ABSTRACT
The impact of the COVID-19 pandemic is currently reverberating throughout the formal and informal sector of the South African economy - including informal street vendors. The informal sector and key activities such as informal street trading play an important role in the South African economy and the unique socio-economic context of South Africa. Despite optimistic theoretical beliefs that the informal sector will mitigate the adverse effects of external shocks (as with the COVID-19 pandemic) by absorbing the job losses that occur in the formal sector, previous studies suggest the opposite. The informal sector is often disproportionately affected by external economic and health shocks, especially in southern Africa (Bassier et al., 2020;International Labour Organisation (ILO), 2020c;Rogan & Skinner, 2018;Skinner & Rogan, 2019). Against this background, the aim of the study was to explore the impact of the COVID-19 pandemic on the lives and livelihoods of informal street traders. A qualitative research approach in the form of a descriptive case study was used to conduct an in-depth investigation of the effect of COVID-19 on the lives and livelihoods of street vendors in Cape Town's city centre. A qualitative approach provides the opportunity to conduct a more comprehensive and in-depth analysis around the research question. The specific area in which the study was conducted was chosen to be close to transport infrastructure such as railway stations and bus stops and other public transport routes, as the literature suggests that these are the areas preferably frequented by street vendors. Before the fieldwork started, a pilot study was done to identify possible challenges and shortcomings in the interview guide. The necessary adjustments were made and the fieldwork took place between 6 and 8 May 2021. In-depth interviews, by means of a semi-structured interview guide, were conducted with 19 different street vendors, after which data saturation was achieved. Thematic analysis was used to identify, analyse and describe "trends or themes" (Bryman & Bell, 2014:439). Guided by the protocol of Du Plooy-Cilliers et al. (2014:230) and Guest et al. (2012:7), the researchers revisited the data numerous times, simultaneously identifying the themes several times in order to refine the analysis. The researchers consistently adhered to the "Code of Conduct for Researchers" as stipulated by the North-West University. The empirical component of the study only began after the researchers had obtained ethical approval from the Faculty of Economic and Management Sciences' Research Ethics Committee. All relevant ethical principles were adhered to during the interviews with informal street vendors and COVID-19 protocol was strictly observed. The demographic and business characteristics of the respondents serve as a precursor and background to the rest of the thematic analysis on the impact of COVID-19 on street trading as a sector of the informal economy. Interviews were conducted with 19 informal enterprises. During two of the 19 interviews, there were two respondents from the same stall participating in the interview. This means that the researchers engaged with 21 informal street traders, representing 19 informal enterprises. Most respondents were men (12 out of 21) and nine had completed matric. Although four (20%) of the respondents possessed a tertiary qualification, seven (35%) respondents had not completed their schooling. The respondents, who were mostly foreigners from Cameroon, Somalia and Malawi, were mainly between 35 and 64 years old;the youngest retailer was 23 years old and the oldest retailer 74. At the time of the interviews, clothing and/or footwear were the main products sold, followed by fruit and vegetables, jewellery, accessories and handbags. Some product offerings (such as flowers and fruit and vegetables) mainly have a local customer base, while traders selling arts, crafts or curio's and some selling jewellery or accessories and bags are largely supported by tourists. The respondents'experience as informal street traders ranged from about one year to 56 years. In general, 14 (67%) of respondents had been working as informal traders for more than five years. A thematic analysis of the data showed that all the respondents' businesses closed for between one and five months in 2020 due to the national lockdown and associated regulations. Inventory losses, lack of income, depletion of their savings, layoffs of employees and significant food shortages were on-going themes. It was also not possible for the foreign respondents to make significant remittances to family in their countries of origin. Declining tourism numbers and local customers who lost their jobs are a constant threat to the livelihoods of informal street vendors. Furthermore, most of their local clients work from home and avoid public spaces to comply with social distancing regulations. In addition, several respondents said that tourists had had a positive impact