Most of South Africa’s children are surviving, but too many are failing to thrive and achieve their full potential, and this is costing the economy billions in lost human potential.
Investing in children — and particularly in violence prevention, networks of care, nutrition, education and inclusive services — would drive the next wave of social and economic transformation, boost gross domestic product, and secure a more sustainable future for everyone.
Since 1994, child poverty has decreased and children’s survival and access to basic services has improved. But these changes are not enough to unlock the full potential of all children.
Violence, poverty, hunger, and poor-quality education continue to compromise children’s development and life chances — with a negative impact on the country’s development.
The South African Child Gauge 2017, which is released today, explores what the country’s children need to not only survive but also to thrive. The 12th annual review of the situation of the country’s children is published by the Children’s Institute (CI), University of Cape Town, in partnership with UNICEF South Africa; the DG Murray Trust; the DST-NRF Centre for Excellence in Human Development, University of the Witwatersrand; The Standard Bank Tutuwa Community Foundation; and the Programme to Support Pro-poor Policy Development in the Department of Planning, Monitoring and Evaluation.
The theme of the 2017 issue — “Survive, Thrive, Transform”– echoes the Global Strategy for Women’s, Children’s and Adolescents’ Health, which aims to end preventable deaths, ensure health and well-being, and expand enabling environments in line with the United Nations’ Sustainable Development Goals. Adopted by South Africa and other member states in 2015, the SDGs set an ambitious agenda:
“They call for a coordinated global effort to transform societies, economies and the environment to ensure a fairer and safer future for all — and a new approach to human development starting with the most vulnerable to ensure that no one is left behind”, says Hervé Ludovic de Lys, UNICEF South Africa Country Representative.
Lucy Jamieson, CI senior researcher and lead editor of the South African Child Gauge 2017, explains: “While the SDGs are a global agenda, their vision of intersectoral collaboration and inclusive development can help take South Africa forward — provided we start by investing in children.”
“The SDGs do not only assume that reaching the hardest to reach is realistic, but that it can be more cost-effective”, adds the chairperson of the African Union’s Committee of Experts on the Rights and Welfare of the Child, Benyam Dawit Mezmur. He points out that evidence-based programmes targeted at the most disadvantaged can speed up access to services.
The SDGs’ focus on inclusion and equity resonates with the National Development Plan (NDP), notes Jeff Radebe, the minister in the presidency for planning, monitoring and evaluation and chair of the National Planning Commission: “The plan acknowledges that without addressing poverty and inequality, the democratic project remains unfinished. It also recommends interventions … to unlock the potential in our children and allow South Africa to reap this demographic dividend by 2030.”
What will it take for children to thrive?
“Children’s ability to thrive is rooted in their ability to learn, their motivation to succeed, and in healthy relationships that protect them from adversity,” explains David Harrison, CEO of the DG Murray Trust.
The presence of nurturing and responsive caregivers therefore can make an enormous difference to enable children to reach their full potential, help break the cycle of violence and protect them from the adverse effects of poverty.
Nurturing young children’s capabilities, says Harrison, can increase employment; promote economic growth; and create a safer, happier society. “If we nurture all children’s normal growth and development — from conception to adulthood — we will unlock that human potential, disrupt intergenerational cycles of poverty and drive down inequality.”
Frequent or ongoing exposure to toxic stress – like violence, poverty and neglect – can fundamentally change early brain development and lead to negative outcomes such as aggressive and antisocial behaviour across the life course — from bullying on the playground to violent and unstable adult relationships. A recent study found violence against children cost South Africa an estimated R239-billion — or 6% of the GDP — in 2015.
In addition, stunting — a sign of chronic malnutrition that affects one in four children under five in the country — compromises children’s education, long-term health and employment prospects, and costs the country an estimated R62-billion per year.
All children thrive under the right conditions, and there are a range of opportunities to promote optimal development throughout their life course, says Linda Richter, distinguished professor and director of the DST-NRF Centre of Excellence in Human Development at the University of the Witwatersrand. “All children need nurturing care. This includes responsive caregiving; good nutrition; protection from disease, violence and stress; and opportunities to learn. These elements are interdependent and mutually reinforcing, and are essential to prepare them for adulthood.”
Equally important is an inclusive approach to reach the most vulnerable and enable them to participate on an equal basis regardless of age, ability, race, gender or socio-economic status.
