Submission ID 132047
| Issue/Objective | Stokvels are informal rotating savings and credit associations widely used across South Africa and other developing countries, representing organised social and financial networks with collective decision-making and shared norms. Evidence on social capital demonstrates that such networks influence health behaviours and outcomes through trust, reciprocity, and resource sharing. While prior research has examined food insecurity and NCD burden at individual and geographic levels, limited attention has been given to meso-level social units. This study addresses that gap by demonstrating how stokvel-level heterogeneity shapes health risk within structurally similar environments, responding directly to the conference call to move from fragmented, aggregate evidence to contextually grounded action, centring community-embedded, women-led structures as platforms for change in resource-constrained settings. |
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| Methodology/Approach | A cross-sectional baseline study was conducted in 2025 among 214 stokvel members across 24 stokvels in three low-income townships in Cape Town, South Africa, Khayelitsha, Langa, and Nyanga/Gugulethu shaped by high unemployment and historical spatial inequality. Data collected included sociodemographic and socioeconomic characteristics, household food security, anthropometric measures (BMI), self-reported NCD diagnoses, dietary behaviours, physical activity, and perceptions of the local food environment. The analytical approach combined individual-level descriptive analysis with meso-level aggregation, grouping individual responses to generate stokvel-specific risk profiles, enabling identification of within-township heterogeneity and informing stratified intervention design. |
| Results | Participants were predominantly women, with a mean age of 42 years (range: 18-76 years), and had high socioeconomic vulnerability (55.6% unemployed; 67.3% on social grants). Meso-level analysis revealed substantial within-township heterogeneity: obesity (74%), ranging from 22.2-100%; hypertension (0-90%); and food insecurity (20-100%). High-burden clusters were concentrated in Khayelitsha, with extreme BMI levels (>50 kg/m²). |
| Discussion/Conclusion | These findings demonstrate that socially embedded informal financial groups mediate structural constraints, producing distinct and clustered risk profiles within the same macro environment, challenging the assumption of township homogeneity that underpins many policy responses. Stokvels represent not only an analytical unit but a community-of-practice platform for intervention delivery. Their social cohesion and financial organisation position them as viable entry points for targeted NCD prevention and food security action, creating a direct pathway from meso-level evidence to community-embedded strategies that can address health inequities in resource-constrained urban settings. |
| Presenters and Affiliations | OLUFUNKE ADUKE ALABA University of Cape Town Vicki Lambert HPALS, University of Cape Town Zulfah Albertyn-Blanchard HPALS, University of Cape Town |
