gustafsson, M. (2012). Incentives for teachers within the salary system. DBE. Pretoria.
- Gustafsson. 2020. Selected extracts from teacher demand work.
(6) Government plans for South African Education
- *Gustafsson, M. (2019). Pursuing change through policy in the schooling sector 2007-2017. In Spaull, N. & Jansen, J. (eds): South African Schooling: The Enigma of Inequality. Springer.
- *Van der Berg, S., Gustafsson, M., & Malindi, K. (2020). Education and skills for the economy and links to labour markets in South Africa. Position Paper June 2020. National Planning Commission.
- Department of Basic Education. (2020). Action Plan to 2024: Towards the realisation of Schooling 2030. Overview. Full document. DBE. Pretoria.
- Presidency (2019). Medium Term Strategic Framework (MTSF) 2019-2024. Presidency. Pretoria
(7) The myth of evidence-based policymaking
- *Cairney, P. & Oliver, K. (2017). Evidence-based policymaking is not like evidence-based medicine, so how far should you go to bridge the divide between evidence and policy? Health Research Policy and System 15:35.
- *White, H. (2019). The twenty-first century experimenting society: the four waves of the evidence revolution. Palgrave Communications 5(47) 2019.
- Ganimian, A. (2017) Not drawn to scale? RCTs and education reform in developing countries. Research on Improving Systems of Education. (Online). [5 June 2019]
- Kremer, M., Brannen, C., & Glennerster, R. (2013). The Challenge of Education and Learning in the Developing World. Science 340, 297 (2013)
- Ravallion, M. (2020) Should the Randomistas (Continue to) Rule? Working Paper 27554. NBER Working Paper.
(8) #FeesMustFall: Who should pay for higher education?
This ‘lecture’ is actually a class debate. The class will be split into two opposing teams and the motion is “This House believes that higher education should be completely free for all students who are accepted by higher education institutions in South Africa.”
- *Van Broekhuizen, H., Van der Berg, S., & Hofmeyr, H. (2016). Higher Education Access and Outcomes for the 2008 National Matric Cohort. Stellenbosch Economic Working Papers 16/16.
- Davis Tax Committee. 2016. Report on the Funding of Tertiary Education. (Online).
- Chapman, B. (2006) Income Contingent Loans for Higher Education: International Reforms. Handbook of the Economics of Education (Vol 2) pp 1435-1503.
(9) Vouchers & Public Private Partnerships
- *Epple, D., Romano, R., & Urquiola, M. (2017). School Vouchers: A Survey of the Economics Literature. Journal of Economic Literature, 55(2), 441-492.
(10) Are we there yet?
This session will discuss South Africa’s current rates of improvement, promising avenues for improvements and key research questions going forward.
- *Cruz., L & Loureiro, C. (2020). Achieving world-class education in adverse socioeconomic conditions: The case of Sobral in Brazil. World Bank
Gustafsson, M. (2019). How fast can levels of proficiency improve? Examining Historical Trends to Inform SDG 4.1.1 Scenarios. UNESCO Institute for Statistics. (also see blog here)
SA is in flux: we’re waiting for what we know we need, even as we gird ourselves for disappointment. We’re waiting for an uptick in the economy; waiting for jobs; waiting for the ANC to sort out who is suspending who — but most of all, we’re waiting for vaccines.
The latest results of our National Income Dynamics Study — Coronavirus Rapid Mobile Survey (Nids-Cram), released this week, show that in February and March this year, the vast majority of South Africans (71%) said they would take the vaccine if they could. The problem is, there is none available.
By May 4, SA had vaccinated only 353,000 people. This is less than half those vaccinated in Kenya (853,000) or Ghana (850,000), and lower than in poorer countries like Senegal (417,000) or Zimbabwe (452,000). This picture is even more sobering if you consider the population size. Only 0.6% of SA has been vaccinated — less than Iraq (0.8%), Somalia (0.8%), Afghanistan (1%), and Libya (1.2%), and also less than the vaccination rate in 140 other countries.
Why is this? SA has the resources. It has the expertise. It has the health infrastructure. Instead, it would seem, there was a failure to strategically plan, and to hedge bets. Given the uncertainty around new vaccines, many countries sourced multiple types in the hope that at least one would work. SA came late to that party, then put all the eggs in the AstraZeneca basket — which proved less effective against the local variant. So here we are, back to square one.
Fingers crossed, May could be a turning point. Health minister Zweli Mkhize says SA will get 6-million Pfizer-BioNTech vaccines and 1-million Johnson & Johnson vaccines this month. And President Cyril Ramaphosa says the government has bought vaccines to cover more than 40-million people. All these vaccines, we are told, will arrive at some point in 2021. However, Ramaphosa hasn’t given specifics. So when those vaccines actually arrive, and how quickly they’re administered, remains to be seen. All while a third wave of Covid threatens to break.
While SA has been preoccupied with supply problems (how to get more vaccines), it will, like other countries, soon confront a demand problem: how do we get people to take the jabs we do have? Today, the US has vaccinated about 150-million people (45% of its population), but the average number getting a first or single dose has fallen by nearly 50% since April 13.
That was the day that US health officials announced they would temporarily stop the rollout of the Johnson & Johnson (J&J) vaccine, because a tiny proportion of people getting the vaccine had developed blood clots.
This was a huge failure of judgment by the US — and by SA, which slavishly followed that approach. The US had other vaccines to offer, while SA simply paused its entire rollout without any other alternative. Among 7-million US adults vaccinated with the J&J jab, six people (0.00009%) developed blood clots. One died. Oxford researchers have shown that you are 8-10 times more likely to get a blood clot if you get Covid than from the vaccine, and 3,000-times more likely to get a blood clot from birth control pills (a 0.3% chance).
While regulators said they pressed pause due to “an abundance of caution”, it was a failure of judgment on multiple levels. SA (unlike the US) had no other vaccine at the time. The US stopped J&J, but continued with Pfizer and Moderna — but SA stopped rolling out the only vaccine it had. Apart from the fact that the mortality risk from Covid is orders of magnitude greater than the infinitesimal risk of blood clots, it means South Africans will have died unnecessarily due to that pause. But there is another more insidious cost: the increase in vaccine hesitancy, since people are now more wary of the vaccine.
Few genuinely understand that you are as likely to get struck by lightning (one chance in a million) as you are to get a blood clot from a vaccine. It’s not going to happen — but thousands of people who were on the fence may now opt against vaccination. The latest Nids-Cram (wave 4) results, released this week, shed light on whether these communication blunders are likely to have an impact on SA’s rollout. While the survey showed that 71% of South Africans are willing to get a vaccine (higher than many countries), the flip side is that nearly a third were vaccine hesitant. The three main reasons for hesitancy were: concern about side effects (31%); lack of belief in effectiveness (21%); or general lack of trust in vaccines (18%). To combat vaccine hesitancy, we need to know not only why people are hesitant, but also who they are.
This new data shows that those most at risk of Covid (the elderly and those with chronic conditions) are more willing to get the jab. By contrast, those least at risk — people aged between 18 and 25 — were less willing, with only 63% saying they would have a vaccination. This isn’t entirely surprising. As research has revealed elsewhere, those who trust social media as an information source (predominantly young people) were significantly more likely to be vaccine hesitant. One unexpected finding from the survey results was that a respondent’s home language was also a significant predictor of vaccine hesitancy, with 42% of Afrikaans home-language respondents being vaccine hesitant. This is higher than the national average of 29% and far higher than in people belonging to seven of the 11 language groups.
Though Nids-Cram is not provincially representative, in light of the predominance of Afrikaans in the Western Cape and Northern Cape, it accords with the finding that people from these provinces had higher vaccine hesitancy rates of 42% and 41%. More research is needed to understand this finding. But it is a key insight because vaccines are being rolled out provincially and the media that reaches them is predominantly segmented by language.
To what extent have the communication blunders affected these figures? It must be said that already in the Nids-Cram data in February and March, high rates of hesitancy were observed among certain groups — even before the temporary pause of the J&J rollout. However, this past weekend Gauteng premier David Makhura revealed that the J&J suspension did seem to be affecting vaccine registrations in his province. In the past three weeks, of the 1.3-million Gauteng residents older than 60, only 235,000 (18%) had registered to get a vaccine.
It shows there is no room for fuzzy messaging around the efficacy and safety of the jab, if we want a successful roll-out. But the bungle around the J&J vaccine points to what I believe is a bigger underlying problem: politicians are slavishly following the recommendations made by medical experts and trying to minimise deaths, rather than weighing up all sources of harm. Mkhize’s Ministerial Advisory Committee (MAC) is currently made up of 51 doctors and medical academics, but not a single social scientist. Perhaps if there were people from the social sciences (like communications experts, economists and sociologists), the J&J debacle wouldn’t have happened.
Of course, it is a welcome change that the president and his health minister are listening to medical experts — a notable change from the Mbeki or Zuma eras, when Aids denialism was rampant — but we mustn’t fall off the horse on the other side. Medical experts are trained to measure medical risks, and make judgment calls about the efficacy of trials and rates of transmission. But a vaccinologist will be the first to admit he or she knows little of the non-medical risks like increasing unemployment, rising hunger, and growing learning losses. Measuring the social and economic costs of a nationwide lockdown isn’t part of a vaccinologist’s expertise. Instead, it is the politicians’ job to make the call as to what the right course of action is, when it comes to lockdowns, or opening schools.
Take schooling. Medical experts say the social distancing guideline to prevent the spread of Covid should be 1m-2m. Education officials reply that classrooms were not designed to have such large spaces between children — so if we need that distancing, we need “rotational timetables”, where only 50% of children can attend school on any one day. Last year, SA’s National Coronavirus Command Council accepted the experts’ distancing advice for schools without question, leading to rotational timetables in almost all no-fee schools, which make up more than 70% of the country’s schools. But how does one measure the costs of 5-million children not attending school on any one day for an entire year, or two?
Do the hypothesised benefits of limiting the spread of Covid justify these long-term costs to children? That’s not a decision for the medical experts, but for politicians — who are elected to use their judgment about what is in their population’s best interests, by weighing up the costs and benefits. Let’s consider these nonmedical costs.
Learning losses and school feeding
The rotational timetables that have been implemented in no-fee schools have created two major problems. The first is a loss of school days and learning; and the second is the loss of school meals, since poorer children generally don’t get meals on days they don’t go to school. The phased re-opening of public schools and implementation of rotation timetables means that in 2020, primary school learners lost 60% of a possible 198 school days.
For the first time since the pandemic started, we now also have data on learning outcomes for children affected by the pandemic. This makes it possible to estimate the true educational costs of lost schooling. In a paper published this week, Debra Shepherd and her co-authors examine these learning losses. This research was possible because the department of basic education, together with independent researchers, collected new data from two studies of 130 no-fee primary schools in Mpumalanga, and 57 no-fee primary schools in the Eastern Cape.
By comparing learning gains in 2020 against 2019, researchers estimated the impact of Covid and rotational timetables in no-fee schools in grade 2 and grade 4. The results confirm the worst fears: primary school children in these no-fee schools learnt 50%-75% less in 2020 than normal. Put differently, grade 4 learners in 2020 learnt a quarter of what their peers learnt in 2019.
This is all the more disturbing since education is a cumulative process, where subsequent learning depends on prior learning. Using that same data, we can compare the learning trajectories of children who were in grade 1 in 2019 and see how they fare in grade 2 in 2020. The graph shows how the learning trajectory of those children affected by school closures and rotational timetables flattened in 2020. The impact is likely to be felt for years to come, with some suggesting we will be able to get back to pre-pandemic learning outcomes only by 2030.
And schools are about more than learning. In 2019 it was estimated that 9-million learners benefited from free school meals. The Nids-Cram survey asked respondents with children at school if their child had received a school meal in the previous seven days. For the dates that schools were open in February and March this year, less than half (43%) said their child had had a meal in the previous seven days. This suggests the feeding programme still hasn’t recovered — it is well below the pre-pandemic level of 65% in 2018 — and the main reason is the rotational timetable. Given the extraordinarily high costs that children are paying, educationally and nutritionally, because of rotational timetables, it is unsurprising that most parents and caregivers support the full re-opening of schools. In November 2020, Nids-Cram respondents with children in their households were asked: “Do you think children should be able to attend school every day?” In all, 58% answered yes. Given all the evidence, it’s unclear why SA still practises rotational timetables.
