The constructive power of informality? Relationships, emotion, and empathy in the administration of social assistance for childhood disability in South Africa

Zara Trafford

Social Science & Medicine, 2025, vol. 380, issue C

Abstract: Social assistance cash transfers, known locally as grants, are the only regular financial support available to low-income families in South Africa. There are two broad categories: poverty alleviation and disability-related grants. All disability-related grants are linked with the public sector health system, because only medical doctors are permitted to conduct the required assessments. This article reflects on a three-year qualitative study of the perspectives of stakeholders around the central focus of the Care Dependency Grant for primary caregivers of disabled children. In this article, various framings of disability-related grants are unpacked, with a specific focus on the gatekeeping practices of frontline social security officials in South Africa. I situate their behaviours within local and global conversations about systems for disability benefits assessment and distribution, which increasingly aim to suppress bureaucratic “emotionality” for fear that this produces subjective – and thus, unfair – decision-making. The latter imperative is intensified in South Africa because of justified concerns about corruption. In an under-resourced bureaucracy catering to a large population, however, high levels of informality are likely to persist. Building on Rupert Hodder's concept of positive informality, I share examples of “constructive” informality from the abovementioned study and argue for the importance of closely examining and learning from these instances. I conclude by suggesting that instead of trying to suppress their humanity, public servants' engagement with the populace could be enhanced by investing in their professional development toward increased empathy and relationship-building. This might be an untapped complementary approach to improving social justice in redistributive efforts.

Date: 2025
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DOI: 10.1016/j.socscimed.2025.118211

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