Investigation of the socio-economic impacts of morbidity and mortality on coping strategies among community garden clubs in Maphephetheni, KwaZulu-Natal.

Thesis (Ph.D.)-University of KwaZulu-Natal, Pietermaritzburg, 2007.

The impact of morbidity and mortality on women’s coping strategies has not been explored or documented in South Africa. Therefore, the main objective of this study was to investigate the influence of morbidity and mortality on coping strategies among 10 community vegetable garden clubs representing 79 households in the Maphephetheni uplands, rural KwaZulu-Natal. An innovative mix of qualitative and quantitative methodologies was used to determine the impacts of morbidity and mortality on women’s coping strategies. Qualitative research methodologies included group sustainable livelihoods analyses. Quantitative methodologies included three annual household surveys conducted between 2003 and 2005. The coping strategy index was also used to determine the levels of food insecurity and understand how morbidity and mortality compromised the coping ability of participating households. The coping strategy index has not been previously used in assessing the impact of morbidity and mortality on coping strategies. Chi-Square tests, Pearson correlation, paired-sample t-tests, and frequency and descriptive statistics were applied to analyse data. The study found that the key contribution of women in community gardening and non-farm activities was compromised by the burden of morbidity and mortality that had negative effects on women’s coping strategies. Findings indicated that the frequency of illness among garden club and household members increased between 2003 (21.2% of household members) and 2004 (25%). Similarly, more households (42% of the sample households) experienced a death in 2004 compared to 7.6 percent of households in 2003. As a result, costs associated with health care and funerals were significantly (P = 0.01) lower in 2003 than in 2004. Most garden club and household members relied on subsidised medication to treat illness. Number of households dependent on subsidised medication dropped from 86 percent of households in 2003 to 66.7 percent in 2004. In 2004, households reported purchasing medication in addition to subsidised medication. Caring for the sick and contributions to household chores were significantly (P = 0.01) correlated in 2003 and 2004. This means that increased caring for sick members resulted in increased workloads for women. Caring for the sick and engagement in community garden activities were significantly (P = 0.01) correlated in both 2003 and 2004, suggesting that caring for the sick reduced participation in community gardens. Analysis showed that reduced labour supply due to increased incidences of sickness and deaths, increased health care and funeral costs, reduced household income and increased care-giving minimised women’s ability to cope with adverse situations. Women used erosive coping strategies such as borrowing money, selling assets, limiting portion sizes at meal times and relying on less preferred and less expensive foods to cushion the effects of morbidity and mortality. Application of erosive coping strategies minimises household resilience to future shocks and stresses. Findings showed that farm and non-farm livelihood activities were critical components of rural livelihoods in Maphephetheni because sample households depended on community gardens, home gardens and small-scale non-farm enterprises for food and income to cushion the negative effects of morbidity and mortality. Community gardening contributed less to total monthly household income (4% of total monthly household income) than wages (41%), social grants (40.9%), home gardens (7%), small-scale enterprises (4.2%) and remittances (2.9%). Even though low, the contribution of community gardens to food security cannot be ignored considering the number of households (about 32% of sample households) that depended upon subsistence agriculture for food. Further analysis indicated that community gardens were themselves a coping strategy in the face of morbidity and mortality. Community gardens provided a risk aversion strategy and minimised risk by providing food resources and social and moral support for households facing hardship. Strategies to enhance household asset bases and promote more productive farm and non-farm activities are needed to improve resilience against the effects of morbidity and mortality. Government and non-governmental organisations need to establish a multi-purpose centre where women can learn agricultural and entrepreneurial skills to help households cope more effectively with shocks and stresses. However, such strategies should ensure that tasks allocated to various activities such as community gardening, non-farm activities and household chores such as fuel and water collection should be distributed equally across household members so that women do not carry excessive workloads since increased workloads reduce women’s ability to respond to livelihood insecurity shocks and stresses.