Although the government has said it will set aside money to combat child stunting, and interventions to support pregnant women and their babies for their first 1 000 days of life, it is unclear how the R1.6bn – over three years – will be spent, reports GroundUp.
This targeted nutritional support will be extended into pre-birth care nationally, though specific details are not yet available.
Finance Minister Enoch Godongwana’s announcement of the funding injection during his Medium-Term Budget Policy Statement (MTBPS) recently was welcomed by David Harrison, CEO of the DG Murray Trust, which advocates for a maternal support grant and improved child nutrition.
He described the R1.6bn allocation as “a foot in the door”, but added that “the amount needed is far greater than what has been allocated, but it is still welcome”.
“Without yet seeing the breakdown, this is the first time that the focus has shifted into pregnancy, providing targeted support to at-risk pregnant women and mothers of low-birthweight babies. It is the first step towards a more comprehensive strategy to reduce stunting,” he said.
In February, in his State of the Nation Address, President Cyril Ramaphosa announced a national campaign to tackle childhood stunting, which he called a national crisis, affecting more than a quarter of South African children under five.
Pledging to end it by 2030, he established a special task team chaired by Saul Musker, the Presidency’s head of strategy and delivery support. The President said the government would focus on the first 1 000 days of life, a period covering pregnancy and a child’s first two years.
The President also promised targeted interventions to ensure pregnant women and babies born with low birthweights receive the protein and nutrients they need.
Treasury confirmed that the R1.6bn will be channelled to provincial Health Departments through the District Health Programmes Grant. It will support nutrition services, including micronutrient supplementation for pregnant and breastfeeding women and children at primary healthcare facilities.
No funding had been set aside for a maternal support grant.
The R1.6bn forms part of a broader reprioritisation of government spending, with Treasury identifying savings in social grant expenditure that will be redirected towards combating gender-based violence and supporting child malnutrition interventions. It also comes as the Department of Basic Education expands its focus on early childhood development.
In May, Basic Education Minister Siviwe Gwarube announced that an early childhood development (ECD) nutrition pilot was being implemented, beginning with ECD centres in the Eastern Cape. She said the initiative responded to findings from the Thrive by Five study, which identified stunting among children attending early learning programmes.
The ECD nutrition pilot and the R1.6bn allocation are separate initiatives, but it remains unclear how the departments of Health and Basic Education will co-ordinate their efforts.
Harrison said the DG Murray Trust had been working with the Presidency to reduce the number of babies born with low birthweights through multiple micronutrient supplementation and ring-fenced nutritious foods.
He cited the Khulisa Care Programme in the Western Cape as a promising model. The pilot, implemented in partnership with the provincial government, DG Murray Trust, Grow Great Campaign and Shoprite, aims to improve maternal nutrition and reduce childhood stunting: it targets underweight pregnant women and women at risk of delivering low-birthweight babies.
Harrison said the organisation plans to mobilise private donors to match the government’s R1.6bn allocation within the next three months.
The DG Murray Trust is among a network of organisations that have been researching and lobbying for nutrition programmes, and the extension of the child support financial grant into pregnancy via a maternal support grant through the Social Development Department.
This has not yet happened.
While the additional nutrition funding signals a commitment to addressing childhood malnutrition, questions remain about implementation.
National Treasury and the Department of Health have yet to clarify how they will divide the allocation, whether it will support existing nutrition services or new interventions, and what measures will be used to determine whether fewer children are experiencing stunting.
See more from MedicalBrief archives:
South Africa’s shame of child stunting and its echoes of HIV
Ending childhood stunting vital for South Africa's future prosperity
UFS: Child malnutrition – human rights violation and slow violence against children