Presented at the Sixth RENEWAL Regional Workshop: A decade of work on HIV, food and nutrition security. By

1. Jo Vearey (FMSP-Wits & HEARD-UKZN), Scott Drimie (RENEWAL), Lorena Nunez
(FMSP), Khangelani Moyo (FMSP) and Mthokozisi Hlengwa (HEARD-UKZN)
RENEWAL Regional Workshop: November 9-11, 2010, Cape Town ember 9-
11, 2010, Cape Town

2.  Urbanisation, HIV and circular migration in South Africa:
Urban informal settlements, health risks and HIV
Interlinked livelihood systems
 Exploring the impact of HIV in urban, informal
migrant households on linked, rural households:
 Johannesburg and rural kwaZulu-Natal
 Findings from research:
2008 household survey
2010 in-depth qualitative research (case-studies)
 Key messages for policy makers.

3. By 2030, 50% or more of the
African population will be living in Urbanisation processes in South
a city Africa
• Urban population is stabilising
at just over 60% (Bocquier)
• Rural population has not
decreased
• Circular migration
• Peripheral urban informal
settlements
World Urbanization Prospects (2005 Revision), United Nations, Department of
Economic and Social Affairs

5. Key Findings of 2008 survey
Urban migrants residing in peripheral informal
settlements are part of an interlinked
livelihood system that connects them with
another place.
This system involves various reciprocal
relationships that change depending on the
urban context and adapts to different shock
and stressors.

6. An interlinked livelihood system
Remittances and networks of care connect
urban migrants residing in peripheral informal
settlements with their (predominantly) rural
home.
CARE
HIV ?
GOODS
FOOD $

7.  In-depth exploration of the impact of HIV
on interlinked livelihood systems that
connect urban-rural households.
 Eight households in informal JHB and
seven linked households in rural KZN.
Five visits per household in JHB and one visit in KZN
 Multi-site research team:
 In-depth interviews, narrative interviews, food
security assessments, household mapping,
observation.
 A challenging methodology
 Identifying respondents/selection criteria, geography,
HIV disclosure, hunger, unemployment, research ethics.

8. Maisy

9. Nembo

10.  No longer appropriate to conceptualise rural – urban
migration and urbanisation as a linear process
 There is a complex system of reciprocity between rural and urban
areas
 The importance of an interlinked livelihood system
between the city and another place (predominantly rural):
 These interlinked livelihood systems manifest in different ways in
different cities;
 Rural-urban linkages;
 Remittances;
 The importance of ‘care as a commodity’.
 Sickness and HIV affect this livelihood system:
 Urban – rural linkages mitigate the ill health of urban migrants

11. Food security Comparison
JHB Food Livelihood KZN food Livelihood
participant security strategies Participant security strategies
part time work & Old age
Maisy average child grant khwezi Average pension
Child grant &
Linda Good selling liquor Jabu Average piece jobs
Taxi door
Bonga Good husband income Zwe Poor operator
part time
Mano Good gardener
Scavenging & Old age
Nembo Poor selling liquor Khanya Very Poor pension
laundry & Old age
Nom Very Poor scavenging Rosaria Very Poor pension
Mab Poor sell pillows Mpilo Very Poor Nothing
cleaner Works for
TAG Poor (municipality) Hari Good Cashbuild

12. Survival options in Sol Plaatjies
1. Child support grant
2. Scavenging
3. Fulltime employment
4. Informal (piece jobs)
5. Part time formal work

13. Reflecting on Methods
• Validating method (five visits in JHB and one visit
in KZN)
• Researchers in JHB & KZN experienced ethical
dilemmas and the challenge of transcending the
personal during fieldwork
• Handling the fieldwork process and balancing
participant expectations and need to obtain valid
data proved onerous
• Challenge of attaching meaning to disclosure in
HIV sensitive community

14. Reflecting on Methods
• Method used could be of great value in future
research on the interlinked livelihood system

15. Policy Implications
• In support of previous work, this study emphasises the need for urban and
rural social and health systems to engage across the urban-rural
continuum. Policy makers and programmers must engage in developing
spatially-aware policies.
• There is an urgent need to address the social security of urban and rural
poor, including those residing in urban informal settlements.
• Food insecurity is a challenge facing urban and rural poor households.
• The experiences of people living with HIV in informal settlements must be
incorporated into policy making and planning processes.
• People living with HIV require support in “disclosing” their status to their
partners.

16.  All participants;  Survey team:
 Simon Mporetji
 Ingrid Palmary (FMSP);  Khangelani Moyo
 Nedson Pophiwa
 Aline Philibert (CINIBOISE);
 Morgan Theba
 Sizwe Myataza
 Farah Pirouz;
 Mthokozisi Mlilo
 Technical Advisory Group:  Chuma Nombewu
 Brendon Barnes (Wits)  Siphatisiwe Dube
 Sibekithemba Njani
 Brigitte Bagnol (Wits/Pop
Council)  Eugene Bope
 Lesley Bourne (MRC)  RENEWAL
 Liz Thomas (MRC/Wits)
 IDRC
 Jacques Bezuidenhout
 Atlantic Philanthropies