COVID-19 Pandemic, Poverty and Health Outcomes in South Africa: Do Social Protection Programmes Protect?

Abstract The COVID-19 pandemic resulted in significant income loss for many people and deepened poverty for individuals and vulnerable populations who were adversely affected through job losses. In South Africa, income loss made it harder to acquire health care and a healthy food, which had a negative impact on health outcomes. This study hypothesised that the COVID-19 shocks disproportionately affects the poor's health, hence the need to know the impact of social protection programmes and interventions through the South Africa Social Security Grant (SASSG). Herewith, we employed the nationally represented, robust and reliable National Income Dynamics Study (NIDS) data set which was conducted in 2017 (pre-COVID-19), with the first wave of the NIDS-Coronavirus Rapid Mobile Survey (NIDS-CRAM) conducted in 2021 (during COVID-19). The household's per capita total income was used to generate poverty lines, while concentration curves and indices were employed to explain the income-health inequalities. The difference-in-difference with fixed effects model was used to estimate the impact of SASSG on the COVID-19 poverty stressors and self-reported health status. Given the significance and magnitude of institutional variables in determining the socio-economic inequalities in poor health, addressing hunger, income inequality and unemployment slightly helped to mitigate income-health inequalities during the COVID-19 shocks. We found that the social protection intervention in South Africa (SASSG) cushioned the impact of the COVID-19 pandemic in the context of poverty stressors and self-reported health status. Therefore, we advocate for programmes in South Africa that focus on reducing poverty and health disparities connected to income, as well as more proactive social protection programmes.