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National task force needed to address child stunting in South Africa

Child health organisations, an academic and the FairPlay movement have called for a national task force to address the high incidence of child stunting in South Africa.

The task force proposal arose from priorities identified during a webinar hosted by Food for Mzansi and FairPlay and was endorsed by the panellists. 

The webinar looked at urgent and longer-term interventions to address child stunting, a health issue that afflicts more than 1.5 million South African children. The theme was the need for a much higher national focus on preventing child stunting, because not all existing plans and policies were being implemented.

The discussion was co-hosted by Ivor Price and moderated by Dawn Noemdoe of Food for Mazansi, which celebrates agricultural success stories and promotes jobs in the agricultural industry.

Some 27% of South African children – more than one in four – suffer from stunting by the age of five, which affects them both physically and cognitively for the rest of their lives. Stunting results from chronic malnutrition in the first five years of a child’s life, and particularly in the first 1000 days.

Stunting can be prevented. Webinar panellists identified actions that could be taken immediately to reduce the incidence of child stunting, and set South Africa on a path to eliminating it altogether.

These priorities ranged from “putting stunting in the spotlight” to revising and implementing health care policies from national to local level to ensure access to nutritious food.

Dr Kopano Mabaso, executive director of Grow Great, an organisation dedicated to galvanizing a national commitment to zero stunting by 2030, said other countries with fewer resources than South Africa had reduced the prevalence of childhood stunting. 

“The countries that get this issue right, treat stunting as a major political issue,” she said,

“They manage and track this issue at the highest levels of office, coordinating multiple players. The countries which have made progress against stunting have had a targeted, focused and coordinated response at the highest levels of government”

She said one quick intervention would be to better support the country’s 70 000 Community Healthcare Workers, who are already in communities, trusted by the families they serve and best placed to identify early young children who are vulnerable to stunting. 

She also proposed increasing community awareness of the nutritional value of eggs for young children. Eggs are commonly regarded as adult food, but adding an egg to the diets of young children has been shown to help reduce stunting.

Because stunting affects a child’s brain development and physical wellbeing, it ultimately affects the nation’s human capital when more than a quarter of children under 5 are disadvantaged even before they start school. 

“Stunting short-changes the next generation’s chances,” she said.

The World Bank estimates that countries that have high burdens of childhood stunting lose 8-11% of GDP per annum. “The capacity of children to learn is undermined even before they enter school. It’s heart breaking, this preventable loss of precious human capital.

“If we want to be the South Africa we know we can be, we have to invest in the foundations for success. Ending stunting is one of these foundations,” Dr Mabaso said.

Dr Marc Wegerif, a lecturer in development studies at the University of Pretoria, said South Africa has a food and nutrition policy, adopted in 2013, but it was not being implemented efficiently. 

“More than 51% of South Africans are experiencing either moderate or severe food insecurity. This was before Covid.  More food insecure people today means more stunting tomorrow.”

He advocated extending child grants to pregnant mothers and said that food security could only be achieved through a systemic approach that transformed the food system.

He proposed land and agrarian reform, but said that this has to be combined with wider changes in our agri-food system that is highly unequal with far too much of the value going to a few large corporations. We need to do more to support small-scale farmers and street traders who create more work and income earning opportunities and can play a larger role in getting get nutritional food to poorer communities. Street traders had been shown to provide more affordable food, especially vegetables and other fresh produce, than large supermarkets.

Credit should also be given for successful interventions. The government was feeding nine million schoolchildren a day in their National School Nutrition Programme, but this needed to be extended to younger children because by the time they reached school the nutritional damage had already been done.

Dr Wegerif said interventions were urgent because, even before the impact of the coronavirus pandemic, predictions were that the incidence of child stunting would rise due to widespread poverty and unemployment in the country.

“We have lost hundreds of thousands of jobs in the agricultural sector in the last 20 years,” he said.

Francois Baird, founder of the FairPlay movement, said the national task force was needed because the country was not focused on the huge problem of child stunting, and interventions that could have an impact were not happening.

“This terrible condition is man-made… and entirely preventable. Where is the national outcry? Where is the national focus on fixing this? Why is the plight of our children not on the nation’s conscience?”

Ending child stunting had to become a national priority, involving people at all levels – government and private sector, large companies and small-scale farmers. Reducing unemployment, and preventing job losses through predatory trade, had to be a focus because unemployment led to the poverty and malnutrition that resulted in child stunting.

Noting that 20 November is World Children’s Day, he said the webinar should result in seven actions:

1. The establishment of a national task force to end child stunting.
2. Implementation of all current policies and plans to end child stunting.
3. End predatory trade practices.
4. Let all legal businesses flourish to save and grow jobs.
5. Extend the child grant to include expectant mothers.
6. No VAT on chicken, eggs, fresh fruit and vegetables produced in SA.
7. Focus on better supporting Community Health Workers to enable them to care identify early and refer children who are vulnerable to stunting.

“Let’s get a national focus, and do all the practical things that can be done today,” Baird said.

Issued 20 November 2020.

End.

Watch a recording of the webinar, here:

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