Risks to learners and teachers
At the start of the pandemic, when there was still so much uncertainty, closing schools was a rational and justified response. We didn’t know if children caught and spread the virus like adults, or if they were at severe risk from Covid.We know now. The risks to children of getting ill or dying from Covid are exceedingly low. To date, 194 children aged between five and 19 have died of Covid in SA — 0.4% of the total 51,527 deaths. For perspective, Stats SA estimates that of those aged between five and 19, about 12,870 die of “regular” causes in a given year. The issue, of course, is that it’s not only children who are at risk if schools increase transmission — there are also teachers and parents to consider.
Again, we have more evidence now than we had last year. In January, the National Institute for Communicable Diseases (NICD) released a report revealing “no consistent changes in incidence trends, associated with the timing of opening or closing of schools”.
But that’s for the general population — what about teachers specifically? In a report released this week, professor Martin Gustafsson analysed the department of basic education’s national teacher payroll database (Persal) for 2020, to calculate the number of excess teacher deaths from Covid compared to 2019. This is an incredibly accurate source of information on teacher mortality. When teachers die, they are removed from the payroll database. The analysis showed that these “excess deaths” map almost perfectly onto the first and second “waves” of the pandemic (see graph above), indicating they are almost certainly related to Covid. (The slight difference between the red and black lines is due to the delay in reporting national deaths since payroll data is less delayed.) Critically, however, this study reveals that there is no discernible relationship between teacher deaths and when schools are open.
Of the 401,327 teachers on the payroll, 1,678 are estimated to have died from Covid between the end of March 2020 and the end of February 2021. While tragic, it reveals that most “excess teacher deaths” occurred when schools were closed. We don’t see substantial excess deaths among teachers between September and November 2020 — when all grades were attending school. The SA Medical Research Council estimates that SA’s total excess deaths up to January 23 was 125,744. So, excess teacher deaths make up 1.3% of total excess deaths, with the other 98.7% coming from other fields of work and the unemployed. The analysis also shows that teachers at secondary schools are not at higher risk of Covid transmission than teachers at primary schools. This supports the claim that schools are not the main cause of Covid infection among teachers.
Vaccinate like our lives depend on it
According to Mkhize, SA will enter phase 2 of the vaccination strategy on May 17. The plan is to have 40-million people aged 18 years and older vaccinated by February 2022 — all using Johnson & Johnson and Pfizer-BioNTech vaccines.
To reach that goal, SA needs to administer 188,000 doses a day, every day, for the next 287 days. Yet in the past three months we administered only 353,000 shots. Granted, these were part of the Sisonke trial of health-care workers. But if you do the maths regarding the envisioned rollout rate, this would make SA the world leader in vaccine administration — faster than Chile, the UK or Israel, the three fastest countries to date.
The world leader, Chile, managed “only” 117,000 a day for 132 days. So SA — which now ranks 140th in the world in administering jabs — will have to vaccinate faster than the fastest countries in the world. Most experts I speak to know this is not possible, which is why the thinking has shifted from herd immunity to epidemic control. Covid, like the flu, will be with us for the foreseeable future, with top-up shots to protect against new variants.
The strategy will centre on vaccinating (and re-vaccinating) the elderly and those at high risk. This is still a mammoth task akin to the roll-out of antiretrovirals at the peak of the HIV/Aids epidemic. The government needs to vaccinate like our lives depend on it. But we also need to accept that we are entering a new normal where schools are fully open, and children and teachers wear masks. If we continue to deny children 50% of their education, we are moving closer to the reality of writing off a generation of children, the lost “Covid kids”.
The human and financial costs associated with lockdowns, and an uncontrolled pandemic, are thousands of times higher than any conceivable costs of getting and distributing vaccines. This is why every other country has thrown everything they have at this.
Less than a decade ago, SA went from the country with the highest uncontrolled spread of HIV in the world, to the country with the largest antiretroviral programme. It was thanks to a system-wide urgency, and partnerships between the government, the private sector and donors. And it was only possible because it was treated as a war effort, prioritised above all else.
This is what SA needs to do again.
This article was first published in the Financial Mail on the 12th of May 2021.
Today we launched Wave 4 of our National Income Dynamics Study Coronavirus Rapid Mobile Survey (NIDS-CRAM). Only one more to go! (Phew!) I presented what I think are the 13 main findings from the 11 Working Papers at the launch, I’ve summarised them below. These are a little better summarised in our Synthesis Report which I would encourage everyone to read (it’s only nine pages). To download the full papers on which the Synthesis Report is based (or to get the questionnaires, do-files or panel user manual) go to the NIDS-CRAM Website, and if you want to download the data head to DataFirst.
Key findings from Wave 4:
(1) VACCINES: 71% of South Africans say that they would get vaccinated if a COVID-19 vaccine were available
(2) VACCINES: Vaccine hesitancy is highest among youth, those who trust social media, Afrikaans-HL respondents, and those in WC+NC.
(3) SCHOOL MEALS: Less than half (43%)of respondents with kids reported that their child had received a school meal in Feb/March 2021 while schools were open (pre-pandemic it was 65%)
(4) LEARNING LOSSES: Children in no-fee schools have learnt 50-75% less in 2020 compared to what they normally learn
(5) LEARNING TRAJECTORIES: Due to school closures and rotational timetables (only 50% of kids can attend on any one day) we’re seeing the flattening of learning trajectories
(6) TEACHER MORTALITY: Tragically, teacher mortality went up in 2020, but analysis of teacher payroll data shows that excess deaths from COVID follow SA trends NOT school opening/closing.
(7) TEACHER MORTALITY: Teachers at secondary schools are not at higher risk of COVID-19 transmission compared to those at primary schools.
(8) HUNGER: Weekly child hunger has declined from 16% in Nov/Dec 2020 to 14% in Feb/March 2021, although it is still nearly double pre-pandemic levels (8%)
(9) HUNGER: NIDS-CRAM has been administered four times in the last year. Two thirds of respondents (67%) said that in at least one of these waves their household had run out of money to buy food in the last month.
(10 HUNGER: One third of respondents (32%) in households with children in them said that in at least one of these four waves, a child had gone hungry in the past week in their household
(11) EMPLOYMENT: Between Oct’20 and Jan’21 the % of employed adults in the NIDS-CRAM cross-sectional sample declined from 55% to 53%
(12) EMPLOYMENT: Between October 2020 & January 2021 1/5th of those who were employed lost their jobs and 1/5th of those who weren’t employed found work.
(13) ECD: Temporary ECD programme closure remains the primary reason (26%) for non-attendance at ECD programmes, and attendance in 2021 (19%) is still well below pre-pandemic levels (38%)
After founding Funda Wande more than four years ago we’re now looking for a new CEO! If you know someone who is dynamic, passionate about early grade reading and mathematics and the right person to steer the funda Wande ship into the future please send them the Funda Wande CEO Recruitment Pack (deadline for applications is 31 May 2021). You would be leading one of the most capable, dynamic and passionate bunch of people in South African education. For more about us check out our 2020 Annual Report.
Four year’s ago I founded Funda Wande at the request of the Allan Gray Orbis Foundation Endowment with the aim of boldly experimenting with the best ways of ensuring that all children learn to read for meaning and calculate with confidence by age 10 by 2030. We have grown from strength to strength and went from having 3 employees in 2017 to over 50 employees in 2021, with offices spread out across four cities (Cape Town, Polokwane, Joburg and Gqeberha (formerly P.E), and trialing promising interventions in three provinces.
I know my time at the helm of this ship is coming to an end, and that a new captain will be needed for the next stage of the journey. Partly this is because of the history of our country and the need for the next generation of young leaders to have the opportunities that people like me have had; to step up to the plate and make their mark on our country. But also because I feel called to move on and into a different space from next year. I know I want to spend more time thinking and writing about some of the seemingly intractable problems in South African education and that needs sustained and undivided attention.
I will still be within the broader Allan Gray Philanthropy ecosystem going forward, but no longer at Funda Wande.
If anyone springs to mind, please forward them this job notice and encourage them to apply (apply here). The deadline for applications is the 31st of May 2021.
Onward and upward…
- Nic Spaull & Adaiah Lilenstein
Let us start our foray into this year’s education budget by considering blessings and curses. Given the times that we are in there is one English ‘blessing’ that is especially apt: “May you live in interesting times.” It’s also claimed that this is actually a traditional Chinese curse, and that life is better during “uninteresting times” of peace and prosperity than in “interesting” ones which are usually times of trouble. However you spin it, we are in very interesting times.
In the 2021 budget, public sector wages make up R650-billion or a third of the total budget. Because there are more teachers (407,000) than any other kind of public servant, teacher salaries are the largest single line item in the entire budget and make up a third (R208-billion) of all public sector wages. That’s 4,1% of GDP. For the second year teacher salaries in South Africa will decline in real terms. The 2021 budget showed that salaries in basic education increased by only 1.4% (from R205-billion to R208-billion), and given that inflation was about 3,3% in 2020, that’s a 1.9% decline in real terms. That sounds like a bad thing, but it’s worth putting this in historical perspective – both politically and economically.
Exactly one year ago, the Confederation of South African Trade Unions (COSATU) threatened to “collapse the public service” and “part ways” with government if Treasury did not honor it’s 7% wage increase. Treasury explained that it could not fulfill other constitutional obligations if it honored that wage agreement, and argued for a public sector wage freeze (the one it then implemented). The courts agreed with Treasury, but the judgement is under appeal in the Constitutional Court (see p.32). As much as the 2021 Budget fuss has been about other issues like provisions for vaccines and higher sin taxes, the real story is the ongoing implementation of the public sector wage freeze. Public sector wages are the left, right, and center of government spending, government debt, and government’s ruling alliance with COSATU.
In a research paper we released last year we found that between 2008 and 2019 teacher wages increased by an average of 9,2% per year while average inflation was only 6,3% per year. The only way provinces have coped with higher salaries is to implement hiring freezes leaving schools without principals and heads of departments.
Perhaps this is all a bit abstract for some readers, so let’s talk about monthly salaries. What do teachers actually get paid in South Africa? The common perception is that teacher’s salaries are low. What does the data say? A paper published last year using government payroll data shows that the average teacher in South Africa was paid about R42,700 a month (including benefits), and the total package for teachers 50 years and older was R47,874 per month or about R575,000 a year (see figure). This is not to say that teachers are overpaid, but rather to highlight that teacher salaries have increased dramatically over the last 10 years, and thus the halt in salary increases along with other wages in the public sector is apt.
Figure 1: Monthly teacher pay in South Africa according to 2019 government payroll data
(Source: Gustafsson & Maponya, 2020)
In our view, given the circumstances in South Africa – not only the need to fund vaccines and their rollout, but also to address chronic unemployment and hunger – it is fair and reasonable to implement a wage freeze. The unemployment rate for those aged 15-24 years is now 63% according to the latest StatsSA survey. While we do need more money to go into education, it is not in the form of further salary increases for teachers. Class sizes are set to expand, and pressure on non-personnel spending (like books) is also rising. We need to hire and train unemployed youth-with-matric as Teacher Assistants (R3,600 per month) and make sure all kids have books. These TA’s can be allocated to primary school teachers throughout the country with a special focus on early grade reading and mathematics, thus helping to manage large class sizes and employing 400,000 youth. It’s time to pivot from our old strategy of salary increases for the well-paid and prioritise those who are actually marginalised in society.
This article first appeared in the Financial Mail on the 25th of February 2021
How four months wiped out 10 years of jobs growth – and matched a decade of growth in SA’s social security net
Vladimir Lenin is famously quoted as saying that “There are decades where nothing happens and weeks where decades happen.”
Looking back on the last few months it is clear now that a decade’s worth of change has happened in the space of just four months. In an ironically symmetrical fashion we seem to have lost a decade’s worth of jobs in less than half a year, and expanded the grant system by the equivalent of a decade over the same period. Between 2009 and 2019 the country managed to create 2,4-million jobs, while early indications are that in the last four months we may have lost as many as 2,8-million jobs. Over that same decade the number of grant recipients grew from 14-million to 18-million as more people were brought into the grant system. If the 4-million recipients of the new COVID-19 Social Relief of Distress Grant (SRD) of R350 per month keep their grants beyond October then we will have achieved a decade’s worth of expansion (an additional 4-million grant recipients) in the space of 4-months.
As we think about the future, the key uncertainties are beginning to coalesce around three important questions, the answers to which will determine what South Africa looks like in the decade to come: (1) Who gets jobs? (2) Who gets grants? (3) What happens to growth?
