National Treasury

ABSTRACTThis paper uses administrative tax data to examine the impact of strengthening employment protection legislation in the temporary employment services (TES) sector in South Africa. The study uses a regression discontinuity design to investigate whether the 2015 amendments to the LRA had a causal impact on the employment, wages and contract duration of workers employed in the sector. The findings suggest limited impacts in the short‐term. There were no significant effects on worker transitions, and improved working conditions only for the relatively small group that did move out of the TES sector into the non‐TES sector after the reform.

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The COVID-19 pandemic has brought the need for well-functioning primary health care (PHC) into sharp focus. PHC is the best platform for providing basic health interventions (including effective management of non-communicable diseases) and essential public health functions. PHC is widely recognised as a key component of all high-performing health systems and is an essential foundation of universal health coverage. PHC was famously set as a global priority in the 1978 Alma-Ata Declaration. More recently, the 2018 Astana Declaration on PHC made a similar call for universal coverage of basic health care across the life cycle, as well as essential public health functions, community engagement, and a multisectoral approach to health. Yet in most low-income and middle-income countries (LMICs), PHC is not delivering on the promises of these declarations. In many places across the globe, PHC does not meet the needs of the people—including both users and providers—who should be at its centre. Public funding for PHC is insufficient, access to PHC services remains inequitable, and patients often have to pay out of pocket to use them. A vicious cycle has undermined PHC: underfunded services are unreliable, of poor quality, and not accountable to users. Therefore, many people bypass primary health-care facilities to seek out higher-level specialist care. This action deprives PHC of funding, and the lack of resources further exacerbates the problems that have driven patients elsewhere.

COVID-19 disease models have aided policymakers in low-and middle-income countries (LMICs) with many critical decisions. Many challenges remain surrounding their use, from inappropriate model selection and adoption, inadequate and untimely reporting of evidence, to the lack of iterative stakeholder engagement in policy formulation and deliberation. These issues can contribute to the misuse of models and hinder effective policy implementation. Without guidance on how to address such challenges, the true potential of such models may not be realised. The COVID-19 Multi-Model Comparison Collaboration (CMCC) was formed to address this gap. CMCC is a global collaboration between decision-makers from LMICs, modellers and researchers, and development partners. To understand the limitations of existing COVID-19 disease models (primarily from high income countries) and how they could be adequately support decision-making in LMICs, a desk review of modelling experience during the COVID-19 and past disease outbreaks, two online surveys, and regular online consultations were held among the collaborators. Three key recommendations from CMCC include: A ‘fitness-for-purpose’ flowchart, a tool that concurrently walks policymakers (or their advisors) and modellers through a model selection and development process. The flowchart is organised around the following: policy aims, modelling feasibility, model implementation, model reporting commitment. A ‘reporting standards trajectory’, which includes three gradually increasing standard of reports, ‘minimum’, ‘acceptable’, and ‘ideal’, and seeks collaboration from funders, modellers, and decision-makers to enhance the quality of reports over time and accountability of researchers. A framework for “collaborative modelling for effective policy implementation and evaluation” which extends the definition of stakeholders to funders, ground-level implementers, public, and other researchers, and outlines how each can contribute to modelling. We advocate for standardisation of modelling processes and adoption of country-owned model through iterative stakeholder participation and discuss how they can enhance trust, accountability, and public ownership to decisions.

We use a fiscal incidence model based on the South African 2014/15 Living Conditions Survey to simulate the poverty reduction impacts of a selection of medium-to-long-term social grant options with the goal of replacing the existing special COVID-19 Social Relief of Distress grant upon its expiry and closing the extreme (food poverty line) poverty gap. Our key findings are that the introduction of a household-targeted family poverty grant is theoretically able to reduce extreme poverty most efficiently; however, it faces stark implementation challenges. The basic income grant has the largest impact on poverty with its large budget and is possibly easier to implement through the tax system, but ties for the least efficient scenario. A redesigned special COVID-19 Social Relief of Distress grant is similar in budget size to the family poverty grant and presents a middle-ground in terms of efficiency and implementation challenges. Finally, topping up the child support grant is more efficient than implementing a public works programme, but both are small in size, and the former would exclude households without children, while the latter has operational constraints and competing goals, diluting its short-term poverty reduction impact. We find some sensitivity to the poverty line chosen and size of the budget, and strongly recommend that further research be conducted on the implementation aspects of new grants which may substantively change the theoretical results and ranking of options presented here. In addition, the sociological consequences of a possible shift towards a household-based social grants system may prove important.