on their profit margin because tourists bought more expensive products compared to the local customers. Most respondents said that their average monthly profit since the initial Level 5 lockdown in 2020 was about half of the average monthly profit the enterprise could generate before COVID-19. In addition, there were three businesses that could show only a third of the profits they had enjoyed before COVID-19, with another two businesses even reporting less than a third of their average profit prior to COVID-19 - one vendor's profit was about 20-30% less than before COVID-19. More specifically, three of the businesses made an average monthly profit of between R6 000 and R10 000 before COVID-19 and two of the businesses made an average daily profit of between R250 and R300. In the last year since the pandemic, however, three of the businesses generated an average monthly profit of between R2 000 and R5 000 and several businesses generated an average daily profit of between R100 and R200. Street vendors use various strategies, such as good customer service, efforts to obtain the best possible location, the acquisition of fresh stock, and the use of social media and electronic payment instruments in an attempt to deal with the adverse consequences of the COVID-19 pandemic. However, despite their best efforts, several respondents had no choice but to reduce their employees' working hours and/or remuneration. The challenges that the COVID-19 pandemic presents to informal street vendors in Cape Town's city centre are therefore an on-going daily reality. Continuous state support and follow-up studies with the same group of respondents to examine the impact over the medium and longer term are necessary. An important example of this is action research with respondents on the impact of the existing assistance measures on their lives and living conditions. These research results may help to develop action plans that will enable the city, province and country to deal with future exogenous shocks in a manner that would ensure some mitigation of the adverse effects of similar shocks on the structurally vulnerable sections of the society and the economy.
ABSTRACT
Y Background. South Africa (SA) has embarked on a process to implement universal health coverage (UHC) funded by National Health Insurance (NHI). The 2019 NHI Bill proposes creation of a health technology assessment (HTA) body to inform decisions about which interventions NHI funds will cover under UHC. In practice, HTA often relies mainly on economic evaluations of cost-effectiveness and budget impact, with less attention to the systematic, specific consideration of important social, organisational and ethical impacts of the health technology in question. In this context, the South African Values and Ethics for Universal Health Coverage (SAVE-UHC) research project recognised an opportunity to help shape the health priority-setting process by providing a way to take account of multiple, ethically relevant considerations that reflect SA values. The SAVE-UHC Research Team developed and tested an SA-specific Ethics Framework for HTA assessment and analysis. Objectives. To develop and test an Ethics Framework for use in the SA context for health priority-setting. Methods. The Framework was developed iteratively by the authors and a multidisciplinary panel (18 participants) over a period of 18 months, using the principles outlined in the 2015 NHI White Paper as a starting point. The provisional Ethics Framework was then tested with multi-stakeholder simulated appraisal committees (SACs) in three provinces. The membership of each SAC roughly reflected the composition of a potential SA HTA committee. The deliberations and dedicated focus group discussions after each SAC meeting were recorded, analysed and used to refine the Framework, which was presented to the Working Group for review, comment and final approval. Results. This article describes the 12 domains of the Framework. The first four (Burden of the Health Condition, Expected Health Benefits and Harms, Cost-Effectiveness Analysis, and Budget Impact) are commonly used in HTA assessments, and a further eight cover the other ethical domains. These are Equity, Respect and Dignity, Impacts on Personal Financial Situation, Forming and Maintaining Important Personal Relationships, Ease of Suffering, Impact on Safety and Security, Solidarity and Social Cohesion, and Systems Factors and Constraints. In each domain are questions and prompts to enable use of the Framework by both analysts and assessors. Issues that arose, such as weighting of the domains and the availability of SA evidence, were discussed by the SACs. Conclusions. The Ethics Framework is intended for use in priority-setting within an HTA process. The Framework was well accepted by a diverse group of stakeholders. The final version will be a useful tool not only for HTA and other priority-setting processes in SA, but also for future efforts to create HTA methods in SA and elsewhere.