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Description of participants
A total of 39 AGYW took part in the interviews. Twenty-six AGYW were interviewed three times, 12 interviewed four times, and six interviewed five times. Interview participants comprised 18 CCT recipients and 21 non-recipients, and their age range was 13–20 years. A total of 18 FGDs (n = 108) were conducted during the three-year study period. Study participants came from households where the majority were dependent on child support grants, and on income from single parents and migrant remittances. Most households were made up of 5 to 8 family members, with grandmothers mostly assuming the role of guardians if both parents were absent or had died.
Positive consequences of the CCT on peer relationships
Allowing recipients to identify with peers: ‘I am now like other children’
Receipt of the CCT enabled AGYW to fit in within their peer groups in terms of how they looked and ate, and the activities in which they participated. CCT recipients reported that before the CCT trial, there was a distinction between ‘girls from ‘rich’ households’ and ‘girls from ‘poor’ households.’ Young women from better-off families had pocket money to take to school, which afforded them better meals during lunch breaks at school, had proper school uniform and supplies, and had better clothes than those from poor family backgrounds, who relied on ‘free food from the feeding scheme’ and lacked some school necessities. Consequently, young women from poor households felt that they were different from their peers – they ‘felt out of place’. As Yolisa (recipient, IDI) indicated, ‘if I go to school without money, it’s like I’m not like other people.’ This affected some participants emotionally. Thembi (recipient, IDI) recounted that before she received the CCT, she was unwell and dreaded going to school, knowing that her friends would have money and she did not. Emyoli also shared a similar experience:
‘In the past, I was not feeling well; I was feeling like I’m down [depressed] when I’m with my friends, and they have money, and I don’t have it’ (Emyoli, recipient, IDI).
For other participants, these feelings were exacerbated because they were ridiculed by their peers for lacking desirable items. For example, Thandeka (recipient, IDI) reported that girls from well-off households had branded clothing, while she wore the cheapest, unbranded clothes.
“In my class, there are girls who always wear expensive clothes like Nike, Levi’s jeans … I always wear no names from PEP [store] or Mr Price, you see. I don’t feel good.” (Thandeka, recipient, IDI)
She also said that she was hurt by her peers ridiculing her for lacking necessary school supplies.
This was echoed in one FGD where a participant shared experiences of young women who were mocked for compromising their personal care and hygiene because they could not afford to buy cosmetics. In some instances, this led to young women missing school. She recalled,
‘ … some of the kids were not going to school because they were afraid because boys were laughing at them because they smelled bad under their arms’ (recipient, FGD).
Young women reported that receipt of the CCT allowed them to ‘be like other young women’, a phrase used by many participants to describe how the CCT had changed their lives in relation to their peers.
‘When the other young women buy something at school, I also buy because I do have money.’ (Emyoli, recipient, IDI)
‘When you go to school, you feel like other learners like having lunch.’ (Zama, recipient, IDI)
‘Since I take part in the study, I do have money to carry when I go to school every day like other learners.’ (Sbonga, recipient, IDI)
These quotes show how significant it was for young women to feel the same as their peers, particularly when it came to having pocket money at school. Thandeka reported that the CCT had made a difference in her life and that her peers had stopped making fun of her:
‘I have my school bag, school uniform, I feel happy about it. At school they were laughing at me because I was using a shopping bag to carry my books, now they are no longer laughing at me.’ (recipient, IDI)
The cash enabled recipients to fit in and not be seen as different from other young women; this gave them a sense of peer identity and a sense of belonging. Receipt of CCTs enabled AGYW to not stand out as different from their peers, which had previously made them vulnerable to teasing or bullying.