If there is one thing that all South Africans agree on, it is that more jobs are a good thing. Across the political spectrum everyone realises that jobs are preferable to grants and typically come as a package deal with economic growth, which again most people think is a good thing. On the topic of economic growth we already know the situation is dire; the Statistician General announced that the economy shrunk by 16% in the second quarter of 2020 compared to 2019 and if that trend continues for the next three quarters then the economy will have essentially shrunk by 51% (the annualised figure much touted in the media). Put differently, if this short-term drop in production and consumption is sustained for a full year, our GDP will be half of what it was pre-COVID. Such a decline is unprecedented outside of civil-wars and coups. But what about jobs?
Three months ago we released the results of the first wave of our National Income Dynamics Study Coronavirus Rapid Mobile Survey (Nids-Cram). This is a nationally-representative telephonic survey of over 7000 South Africans asking them about their employment, income, hunger, grant receipt, and a host of demographic background questions. Using over 50 call-center agents and conducting 20-minute interviews with each participant we were able to collect vital information on how they were faring. Because they were sampled from an existing survey that was broadly nationally representative we can extrapolate our findings to the country at large.
Wave 1 showed that about 2,8-million South Africans lost their jobs between February and April 2020 and a further 1,4-million were furloughed (that is, they did not work and earned no income, but thought they had a job to return to). We have now conducted our second wave of the survey by re-interviewing the same individuals two months later and asking them if any of these key outcomes have changed between April and June. We received 5,700 responses (81% response rate) which we can use to calculate the change in jobs from Level 5 lockdown (April) to Level 3 lockdown (June). We are also in the fortunate position of having the imminent release of StatsSA’s Quarterly Labour Force Survey (QLFS Q2) which uses a much larger sample and will also estimate changes in the labour market from Q1 to Q2.
It is difficult to describe the situation emerging from the data as anything other than a jobs bloodbath. Of those 2,8-million job losses between February and April, essentially none have returned by the end of June. The number of those not employed in April is the same as the number not employed in June. While that may change under Level 1 lockdown (and we will be able to track this in Wave 3) – the fact that we see practically no change whatsoever is extremely worrying. Some of the good news emerging from Wave 2 was that among the 1,4-million additional furloughed workers, 750,000 (54%) were re-employed and earning an income in June. Less positively 550,000 (39%) became unemployed and 100,000 (7%) are still furloughed, with the number of furloughed workers now the same as it was pre-COVID. The fact that only half of those who thought they had a job to return to actually did does not bode well for the ‘bounceback’ hypothesis where jobs that were lost return quickly.
Figure 1: Employment status in February, April and June 2020 (millions) – NIDS-CRAM Wave 1 and 2 (Source: Jain et al. 2020)
To put some of these numbers in perspective, earlier this year the Statistician General Risenga Maluleke reported that over the last decade the South African economy had created 2,4-million additional jobs (from 2009 to 2019). If the job losses we see in NIDS-CRAM are accurate and long-lasting then we will have lost the equivalent of 10 years’ worth of job growth in the space of four months.
This paints the national picture overall and shows a 16% decline in net employment between February and June 2020. But as with everything in South Africa, the average is uniquely misleading. Ronak Jain and her co-authors show that employment losses for manual labourers were twice as high (-30%) as the national average, while those for the tertiary educated were half as much (-8%) as the national average. Between February and June 2020 the poor were ten times more likely to lose their jobs (-31%) compared to the rich (-3%).
Figure 2 Percentage net loss in employment between February and June 2020 by sub group (Source: Jain et al., 2020, using NIDS-CRAM Wave 1 and 2 data)
So much of these results were predictable given the way that the lockdown happened and the way that the South African labour-market works. It is a misnomer to think that the distinction is only between the ‘employed’ and the ‘not employed’, as critical as that distinction might be. There is an important sub-category of the employed, who we might call the ‘precariat’ – those without formal contracts, without qualifications and without in-demand skills. To that list we should now also add ‘ability to work from home’ since that also seems to have been critical to retaining employment during lockdown. Vimal Ranchhod and Reza Daniels show that only 24% of South Africans said they were able to work from home ‘Sometimes’ or ‘Mostly’ in June, with job losses tracking ability to work from home quite closely. The highest rates of reported ability to work from home were seen among White respondents (79%), and those with post-matric qualifications (40%) with the lowest rates for Black Africans (16%), those with matric or less (15%) and those living in Farms and Traditional areas (11-19%). If one looks at June levels of employment for these groups it is highest for White respondents (79%) and those with post-matric qualifications (65%) and lowest for Black Africans (45%) and those living in Traditional areas (38%).
It would be incorrect to jump on ‘ability to work from home’ as if that were the deciding factor – it isn’t. Each of these iterations – race, qualifications, occupation, employment protection etc. – is simply singing the same song in a different key, a common story but from a different angle. That story is one of two South Africa’s – a center and a periphery. That has always been the case in South Africa, the scary thing is that this already small ‘center’ is now contracting and the already large periphery is now expanding.
Let us now turn to the three questions that will dictate what South Africa looks like in the decade to come: (1) Who gets jobs? (2) Who gets grants? (3) What happens to growth?
Who gets jobs?
The first of these is about the labor market: In six months time will we see a ‘bounce-back’ to some previous level of employment, even if quite a bit lower? Or will there be a further intensification of the two-South Africa’s we have always had – a shrinking center and a widening periphery. If so that would amount to a fundamental restructuring of who has jobs and who doesn’t. Given the sheer scale of job-losses to date, and the fact that there is no evidence of any bounceback between April and June, it looks increasingly likely that we’re stuck with the second option. Businesses are choosing not to rehire those they retrenched. In this time of uncertainty it would seem business owners are both pessimistic about the country’s future and also unwilling or unable to absorb the costs of re-employing those they retrenched. A cynical view is that businesses are using this crisis as an opportunity to further pivot away from labour which they see as costly, risky and possibly unnecessary. If that is the case then COVID-19 and the lockdown will have not only revealed our inequalities like never before, but actually made them far worse, accelerating a disjuncture that has been long in the making.
Who gets grants?
The second question of who gets grants is about social welfare and the introduction of a new type of grant bringing previously uncovered individuals into the system, the COVID-19 Social Relief of Distress (SRD) grant of R350 per month. This is available for those with no other income and no other grant. Although this was introduced as a temporary relief mechanism, there are currently serious discussions about extending this grant (and the top-ups to the other grants) beyond the end of October when they were originally meant to expire. One of the success stories of the COVID-19 period in our country is that the government has successfully created a new grant distribution system incorporating vulnerable and uncovered South Africans and doing so in a way that is both pro-poor and relatively effective. Between April and June we see rates of weekly hunger declining by 27% for both adults and children, almost certainly driven in part by the roll out of the new grants and the top-ups of the old ones.
Given that millions of South Africans are currently left destitute without work and relying solely on these grants for their livelihoods, it is difficult to imagine a world where they are not extended at least until the end of the year if not later. Yet that introduces new complexities since what was introduced as temporary can very quickly become permanent. Put differently, the longer that door stays open, the harder it will be to shut. Treasury officials are acutely aware of this.
In a weirdly similar fashion to the labor market, what we are seeing with grants is simply the rapid acceleration of the pre-COVID trend, which was the steady expansion of social welfare to cover more people over time. In their paper on social grants Tim Kohler and Haroon Bhorat show that the number of grant recipients in the country increased by about 4-million people between 2009 and 2019 (from 14-million to 18-million recipients). What took 10 years has now been re-accomplished in 4 months: the weighted results from Nids-Cram Wave 2 shows that by July/August 4,3-million additional people had received the COVID-19 SRD grant. (SASSA administrative data report an almost identical number of recipients; 4,4-million).
The one key difference between the pre- and post-COVID trend is the inclusion of young unemployed men. Previously government grants were only allocated to those who could not work or somehow needed the State to act as a ‘provider’; the elderly (Old Age Pension, R1860/mo), women with children (Child Support Grant, R440/mo) and those with disabilities (Disability Grant, R1860/mo) together with a few others. Yet COVID-19 has pushed us into the realm long predicted as the end point of ‘grant-logic.’ That logic says that whether or not government’s can create jobs, they have a moral responsibility to prevent destitution at all costs. The right to some minimum amount of food or income is bound up in an understanding that all people have worth and their basic dignity must be protected, irrespective of the cost or the consequences. Grant-logic also recognises that deferring this responsibility to some future point when jobs can be found is both unacceptable and disingenuous. Johnny Steinberg made this point most eloquently in 2013 calling a spade a spade:
“If we are honest with ourselves, we have long ago given up trying to employ everyone, or even to halve unemployment…South Africa started bleeding jobs in the mid-1970’s, along with much of the rest of the world. We have been bleeding jobs ever since…It hasn’t mattered who has been in power or whether our political system has been a racial dictatorship or a democracy, or whether our labor law has been rigid or flexible – we cannot employ everybody. We can’t even come close. To think that we can is to indulge in millenarian thinking, as if Jesus will come and remake the world, as if there is a thing called magic. Deep down, we know this. For while we talk about creating jobs, we have been doing something else – we have been handing out grants. Some say that it is a stopgap measure, just to tide us over until jobs are found. Others say that it is creating a culture of idleness from which there will be no return. But if we are honest, it is what we do now and what we will keep doing forever. It is a substitute for work and it holds the country together; it has saved millions from starvation and misery. If we accept that welfare is permanent, we must go the whole hog; we must start giving grants to the one category of poor people entirely excluded from them – young men.”
That is exactly where we are today and now that the genie is out the bottle it will probably be political suicide to try and put it back inside. Every month that grants are paid to those who previously did not receive them (or, as we will see, any income whatsoever) further solidifies new relationships and expectations between those citizens and the State. Every month that someone does not go hungry because they receive R350 from the government, is another month they move towards being single-issue voters: ‘Kkeep the grants’. By its very eligibility criteria, the Covid-19 grant excludes anyone who receives any other kind of government grant. Thus, in almost all cases they are ‘first time grant recipients.’ It turns out that about 40% are probably also ‘first time income recipients’ in the sense that they are not only not employed, but have never been employed before. That is only possible to ascertain using a panel survey like Nids-Cram that has followed the same people over time.
What our data shows is that of the 4,3-million Covid-19 grant recipients, about half (2,2-million) were not employed at any time in 2020, neither in June, April or even in February before the crisis. In fact about 40% of recipients (1,7-million) were not only not employed in 2020, but also not employed in 2017 when last they were surveyed in Nids-2017. For the first time, potentially in their lives, they have access to a very modest income source that is theirs. It is exceedingly unlikely they will give this up without a fight. The conceptual shift gaining ground every day, is not only that a new grant is here, but that a new grant should be here. The semantic shift from ‘Covid-relief’ to ‘Unemployment-relief’ might not sound like much, but it will become politically consequential as we approach elections.
The ANC is fast approaching a double-bind: remove the grants and face the anger of your voter base, or keep the grants and find the money from new debt, new taxes or tackling corruption. Any of those options will anger an important ANC constituency: the ratings agencies, the tax-base or corrupt politicians.
(3) What happens to growth?
Economic growth is important for both of the two preceding questions – it heavily influences how many new jobs get created, as well as how much tax revenue is raised and can then be redistributed as grants. What we know so far is that the lockdown and the pandemic have been disastrous for economic growth. The International Monetary Fund (IMF), the South African Reserve Bank (SARB) and the National Treasury all estimate that the economy will shrink by about 7,3% in 2020. This is the equivalent of having the 2009 recession four times in one year. (The SA economy shrunk by 1.8% in 2009 following the Financial Crisis, according to Treasury). The President seems to be aware of this and all indications are that we will not lockdown again in the coming months, irrespective of a second wave of infections and irrespective of the death-toll. The collateral damage is simply too large. Yes, people might not be dying of COVID-19, but they are losing practically everything else that they value.
We know that children have lost 40% of the academic year, and some estimates are that we will only get back to our pre-pandemic learning trend in 2031 depending on how much catch-up there is in the years to come. Mental health across the country has deteriorated significantly with twice as many people screening positive for depressive symptoms in June 2020 (24%) compared to 2017 (12%). Those that experienced hunger ‘Almost every day or every day’ were twice as likely (44%) to screen positive.
One of the unhelpful developments during the pandemic has been the false dichotomy between ‘saving lives’ and everything else. This often manifests as statements like “saving lives is more important than saving jobs’ or ‘saving lives is more important than saving the academic year.’ Discovery Health estimates that the lockdown might have saved 16,000 lives in 2020, yet at what cost? When are we allowed to have the conversation about whether the costs that were incurred were justified to save this number of lives? To even bring it up risks accusations of being callous and insensitive.
