Nhede Norman Tafirenyika, Mazenda Adrino, Gondwe Dymon
School of Public Management and Administration, University of Pretoria, Private Bag X20, Hatfield, Pretoria 0028, South Africa.
Dialogues Health. 2025 Jul 5;7:100228. doi: 10.1016/j.dialog.2025.100228. eCollection 2025 Dec.
This study examines the impact of Child Support Grants (CSGs) on access to medical care and contraception use in South Africa, investigating whether social assistance can enhance healthcare access beyond its primary aim of alleviating poverty. While previous research highlights CSGs' poverty reduction and welfare enhancement effects, little is known about their effects on healthcare and reproductive healthcare access, especially given South Africa's healthcare disparities. Using data from the first wave of the 2020 National Income Dynamics Study-Coronavirus Rapid Mobile Survey (NIDS-CRAM), this study employs mediation analysis to analyse the effects of CSG receipt on healthcare and contraception access while controlling for socio-economic factors. The findings indicate a complex relationship. CSGs have a positive but insignificant indirect effect on healthcare and contraception access and a significant negative direct effect, suggesting that the current grant structure may not adequately address existing barriers. The results highlight the need for policy changes, indicating that while CSGs are vital as a social safety net, their effectiveness in improving healthcare access could be enhanced through increased grant amounts and targeted interventions to address healthcare costs and structural barriers.
本研究考察了儿童抚养津贴（CSGs）对南非医疗服务获取和避孕措施使用的影响，探究社会援助能否在减轻贫困这一主要目标之外，增强医疗服务的可及性。尽管先前的研究强调了儿童抚养津贴在减贫和增进福利方面的作用，但对于其对医疗保健和生殖健康服务可及性的影响却知之甚少，尤其是考虑到南非存在的医疗保健差距。本研究利用2020年国民收入动态研究-冠状病毒快速移动调查（NIDS-CRAM）第一波的数据，在控制社会经济因素的同时，采用中介分析来研究领取儿童抚养津贴对医疗服务和避孕措施可及性的影响。研究结果显示了一种复杂的关系。儿童抚养津贴对医疗服务和避孕措施的可及性有积极但不显著的间接影响，以及显著的消极直接影响，这表明当前的津贴结构可能无法充分消除现有的障碍。研究结果凸显了政策变革的必要性，表明尽管儿童抚养津贴作为社会安全网至关重要，但通过增加津贴金额以及采取针对性干预措施来解决医疗费用和结构性障碍，其在改善医疗服务可及性方面的效果可能会得到增强。
