The impact of Covid-19 on food aid systems in South Africa: a cross-sectional mixed-methods study.

Covid-19 and South Africa's response to Covid-19 resulted in increased food insecurity and reliance on food aid. This study aimed to describe the functioning of the food aid system during South Africa's Covid-19 response. We conducted a mixed-methods study from August 2020 to January 2021 in South Africa. Data collection comprised of a desk-based review of private actor activities related to food aid during Covid-19; key informant interviews with food aid providers in both civil society and government, informal traders, and academia (n = 20); and a survey with HIV-positive women (n = 202). Interviews were transcribed and inductively coded. Data were analysed qualitatively using thematic analysis. Results showed that Covid-19, and the response, caused disruptions to food supply, specifically informal food economy and reduced incomes, resulting in increased reliance on food aid. While food donations increased, this did not meet increased demand for aid. Recipients of food aid reported low access to food aid and a mismatch between the contents of food aid parcels and their needs, despite aid providers outlining policies that considered nutritional and cultural acceptability of food parcels. Many participants indicated a preference for a food voucher or grant over food parcels. The paper highlights the unintended adverse consequences of the Covid-19 response on food insecurity. South Africa's food aid system was insufficient to respond to the needs of vulnerable groups during the pandemic. We recommend ongoing monitoring of interventions to identify and mitigate unintended consequences and the implementation of a food voucher system.