Of course hindsight is 20:20 and no one knew whether the death toll would be ten times higher than it was. We didn’t know if HIV and TB would increase COVID-19 death rates or introduce some other complications. There were so many unknowns and policymakers were placed in the most difficult situations of their lives. Yet, now we do know and we have for some time. Is this not just water under the bridge? What good is it now to assess whether the lockdown was fit for purpose, accomplished its goal or was the right length? The answer is twofold: (1) Unless there is an adequate recognition of the devastation caused by the lockdown, it’s possible that it will again be seen as a viable policy tool to limit infections. It shouldn’t be. It is the ‘nuclear’ option and should be avoided at all costs. And (2) It’s a mistake to think that the lockdown is over – it is still with us in innumerable ways – both in bureaucratic operating procedures (like occupancy rates in stores and queues), and psychologically as many people are still terrified of this virus. What most people don’t realise is that about 450,000 South Africans die every year of something (illness, old age, car accidents etc). About 14,000 people in South Africa die every year from road accidents. At the time of writing 16,000 people have tragically died of COVID-19 in South Africa with projections indicating it will be less than 20,000 for the whole year. A big part of that is that, for whatever reason, South Africa’s COVID-19 mortality rate is much lower than in Europe or America, even if excess deaths are allocated to COVID-19. This is not to trivialize the coronavirus or the deaths that it has caused. It is only meant to place these deaths in perspective with the aim of having an evidence-based plan on the best policy responses to the social and economic crises that are now on our doorstep.
So where to from here? Firstly, the lockdown was meant to buy time to prepare the healthcare system, not to prevent infections or deaths. Given the extraordinary collateral damage it should be ended immediately – in all its forms – and not reinstated in the future. Secondly, the grant top-ups and the new COVID-19 grant should be extended for a further six months to prevent hunger and destitution and maintain political stability. In all likelihood this will make them a permanent feature of South African society, and that will not be a bad thing. With millions of job losses and a fragile economy with no indication of a bounceback, more than ever South Africa needs the glue that holds it together. That glue is the grant system and while it may seem costly it seems less so when one considers the alternatives. It is also the right thing to do.
Nic Spaull is the Principal Investigator of NIDS-CRAM and all NIDS-CRAM papers are all available for download at: https://cramsurvey.org/reports/ and the Wave 1 and 2 data are available from DataFirst.
This article originally appeared in the Financial Mail on 30 September 2020.
Tomorrow (30 September, 12:00-14:00) we will be launching the results of the National Income Dynamics Study Coronavirus Rapid Mobile Survey (NIDS-CRAM) Wave 2. Wave 1 showed that 2,8-million South Africans lost their jobs between February and April – have they returned? It also showed that 1-in-5 experienced weekly hunger – has hunger declined as a result of the roll-out of the new COVID-19 grant and the other grant top-ups? REGISTER for the webinar where we will be discussing these issues and releasing the 15 papers that have been written on the Wave 2 results.
Earlier this week Judge Dennis Davis and I spoke about COVID-19, school closures, the National School Nutrition Programme, child hunger, NIDS-CRAM, job losses, gender discrimination and the Basic Income Grant. The full interview is available here.
There are three new pieces of writing worth highlighting on COVID-19 and schools:
(1) Today the DBE launched a report “Patterns in the COVID-19 cases among learners and staff in Gauteng schools Analysis of school-level data to 8 July” (PDF) written by Prof Martin Gustafsson in collaboration with Albert Chanee (DDG in GDE). Executive Summary below. It shows teachers have a 0.8% risk which is the same as the 0.8% risk for the general public in Gauteng.
(2) Martin’s Daily Maverick op-ed “Figuring out what the WHO is really saying about schools and the pandemic.” ‘A careful reading of the World Health Organisation’s policy documents shows that it does not stipulate when schools should reopen’.
(3) The new strongly worded position statement by the SA Paediatric Association’s on public school closures.
“The paediatric community, as represented by the Paediatrician Management Group (PMG) and the South African Paediatric Association (SAPA), is disappointed with the recent cabinet decision to close all public schools again. Following on the original SAPA position statement, supported by PMG, we believe this recent decision is not based on best available scientific evidence and it is not in the best interest of children in South Africa.”
Next week I am starting my Applied Economics of Education course for graduate students in the Economics Department at Stellenbosch University. Given all the drama with the opening/closing of schools I am really looking forward to engaging with students about some of the bigger issues in South African education. I will be teaching the first part of the course (lecture schedule above) and, as always, I am open to accepting auditors from other departments within the university, students from other universities and people from NGOs / civil society. Although there is no cost to auditing you will be required to submit the weekly reading reflections if you want to stay in the course. If you would like to audit the course all the information on how to apply is included in the course outline.
Nationwide lockdowns and school closures have incredibly high costs for families and children. Limiting Covid-19 infections must be a top priority, but it cannot come ‘at any cost’.
These are six main reasons why schools must remain open while implementing rigorous safety protocols and physical distancing:
- Schools provide essential meals to hungry children
When schools were open and operational, they provided a nutritious meal to 9 million children every day. Child hunger has more than doubled since the start of lockdown with 1-in-7 people reporting that a child went hungry in their household in the past week. The courts have ordered the Minister of Basic Education, Angie Motshekga to reinstate school feeding for all 9 million children immediately. Realistically, schools cannot provide meals to 9 million children if they are closed. While children do not get severely ill from Covid-19, they are at risk of suffering from stunting and malnutrition.
2. You cannot reopen the economy without reopening schools
There are 4.5 million essential workers in South Africa and 650,000 healthcare workers who are on the frontline of dealing with the pandemic. If schools are closed, what happens to their children while they are at work? We compromise the healthcare system if schools are closed. Furthermore, we have already lost 3 million jobs during 2020, plunging more than 1 million people into food poverty. Parents cannot go back to work if schools are closed.
3. There is no evidence that schools lead to above-average Covid-19 infections among teachers or pupils
It is true that some teachers have been infected with Covid-19, but it is also true that many teachers were infected even before schools reopened. Teachers are more likely to get infected in their community than at school. An analysis of 709 Gauteng schools shows that Covid-19 infection rates are no higher among teachers than similar people in the Gauteng population. Put differently, just because teachers get infected does not mean they got it at school. Further evidence comes from hospital admission data from the Western Cape during its Covid-19 surge and provides reassuring evidence. Opening schools had little impact on children getting infected with Covid-19 or getting admitted to hospitals.
4. Medical experts and advisors are saying that children returning to school is what is in the best interests of the child
The South African Paediatric Association, the Ministerial Advisory Committee and the South African Human Rights Commission have all stated clearly that they believe that children returning to school is in the best interests of children. The costs of being locked up at home (potentially alone), are far greater than the small risks they face at school. Children do not get severely ill from Covid-19. Those under the age of 20 make up less than 1% of total Covid-19 deaths in SA.
5. The World Health Organisation’s recommendation must be contextualised to South Africa
When the WHO is making recommendations, it is doing so for 195 countries. But there is no one size fits all approach. What makes sense for Germany might not make sense for Malawi. What makes sense in South Korea does not make sense in South Africa. They do not have 1 million stunted children, widespread HIV and TB, school feeding schemes etc. South Africa’s own epidemiologists are advising that schools must stay open if we are to fight the pandemic.
6. School closures will increase inequality
Only 20% of households have a computer and 10% have an internet connection. Closing schools will increase inequality between rich and poor for the next 10 years. Elderly teachers with serious comorbidities should be replaced in schools. Schools that do not have adequate masks and sanitisers should remain closed until they do, but closing all schools will hurt the poor much more than temporarily closing the 10-20% of schools that are not yet ready to open.
Teacher unions are undermining our pandemic response. All other government officials as well as those in the private sector have gone back to work and implemented physical distancing, wearing masks etc. But somehow teachers are different? The evidence is showing that teachers are not at higher risk than others and yet they are being paid whether they work or not. By refusing to work, they are risking the lives of children and undermining other parts of society that rely on schools at this critical time. By forcing parents to choose between going to work and taking care of their children at home, they are weakening our ability to fight the pandemic.
The question is not: “When is it safe to reopen schools?” The question is: “Does the cost of closing schools outweigh the benefits?” We should not implement a nationwide lockdown again and we should not implement nationwide school closures either. The costs to children and their families are simply too great, and importantly, fighting the pandemic needs all hands on deck and schools need to be open for that to happen. Limiting Covid-19 infections must be a top priority, but it cannot come “at any cost”.
This article first appeared in the Daily Maverick on the 22nd of July.
“Women are bearing more costs & receiving fewer benefits” – my DM op ed (with Daniela Casale & Dori Posel)
Covid-19: Women are bearing more costs and receiving fewer benefits
Even though women have suffered two thirds of the job losses since February, men have received two thirds of Covid-19 grants (65%).
On 15 July we released the results of the largest non-medical Covid-19 research project in South Africa: the National Income Dynamics Study (NIDS) Coronavirus Rapid Mobile Survey (CRAM). It shows that three million jobs were lost during the first stage of the lockdown, and of those, two million (66%) were accounted for by women, and in particular poor women. This is a very concerning finding since there are large knock-on effects of this income loss for women and for the children who live in their households, especially when the woman is the sole breadwinner.
Perhaps unsurprisingly, given that initial job losses were so large and concentrated among women, we see unprecedented levels of household vulnerability, with half of all respondents (47%) saying that their household ran out of money to buy food in April and one in five (22%) reporting that someone in their household went hungry in the last seven days. Child hunger has at least doubled since 2018 with one in seven (15%) reporting that a child went hungry in the last week because there was no money for food.
What makes these results all the more devastating is that women are not receiving the new R350 Covid-19 grant at the same rate as men.
In a presentation to NEDLAC on 30 June, SASSA reports that of the 3.25 million Covid-19 grants paid out up until the end of June, only 1.15 million were paid out to women. Put differently, two thirds of Covid-19 grants (65%) were paid to men even though women suffered two thirds of the job losses.
One potential reason is that people who receive other grants are ineligible for the new Covid-19 grant. For example, many women receive the Child Support Grant which has now been topped up by R500 per caregiver (note not per child). Yet, this grant is primarily for the benefit of the child rather than the caregiver. The implication is that women who have lost their jobs are being disadvantaged because they have children.
This policy response assumes that those who receive the CSG were not personally dependent on their employment or earnings to make ends meet. It is a mistake to think that those who receive grants are somehow “immune” from job losses since they already have a grant.
Gabrielle Wills’ analysis of the General Household Survey of 2018 shows that 63% of grant-receiving households report receiving some income from employment or business, and only 42% said that grants were their “main source of income”. In other words, even grant recipients depend heavily on earnings from employment. And this is not surprising, since the CSG is not sufficient to lift a child above the poverty line, let alone children and their caregiver.
Because the top-up paid for the CSG is constant, regardless of the number of children the caregiver is responsible for, the extra support is often spread very thin, and in a sense is regressive – the more children you have the less there is to go around.
Let’s take the example of a mother living with two children who has lost her job and has no other income support. Her household of three would have to live on R1,380 a month (i.e. the R440 CSG per child plus the R500 top-up). This amounts to R460 per person, which is below StatsSA’s “food poverty line” of R578 a month.
And, of course, this minimum subsistence amount does not take into account the cost of rent, fuel, electricity, clothing and other essentials. Add to this rising food prices during the lockdown, and the loss of the one meal a day through the school-feeding scheme that 9 million children relied on to meet their minimum caloric needs, and it is easy to see how quickly families can fall into destitution.
The Covid-19 grant was designed to protect those who have suffered job loss and the income they were relying on. These grants should be provided regardless of whether a CSG is being received on behalf of a child.
Why so many women are not receiving the Covid-19 grant is not clear at the moment, and Sassa should investigate this urgently. The exclusionary criterion which prevents concurrent grant-holding is likely to be a key factor. It may also dissuade women from applying in the first place. What is clear is that half as many women as men are receiving these grants and yet twice as many have lost their jobs.
This is deeply troubling and requires immediate attention.
Nic Spaull is a Senior Researcher at RESEP in the Economics Department at Stellenbosch University; Daniela Casale is an associate professor in the School of Economics & Finance at Wits University; Dorrit Posel is Helen Suzman chair and a distinguished professor in the School of Economics & Finance at Wits University. They are also part of the Nids-Cram consortium of researchers, visit http://www.cramsurvey.org
**This article first appeared in the Daily Maverick on the 17th of July**
(The article below first appeared in the Financial Mail on the 15th of July under the heading ‘Feeding a family‘ – a slightly longer version of that article is included below.)