Previous research on the association between maternal HIV status and child mortality in sub-Saharan Africa was published between 2005-2011. Findings from these studies showed a higher child mortality risk among children born to HIV-positive mothers. While the population of women with disabilities is growing in developing countries, we found no research that examined the association between maternal disability in HIV-positive mothers, and child mortality in sub-Saharan Africa. This study examined the potential compounding effect of maternal disability and HIV status on child mortality in South Africa. We analyzed data for women age 15-49 years from South Africa, using the nationally representative 2016 South Africa Demographic and Health Survey. We estimated unadjusted and adjusted risk ratios of child mortality indicators by maternal disability and maternal HIV using modified Poisson regressions. Children born to disabled mothers compared to their peers born to non-disabled mothers were at a higher risk for neonatal mortality (RR = 1.80, 95% CI:1.31-2.49), infant mortality (RR = 1.69, 95% CI:1.19-2.41), and under-five mortality (RR = 1.78, 95% CI:1.05-3.01). The joint risk of maternal disability and HIV-positive status on the selected child mortality indicators is compounded such that it is more than the sum of the risks from maternal disability or maternal HIV-positive status alone (RR = 3.97 vs. joint RR = 3.67 for neonatal mortality; RR = 3.57 vs. joint RR = 3.25 for infant mortality; RR = 6.44 vs. joint RR = 3.75 for under-five mortality). The findings suggest that children born to HIV-positive women with disabilities are at an exceptionally high risk of premature mortality. Established inequalities faced by women with disabilities may account for this increased risk. Given that maternal HIV and disability amplify each other's impact on child mortality, addressing disabled women's HIV-related needs and understanding the pathways and mechanisms contributing to these disparities is crucial.

This paper uses firm-level data and a news-based measure of economic policy uncertainty to provide empirical evidence that economic policy uncertainty has a negative impact on firm-level investment in South Africa. Firms’ investment decisions in response to uncertainty reflect firms’ heterogeneity. Medium-sized firms and, to a different extent, small firms reduce their investment by much more than large firms in response to increased policy uncertainty. The relationship between firms categorized by size and the degree of financial constraints they face implies that financially constrained firms are more sensitive to uncertainty than large, unconstrained firms.

Background: South Africa has pioneered national evaluation systems (NESs) along with Canada, Mexico, Colombia, Chile, Uganda and Benin. South Africa’s National Evaluation Policy Framework (NEPF) was approved by Cabinet in November 2011. An evaluation of the NES started in September 2016.Objectives: The purpose of the evaluation was to assess whether the NES had had an impact on the programmes and policies evaluated, the departments involved and other key stakeholders; and to determine how the system needs to be strengthened.Method: The evaluation used a theory-based approach, including international benchmarking, five national and four provincial case studies, 112 key informant interviews, a survey with 86 responses and a cost-benefit analysis of a sample of evaluations.Results: Since 2011, 67 national evaluations have been completed or are underway within the NES, covering over $10 billion of government expenditure. Seven of South Africa’s nine provinces have provincial evaluation plans and 68 of 155 national and provincial departments have departmental evaluation plans. Hence, the system has spread widely but there are issues of quality and the time it takes to do evaluations. It was difficult to assess use but from the case studies it did appear that instrumental and process use were widespread. There appears to be a high return on evaluations of between R7 and R10 per rand invested.Conclusion: The NES evaluation recommendations on strengthening the system ranged from legislation to strengthen the mandate, greater resources for the NES, strengthening capacity development, communication and the tracking of use.

This paper uses matched employer-employee data from South Africa to examine the extent to which technology transfers between firms through the hiring of workers. Allowing for differential spillovers based on observable technology differences between sending and receiving firms, we find strong evidence for positive productivity spillovers through worker mobility. In contrast to previous studies set in more advanced economies, our results suggest that negative spillovers can occur.