Facilitating interactions, conversations, and information sharing among young women
Receipt of the CCT appeared to have created networking opportunities between AGYW. Generally, the participants travelled together to the post office to collect or withdraw the CCT. A young woman in an FGD mentioned that networking with others had improved as a result of participation in the CCT trial:
‘You find that you did not have someone’s phone (contact) number, but you find that now you can communicate and ask one another what is going on. Like the other day, they came home, and then I asked her if they [trial staff] did come to her house as well … but we did not communicate before [the trial].’ (recipient, FGD)
Some non-recipients observed that CCT recipients befriended one another, formed groups, and hung out together:
‘Those who are getting money, they are grouping themselves as they are getting money; because of the money that they are getting from the study…’ (Lettie, non-recipient, IDI)
Londiwe, a non-recipient, also claimed that ‘now they [recipients] get together, but in the past, it was not like that.’ These findings suggest that participation in the CCT trial may have led to new friendships, particularly among recipients.
Unsurprisingly, there were conversations between the girls about the CCT and subsequently, study group allocation became common knowledge. The conversations entailed sharing subjective experiences, perceptions of the trial, advising and guiding each other, and sharing trial information with one another. These took place in communities, schools, during study visits, and at the post office bank when recipients went to withdraw their CCT payments. Conversation among recipients was mostly about the CCT. Lucy, a CCT recipient, remarked, ‘We ask each other if you received it [money]?’
Similarly, Khensani stated,
‘we are chatting about many things like when are you going to take money from Wits [the trial]?’ (Recipient, IDI).
CCT recipients shared their spending plans and advised one another on how to spend the cash appropriately. As a CCT recipient in the FGD indicated,
‘we are able to share how we spend the money, and if she misuses the money, we tell her that it is not good – you have to use it on necessary things.’
CCT recipients also shared complaints and frustrations related to cash payments, such as missed payments or dissatisfaction with the amount of cash received. Nkateko recounted the following about her friend: ‘She is always complaining that they must add money.’ (recipient, IDI).
Thuthu also remarked,
‘They [recipients] are complaining that the amount is too little; it can only buy a bag of mealie meal.’ (non-recipient, IDI)
During an IDI, one participant stated,
‘our relationship is good because we chat with the other girls and we guide each other. We talk about good and bad things and how we should take care of ourselves.’ (Zinhle, recipient, IDI)
Facilitating reciprocity and resource sharing
Most CCT recipients spoke of how the money allowed them to assist friends and family members financially, particularly those who gave them money prior the CCT trial. They described how, before the trial, girls from ‘poor’ households had relied on those who had pocket money for lunch at school. Not only did the receipt of the CCT enable recipients to be more self-reliant, it also improved some recipients’ ability to pool finances with their friends and enhanced these relationships by allowing reciprocity. A young woman in a recipient-only FGD remarked,
‘Before I received this money, she [friend] was able to help me, and now that I have my own money, we can help one another (FGD3).
Another participant reported,
‘When I go to school, the money that I get from Swa Koteka, I use it as pocket money. When my friend doesn’t have pocket money, I share food with her, and if I don’t have pocket money, she shares with me.’ (Thoko, recipient, IDI)
The ability to help in this way therefore gave recipients a sense of personal fulfilment, as they could now also return the favour. The ability to reciprocate financially also gave recipients a higher social standing, as access to cash appears to have increased one’s visibility and perceived value in the peer group.
Recipients could also lend money to friends who were non-recipients. Noma, a non-recipient, had a friend who was a CCT recipient. She reflected on the day she found out that she would not be receiving the monthly CCT payment:
‘I just told her that ‘my friend, you know I did not get the money’ and then she just said, ‘do not worry … if you have a problem like you need something, just tell me I will share with you … ’ When she has money, she comes to my class and gives me money and says, ‘go and buy food.’ (Noma, non-recipient, IDI)
Only in a few instances did it seem that the CCT had negatively affected the reciprocity between peers and the culture of lending and sharing. Some participants felt that once CCT payments started, the inclination to share disappeared. Non-recipients observed that some recipients found it tiring to be the only one buying items for friends who never contributed. As one FGD participant explained,
‘You go to the market together, and she buys you snacks for two days, and after that, she will complain that ‘I am not going to buy her stuff anymore because she always does not have money; I cannot, anymore.’ (FGD1, non-recipients)
Negative consequences of the CCT on peer relationships
As hinted at above, we found a few instances where CCTs appeared to have negatively impacted on peer relationships. This negative impact took the form of an increase in negative emotions, rumours, teasing, stigma and gossip. Disrupted friendships was a further negative consequence.
