The nutritional status of South Africa’s children is deteriorating. One in four children under the age of five are stunted, a sign of chronic undernutrition that has remained stubbornly unchanged for 20 years.
Over the same period, South Africa has seen a steady increase in childhood overweight and obesity (one in eight children under the age of five) which is now double the global average.
This was shared in the 2020 South African Child Gauge published annually by the Children’s Institute at the University of Cape Town (UCT) to review the status of children in South Africa and inform evidence-based policy and programming.
The double burden of malnutrition can occur in the same household or even the same individual. For example, children who are stunted early in life are at greater risk of becoming obese – with prevalence rising across the life course especially amongst adolescent girls (28%) and adult women (64%). This increases their risk of developing non-communicable diseases such as diabetes, heart disease and certain cancers – and severe Covid-19 infection.
The high-profile launch event was opened by Dr Tshepo Motsepe, who calls on all South Africans to take action: “Let us become that society that ensures that no child goes to bed hungry.”
South Africa’s burden of child malnutrition remains unacceptably high for a middle-income country, placing it as an outlier among countries of similar wealth. Poverty has a profoundly damaging effect on children’s care, health and development – with young children in the poorest of households three times more likely to be stunted than those in the richest 20% of households.
UCT vice-chancellor, Professor Mamokgethi Phakeng, says: “Children who manage to survive malnutrition continue carrying the harm in their bodies, minds and spirits for the rest of their lives. And it doesn’t stop there: by attacking our children, malnutrition erodes our national development. The nation that starves its children is also starving itself.”
Thirty percent of South Africa’s children live below the food poverty line in households with a per capita income of less than R571 per month. These households do not have enough money to meet the nutritional needs of children, while frequent infections caused by overcrowding and poor access to water, sanitation and health care services further compromise children’s nutritional status.
According to the National Department of Health Ministerial Committee for the Morbidity and Mortality of Children under five years, severe acute malnutrition is one of three leading causes of child deaths in South Africa.
“There is much that we can do as individuals to protect and promote our own health and nutrition and that of our children, but we cannot do this in isolation,” says Lori Lake, communication and education specialist at the Children’s Institute at UCT.
“Safeguarding children’s health and nutrition requires intervention at every stage in the life course and collective action from a range of government departments, civil society and the private sector.”
Malnutrition is not simply a threat to child survival. It robs them of health and development. The 2020 issue of the South African Child Gauge focuses attention on and identifies points of leverage to improve children’s nutrition outcomes, calling for the strong leadership and concerted action from government, civil society and the private sector to ensure children’s rights are upheld.
“But all is not lost,” says Professor Shanaaz Mathews, director of UCT’s Children’s Institute. “There is much that the state can and must do, and the 2020 South African Child Gauge outlines a range of opportunities for double-duty actions to address the double burden of malnutrition – starting early during the antenatal period and extending across the life course.”