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Childhood stunting and malnutrition are critical health challenges for SA


Mbali Ntuli is the founder and CEO of Ground Work Collective.

The prevalence of childhood stunting in South Africa is alarmingly high, with around 27% of children under five years of age affected, meaning that these children will likely not reach their full growth and developmental potential.

Childhood stunting and malnutrition remain critical public health challenges in South Africa, affecting the physical and cognitive development of millions of young children.

Stunting is defined as the impaired growth and development that children experience due to poor nutrition, chronic infections, and inadequate psychosocial stimulation. It is a severe form of malnutrition and has long-term consequences for both individuals and societies.

South Africa, despite its status as one of the most developed countries in Africa, continues to grapple with the issue of childhood stunting which disproportionately affects children in largely rural areas.

According to a United Nations South Africa publication titled The ‘slow violence’ of malnutrition in South Africa”, acute malnutrition (including moderate and severe forms) remains a significant underlying cause of child mortality, being associated with one-third of all child in-hospital deaths.

The prevalence of childhood stunting in South Africa is alarmingly high, with around 27% of children under five years of age affected, meaning that these children will likely not reach their full growth and developmental potential because of the irreversible physical and cognitive damage caused by persistent nutritional deprivations.

This figure varies significantly between rural and urban areas, with rural communities facing higher rates of stunting. The root causes of childhood stunting in the country are multifactorial.

Poor nutrition, primarily due to limited access to nutritious food and the inability of many households to afford a diverse and balanced diet, is a major contributing factor. Food insecurity and poverty often force families to rely on cheap, calorie-dense but nutrient-poor foods, leading to malnutrition.

The consequences of childhood stunting are profound and long-lasting. Stunted children face a higher risk of morbidity and mortality, impaired cognitive development, and reduced school performance. As they grow into adulthood, stunted individuals are more susceptible to chronic diseases such as diabetes and heart disease, perpetuating a cycle of poor health and poverty.

Addressing childhood stunting requires a comprehensive, multi-dimensional, and societal approach. The South African government, together with international organisations and non-governmental bodies, has taken steps to combat malnutrition.

The National Development Plan has committed the government to reducing stunting in children under five years to 10% by 2030. This plan focuses on improving food security, maternal and child health, access to clean water and sanitation, and providing targeted support to vulnerable communities.

South Africa is purportedly on track to meet some of the World Health Assembly 2025 targets but there is a need to accelerate our work. South Africa would have 1.7 million stunted children in 2025, which is nearly twice as high as the 900,000 children target for 2025.

At Ground Work Collective, under our Food Production pillar of work, we have set a goal to work with communities to facilitate their access to consistent, reliable, safe, and nutritious food, which we hope will add to the efforts currently underway to combat childhood stunting nationally.

Our approach is focused on the need to increase food production at household level and to promote the subsistence farming of fortified foods. We must enhance agricultural productivity, especially in rural areas, and promote sustainable farming practices.

During my time in politics, while working in the uMkhanyakude constituency in the north of KwaZulu-Natal, I was able to observe the disastrous effects that malnutrition continues to have on children, spanning well into their adult lives. Other community-based interventions, such as promoting exclusive breastfeeding and educating caregivers about proper nutrition, play a crucial role in preventing childhood stunting.

Nutritional supplementation programmes, especially during the critical first 1,000 days of life (from conception to the child’s second birthday), can have a significant impact on reducing stunting and improving a child’s health and development.

At Ground Work Collective we believe that childhood stunting can be effectively addressed if we invest in early childhood nutrition and healthcare, increase food production at household level, and promote sustainable agricultural practices that improve access to fortified foods.

Only then can South Africa break the cycle of malnutrition, improve the well-being of its citizens, and foster a healthier and more prosperous future for the nation. DM


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  • Raymond Auerbach says:

    Over the past fifty years the number of people who say they are hungry has decreased, thanks to child grants; however, as Mbali Ntuli points out above, the childhood stunting remains stubbornly high, mainly because people often buy junk food (empty calories) with grant money. The research of Dr Stephen Devereux compares these two phenomena, and in a joint chapter on this topic in our recent book (Organic Food Systems: Meeting the Needs of Southern Africa, CABI 202), we show the links to supporting organic food production (thus reducing dependence on expensive external inputs). Chapter 7 can be downloaded free of charge (google “CABI Auerbach”). Chapters 18-22 show how organic farmers can produce as much as conventional farmers with lower input costs, and chapters 23 & 24 show how the organic sector can develop in Southern Africa. Thanks to Mbali and UN for insightful work!

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