Abstract
Communities in major cities in developing countries may experience economic vulnerability,
which has detrimental consequences for maternal and child health. This study investigated individual-
, household-, and community-level factors associated with child growth and resilience of early-grade
learners aged 6 to 8 years. Demographic characteristics, depression scale, child wellbeing, and
anthropometric measurements were collected on a sample of 162 caregiver–child pairs (children
46% female) who receive the child support grant (cash transfer programme) from five low-income
urban communities in the City of Johannesburg, South Africa. Height and weight were converted to
z-scores using the WHO Anthroplus software. Multiple linear regression was used to assess factors
associated with child health outcomes and multi-level regression to account for community-level
factors. Higher income vulnerability was associated with lower weight- and height-for-age z-scores
(WAZ and HAZ). Not completing secondary schooling and higher household size were associated
with lower HAZ but higher BAZ. Child male sex and caregiver with depression were associated
with lower child resilience. Caregiver’s level of schooling and household size remained independent
predictors of child growth, while the caregiver’s mental health status independently predicted child
resilience. Thus, notwithstanding systemic constraints, there may be modifiable drivers that can help
in developing targeted intervention