Promoting caring relationships
Lizette Berry, CI senior researcher and co-editor emphasises the importance of relationships in helping children to thrive. “The extent to which children and adolescents experience responsive care impacts on their self-confidence, motivation and ability to form healthy relationships. Yet caregivers’ capacity to provide nurturing care is hampered by violence, poverty, social isolation and depression.”
For these reasons, parents and caregivers need family support, parenting programmes, community-based services and practical support such as maternity leave, child care and social assistance.
Creating safe environments
CI director professor Shanaaz Mathews explains that children’s exposure to abuse, neglect and other forms of violence increases the risk of mental health problems and substance abuse, and contributes to an intergenerational cycle of violence. “The good news is that South Africa now has a significant body of research that outlines the drivers of violence across the life course and what can be done to prevent it. We need carefully designed, multi-sectoral prevention strategies that have been proven to work, and to take these to scale.”
Improving child nutrition
Stunting has remained high in South Africa over the past 20 years, affecting 27% of children under five. Inadequate child care and feeding practices, household food insecurity, unhealthy living conditions and poor access to health-care services contribute to stunting — compromising children’s ability to thrive.
David Sanders, emeritus professor and founding director of the School of Public Health at the University of the Western Cape, calls for greater investment in community health workers (CHWs) “who have the potential to extend health care to vulnerable households, promote breastfeeding and nutritious weaning foods, and ensure the early identification and treatment of severe infections such as diarrhoea and pneumonia”.
But, says Sanders, an expanded role for CHWs, and strengthening the public health-care system, require strong leadership, concerted intersectoral action and a broad social movement for child health to address the root causes of stunting.
Zanele Twala, CEO of The Standard Bank Tutuwa Community Foundation, points to the links between nutrition, learning and care. “There is strong evidence that children who receive early stimulation with nutrition supplements have better outcomes than children who only get supplements. And early child development programmes can buffer the negative effects of stress and improve the body’s absorption of nutrients.”
For these reasons, Twala supports the NDP proposal for a nutrition programme for pregnant women and young children, and an early development and care programme for all children under the age of three.
Getting reading right
Reading is the basis for both literacy and numeracy, and a strong motivator for learning. Yet, a 2011 study has showed that 58% of learners cannot read fluently and with comprehension by the end of grade 4.
“Reading and writing are an essential foundation for formal education, inclusive economic development and active citizenship”, explains Dr Nic Spaull, senior research fellow at the Research on Socio-Economic Policy group at Stellenbosch University. “Reading needs to be prioritised at all levels, from national government to school leadership and parents, to promote a culture of reading and improve reading outcomes”.
Spaull says children need access to books; teachers require training, feedback and support (especially as curriculum changes have created confusion on how reading should be taught); and reading should become a daily routine — both in and outside the classroom.
Creating inclusive and enabling environments
The SDGs promotes equality and inclusive development by reaching out to the most vulnerable. Dr Sue Philpott, a post-doctoral Candidate at the College of Education, University of KwaZulu-Natal, says that children with disabilities are a case in point.
“Children with disabilities remain deprived of the services and support they need, and experience stigma and multiple exclusions. We need to strengthen linkages between families, non-profit organisations and government to support such children and their caregivers.”
Services also need to be humanised, says Philpott. This means service providers need to shift attitudes and behaviour to create more welcoming and inclusive environments for children and caregivers. “Embracing inclusive practices has benefits for all children, not only those who are disabled or considered vulnerable, and is further motivation to ensure that no child is left behind.”
A call to action
With many demands on the government budget, it is important to know what — and how — to prioritise. The South African Child Gauge 2017 calls for investment in responsive care, child nutrition, violence prevention, reading, and inclusive services.
Building on what is working, removing barriers to quality services and strengthening interconnections between services are vital to ensure a seamless experience for children of all ages. Jamieson explains: “We need to radically transform how services are delivered. This calls for a multi-sectoral plan of action to address the many forms of deprivation and exclusion that children experience.”
The South African Child Gauge 2017 asserts that the necessary action is not just up to government. All sectors of society — health professionals, educators, social workers, business, civil society, communities, parents and children themselves — have a shared responsibility to ensure that no one is left behind in the drive to realise the SDGs and build an equitable and thriving South Africa.