Bridging the gap: The impact of home visiting programs for orphans and vulnerable children on social grant uptake in South Africa

Cash transfer programs hold significant potential to mitigate the economic burdens resulting from the HIV epidemic and enhance the wellbeing of affected children. South Africa offers two cash transfers designed specifically to benefit children: the Child Support Grant, for low income families with children, and the Foster Child Grant, for children living outside of parental care. Given the high proportion of HIV-affected children who qualify for these grants, increasing grant access among eligible families is a natural objective for many programs targeting orphans and vulnerable children. We present results from a quasi-experimental study examining differences in grant uptake over a two year period among 1487 children enrolled in one of two types of supportive home visiting programming: volunteer-based or paraprofessional. The study also examined related outcomes including household food security and children's access to basic educational and material needs. Results show that programs staffed with trained paraprofessionals who received training, compensation and other support were significantly more effective at linking families to social grants for children. Controlling for important covariates, at follow-up participants in the paraprofessional model programs were nearly three times as likely as volunteer-based service recipients to have access to the highest grant they were eligible to receive. Grant receipt was also positively associated with household food security and children's obtainment of basic educational and material resources. Effective strategies for promoting social grant access among HIV-affected households therefore have the potential to yield significant improvements in wellbeing for orphans and vulnerable children.