Addressing the interaction between food insecurity, depression risk and informal work: findings of a cross-sectional survey among informal women workers with young children in South Africa.

Abstract

Background: There is a high burden of depression globally, including in South Africa. Maternal depression is associated with poverty, unstable income, food insecurity, and lack of partner support, and may lead to poor outcomes for mothers and children. In South Africa one-third of working women are in informal work, which is associated with socioeconomic vulnerability. Methods: A cross sectional survey explored work setting and conditions, food security and risk of depression among informal working women with young children (0-3years). Depression risk was assessed using the Edinburgh Postnatal Depression Score (EPDS) and Whooley score. Food insecurity was evaluated using Household Food Insecurity Access Scale (HFIAS). Data was analysed using SPSS and Stata. Results: Interviews were conducted with 265 informal women workers. Types of work included domestic work, home-based work, informal employees and own account workers, most of whom were informal traders. Most participants (149/265; 56.2%) earned between US$70-200 per month, but some participants (79/265; 29.8%) earned less than US$70 per month, and few earned >US$200 per month (37/265; 14.0%). Many participants experienced mild (38/267; 14.3%), moderate (72/265; 27.2%) or severe (43/265; 16%) food insecurity. Severe food insecurity was significantly higher among participants with the lowest income compared to those with the highest income (p= 0.027). Women who received financial support from the baby’s father were less likely to be food insecure (p=0.03). Using EPDS scores, 22/265 (8.3%) women were designated as being at risk of depression. This was similar among postnatal women and women with older children. Household food insecurity was significantly associated with depression risk (p<0.001).Conclusions: Informal women workers were shown to be vulnerable with low incomes and high rates of food insecurity, thus increasing the risk for poor maternal health. However, levels of depression risk were low compared to previous estimates in South Africa, suggesting that informal workers may have high levels of resilience. Interventions to improve social protection, access to health services, and support for safe childcare in the workplace could improve the health and wellbeing of these mothers and support them to care for their children.

Food insecurity, depressive symptoms, and the salience of gendered family roles during the COVID-19 pandemic in South Africa

“…The impact of FI on the psychological distress of adults is not well established in SA, and most studies have focused on relatively small, non-representative samples such as women during the perinatal period ( Zar et al, 2019 ; Garman et al, 2019 ; Abrahams et al, 2018 ) and informal women workers with young children ( Horwood et al, 2021 ). The consistency with which households, particularly those with children as residents, experience FI in SA, and the significant increase in rates of food insecurity, hunger, and depressive symptoms during the COVID-19 pandemic, demands a more systematic understanding of the pathways linking these outcomes.…”

Urban Informal Food Traders: A Rapid Qualitative Study of COVID-19 Lockdown Measures in South Africa

“…The informal sector is associated with socio-economic vulnerability [26] and occupational risk hazards [27], due to inadequate working conditions, such as limited access to water, sanitation and hygiene, as well as low and inconsistent daily incomes. Low wages are associated with an increased risk of food insecurity among informal traders [28][29][30]. Vulnerability of informal traders is exacerbated during emergency periods, like the COVID-19 pandemic.…”