Negative emotional consequences
Some conversations by non-recipients in the IDIs and FGDs portrayed cash payments to their counterparts as unfavourable – triggering negative emotions such as jealousy, anxiety, hurt, and resentment. Participants said, ‘I become worried’, ‘I feel heartaches’, ‘Sometimes, my heart breaks’, and ‘I get bored [irritated]’. These emotions were often prompted when recipients talked about the CCT. Sindy reported,
‘if we told them [friends not getting cash] that we are going to the post office to collect money, they become angry.’ (Sindy, recipient, IDI).
These negative emotions were also triggered when non-recipients observed recipients’ purchases, such as lunch at school or a new outfit.
‘We do have jealousy because those who are in the intervention [recipients] eat well. They buy cool drinks, fish, and chips; that makes us jealous, as we are in the control arm [non-recipients].’ (Mantwa, non-recipient, IDI).
The non-recipients felt that the recipients ‘always spoke about the Swa Koteka money’. Some non-recipients interpreted this as being boastful. In one of the FGDs, a non-recipient reported,
‘They [recipients] are boasting on us saying ‘on Friday we are getting our payment, I am going to buy chocolate…”
These encounters made non-recipients jealous and feel left out since they had neither the money nor the items bought with it by recipients. One young woman in the FGD narrated the following example:
‘You find that you are three friends and then those two got the [CCT] payment [intervention arm] and you are in the control [arm] and then find that on Saturday it’s the 1st [date], and they are going to get the money, and then one says ‘my friend, let’s go to the post office and withdraw money because I saw a jersey at Fashion World [store],’ and find that you [a non-recipient] sat alone and you do not have anything (money) and in that way, you feel like they are discriminating [against] you.’
In an FGD, one young woman described a scenario that triggered negative emotions:
‘Let us say we are friends and when we are hanging out, and then P11 [another FGD participant] says “tomorrow I am going to Thulamahashe [shopping centre], I am going to get the money.” Definitely, that will hurt me. She is going to get the money, and I do not have the money or money to carry to school, and she is telling me that she is going to withdraw the money and her family is wealthy, they have everything, she wears Carvella [a luxury brand of shoes], and I am wearing cheap takkies [trainers/gym shoes].’
Hearing recipients talk about their money, and the fact that recipients’ lifestyles had visibly improved meant that spending time with recipients was distressing for the non-recipients. Many of these non-recipients did not explicitly express or show their anxiety; instead, they tried to hide it:
‘When I am with them, my heart breaks, but I do not show them; when I am alone, I can see that it is not fair.’ (Mbali, non-recipient, IDI)
However, these negative emotions were also sensed by some recipients, even if non-recipients were discreet in showing it.
‘When I buy something now, those who are not getting the money… they get angry because she knows that she does not have money and, at that time, she hates you (FGD, recipient).’
Thandeka, a cash recipient, also alluded to this:
‘It was difficult when you talk with them [non-recipients]. You can feel that this person is not happy, especially if you can tell her that tomorrow you are going to the post office to withdraw money.’ (Thandeka, recipient, IDI)
In some instances, recipients reported that they stopped talking about the CCT money altogether to avoid upsetting the non-recipients.