As the NIDS-CRAM data began to come in during the month of May, it was immediately clear that hunger was widespread. As has been reported in other articles in this edition, 47% of NIDS-CRAM respondents reported that their household had run out of money to buy food, with 22% reporting that someone in the household had gone hungry in the last 7 days. In households with children, 15% of respondents reported that a child had gone hungry in the last 7 days. These are all especially worrying, and considerably higher than anything we have seen in other household surveys. However, given that NIDS-CRAM survey is sampled to look at the entire population, we could not reliably disaggregate these results and explore the impacts on especially vulnerable groups. Two groups of people are at particular risk of long-term negative outcomes if they experience hunger: (1) pregnant women, and (2) new mothers and their young babies.
In order to sample a large enough group of these women, we conducted a separate survey, the Maternal and Child Health (MATCH) survey. This is completely independent of NIDS-CRAM. With the permission and support of the national Department of Health, we were granted access to the MomConnect platform. This is an innovative mobile-phone service and more than half of the women attending public sector antenatal care services in South Africa are registered on the platform. It is the largest database of pregnant women and new mothers in the country. Together with Professor Ronelle Burger, we drew a sample of 15,000 new and prospective mothers from the MomConnect platform with the sampling done such that it is broadly representative of the 930,000 new and prospective mothers on the platform. This was a short SMS survey with two waves of about 15 questions (in English), with mothers receiving R10 airtime per wave to thank them for their participation. The survey covers access to antenatal care, vaccinations, ART, as well as maternal hunger and maternal mental health. We will focus on these last two in this article. It must be noted that because this is an SMS survey, the number and types of questions that can be asked are limited. Mothers’ English literacy levels are also likely to affect the results.
We asked mothers “In the last 7 nights did you ever go to bed hungry?” and if they answered yes, then how many nights they went to bed hungry. Of the 2,214 pregnant and new mothers that answered both questions, 350 (16%) reported that they had gone to bed hungry at least once in the last week (246 for 1-2 days and 102 for 3+ days). More worryingly, 11% reported going to bed hungry for 1-2 nights and 5% reported going to bed hungry for 3+ nights in the last seven.
The evidence is now indisputable that in the first 1000 days (conception to age 2) a child’s brain is hypersensitive to either benefit or harm. In utero, the foetal brain grows rapidly, and after birth the infant brain grows 1% heavier every day for the first three months of life and reaches 80% the size of the adult brain by the age of 3. Because of this profound and rapid development, the foetus and the infant are highly susceptible to potential harms, including frequent hunger. The consequences of maternal and child undernutrition are enormous and include shorter adult height, less schooling, mental illness, diabetes, obesity and reduced economic productivity, and—for women—lower offspring birthweight.
From existing research, we also know that maternal hunger is a risk factor for depression during pregnancy, and that maternal antenatal depression during pregnancy is a strong predictor of a depressive episode in the postnatal period and beyond which is itself associated with a range of later negative outcomes. In addition to the hunger questions we also asked women “In the last 7 days have you felt hopeless, down or depressed?” with frequency options of a few days or most days. Figure 1 below reports those results relative to reported frequency of going to bed hungry. The trends are quite clear, and incidentally are identical for pre- and post-birth mothers. New and prospective mothers who report going to be hungry for 3+ nights in the week were eight times more likely to say that they felt hopeless, down or depressed “most days”.
In our view, new and pregnant mothers must be prioritized when targeting government relief. Many do not yet receive the Child Support Grant and are thus without that important lifeline. Maternal hunger and poor mental health can have profound long-term consequences for both mother and child.
*Dr Nic Spaull is the Principal Investigator of the NIDS-CRAM project and the co-investigator of the MATCH study. Prof Mark Tomlinson is a Professor of Maternal and Child Health at Stellenbosch University.
**Note the MATCH data should be publicly available in the next 2 weeks.
(The article below first appeared in the Financial Mail on 15 July. The unedited version is available below and their slightly edited version is available here).
A National Reckoning
The impacts of COVID-19 on employment, hunger and inequality
– Nic Spaull
The coronavirus pandemic is the largest social and economic shock in our lifetimes. It has fundamentally interrupted everything we do and exacerbated existing problems like poverty, inequality and unemployment. The collateral damage of this one virus has been profound and will be with us for the next 10 years, if not longer. While the South African government acted swiftly and decisively to limit the spread of the coronavirus, implementing a nationwide lockdown within 7 days – arguably necessary and defensible – these mitigation measures have come at a high cost. Never before have we seen so much damage caused in such a short space of time, at least not in the last 50 years. This includes damage from the lockdown, the recession and the pandemic itself. As will become evident in this essay, the true scale of job loss and hunger throughout South Africa is difficult to fathom. We estimate that between February and April 2020, 3 million South Africans lost their jobs, and a further 1,5 million lost their income (through being furloughed). Furthermore, losses were concentrated among women who accounted for 2 million of those 3 million job losses. Half of all respondents (47%) reported losing their main source of income. These are sobering results. In this essay I will summarize the findings of the 11 research papers that were released on the 15th of July focusing on two related areas: employment and hunger.
Over the last three months, and together with 30 leading social science researchers, we have surveyed over 7000 South Africans from the length and breadth of our country. Using 50 call center agents and interviewing in 10 languages, we administered a 20-minute telephonic questionnaire asking respondents about their employment, household hunger, migration, and receipt of grants. This study, the National Income Dynamics Study (NIDS) – Coronavirus Rapid Mobile Survey (CRAM) is the largest non-medical COVID-19 research project currently underway in South Africa. Our sample was drawn from, and is representative of, a previous survey – the National Income Dynamics Study (NIDS). NIDS was a nationally representative sample of South Africans in 2008 who were selected to be part of the study and have subsequently been visited every 2-3 years, with follow-up surveys in 2010, 2012, 2014 and 2017. Hundreds of academic papers have been written using this study. Earlier this year we were given permission by the Presidency to use the NIDS sampling frame for a new ‘NIDS-CRAM’ study. Due to the operational constraints around surveying people during a pandemic, and the limitations of telephone surveys compared to in-person surveys, this latest iteration has a much shorter questionnaire and a smaller sample size than previous rounds of NIDS. (See also the essay by Andrew Kerr and his co-authors on representivity). While these caveats should not be brushed over, and they are readily and freely acknowledged by the researchers, it is also our view that the trends evident in the NIDS-CRAM data are indicative of the underlying labour market and welfare dynamics in South Africa today. It is also the only broadly nationally representative survey currently available. As the authors in this special issue, we all agree with economist Stefan Dercon when he says that “waiting for better data is not an option: decisions have to be made now as this risks turning into a disaster, not just for health, but also for people’s livelihoods.” And it is to livelihoods that I would now like to turn and summarise some of the findings emerging from the data.
Unprecedented job losses
During our survey in May and June, the NIDS-CRAM survey asked respondents whether their household had lost its ‘main source of income’ since the start of the lockdown on the 27th of March. A staggering two in five respondents (40%) reported that they had. This has profound consequences for welfare and hunger in South Africa. An underappreciated fact in South Africa is that grant-receiving-households also rely heavily on income earned from the labour market, not only income from grants. Gabrielle Wills and her co-authors show that 39% of grant-receiving-households reported that income from wages was the main source of income, compared to 70% for non-grant-households. If many people lost their job, were furloughed, or were locked-out of their income (for example informal traders), this helps explain the sharp increase in reported hunger that we see in the survey. So, how many people lost their income?
The survey asked respondents a number of retrospective questions about employment and income in both April and February allowing us to compare job losses and income losses over this period. In their paper Vimal Ranchhod and Reza Daniels find that 1-in-3 income earners in February (33%) did not earn an income in April. The weighted NIDS-CRAM data further shows that there was an 18% decline in employment between February and April 2020. In terms of real numbers, the estimate is that there were 17 million people employed in February but only 14 million in April 2020, i.e. that 3 million people lost their jobs. A further 1,5 million (9%) were furloughed. That is, they received no income but reported they had a job to return to. If these numbers are true, the scale of this job loss is unprecedented in South African history.
The next important question is who are we talking about? Who lost their jobs? Who lost their income? It turns out that job losses were most severe for those who were already disadvantaged in the labour market. The rates of net job loss are much higher for manual labourers (-24%) compared to professionals (-5%), for those with verbal contracts (-22%) compared to those with written contracts (-8%), for women (-26%) compared to men (-11%), and for those with a tertiary education (-10%) compared to those with matric or less (-23%). The graph below draws on data from the paper by Ronak Jain and her co-authors and starkly illustrates the disproportionate nature of net job losses and income losses (furlough).
Figure 1: The net percentage of respondents experiencing job loss (i.e gains minus losses) or furlough (an employment relationship but no income) in the working age population: February to April 2020
It is important to note that the data reported by Ronak Jain and her co-authors is “net job loss”, i.e. it takes account of the people (albeit a smaller percentage) who gained jobs over this period. In another paper, Vimal Ranchhod and Reza Daniels look specifically at job loss (not net job loss) among those who were employed in February, and report this by income and race (Figure 2). What is clear is that Black people were three times more likely to lose their job (28%) compared to White people (11%), and that those earning less than R3,000 a month were eight times more likely to lose their job (38%) compared to those earning more than R24,000 a month (5%).
Figure 2: Percentage of respondents experiencing job loss or furlough (an employment relationship but no income) in the working age population February to April 2020
Clearly the collateral damage of the lockdown has landed disproportionately on the poor who are also more likely to be in the informal sector, have lower earnings, are less educated, and are more likely to be Black African. This finding is corroborated by all the NIDS-CRAM papers looking at employment.
Women face a double disadvantage
One final trend that is perhaps most clear across all domains is that this pandemic and the job losses it has left in its wake have fallen most heavily on women. Of the approximately 3 million net job losses between February and April, women accounted for 2 million, or two thirds of the total. Daniela Casale and Dori Posel show that among those groups of people that were already disadvantaged in the labour market, and already faced a disproportionate share of job losses from the pandemic (the less educated, the poor, Black Africans and informal workers), women in these groups faced even further job losses, putting them at a ‘double disadvantage.
Given what we know now about the extent of job losses and income losses it was inevitable that household hunger would rise. This is clearly what the data shows. Half of all respondents (47%) reported that their household ran out of money to buy food in the month of April. This ‘monthly figure’ is double the ‘annual figure’ reported in the General Household Survey (GHS). 21% of households in the GHS reported they ran out of money to buy food at some point in the last year.
Looking specifically at reported hunger and depth of hunger in NIDS-CRAM, 1-in-5 (21%) respondents indicated that someone in their household had gone hungry in the past week. 1-in-8 (13%) reported frequent hunger (3+ days / week) and 1-in-14 (7%) reported perpetual hunger (every day or almost every day in the week). The same questions were repeated asking specifically about child hunger. In households with children, 1-in-7 respondents (15%) indicated that a child had gone hungry in the last week because there wasn’t enough food. 1-in-13 (8%) reported frequent child hunger (at least every other day), and 1-in-25 (4%) reported perpetual child hunger (child hunger every day or almost every day).
Figure 3: Reported hunger in the last seven days (asked separately for “anyone in the household” and children (<18 years).
Source: Van der Berg et al., 2020 using NIDS-CRAM Wave 1 data weighted.
In a set of reports that makes for disturbing reading, there is also clear evidence of altruism, sacrifice and resilience within poorer households. The best example of this is the practice of “shielding” where households report adult hunger but not child hunger. In households that experienced hunger in the past week, nearly half (42%) managed to ‘shield’ children from that hunger, despite adults going hungry in the household. Where adult hunger was less than 4 days per week, the practice of shielding is higher (47%), but where adult hunger is perpetual (almost every day or every day) fewer households seem able to shield their children from hunger since only 33% reported that children did not go hungry in those households. It would seem that in times of acute crisis, like this pandemic, many households have managed to protect or ‘shield’ their children. But this protective capacity of households has its limits; where adult hunger becomes too pervasive, households seem unable to protect their children from hunger.
While the employment losses reflect on the period February to April (and before the roll-out of the government’s COVID-19 Social Relief of Distress Grant), the hunger questions reflect on the “last 7 days.” Given that this survey was done in May and June, and that government grants were topped up from the beginning of May, these hunger figures are after households have received grant top ups (note also that these top ups were largest in May).
