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There is widespread concern that the number of children living in child-headed households is rapidly increasing as a result of AIDS-related adult mortality in much of sub-Saharan Africa. Based on analyses of data from several representative national surveys over the period 2000-2007, this paper examines the extent to which this is the case in South Africa. It explores trends in the number of children living in child-only households and characterises these children relative to children living in households with adults (mixed-generation households). The findings indicate that the proportion of child-only households is relatively small (0.47% in 2006) and does not appear to be increasing. In addition, the vast majority (92.1%) of children resident in child-only households have a living parent. The findings raise critical questions about the circumstances leading to the formation of child-only households and highlight that they cannot for the main part be ascribed to HIV orphaning. Nonetheless, the number of children living in this household form is not insignificant, and their circumstances, when compared with children in mixed-generation households, indicate a range of challenges, including greater economic vulnerability and inadequate service access. We argue that a solitary focus on the HIV epidemic and its related orphaning as the cause of child-only households masks other important issues for consideration in addressing their needs, and risks the development of inappropriate policies, programmes and interventions.
Statistics South Africa, the agency responsible for both surveys used in this analysis, defines a household as consisting of people who have stayed in a common dwelling for an average of at least four nights a week in the month preceding the survey. In this analysis, the term “child-only” is used to denote households in which all members were under 18 years at the time of the survey (commonly referred to in the literature and in popular discourse as “child-headed” households). The term “mixed-generation” is used to denote households that include both child and adult members. Orphans are defined in three mutually exclusive categories: maternal orphans (mother deceased or vital status unknown, father alive); paternal orphans (father deceased or vital status unknown, mother alive) and double orphans (both parents deceased or vital status unknown). We refer to children with both biological parents alive as non-orphans. The analysis of trends in the prevalence of child-only households draws on the annual General Household Survey (GHS) for the years 2002–2006 and the bi-annual Labour Force Survey (LFS) for the years 2000–2007. These are the only representative national surveys which provide appropriate data over time at sufficient frequencies, and are adequately standardised to provide comparability between iterations (Barnes et al., 2007). Both surveys are based on two-stage sampling procedures, with the selection of 3000 clusters and 10 households per cluster, stratified by the 53 districts in the country (Statistics South Africa, 2008a, 2008b). All available survey data from 2000 to 2007 were included from both surveys, with a total of 21 analyses. The more detailed demographic analyses and comparisons of child-only and mixed-generation households draw specifically on the 2006 GHS. In each of the surveys used in this analysis, a small proportion of enumerated household members did not have an age recorded (<0.1%). In households with no recorded adult members but a member of unknown age, the household was considered mixed-generation if the relationship between any children and the head of household was that of grandchild, or in the case of children aged seven years or older, child. Such households were also considered mixed-generation if any member had completed schooling up to Grade 12, or received a state old age pension, or disability grant (available only to adults over 18 years). Remaining households with no adult members but a member of unknown age were coded as “undefined” but were included with the category of child-only household in sensitivity analysis. The sensitivity analysis indicated that the exclusion of undefined households had a negligible effect on the estimated proportions of children in child-only households. The proportion of children in child-only households was calculated nationally for each iteration of both the GHS and LFS, and additionally by province for the five consecutive years of the GHS. Illustrative numbers of children or households were derived from these proportions by applying them to the national population in the given year. The weights are derived from mid-year population estimates, which are themselves subject to error. Population numbers should therefore be regarded with some caution. The analysis was conducted predominantly at the individual level (i.e., proportion of children, rather than of households). This helped to avoid the confounding effect of a household denominator that has changed faster than population growth over the analysis period – due in part to the large-scale roll-out of housing in South Africa. Household-level comparisons distinguished between child-only households and mixed-generation households. Households without children (41%) were excluded from selected analyses. The orphan status of children was described for each household type based on responses to survey questions about the vital status of each parent. The relationship between orphanhood and child-only households was explored in univariate logistic regression in the 2006 GHS survey. Individual and household characteristics including age, gender, race, schooling, poverty, household size and employment were described using appropriate summary statistics (proportions with 95% confidence intervals [CI] and medians with interquartile [IQR] ranges). All estimates used the provided survey probability weights with the standard errors adjusted for design effect resulting from the cluster survey designs. Proportions were compared using Pearson chi-squared tests corrected for survey design and the continuous measures (age and household size) with Wilcoxon rank-sum tests. All tests of significance were two-sided. Analyses were done using StataTM (StataCorp, 2007).
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