If it is true that we are what we eat, then we South Africans need to take a long, hard look at our diets, especially those of infants and children. Now is a good time to do so, because World Food Day (Wednesday October 16) is in recognition of the importance of attaining food and nutrition security for all.
The right to food is enshrined in our Constitution. According to the 2018 Global Food Security Index, South Africa is ranked as the most food secure country in Africa and 45th out of 133 countries worldwide. But, this status is in stark contrast to the fact that at least a quarter of South African children suffer from stunting. In essence, we produce enough food, but not enough of it is finding its way on to everyone’s plates.
Stunting is a condition that arises from prolonged undernutrition and affects the physical and brain development of children, especially in pregnancy and the first two years of life. This affects the cognitive development of young children and undermines their ability to learn. As a result, stunted children are more likely to drop out of school and live in poverty and unemployment as adults.
National dietary surveys estimate that 77% of children between the ages of six and 23 months do not receive a minimally acceptable diet and that 2.5-million children live below the food poverty line, because there is insufficient money in their households to cover the cost of their basic nutritional needs.
It’s not surprising that the 2016 South African Demographic Health Survey found that 27% of children under five are stunted, and a comparison with earlier surveys suggests that levels of stunting have not come down substantially over the past 20 years.
South Africa’s prevalence of stunting is far higher than one would expect for a country that ranks as the most food-secure country on the continent; it is much higher than its development counterparts Gabon, Ghana and Senegal, which rank lower than South Africa on the Global Food Security Index.
Malnutrition in the first five years of life not only costs children the opportunity to live full and productive lives as adults, but is also an underlying cause of mortality in the majority of infant deaths.
The good news is that stunting can be beaten. Countries such as Brazil, Mexico and Chile have reduced stunting significantly by prioritising political and economic responses to malnutrition. They employ a well-co-ordinated, multisectoral approach to ensure that children can get nutritious foods in their neighbourhoods, as well as clean water and sanitation to protect them from diarrhoeal diseases that limit the absorption of nutrients. These countries also prioritise local health workers as the workforce best placed to reduce stunting, equipping them with the skills to support families to make healthy food choices and identify vulnerable children early so that they can receive the extra care they need.
These countries also all recognise that investing in the nutritional status of pregnant women is key to reducing stunting. They support vulnerable pregnant women with cash transfers during pregnancy to enable them to buy the nutritious food they need to support the growth of their baby, their own physical and mental wellbeing, and attend the antenatal care visits to ensure a healthy pregnancy.
None of these interventions are beyond our reach. South Africa has a Food & Nutrition Security Plan (2017-2023) in place, but this is yet to be implemented. This plan needs to be prioritised and supported by the resources necessary to see it have a meaningful effect on people’s lives.
The quality of water and sanitation services needs to be improved as a matter of urgency. That 30% of children under six live without piped water on site and that more than 1.5-million children do not have access to adequate sanitation is a blight on our nation. Our healthcare workers need to be supported and equipped with the resources and skills required to become champions for children and their families.
World Food Day is an opportunity to reflect on what we are not feeding the next generation and how that will affect our future. Apart from the injustice, it simply does not make social or economic sense to produce enough food and then fail to share it adequately.
Ofentse Mboweni is the communications officer at the Grow Great Campaign’s Flourish franchise, which offers antenatal and postnatal classes but is not a replacement for clinical care