Capacity to prevent and capacity to provide
The severely delayed roll-out of the COVID-19 grant and UIF payments to those who have lost their jobs or incomes, reflects the difficulty of rapidly implementing social relief. This is in stark contrast to the rapid pace at which the lockdown was implemented. On the one hand government implemented a hard lockdown swiftly and severely, deploying the army across the country within 7 days of the announcement. On the other hand, government has taken more than two months to provide any form of relief to those most affected by that same lockdown. Two months after at least 4,5 million South Africans lost their income (3 million from job loss, 1,5 million from furlough) only 117,000 people (3% of that number) had received the Special COVID-19 Social Relief of Distress Grant. That 117,000 number is the official number of payouts up to the 31st of May 2020. Clearly governments ability to prevent (travel, socialising, commerce) is far greater than its ability to provide. This lopsided capacity of government is critical in understanding why hunger has risen to unprecedented proportions.
Knowing what we know now about the collateral damage of a nationwide lockdown, including who it affects and how it affects them, as well as knowing what we know now about government’s administrative and financial capacities to provide, we should exercise extreme caution before again implementing a nationwide lockdown. While hindsight is 20:20, we can all acknowledge that the great uncertainty around the pandemic justified the lockdown (at least initially), but going forward other mitigation measures like implementing social distancing will have to be found and pursued with greater vigor. Preventing COVID-19 deaths should clearly be one of the top priorities of government, but it cannot come “at any cost.”
What is to be done?
There is a saying in banking that “it’s only when the tide goes out that you realize who has been swimming naked.” This refers to liquidity positions when there is a run on the bank or a financial crisis, but it is equally applicable here. It is only in times of crisis that we are able to see the true nature of things. In our case, the true nature of South African society. We have always known that there are large inequalities between the rich and the poor in our country, and that these inequalities are heavily determined by the colour of your skin, the place of your birth and the wealth of your parents. All of that is now uncomfortably laid bare in front of us. The pandemic has forced on us the unwelcome realization that we are only as safe as the least among us. “Your health is as safe as that of the worst-insured, worst-cared-for person in your society. It will be decided by the height of the floor, not the ceiling” (Anand Giridharadas).
We know that one of the true measures of a country is whether it can provide basic dignity for all who live in it. In our context this means enough food to eat, warm running water in a safe and dignified shelter, and access to essential healthcare and basic education. Of course, this is not the ceiling of our aspirations, which might include things like meaningful employment, higher education, art and cultural production etc. Rather we are speaking about the floor of our obligations to each other as citizens of the same country.
This is not usually something we think about when talking about budgeting, tax rates or property laws, yet it is very much at the heart of what it means to be civilized. How will we feel about our collective selves if we continue to turn our backs on the least among us simply because it is “legal” to do so? What is legal is not always ethical, and quite often not what is moral.
Which brings us back to inequality. Three months ago, Aroop Chaterjee and his co-authors published an important study analyzing South African tax data and showed that the richest 10% of South Africans own 86% of all wealth and the richest 1% own half of it (55%). Furthermore, the richest 3,500 individuals alone own more wealth than the poorest 32-million people in the country (the poorest 90%). Of course, all of this is strongly racialized. White South Africans make up the majority (60%) of the richest 10%. One doesn’t have to be a statistician to do the maths here; white South Africans own at least half of the country’s wealth despite being only 9% of the population.
Figure 4: Shares of total South African wealth using tax data (Source: Charterjee et al., 2020: p20)
The pandemic is a rare opportunity to reflect on the country we have inherited and the country we are building. To recognize in earnest that the pre-pandemic South Africa only worked for a few and that people like me and you will have to agree (or at the very least accept) that we will need to share more of our wealth and privileges going forward. Both through new private acts of generosity and new public forms of redistribution.
That is what the situation requires. As Van der Berg and his co-authors explain in their NIDS-CRAM paper, “Social grant top-ups must continue beyond October. The severity of the economic shock and the depth of poverty make this imperative, despite fiscal constraints. Although top-ups are inadequate to compensate for other income and job losses in many households, the most common social grants, the Old Age Pension and the Child Support Grant (CSG), inject much needed financial resources into many poor households.” Furthermore, they argue that the CSG top-ups must be paid per child not per caregiver, and must increase if they are to prevent further child hunger. Gabrielle Wills and her co-authors come to a similar conclusion: “To stave off mass, chronic hunger we simply cannot let up on the support being provided to households … Failure to do so will deepen an emerging humanitarian crisis, hamper economic recovery and threaten socio-political stability.”
All of this will cost a lot money that the state does not currently have. Either we must find new social compacts and mechanisms to share wealth, income and opportunity, or we will continue towards our dystopian future, with islands of excess sitting precariously on a sea of poverty.
It is obvious that the willingness of the rich to part with some of their wealth – especially when compelled to do so via government – is far greater when there is a trust that the money will be used wisely, by competent and ethical bureaucrats and to achieve goals we can all believe in. That means that government will need to clean house and show their own moral integrity before they call on rich South Africans to do likewise. Appoint clearly competent and ethical technocrats to lead key initiatives and deliver results. Put in place consequences for non-performance and inept bureaucrats, and jail corrupt politicians. Realistic targets with reasonable time frames must be met with success or resignations. Build 400,000 new houses and apartments within the next two years. Eradicate pit-latrines within two years. What is the reason why these things cannot be done? Perhaps most importantly, a competent development State is also necessary for long-term economic growth since redistribution can only take us so far. Ultimately the economy will also have to start growing and employing large numbers of people.
While there has been some tinkering around the edges of the political and economic possibilities available to us, nothing we have done has made inroads into the gross income inequality that characterizes our country. And now with a pandemic on our doorstep, a decimated labour-market, and a hunger crisis not far behind it, where are we to turn?
One thing that is clear is that business as usual will not cut it. Like those resilient parents who manage to shield their children from hunger, it will require altruism and sacrifice. That is because, like those parents, there really are limits to the poor’s benevolence. I recall being told about a popular slogan during the democratic transition that went something like this: “If they don’t eat, we don’t sleep.”
There is no longer any room for the fat of corruption, or the waste of ineptitude. But similarly, there is also no room for those who cannot see the basic dignity inherent in all people. A dignity that is currently being eroded. I have little doubt that this pandemic will be the straw that broke the camel’s back in South Africa. Whether that is for good or for ill, remains to be seen. I also have no doubt that South Africa has the skills and the moral conscience to forge a new and better path, but it will require decisiveness and clarity of vision, and above all, leadership.
President Ramaphosa, I know you already know this; don’t waste a good crisis. Leadership requires courage and moral integrity. Be bold.
Nic Spaull is the Principal Investigator of the NIDS-CRAM study. The views expressed here and those of the author not necessarily those of the other NIDS-CRAM researchers. All papers are available at cramsurvey.org. and the NIDS-CRAM data is freely available for download on the DataFirst website.
During this launch event we will present the main findings from the National Income Dynamics Study (NIDS) Coronavirus Rapid Mobile Survey (CRAM). This includes the increase in unemployment during the lockdown, the rise in hunger and child hunger and the impact on women. All are welcome to attend but must register first.
- Date & Time: 15 July, 12:00-2pm
- Register: HERE to receive the Zoom link.
- Welcome and introduction to the study Nic Spaull (SU)
- Overview of findings :Employment Vimal Ranchhod (UCT)
- Discussant/response: Murray Leibbrandt (UCT)
- Overview of findings :Hunger & Welfare Servaas van der Berg (SU)
- Discussant/response: Ruth Hall (UWC)
- Overview of findings: Gender & Migration Daniela Casale (Wits)
- Discussant/response: Umunyana Rugege (S27)
- Overview of findings: Health Ronelle Burger (SU)
- Discussant/response: TBC
- Overview of Survey Implementation Reza Daniels (UCT)
- Overview of Sampling & Representivity Andrew Kerr (UCT)
- Comments from other authors
- Q&A – 30-min
- Closing & thanks -Nic Spaull (SU)
Today we launched a report we have been working on for the last 18 months: The Race between Teacher Wages and the Budget: The Case of South Africa 2008-2018 which I wrote with one of my doctoral students (Adaiah Lilenstein) and long time collaborator (David Carel). I include the abstract and executive summary below.
In South Africa the wages of school-based personnel (teachers and teacher-managers) make up 3.5% of GDP, the largest single line item in the government budget. In this paper, we analyze a decade’s worth of publicly available data on expenditure, collective bargaining agreements, teacher demographics, and learner enrolment. We show that discounting historical educational expenditures using CPI is naïve when wages make up approximately 80% of the education ‘price basket’ purchased by government. To remedy this we create a sector-specific Basic Education Price Index (BEPI) for South Africa that is weighted by the real cost drivers in education (i.e. ~80% wages and ~20% CPI). Using BEPI we find that there has been a -2.3% decline in real per-learner expenditure over the period 2009-2018 with much larger declines seen in the Free State (-13%), Limpopo (-13%) and the North West (-11%).
Despite a rise in fertility and subsequent enrolment over the period we show that only 30% of the decline is due to the rise in enrolment while 70% is due to the rise in wages. The two main impacts of this real decline in purchasing power is that class sizes have increased and hiring freezes have been implemented. Analysis of government payroll extracts from 2012 and 2016 shows that nationally there were fewer teachers employed (-2%), fewer principals employed (-9%), fewer deputy-principals employed (-8%) and fewer Heads of Department (HODs) employed (-7%), despite there being only -2% fewer schools in 2016 compared to 2012. In Limpopo alone, there were -23% fewer deputy principals in 2016 compared to 2012.
It is uncanny how similar the declines are in per-learner spending between 2009 and 2018 to the declines in the number of principals employed between 2012 and 2016 (the years for which we have PERSAL data). In the Free State per-learner spending declined by -13%, principal posts declined by -14%. In Limpopo per-learner spending declined by -13%, principal posts declined by -13%. In the North West per-learner spending declined by -11%, principal posts declined by -12%.
We conclude by making the case for BEPI being used when analyzing expenditure trends and projections in education. The argument presented throughout the paper is not that educator salaries should not have increased, but rather that there has been a disconnect between government budget allocations and wage and benefit agreements. The longer that wage and benefit increases outpace overall budget increases, the greater the consequences for the education system. Wages must be contained, or educational expenditures must rise, but the status quo is not sustainable for the long-term health of the education system.
The aim of the present analysis is to determine how the real resources available to the average child in South Africa have changed over the period 2008 to 2018. In order to do so the paper makes the argument that existing measures of discounting educational expenditures, notably using the Consumer Price Index (CPI) are inadequate, and in our view, incorrect. They drastically over-estimate the rise in real spending on education and do not take into account the overall rise in enrolments resulting from an unusual birth-spike in 2005. Furthermore, such an approach cannot explain why there has been a simultaneous rise in “real spending” coinciding with the widespread implementation of hiring-freezes, a well-known cost-cutting measure implemented by provinces.
To remedy this, we develop the Basic Education Price Index (BEPI) which uses the prices of the real cost drivers of education in South Africa and weights them in the same proportion as that which makes up actual expenditures in the budget (Estimates of Provincial Expenditure and Revenue). Because educator wages – that is, teachers, school managers and administrators – make up approximately 80% of the education budget, changes in educator wages should be used when discounting historical educational expenditures. Put simply, we ask how much it costs to employ 100 teachers in 2008 and 100 teachers in 2018, rather than how the prices of an average basket of consumer goods (CPI) changed over the period (CPI). We argue for a method that uses the actual cost drivers in education and weights the price-basket in the same proportions as they are found in the budget, approximately 80% personnel and 20% non-personnel. Using this new and more appropriate measure, shows that real per-learner spending in South Africa has shrunk by -2,3% between 2009 and 2018, with much higher figures in some provinces.
The five main findings of the paper can be summarized as follows:
- Clear evidence of a fiscal squeeze: Provinces are clearly facing a ‘fiscal squeeze’ where increases in teacher salaries have outpaced increases in budget allocations to education. While this has led to declines in real per learner spending of -2.3% nationally, this is considerably higher in the Free State (-13%), Limpopo (-12,5%) and the North West (-11%) between 2009 and 2018.
- Provinces coping using hiring freezes: Provinces seem to be ‘coping’ with this squeeze by implementing cost-saving measures such as hiring freezes and leaving vacant posts unfilled. Unsurprisingly these hiring freezes are largest where the real per-learner declines are greatest. Importantly, hiring freezes are disproportionately affecting school management posts rather than regular teaching posts, although there has been a decline in the latter as well. It is uncanny how similar the declines are in per-learner spending between 2009 and 2018 to the declines in the number of principals employed between 2012 and 2016 (the years for which we have PERSAL data). In the Free State per-learner spending declined by -13%, principal posts declined by -14%. In Limpopo per-learner spending declined by -13%, principal posts declined by -13%. In the North West per-learner spending declined by -11%, principal posts declined by -12%.
