/ 13 October 2022

Mothers and caregivers need nutrition education to protect children in food-insecure environment

World Food Day is an opportunity to reflect on what we are not feeding the next generation and how that will affect our future.
World Food Day is celebrated annually on 16 October to shine the spotlight on continued hunger and the lack of a healthy diet for many people globally. (Madelene Cronje/M&G)

World Food Day is celebrated annually on 16 October to shine the spotlight on continued hunger and the lack of a healthy diet for many people globally. The theme for 2022 is “A major problem is poor nutrition”, which underlies many of the current public health concerns and societal challenges. Scientific studies consistently show that diet plays a vital role in both health promotion and disease prevention. 

The national department of health is collaborating with other government departments as well as international and national health organisations during National Nutrition Week (NNW) from 9 to 16 October to address barriers to healthy eating and to promote the week’s theme “Make healthy food choices easier”. 

The overarching objective of the 2022 National Nutrition Week campaign is to help adults, adolescents and caregivers make healthy and affordable food choices every day by eating regular and correctly portioned healthy meals and snacks and by being physically active. 

The department points out that in addition to concerns about non-communicable diseases, South Africa has the highest rates of overweight and obesity in sub-Saharan Africa. When it comes to nutrition, South Africa bears a double burden where both under- and overnutrition occur in our communities, sometimes even existing side by side in the same household.

In a country like ours where a very significant percentage of the population live under adverse socio-economic conditions and fall below the national poverty line, it is not always easy to follow a healthy diet. It should not come as a surprise that many South Africans are food insecure. The very poor include particularly African, female-headed and rural households. Nutrition interventions should focus on both over and undernutrition.

Often the children of these women suffer from malnutrition. Child malnutrition is a major epidemiological problem in developing countries, especially in Africa. The spectrum of undernutrition includes low birth weight, wasting, underweight, stunting and specific micronutrient deficiencies. 

The South African Demographic Health Survey observed that at national level, 27% of children under the age of five were stunted, 3% wasted, 6% underweight and 13% overweight. Undernutrition makes children more vulnerable to disease and death, while a young child who is moderately or severely wasted is at a much higher risk. 

Stunting of young children, a measure derived from children’s height-for-age compared to an international norm, is a reliable nutritional indicator and is also influenced by food quality. 

Poor health also contributes to child stunting, with clean water and sanitation considered to be particularly important. Chronic malnutrition increases the risk of infection and death and is linked to poor cognitive development, while improved nutrition may increase future earnings and contribute to substantial poverty reduction.

Nutrition education aimed at mothers and caregivers can alleviate this malnutrition in their young children. Within our socio-economic framework and dietary constraints, a distinct need exists for effective nutrition education and health promotion strategies aimed at equipping the mothers and caregivers of young children to procure food more sensibly, both in terms of quantity and quality. 

Lack of nutritional knowledge on child feeding among caregivers contributes significantly to poor dietary practices of children younger than five years of age. A fundamental component of nutrition education within adverse socio-economic environments is to guide people to make the best possible food choices with the little money they have available for purchasing food. In short, they should be encouraged to choose foods that are adequate in energy but are also relatively richer in nutrient content.

Nutrition interventions programmes have been launched, targeting young children in South Africa, and include nutrition and health education, promotion of exclusive breastfeeding, growth monitoring and promotion, and implementation of the infant and young child feeding programme. The South African Paediatric Food-Based Dietary Guidelines were also developed to provide a tool for nutrition education. 

The campaign objective of NNW 2022 is to increase caregivers’ knowledge, skill and self-efficacy to enable the caregiver to choose to practise exclusive breastfeeding for the first six months with the introduction of appropriate and safe complementary foods from six months while breastfeeding continues up to two years and or beyond. NNW 2022 also aims to increase household members’ self-efficacy to make healthier choices and to plan and prepare healthy and affordable family meals, including complementary foods.

But we need more than just nutrition education. We must also improve food security in South Africa. Additionally, the fact that undernutrition and overnutrition often coexists in communities presents a major challenge to both nutrition policy-makers and nutrition educators. 

The World Food Summit of 1996 defined food security as existing when all people have access to sufficient, safe, nutritious food to meet their dietary needs for an active and healthy lifestyle at all times. Food insecurity occurs when people’s access to food is minimally adequate and they have trouble meeting their basic needs, while severe food insecurity occurs when there is a critical lack of access to food. 

As food insecurity becomes severe, the quantity of food consumed decreases and some meals are skipped. The most severe situation is characterised by feeling hungry because of not being able to eat and even not eating for an entire day, due to lack of money and other resources. 

Statistics South Africa has been working on improving its measurement of food security and recently introduced the Food Insecurity Experience Scale (FIES) module in the 2019 General Household Survey. In 2020, the proportion of South Africans affected by moderate to severe food insecurity was 23.6%. This is based on the results published by the food insecurity scale. The proportion of those affected by moderate to severe food insecurity, particularly those affected by severe food insecurity, increased between 2019 and 2020. 

While all the provinces were affected, the Northern Cape (17.6%) and Eastern Cape (16.6%) were the exceptions as their food insecurity prevalence rates were below the national average of 23.6% in 2020. The various economic and social effects of the Covid-19 pandemic denied many South Africans their right to adequate food as enshrined in our Constitution. These effects also undermined the efforts that have been made to meet the National Development Plan’s goals and the second of the United Nations’ Sustainable Development Goals, which is to achieve “Zero hunger” by 2030.

We must address food insecurity, alleviate poverty and educate mothers and caregivers of young children about cost-effective, nutrient-dense and diverse procurement of foods. This would empower them to make better food choices, consume a greater variety of foods and improve the nutrient-density of their and their children’s diets. This will ultimately help to improve the nutritional health of their children.

Irene Labuschagne is a dietician at the division of human nutrition in the faculty of medicine and health sciences at Stellenbosch University.

The views expressed are those of the author and do not necessarily reflect the official policy or position of the Mail & Guardian.