Rumours, teasing, gossip, and stigma
Despite ongoing community engagement and information activities, participants noted that most of the girls who were not part of the study did not have accurate information about the CCT trial. As a result, several rumours about the study circulated about who was being offered or not offered the CCT. Some of the rumours were overlapping and contradictory. On the one hand, rumours circulated that cash was being given to AGYW who tested positive for HIV. The assumption was that the CCT was to enable them to buy healthy food to manage their HIV. Some believed that non-recipients enrolled in the trial were not being given CCTs because they were HIV positive and had ‘unclean blood’. On the other hand, there was another rumour that cash was being paid to girls who were HIV negative as they had ‘clean blood.’ Others believed the CCT was only being given to AGYW from poor households.
Another rumour reported by participants emerged around the fact that one of the study procedures necessitated the drawing of blood to run various tests. For some people not enrolled in the study, blood draws meant that CCTs were payments for selling or donating blood.
‘They say they are withdrawing our blood and sell it. They are making fun of us that we are selling our blood.’ (Mpumi, recipient, IDI)
Non-recipients were teased for ‘giving their blood for free.’ They were also teased for choosing a ‘non-winning ticket’ [randomisation into the control study arm]. Mantwa, a non-recipient, recalled, ‘they say we are not clever because we chose to [remain] in the control [non-benefitting] arm.’
While much of this teasing, jealousy, rumours, and stigma apparently emanated from young women outside the CCT trial, teasing also occurred between recipients and non-recipients enrolled in the trial, despite them understanding the randomisation process underpinning the allocation of participants to the two study arms.
Recipients were also teased about the amount of cash they received. One recalled,
‘They say you think you are smart; meanwhile, you only get R100, and R100 is nothing to us because it is a small amount.’ (Yandi, recipient, IDI)
Among the non-recipients in the trial, jealousy was also tied to the belief that some CCT recipients were undeserving. Non-recipients highlighted instances where they felt CCTs were being paid to young women from well-off families and that impoverished families had been left out.
‘We feel the pain as our family background is bad, and when you look at those who got the money, they do not care; that is why they don’t have something important to do with this money because they are coming from rich families.’ (YW FGD, non-recipient only)
The non-recipients suggested that the targeting criteria for CCT recipients should include a socio-economic background assessment and means-testing. They believed that CCT should be given to only low-income or poor households.
When you do it [the CCT trial] again, they do not make us choose [randomise]. The people who go around in our households [census] have to look for the situations, like, in this household there is a big house that is roofed by tiles, so it means they eat well … [but] here there are three rooms so definitely there is no way they could eat well. And then when you sit down and check those forms you will see that ok, at P10’s household they are poor, so we have to give her intervention [CCT].
Besides one exceptional incident of physical assault, in general, the girls managed the teasing and stigma by considering it harmless and laughing it off or by suppressing their feelings.
Disrupted friendships
Significantly, a few AGYW recipients reported ending friendships with friends (non-recipients). In the one instance, Sasa (recipient, IDI) explained that before the trial, she and her friends had influenced each other to miss school, but since she started receiving the CCT she no longer missed school out of fear that she would not receive her school-conditioned cash payment. As a result, she grew apart from her friends. In another instance, a participant reported,
‘Yes, our relationship changed, since I get money, we no longer spend time together. Before [the trial] we were bunking school and going to taverns, but now I decided to focus on my schoolwork.’ (Musa, recipient, IDI)
Overall, however, most of the participants reported that friendships did not change during the course of the trial. For some, the CCT only disrupted peer relationships at the beginning of the trial but these settled over time, as the trial progressed. Senzi, a non-recipient, said, ‘There is no change with my closest friends, like I said, because we grew up together.’
Other participants believed that a change in friendships would be unjustifiable, considering that the CCT was only operational for a limited period. Some participants reported that no changes had occurred because their friends (all enrolled in the study) understood the randomisation process and that receipt of CCT depended entirely on ‘luck.’ It was also evident that many recipients had invested in existing friendships, which they deemed safe and reliable. This investment potentially mitigated the likelihood of relationships with friends deteriorating as a result of the CCT.
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