- Historical overestimation of spending on education: We show that any historical analysis that uses CPI to discount educational expenditures overestimates the real spending on education since the real cost drivers have, especially teacher salaries, have been increasing much faster than CPI. In South Africa a traditional approach of using CPI as the discount rate leads one to conclude that ‘real’ aggregate educational expenditures have increased by 42% between 2008 and 2018, when in fact they have only increased by 8% when using the correct discount rate. Furthermore, when comparing 2009 and 2018 using CPI-discounted figures the aggregate increase was 30% when in actual fact it was only 3% when using the correct discount rate. This is primarily because the vast majority of additional educational spending over this period has simply been on paying existing teachers more, rather than hiring more teachers or buying more non-personnel resources.
- Per-learner figures vs aggregate figures: Much of the existing literature and government reporting is at the aggregate level. Yet the meaningful unit of analysis is the child – what is available to the average child in South Africa? While this may not matter if a population is stable over time, a situation of rising births (as in South Africa) means that resources are being spread over a larger number of children than before. This makes a considerable difference to the conclusion. Between 2009 and 2018 real expenditure on education rose by 3% when looking at the aggregate level and fell by -2.3% when looking at the per-learner level (both using real cost drivers). While there was slightly more money (+3%) being spent on education in 2018 compared to 2009 when looking in the aggregate, for the average child there was slightly less money being spent on them in 2018 compared to 2009.
- Significant inter-provincial variation in spending per child: It is clear that some provinces spend more public money per child than others, despite alleged equal funding per child in the national funding formulas. For example, Gauteng spent R2,500 more per child per year compared to KwaZulu-Natal or Limpopo (R20,037 in Gauteng compared to R17,563 in KwaZulu-Natal and R17,503 in Limpopo in 2018).
Finally, we argue that the national government has agreed to higher teacher wages and benefits without budgeting for those increases, and in the process undermined the education system. This has led to a host of unintended consequences. Provincial departments experiencing salary increases that have outpaced their budget increases have attempted to deal with the subsequent fiscal squeeze by implementing hiring freezes and allowing class sizes to rise. Payroll data shows that even after accounting for a small decline in the number of schools, there are -7% fewer principals employed in 2016 compared to 2012. In the three most severely affected provinces the declines in employed Principals, Deputy Principals and HODs range from -13% to -23% when comparing 2012 and 2016.
The main contribution of the paper, to both the research literature on South African education, and also to policymakers, is to help explain the conundrum of the co-existence of widespread hiring freezes and the alleged rising per-learner spending on education (using CPI as a deflator). The answer to this conundrum is that CPI is the wrong deflator for education – both in South Africa and internationally. When using the correct deflator (the Basic Education Price Index) there is a logical explanation behind both increases in class sizes and the implementation of hiring freezes. The provincially devolved nature of South African spending provides further corroborating evidence. Provincial disaggregation of spending trends and hiring freezes shows quite clearly that those provinces experiencing the largest declines in real per learner spending are also the ones who have the highest number of vacancies. This is not a coincidence. For those researchers who are unconvinced that BEPI is the correct discount rate, and instead believe that real education expenditures have been increasing monotonically for the last decade, we ask the following question: If real educational expenditures per learner have been rising over this period, why is it that provinces are implementing hiring freezes?
Finally, we argue that government officials from the National Treasury and the Department of Basic Education need to take account of the dynamics presented in this paper when entering wage negotiation agreements with teacher unions. While many of the choices made in such negotiations are necessarily political, it is fair to ask government to acknowledge the trade-offs and costs in their decisions and to make those trade-offs and decisions public.
The full paper is available here.
Van der Berg & Spaull (2020). Counting the Cost: COVID-19 school closures in South Africa and its impact on children. Research on Socioeconomic Policy. Stellenbosch University. (Released: 16 June 2020).
“There are decades where nothing happens, and there are weeks where decades happen.” — Vladimir Lenin
Looking back to the end of last year, it’s difficult to think that anyone in the world knew how everything was about to change. Here in South Africa, what began as a three-week lockdown period on the 28th of March morphed into an eight-week lockdown that is now in its eleventh week and still on-going, albeit with much fewer restrictions. The eight- week lockdown included bans of all public gatherings, closing all schools, and prohibiting all forms of physical commercial activity, except for the sale of food and medicine. The sale of alcohol and tobacco was banned. A national curfew was imposed prohibiting movement between 8pm and 5am. For the first time since apartheid the army was deployed with 70 000 reserve soldiers distributed across the country, largely in informal settlements, with the intention of maintaining law and order and supporting the police. Even parliament was temporarily closed. Only the courts remained open out of fear that there would be no recourse to challenge government actions or to oppose the constitutionality of the measures being implemented.
By and large these containment measures were initially welcomed, or at the very least accepted, by the public, opposition parties and most scientific advisors. This is now to starting to change.
In the beginning there was so much uncertainty and fear surrounding COVID-19. How deadly was it? How was it transmitted? Who got it? How fast was it spreading? Were kids at risk? There are still key unknowns around immunity, when and if a vaccine will be discovered, and perhaps most importantly, how the impact of the virus will be different in lower- and middle-income countries like South Africa compared to high-income countries. Initially European countries and America made up over 80% of COVID-19 cases, that is now rapidly changing.
In my own field – education and schooling – everything came to a grinding halt. At the time of writing remain schools, ECD centres and creches remain closed for 90% of children, despite the economy re-opening from 1 June 2020. For the ten weeks of lockdown up to the 8th of June, children were not allowed to go to school or see their friends and family outside of their house. During the first five weeks of ‘hard’ lockdown children were not allowed to leave their homes for any reason except to seek medical attention. Based on the government’s current plans, by the end of Term 2 (7th of August 2020), South African children will have lost between 25% and 57% of the ‘normal’ school days scheduled up to that point.
In the beginning, like everyone else, we were supportive of these drastic (but defensible) measures. The logic behind the three-week lockdown was sound; slow the spread the virus, buy time for the Health Department to prepare and ‘flatten the curve.’ Had anyone known this would be a 3-month lockdown I’m not sure there would have been the same support.
It is within this context that my colleague and mentor, Prof Servaas van der Berg, and I decided to write a report setting out some of the evidence on COVID-19 and children in South Africa. We wanted to document some of the non-COVID-19 concerns that affect children specifically, many of which have been drastically exacerbated by the extended lockdowns and prolonged school closures. The aim was not to focus too much on whether children are at risk of getting severely ill or dying from COVID-19 (they aren’t), or whether they are as likely to transmit as adults (they aren’t). Instead we looked at five areas which I’ll touch on briefly here in a Q&A format (see the full report for the detailed discussion).
(1) Does the South African distribution of COVID-19 deaths follow the international trends with respect to age?
In short, yes, but the Western Cape data does show higher mortality from 40+ and 50+ while the high-income trend was 50+ and 60+.
Let’s compare the Case Fatality Rate (CFR) in China and the Western Cape (Table 2). The Western Cape was selected as the best proxy for South African risk by age since it has the highest number of infections (66% of the national total), the highest number of deaths (77% of the national total), as well as the highest rate of testing per 100 000 persons – at least as at the time of writing (NICD, 2020a: p.6). If we are concerned about issues that are especially prevalent in SA (TB, HIV, inequality, malnutrition) then the Western Cape is the best proxy we have at the moment.
While the overall CFR in the WC (2.5%) seems to be comparable to China (2.3%), mortality risk does start increasing from 40+ years.
(2) How does COVID-19 mortality risk in South Africa compare to “normal” mortality risk?
This is a key question since the justification of the extreme measures implemented in South Africa (lockdown, school closures, deploying the army etc.) are warranted to the extent that the the threat is so severe and unusual that the collateral damage from these measures is “necessary”, “unavoidable” or “worth it.”
Although this is not an easy question to answer and any response will rely on certain assumptions, it’s worth emphasising that the justification for the lockdown also relies on many of these same assumptions. Using StatsSA mid-year population estimates and mortality data for the same year, we report the risk of dying by age group for a “normal” year (i.e. non-COVID-19 year), in this case 2016. Of the 55.9-million people alive in 2016, 435 000 died, with higher death rates among the elderly, as one would expect. In order to compare this annual figure to COVID-19 deaths, one needs a figure of total COVID-19 deaths in 2020. This relies on projections and assumptions. The Department of Health has consulted numerous modelling experts to predict the total number of infections and deaths from COVID-19 since this is important information needed for planning and preparation. Reviewing the projections put forward by the Actuarial Society of South Africa (ASA, 2020: p.4), the South African COVID-19 Modelling Consortium (SACMC) and Deloitte indicate that there may be as many as 40 000 deaths (optimistic) or 48 000 deaths (pessimistic) from COVID-19 by the end of 2020. These are also the current projections cited by the Minister of Health. Taking a conservative approach and using the higher projection of COVID-19 deaths in South Africa in 2020 (48 000), we use the distribution of deaths by age in the Western Cape (Column E) to apportion the 48 000 total deaths across the different age categories. For example, if the 48 000 deaths follow the Western Cape distribution of COVID-19 deaths then there will be 13 142 deaths among the 60-69 year age group in South Africa in 2020.
This table allows one to ask “What is the probability that someone in a particular age category is going to die from COVID-19 in 2020 in South Africa?”. It shows that for those under 70 the risk of death from COVID-19 is exceedingly small. For example the average 45 year old has a 1-in-1028 chance of dying of COVID-19 in 2020. the average 45 year old had a 1-in100 chance of dying of non-COVID causes in 2016.
While it is true that these projections depend on the assumption of 48 000 COVID-19 deaths in South Africa in 2020, there are very few specialists who believe that the figure will be higher than this. Furthermore, even if COVID-19 deaths were twice as large as predicted here (96 000) (which would halve the chance numbers in Column H), the risk of death from regular causes for all age groups would still drastically outweigh the risk of death from COVID-19 multiple times over. It is for this reason that the risk categorization in Column I, which reports the relative risk of COVID-19 mortality and regular mortality, indicates that for the population at large under 70 years of age, the risk of death from COVID-19 is low or very low when compared to regular mortality risk. Put differently, people should be far more worried about dying of regular causes than from COVID-19. This doesn’t mean that COVID-19 hasn’t increased mortality risk for everyone 18 years and older – it has – but not nearly as much as one would think when looking at the precautionary measures being taken by government. If you asked the average 50 year old in South Africa “If you died this year do you think the cause would be COVID-19 or something else?” If these assumptions are correct then the average 50 year old has a 5 times higher chance of dying of something else than of dying of COVID-19. This does not, however, indicate that sensible precautions such as social distancing or wearing a mask should be ignored.
The above discussion has important implications for school closures, since these measures are justified partly on the basis that they will prevent the healthcare system becoming overwhelmed, but also because of the excess mortality risk to teachers. For example, schools were scheduled to be opened for some grades on the 1st of June 2020, but this was delayed based on teacher union opposition that schools were not adequately prepared to protect learners and teachers. Yet if the assumptions underlying the above data are correct, the additional mortality risk to teachers and caregivers up to age 70 is low relative to the normal mortality risk that they face. For children the risk is exceedingly small. Following analysis of COVID-19 mortality data in the United Kingdom by Professor David Spiegelhalter at Cambridge University, he concluded that “In school kids aged five to 15 it’s not only a tiny risk, it’s a tiny proportion of the normal risk.” He went on to say that the risk was so low that children were more likely to get struck by lightning (a chance of one in 1.7-million) than die of COVID-19 (one in 3.5-million) (Spiegelhalter, 2020).
The evidence emerging from South Africa on children’s COVID-19 risk of severe illness is completely congruent with international research showing that children do not get severely ill from COVID-19. There are so few recorded deaths of children from COVID-19 that it is difficult to draw any conclusions (see Spaull, 2020 for an overview of the epidemiological research on this). The South African Paediatric Association (SAPA) in their statement on COVID-19 (SAPA, 2020) explain that “Children biologically contain SARS-CoV-2 better than adults, are less likely to get sick if infected, have milder disease, are unlikely to die from COVID-19, and are probably less infectious than adults.”
(3) What is the age and comorbidity distribution of teachers in South Africa?
