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

IF 4.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Zara Trafford
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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.
非正式的建设性力量?南非儿童残疾社会援助管理中的关系、情感和同理心
社会援助现金转移,在当地被称为补助金,是南非低收入家庭唯一可获得的定期财政支助。有两大类:减轻贫穷和与残疾有关的赠款。所有与残疾有关的赠款都与公共部门卫生系统挂钩,因为只有医生才被允许进行必要的评估。本文反映了一项为期三年的定性研究,该研究围绕残疾儿童主要照顾者护理依赖补助金的中心焦点,对利益相关者的观点进行了研究。在本文中,各种与残疾有关的赠款框架被拆解,并特别关注南非一线社会保障官员的把关实践。我把他们的行为置于有关残疾福利评估和分配系统的地方和全球对话中,这些对话越来越多地旨在抑制官僚主义的“情绪”,因为担心这会产生主观的——因此是不公平的——决策。由于对腐败的合理关切,后一种必要性在南非得到加强。然而,在一个为迎合大量人口而资源不足的官僚机构中,高度的不拘礼节可能会持续存在。在Rupert Hodder的积极非正式概念的基础上,我分享了上述研究中的“建设性”非正式的例子,并论证了仔细研究和从这些例子中学习的重要性。我的结论是,公务员与其试图压抑自己的人性,不如通过投资于他们的专业发展,以增加同理心和建立关系,从而加强与民众的接触。这可能是在再分配工作中改善社会公正的一种尚未开发的补充办法。
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来源期刊
Social Science & Medicine
Social Science & Medicine PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
9.10
自引率
5.60%
发文量
762
审稿时长
38 days
期刊介绍: Social Science & Medicine provides an international and interdisciplinary forum for the dissemination of social science research on health. We publish original research articles (both empirical and theoretical), reviews, position papers and commentaries on health issues, to inform current research, policy and practice in all areas of common interest to social scientists, health practitioners, and policy makers. The journal publishes material relevant to any aspect of health from a wide range of social science disciplines (anthropology, economics, epidemiology, geography, policy, psychology, and sociology), and material relevant to the social sciences from any of the professions concerned with physical and mental health, health care, clinical practice, and health policy and organization. We encourage material which is of general interest to an international readership.
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