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Poor nutrition is a weak foundation for a nation with big dreams

What babies and young children eat is important for their development. If we measure their height and weight as they grow up, we can see if they are on the right track. This information helps to identify children at risk of delayed development and other health problems so that health workers and caregivers can give those children appropriate responses.

Interventions in early life, ideally before a child’s second birthday, are considered to be the best investment for the individual and even the country. Research has shown that when a child is stunted (short for their age) at the beginning of their life, they will be more susceptible to disease as adults. There is also evidence that they will earn less than their non-stunted peers. In South Africa, surveys estimate that one in four (27%) children younger than five years suffer from stunting.

You may ask, is that number accurate for the children I see running around my neighbourhood? If you live in Worcester in the Western Cape, a new report by the Grow Great Campaign and Stellenbosch University can answer your question.

In 2018, a team of fieldworkers and researchers visited the homes of 854 children under the age of five. Each child’s weight and height were recorded, as well as information from their Road to Health Booklet.

Their mothers and other caregivers were also interviewed where possible, to capture details on their socioeconomic status as well as access to basic services and grants. The results show that 26% of Worcester’s children are affected by stunting, on par with the national figure. And one in 10 children in this survey were found to be overweight or obese. 

The analysis shows that children who do not have an up-to-date deworming schedule were more likely to be stunted because repeated bouts of diarrhoea go hand in hand with poor nutrition to stunt growth.

Another finding was that children whose mothers finished high school were less likely to suffer from stunting.

Encouragingly, we recorded exclusive breastfeeding rates that were higher than the national average — considered the most powerful action to protect a child from stunting.

We found that a third of children had a diet that did not meet the minimum score of diversity. This means these children were eating too few food groups a day, even in households that were recipients of the Child Support Grant. It reflects the reality that most children in South Africa grow up in food-poor homes and that the value of the grant is insufficient to help families afford nutritious food. 

Covid-19 has really shone a light on this challenge because unemployment increased and feeding schemes were interrupted. We expect that dietary diversity may now be even lower than two years ago. The National Income Dynamics Study — Coronavirus Rapid Mobile survey results keep showing that more children are going hungry.

Civil society, academics and activists continue to advocate for an increase in grants. In the meantime, there are other steps we can take to improve child nutrition outcomes. In many parts of the country, immunisation catch-up drives are underway. Making sure that children regularly take vitamin A and deworming tablets is a critical step towards preventing disease and maintaining healthy immune systems. 

Another measure is to encourage parents through local support groups. These can start as antenatal groups for pregnant women and continue to assist families as their children grow up. Home visit programmes are great opportunities to reinforce health and nutrition promotion messages.We are missing the opportunity to set the next generation up for success by not prioritising children. The children of Worcester and neighbourhoods across the country need more than a few lines in the State of the Nation address; they need to see evidence of our government’s commitment and investment in their lives. Put children first.

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Anna-Marie Müller
Anna-Marie Müller is a nutrition and food systems strategist at Grow Great.

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