In the paper we do report the age distributions of teachers in South Africa and show that only 10% of teachers (38,000 individuals) are aged 58-65 years.
There is currently no nationally-representative data on the comorbidities of teachers specifically. However, nationally 4 581 200 South Africans aged 20-79 are estimated to have diabetes, according to the International Diabetes Federation (2019). Applying the ratio of teachers to the national population in this age group, there could be perhaps around 47 500 teachers who have diabetes, or one in every eight teachers. Cardiovascular disease is a major source of mortality in South Africa, often associated with hypertension. These diseases increase an individual’s COVID-19 mortality risk. However, it should be noted that the mortality total provided in Table 3 is a national figure and already includes deaths associated with these and other comorbidities.
(4) What percentage of South African schools have running water?
The School Monitoring Survey 2017 data show that nationally 74% of primary schools and 80% of secondary schools report access to running water in 2017 (DBE, 2018: p.80). However, there is considerable provincial variation in access to this most basic resource. Lack of access to running water is especially acute in KwaZulu-Natal, where only 53% of primary schools and 59% of secondary schools report access. In contrast, approximately 95% of primary schools and high schools in Gauteng and the Western Cape have running water (DBE, 2018: p.81). Without access to running water, how are children and teachers expected to wash their hands? Thus special measures had to be instituted. COVID-19 is an opportunity for South Africans to reflect and acknowledge that in 25 years of democracy we have not managed to provide all schools with basic infrastructure like running water, electricity, and safe toilet facilities. The fact that a quarter of primary schools do not have access to running water in a middle-income country like South Africa is an indictment and an ongoing source of shame. While this is clearly a pre-requisite for basic hygiene during a pandemic, it is also a pre-requisite for basic dignity in everyday life.
Due to teacher union opposition about returning to schools where there is no running water and therefore limited ability to practice personal hygiene, the Department of Basic Education went into overdrive to provide schools with water tanks so that teachers would return. On the 7th of June the Minister announced that 95% of schools now had running water (Motshekga, 2020). This was accomplished through a contract with Rand Water to provide water tanks to 3500 schools:
“The support provided by the Department of Water and Sanitation, Rand Water, the Department of Health, National Treasury; and the recent involvement of the South African National Defence, the Development Bank of Southern Africa (DBSA), the Department of Transport, and Mvula Trust is second to none. Their involvement has accelerated our interventions in the provinces, especially the reach to the most rural and remote schools” (Motshekga, 2020).
This is a commendable achievement, and may yet be one of the few positive outcomes of the pandemic. It is truly remarkable that in the space of six weeks the Department of Basic Education has managed to do what it was unable to do in the last 20 years.
(5) Is social-distancing feasible in South African classrooms?
The School Monitoring Survey 2017 data on “largest class taught” in Grade 3, 6, 9 and 12 show that nationally 63% of primary school children are in classes of 40 or more learners per class, with 16% in classes of 60 or more per class. In secondary schools 70% of learners are in classes of 40 or more learners per class and 26% are in classes of 60 or more learners per class.
Given that COVID-19 mortality risk is low compared to regular mortality risk (Table 3), and virtually non-existent for children, we believe the Department of Basic Education should acknowledge that it is not feasible for most South African schools to practice social distancing within the classroom. Where they can, they should. Where they can’t they should take the precautions that they can but continue with schooling. While it should require mask-wearing for older children and social distancing on the playground, social distancing within the classroom is simply not realistic. Attempts to do so are futile in our context and are likely to further disrupt teaching and learning, to the detriment of children. Furthermore, as the South African Paediatric Association has explained:
“Teachers are not at high risk of being infected by children. Teachers are at a higher risk of contracting the virus from other adults (e.g. colleagues), at home or in the community (outside school). Teachers with comorbidities are at increased risk for severe Covid-19″ (SAPA, 2020).
We cover a number of other topics in the report including malnutrition, learning losses, economic impacts etc. The last one I want to touch on here is something I am especially worried about:
(6) With the economy re-opening and schools still (largely) closed, how many young children are left “home alone”?
Short answer: 3.3 million kids (18% of all children) are in households were the only adult caregiver in the house has a job. Of these 1-million are aged 0-6 years. What happens to these kids when their parents have to return to work while creches, ECD-centers and schools are still shut for 90% of children?
Reviewing the South African media discourse on the ‘post-lockdown’ regulations, one of the areas that has been most neglected are the unintended consequences of re-opening the economy while schools and crèches remain closed for most children.
Using data from the Quarterly Labour Force Survey (QLFS) of StatsSA for the fourth quarter of 2019, it is possible to determine how many schoolchildren, pre-schoolers and toddlers would be at home with or without an adult caretaker, if everyone who had jobs at the end of 2019 were again to return to work. The table shows that 3.3 million children (18% of all children in this age group) were in households were there was no additional adult care-giver apart from employed adults. In the remaining 82% of households there would still be an adult available to act as caretaker, especially in extended families. As one would expect, proportionately the number of children without a caretaker would be largest in metropolitan areas, where this ratio is 25%. The biggest proportion of children would be affected In the Western Cape (30%) and Gauteng (24%).
One can further estimate these ratios allowing for older siblings (15 or above) who might be able to act as caretakers. While that reduces the numbers (Figure 7), the basic problem remains. Even if one includes household members 15-years and older as possible caretakers, there would still be 2.3 million children aged 0-15 years that could be home alone if their employed caregivers returned to work and their school grade or their ECD centre or crèche remained closed.
Given the job-losses expected to result from the lockdown and the COVID-19 induced recession, more caregivers will become unemployed and therefore would be at home and available to care for children (albeit now with less income). While this does decrease the percentage of children that are home alone, as the figure shows, even if there were 30% job losses there would still be 1.8 million children aged 18 or below that would be left home alone because their only caregivers would be at work, or 1.2 million if 15 year olds can act as caretakers.
Perhaps the most severe instance of this would be the care of very young children, i.e. those under the age of 6 years. Our analysis shows that if all employed workers return to work, there would be almost one million (974 000) children below the age of six who would be left alone in households without an adult caretaker. While it is true that parents and caregivers would try and make some arrangements for members of other households to take care of their children, many caregivers may not have the networks needed, and may feel compelled to go to work to earn income to support their child(ren). This is all because community-based early childhood development centres and preschools are still not allowed to operate despite the economy re-opening.
Government Gazette No. 43381 (1 June 2020) reports that Early Childhood Development (ECD) will be allowed to re-open on the 6th of July 2020, despite the fact that the vast majority of the economy ‘re-opened’ on the 1st of June 2020 when the country moved to Level 3 Lockdown (DBE, 2020a: p.4). It is unclear what the Department of Basic Education and the Department of Social Development think is meant to happen to these 974 000 children under the age of six who have no alternative non-working caregiver.
In addition to the above, given that most ECD facilities in South Africa are primarily privately-operated small businesses, it is unclear how many of these ECD centres and creches will have been able to survive the income loss of the extended lockdown.
(7) What are your conclusions and policy recommendations?
After reviewing the evidence presented in this paper, it is our view that keeping children out of school is not in the best interests of the child. Consequently, all children should return to schools, crèches and ECD centres without any further delay. The profound costs borne by small children and families as a result of the ongoing nationwide lockdown and school closures will be felt for at least the next 10 years.
When the new coronavirus rapidly spread across the globe, the impact of the virus on children was still unclear, and closing schools from an abundance of caution seemed the responsible thing to do. But much has been learnt since about both COVID-19 and about the effects of lockdown and school closures, both in South Africa and internationally. Given the large social and economic costs of hard lockdowns and wholesale school closures we would strongly caution against future nation-wide lockdowns or school closures, even in the presence of a surge in COVID-19 infections. Policy-makers and government leaders have an obligation to weigh up the costs and collateral damage of their policies, particularly for those who are most vulnerable, such as small children, the elderly and those in poverty.
Millions of South African children’s education and mental health have been compromised in this initial period of uncertainty. Given what is now known about the mortality rates of COVID-19, we believe that the ongoing disruptions to children’s care, education and health are no longer justified.
— END —
To read the full report download it HERE.
Dr Alasdair Munro is a Clinical Research Fellow in Paediatric Infectious Diseases at the South Hampton Clinical Research Facility. He is the review lead at the incredibly helpful Don’t Forget the Bubbles website which summarises the epidemiological evidence on COVID-19 as it comes out, especially as it relates to children. I have found their reviews to be the most up to date and helpful of the many that are popping up on the web. Yesterday Dr Munro went through a list of current questions people have on children and COVID-19 and posted their latest thinking on the research informing their views on children and COVID-19. I’m re-blogging that here because I found it so helpful!
Dr Munro: “With so much attention on COVID19 in children, it’s time for an updated Tweetorial on what we do and don’t know. We’ll talk impact, risk, hyperinflammation syndrome, transmission, schools and more. Firstly, children remain grossly underrepresented in all case numbers, hospital admissions and deaths worldwide. See the latest ISARIC report of more than 15,000 severe cases, or Public Health England UK deaths.
This report from Prof Sunil Bhopal and friends looks at child deaths from COVID19 compared to other causes to put them in perspective. Of about 37,000 child deaths, 43 were from COVID19. In the words of Prof David Spiegelhalter, children are “unbelievably low risk”
Are some children higher risk? Small numbers, but children usually at risk from viral respiratory infections look equally at risk from #COVID19, including tech dependent, neurodisability, malignancy or chronic lung disease (see here and here). Important to note that outcomes are still pretty good for these groups, and there are a number of documented cases for some (e.g. oncology, immuno-suppressed) which had a predominantly mild clinical course. Even most of these children don’t get very sick. What about this hyper inflammatory syndrome? It’s called PIMS-TS (or MIS-C in the USA). It seems to be an immune reaction after COVID19 infection (approximately 2 – 4 weeks after). It usually starts with persistent fever, abdominal pain and diarrhoea and vomiting, then can present similar to Kawasaki Syndrome (+/- shock).
We currently have 3 published cohorts from London, Italy and France. Many kids get very sick, but most recover well. It seems to be dissipating (following trends in peaks of infection). Read more about it here. It can be serious, but is incredibly rare. In Europe there have been about 230 cases and very few deaths. There are more than 80-million children and the European Centre for Disease Control (CDC) considers it a low risk. Be reassured.
OK what about transmission? Let’s go step by step. How easily do children catch it? Five studies have looked at transmission to children (mainly household) and 4 out of 5 found significantly lower attack rates in children than adults.
How many children actually have or had COVID19? Well, less than 2% of known cases have been in children, but given symptoms are so mild have we just missed them all? Are they mainly asymptomatic? Are they silent assassins? This is harder to tell, but there is some evidence. Iceland tested those at risk and found half the rate of infection in children under 10 years compared to adults, and zero cases in asymptomatic screening. Vo, Italy screened more than 85% of their population and 2.6% had COVID19, but no children under the age of 10.
Some say the UK Office of National Statistics data shows there’s no difference between children and adult infection rates. But they found about 30 positive cases in 10,000 people. The confidence intervals are too wide for inference about relative infection rates (compatible with 10x rates in any group).
The same principle applies for 2 sero-epidemiological studies from Switzerland & Germany. Despite lower rates of infection in children, numbers are too small to be statistically significant. This is not evidence for equal rates of infection.
What do we find if we do a proper sized sero-epidemiological study? Infection rates of 1-3% in children compared to 5% in adults in a Spanish study of more than 60,000 people.
How infectious are children when infected? Hard to say. Some examples of children not spreading at all despite multiple exposures (more than 100 other children) but spreading other respiratory viruses. A German study claimed to find similar viral loads in children as adults, stating they’re “just as infectious.” Amongst other issues, if analysed properly the data actually showed significantly lower viral loads in children.
What does it mean for schools? Children can get COVID19 so they can almost certainly spread it. But, they are barely affected by infection, and appear less likely to catch or spread it than adults (see here). Schools seem lower risk than adult work environments. Will outbreaks happen? Of course. But this is our new reality for the foreseeable future. We need to mitigate against the risks and ensure mechanisms for quick response (track, trace and isolate) are in place. Children suffer harm from lockdown (see here).
Now for why children seem so much less affected… Still no clear answers. Possible differences in ACE2 expression, but they seem small. Some suggest immune differences. This needs to be proven. More research needed!
Thanks for making it to the end! For our comprehensive review of all paediatric #COVID19 literature (cited by UK Research and Innovation and World Health Organisation) check it out here on Don’t Forget the Bubbles.
Follow Dr Alasdair Munro on Twitter at @apsmunro