A multi-disciplinary panel of academics and fieldworkers took to the virtual stage on Friday, 16 July 2021 to present the structure and findings of an exciting South African case study into the promotion of child well-being. This forms part of the programme at the 22nd Biennial International Consortium for Social Development Conference (ICSD), hosted online by the Centre for Social Development in Africa (CSDA) at the University of Johannesburg (UJ), 13 – 16 July 2021.
Professor Leila Patel – the DST/NRF South African Research Chair in Welfare and Social Development, and the founding director of the CSDA – opened the session, providing the context for the establishment of the community of practice (COP), a multi- and trans-disciplinary, two-year collaborative intervention research study, which set out to identify and measure a broad set of factors that contribute to a child’s mental, education, physical, and emotional health and “… to find breakthrough ideas, knowledge, solutions, and practices to a complex and intractable social issue – child wellbeing,” said Patel.
The COP was made possible by funding from the National Research Foundation, and brings together partners from fields including social work, sociology, psychology, education, health care, community nursing, nutrition, engineering and more, to assess a sample of “early grade learners”, aged six to eight, and drawn from poorer areas and no fee schools. The first wave of data was collected during the Covid-19 pandemic, which also provided an opportunity to explore the effect of the pandemic and responses to the pandemic on aspects of child well-being.
They also set out to answer several ambitious questions, most importantly: how can we overcome the fragmentation of service provision and the lack of functional cooperation between key social sectors to accelerate child wellbeing outcomes in South Africa?
The COP, Patel continued, “places emphasis on cooperation around improving child wellbeing outcomes but realising these synergies across different sectors is easier said than done,” she cautioned, “and implementation is complex.”
With this established at the outset, the panel followed in the same collaborative, multi-dimensional mode as the study itself – featuring presentations from contributors in the fields of engineering, education, social work, and health.
The study is ongoing, but Patel presented a handful of early findings including that the material well-being of families had been “hugely compromised” during the pandemic, with the sample showing high levels of unemployment, indebtedness, hunger, and symptoms of depression.
Designing a robust data collection tool
Patel was followed by Professor Arnesh Telukdarie from the Postgraduate School of Engineering Management, UJ who laid out the approach to designing and building the child well-being tracking tool (CWTT) used by the COP, as well as lessons learned in the first implementation.
The CWTT was used to bring data from various sources and on various indicators into a single platform so there was one version of the information to interrogate. It also needed to be capable of offline functioning, synchronisation of data from multiple streams, assigning user roles and permissions, and advanced analytics.
Unpacking child well-being
The data from the CWTT indicates that there are a range of barriers to child wellbeing. 162 children participated in the first wave of research and the findings highlight that many children live in precarious environments where 65% of primary caregivers are unemployed and 36% report having no source of income aside from the Child Support Grant. An alarming 35% report they don’t have enough money to cover their basic needs.
Although 96% of children attend school regularly, 16% of children are not progressing with their school work and a worrying 36% of children are afraid to go to school. Teachers report that 33% of children have difficulty learning and 21,5 % have difficulty sitting long enough to learn.
In terms of food and nutrition 33% of children sometimes or often go to bed hungry and 37% live in homes where there isn’t enough food. From a health perspective 17% of children have health concerns that prevent them from going to school regularly and although 96% of children have a ‘road to health’ vaccination card, 33% of children’s vaccinations are not up to date. In terms of safety, 67% of children have been exposed to violence, 75% have safety concerns and 8% are victims of abuse. It is interesting to note that teachers only reported evidence of abuse for 5,5%, showing that abuse may go undetected
Intersection of language and mathematics learning
Dr Hanrie Bezuidenhout, a postdoctoral fellow in the Faculty of Education at UJ stepped up next to take the audience through some of the educational assessments done as part of the study. She laid out why it was deemed “particularly relevant to study the interaction of different components in education such as language and mathematics” because previous studies have shown the link between such skills acquisition and because these are foundational skills for later learning.
Sample subjects were drawn from five schools identified to fit the no fee criteria, but the 131 participants (children) were randomly selected from therein, before being assessed on their early grade reading, against the MARKO-D (SA) scale which measures a young child’s number concept development, and using the Meerkat maths language test (MMLT) which works in conjunction with MARKO-D to establish whether mathematical conception or language understanding was contributing to a child’s difficulties.
At this early stage, the children averaged a score of 45,88% in their number concept development, a finding that is “quite concerning because this measure is developed for ages four to eight, and the subjects were aged six to eight.”
In the second phase of the analysis, the academics will be able to merge data sets and begin to see how social, health, family, or other factors correlate with and possibly contribute to educational achievement (or lack thereof), and this will help the COP design multidimensional interventions.
Healthy hearts and minds
For the final component of this presentation, nurse and UJ lecturer Alida du Plessis-Faurie explained the insights and lessons of the nurses involved in the COP, who were in the field collecting data on children’s weight, BMI, temperatures, heart rates, blood glucose levels, vaccinations, their hearing and sight, among other metrics.
Her presentation highlighted the positive experiences of the COP nurses, including seeing “the resilience of these children, despite the difficulties at this time”, but also the complex organisational bureaucracy through which a child’s well-being is tracked. This she called “stakeholder barriers” such as finding which jurisdiction (city, provincial, etc) to report a problem to, and how this complicated referring children who had been “red flagged” for help or intervention by the nurses.
The presentation slides as well as papers relating to the study can be found on the conference website.