OpenUCT is the open access institutional repository of the University of Cape Town (UCT). It preserves and makes UCT scholarly outputs digitally and freely available, including theses and dissertations, journal articles, book chapters, technical and research reports, as well as open educational resources.
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Assessing the impact of social income grants on inequality and economic growth in South Africa
(2026) Senabe, Thato; Gossel, Sean
Researchers and policymakers have long debated the relationship between social grants and economic growth, and social grants and income inequality, alongside the interplay among these three factors. This study thus used a Vector Error Correction (VEC) model to evaluate these relationships in South Africa from 2002 to 2023. The VECM results find a positive long-term relationship between social grants and economic growth, but a negative long-term relationship between social grants, income inequality, and economic growth. The Block Granger causality results, however, find no significant causal associations between economic growth and income inequality. Moreover, the variance decomposition analysis reveals that shocks to GDP growth primarily affect GDP growth itself, while shocks to social grant growth account for a small but increasing portion of the variation in GDP growth over time. The impulse response analysis reveals that a shock to social grants has a significant, positive, and long-lasting impact on GDP growth. The causality results indicate a positive long-term relationship between social grants and economic growth, and a negative long-term relationship between social grants and inequality. The policy implications of these results are that South African policymakers should maintain social grants as a policy intervention to ensure continued inequality mitigation and/or reduction over time, increase government expenditure in key, labour-intensive industries to stimulate growth given its statistical significance, and consider the establishment of an expanded social grant/cash transfer framework, reminiscent of Brazil's Bolsa Familia programme, which will facilitate inequality reduction/mitigation and promote more equitable economic growth in the long term.
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Open Access
Assessing catastrophic and impoverishing health expenditure from out-of-pocket health payments in Botswana
(2026) Sekwati, Banyana; Alaba, Olufunke
Out-of-pocket (OOP) health expenditures can place a heavy financial strain on households, often resulting in catastrophic healthcare costs and driving families into poverty. This thesis assesses the extent to which OOP health costs impact households in Botswana because of healthcare utilization. The study is divided into four main sections. Part A: Literature Review provides an overview of key concepts, theoretical frameworks, and empirical evidence related to catastrophic and impoverishing health expenditures. It explores regional and international studies on the financial hardships caused by OOP healthcare costs. Part B: The manuscript presents the main research findings, utilizing data from the nationally representative Botswana Multi-Topic Household Survey 2015/16, conducted by Statistics Botswana, which includes a sample of 7,049 households. Catastrophic and impoverishing OOP healthcare payments were evaluated using a threshold that varies according to household income. Impoverishment was measured using Botswana's national poverty line of BWP 1,014.00/month and the international poverty line of $1.90 per day. The findings reveal that 13.8% of households in Botswana experienced financial hardship when applying a threshold of 10% of total consumption expenditure. In comparison, 3.1% faced financial hardship using a 40% threshold of non-food expenditure. Additionally, approximately 0.1% of households— equivalent to around 122,588—were pushed below the poverty line based on Botswana's national poverty line. In Part C: Policy Brief, the study's conclusions are summarized into actionable recommendations for policymakers. It advocates for strategies such as the establishment of a national health insurance scheme to enhance financial protection and ensure equitable access to healthcare services. The final section includes Appendices, which provide the study protocol, research instruments used for data collection and analysis, and ethical clearance. The findings from this thesis contribute to the ongoing discourse on universal health coverage in Botswana by offering evidence-based insights into the financial barriers to accessing healthcare. The policy recommendations aim to inform health financing reforms that mitigate the adverse effects of OOP payments while promoting equitable access to healthcare services.
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Open Access
Is inclusive education our answer to increased literacy? Examining the impact of inclusive education in the South African schooling system on the literacy and well-being of learners
(2026) Schmid, Maxine; Kubeka, Khosi
Literacy plays a pivotal role in shaping academic success, mental well-being, and future socioeconomic outcomes. In South Africa, however, many high school learners in under-resourced communities continue to face poor literacy outcomes, despite the implementation of inclusive education policies. This study aimed to investigate the extent of low literacy levels among Grade 8 and 9 learners and to examine the relationship between literacy proficiency, inclusive education practices, mental well-being, and external social factors. A quantitative, descriptive research design was employed. The study sampled 181 learners from two high schools in Cape Town, situated in historically disadvantaged areas. Data were collected using a standardised literacy assessment and a self-report questionnaire that measured perceptions of inclusive education, experiences of social exclusion, and mental health (using the DASS-Y scale). Findings revealed that while learners perceived their schools as inclusive and felt supported by teachers, overall literacy scores remained low. Statistical analysis showed a weak correlation between inclusive classroom practices and literacy performance. Instead, external factors such as poverty, household instability, and psychological distress had a stronger association with poor literacy outcomes. Learners with lower literacy scores were also more likely to report feelings of social exclusion and mental health challenges. The study concludes that classroom-based inclusive practices, while important, are insufficient on their own. A more holistic approach is needed—one that integrates mental health support and addresses the broader socio-economic barriers impacting learners. These findings underscore the need for policy and programmatic responses that target both the academic and emotional needs of learners in marginalised contexts.
