Stunting — a condition that robs young children from reaching their full potential and manifests as shortness in height for a child’s age, is a result of prolonged malnutrition, particularly in the first 1,000 days — from pregnancy to a child’s second birthday. Stunting affects a child’s physical and cognitive development and research has shown it is directly linked with poor performance in school, an increased likelihood to drop out of school and vulnerability to poor health, poverty and unemployment in adulthood.
In newspapers, on our radio stations and social media pages, as a country, we’ve debated how it came to be that approximately half a million of the Grade 1 learners of 2007 didn’t make it to matric. The reasons are no doubt multifactorial — nonetheless, there has been worryingly little to no mention of the likely contribution of the high rates of stunting prevalent at the time the matric class of 2018 began their schooling career.
Sadly, as we enter 2019, the prevalence of stunting in South Africa is little improved from what it was more than a decade ago, with Statistics South Africa estimating it at 27% in children under five 1, much higher than would be expected for an upper middle-income country such as ours, and far higher than many of our developing country counterparts. If nothing changes, if we continue to respond to the educational outcomes of our country’s children in the same reactionary ways we have become accustomed to doing each January, we are likely to continue to lose precious human capital in the years to come.
The good news is stunting can be beaten, and it must be beaten, particularly in light of the large and growing body of literature that attests to the high social and economic returns that can be achieved from reductions in stunting. By not addressing the embarrassingly high burden of stunting in South Africa, we sabotage our collective efforts to ensure no child is unjustly denied the opportunity to reach their full potential and diminish all the other work we do in basic and higher education, health and youth unemployment.
So what needs to be done?
We need to create nurturing environments for pregnant women and protect their right to high-quality health care and nutrition before and after their babies are born.
We need to support and strengthen the approximately 60,000-strong workforce of Community Health Workers — our community heroes — whose courageous job it is to enter homes, care for mothers and young children in that precious first 1,000 days when children are most vulnerable to stunting.
We must hold our leaders accountable for providing our communities with access to clean water and basic sanitation, because the resultant diarrhoeal disease and chronic gut infections that are an outcome of inadequate provision of basic services to our country’s children are an indignity that is not only deadly but undermines the futures of our country’s children by denying them the nutrients they need to grow and thrive.
We need to make this, our country, a country that celebrates, encourages and enables exclusive breastfeeding, anywhere, any time (including in the workplace!) because it is this first, beautifully potent and wondrously designed superfood, that is the first gift that unlocks all the other gifts we hope our children will realise later on in life.
And finally, we need to insist on a national commitment to zero stunting by 2030 at the highest level of government, because it is this kind of strong and visible leadership that has moved the needle on stunting in countries that have made significant progress in recent times, and will spare us the shame of failing future generations of South Africans in the years to come.
In 2019 another million Grade 1s began school — we smile and celebrate their entry into formal education, but know that with stunting rates at 27% for children under five, we have already short-changed the futures of a quarter of them. DM
Dr Kopano Matlwa Mabaso is Executive Director of The Grow Great Campaign.
* Ardington, C.; Case, A. Health: Analysis of the NIDS Wave 1 Dataset, Discussion Paper No. 2. National Income Dynamic Study, July 2009.
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