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Open Access
Building purposeful organisations from the inside out: a feminist's exploration of experiential agency
(2026) Scheepers, Ella; Nilsson, Warren
Social purpose organisations across the world are experimenting with new possibilities and challenging power for more just and caring societies (Lynch et al, 2021). This research examines how organisations fighting for social change live those goals internally instead of perpetuating the inequality and injustice they aim to fight (Nilsson & Paddock, 2014). This research seeks to build on theoretical insights into the emerging field of agency and positive institutional work (Nilsson, 2015), focusing on the experience involved in pursuing social goods (Hampel et al, 2017). It draws on developing literature on institutional work and its transformatory possibilities, in conversation with feminist institutionalism (Mackay, 2009; Kenny, 2011; Montoya, 2016) and politics of care literature (Toronto, 1991; Woodly et al, 2021; Lynch et al, 2021), to offer a more experiential understanding of agency in institutions. To do this, this research also reignites a multiscalar conceptualisation of power in new institutionalism to reflect the deeper societal forces at play that affect the institutional work of organisations and the individuals that experience them. Insight was built via a qualitative inquiry and empirical exploration into the practices and experiences of agency that constitute and maintain experiential legitimacy in three social purpose organisations in South Africa. Experiential legitimacy refers to how organisational members perceive that their lived, subjective experiences reflect—or fail to reflect—the organisation's espoused social purpose. The inquiry shows that organisation members felt most connected to each other and their organisation's purpose through specific practices, such as surfacing subjective experiences, communing as whole persons, and dialoguing around purpose and meaning. It was evident that the question of how experiential legitimacy is accomplished was linked to organisation members' experience of agency as they work to become more conscious and effective participants (Lawrence et al, 2011) in the mutual ongoing inquiry involved in pursuing social goods with a collaborative spirit (Nilsson, 2015). My findings highlight how a deeper understanding of power, experience and agency underscores the transformatory potential of institutional work demonstrating alternative modes of relating inside organisations (Benschop, 2021), specifically building on feminist ideas of agency as a situated, embodied and relational phenomenon (McNay, 2016). By engaging in positive institutional work, organisation members deepen their experience of each other and their organisation's purpose. This research cultivates the idea of experiential agency as the iterative collective process through which actors connect their social purpose goals to their everyday experiences through positive institutional work.
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Open Access
Exploring the change in perceptions of resilience in community service doctors during their community service year
(2026) Saunders, Amanda; Reid, Stephen; Ras, Tasleem
Background: Each year approximately 2000 junior doctors are placed in community service posts in South Africa, a legislative requirement which South African doctors must meet in order to register as independent practitioners. These doctors have two years of experience post-graduation, working as supervised intern doctors. During community service, they are often placed in remote and rural locations which may be unfamiliar to them and without predictable support. There is evidence that junior doctors in South Africa are more vulnerable to burnout. There is also evidence that resilience is protective against burnout, but there is difficulty defining and characterizing resilience. We also have little idea of what resilience means to South African healthcare workers. This study aimed to explore perceptions of the concept of resilience in community service doctors and how that changes over their community service year, in order to gain insight into the concept of resilience in South African healthcare workers. Methods: Nine volunteer community service doctors were recruited and interviewed twice using a semi-structured interview technique, with at least a three-month interval between interviews. Data underwent inductive thematic analysis to generate themes and sub-themes. Results: Six major themes emerged with multiple sub-themes. Community service doctors who volunteered to participate in this study had perceptions of resilience rooted in their personal and professional experiences in the context of their community service year. However, they had not yet developed insight into how the public health system in which they worked impacted their resilience. Conclusion: While this study included only nine participants, it provides us with insight into the community service experience of junior doctors in South Africa and with how they perceive the concept of resilience. In order to improve the sustainability of our human resources for health, it is not only the healthcare workers who must develop their individual resilience, but the capacity of the healthcare system itself to nurture young health professionals, that will make a difference.