Proposed policy aims to extend child support grant to pregnant women – The Citizen

Report on Child Malnutrition and Proposed Interventions in South Africa

Executive Summary

This report details the critical issue of child malnutrition in South Africa, which has resulted in over 1,000 preventable deaths in the last 18 months. The situation severely undermines the nation’s progress towards several key Sustainable Development Goals (SDGs), particularly SDG 2 (Zero Hunger) and SDG 3 (Good Health and Well-being). Civil society organizations are advocating for urgent government intervention, including the implementation of a Maternal Support Grant (MSG), to address the crisis and its long-term consequences.

The Malnutrition Crisis: A Failure to Achieve SDG 2 and SDG 3

The prevalence of malnutrition and stunting among children represents a significant public health and development challenge. The failure to protect the most vulnerable directly contravenes the principles of the Sustainable Development Goals.

Key Statistics and Impact on SDGs

• Child Mortality: At least 1,000 children have died from severe acute malnutrition in hospitals over the past 18 months. This is a direct setback for SDG 3.2, which aims to end preventable deaths of newborns and children under five.
• Stunting Prevalence: Chronic malnutrition affects over a quarter of South African children under the age of five, impairing cognitive and physical development and failing the targets of SDG 2.2 (end all forms of malnutrition).
• Acute Malnutrition Cases: Annually, between 15,000 and 20,000 children experience severe acute malnutrition, leading to illness, hospitalization, and death.

Proposed Interventions to Advance Sustainable Development

The Maternal Support Grant (MSG)

A primary recommendation from organizations like the DG Murray Trust (DGMT) is the fast-tracking of a Maternal Support Grant. This social protection measure is designed to extend the existing Child Support Grant to pregnant women, directly targeting the root causes of low birth weight and stunting.

1. Alignment with SDG 1 (No Poverty) and SDG 10 (Reduced Inequalities): The grant provides crucial income support to vulnerable pregnant women, acting as a social safety net to reduce poverty and inequality.
2. Economic Rationale: While the estimated annual implementation cost is R2 billion, the grant is projected to save nearly R13.8 billion in public health expenditures by preventing long-term health complications associated with malnutrition.
3. Contribution to SDG 3 (Good Health and Well-being): Evidence indicates that income support during pregnancy significantly reduces the incidence of low birth weight (under 2.5kg). Babies born at a healthy weight have a three times lower risk of becoming stunted, contributing directly to improved child health outcomes.

Multi-Sectoral Strategies and Partnerships (SDG 17)

Addressing the malnutrition crisis requires a coordinated effort involving government, the private sector, and civil society, embodying the principles of SDG 17 (Partnerships for the Goals).

Policy and Food Security Measures

• National Food and Nutrition Council: The government’s plan to establish this council is a positive step towards creating a coherent national strategy for achieving SDG 2.
• Food Price Intervention: DGMT and Grow Great have proposed a “double-discounting” scheme for a basket of protein-rich staple foods. This public-private partnership would involve manufacturers, retailers, and the government to lower the cost of nutritious food by 20-25%, at an estimated cost of R4.5 billion to the fiscus.

Integrated Health Support (SDG 3)

Drawing on experiences from Doctors Without Borders (MSF), there is a recognized need to integrate mental health support into nutrition programs. This holistic approach addresses the psychological trauma experienced by both malnourished children and their caregivers, promoting overall well-being as envisioned in SDG 3.

Analysis of Sustainable Development Goals (SDGs) in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 2: Zero Hunger: The article’s central theme is the “scourge of malnutrition” and “stunting” among children in South Africa. It discusses the need for access to “nutritious foods” and addresses “food security,” which are core components of SDG 2.
• SDG 3: Good Health and Well-being: The article directly links malnutrition to severe health outcomes, including the death of over 1,000 children, recurrent illness, and hospitalisation. It also mentions the integration of “mental health support” for mothers and children affected by malnutrition, aligning with the goal of ensuring healthy lives and promoting well-being.
• SDG 1: No Poverty: The proposed solution, a “maternal support grant (MSG)” or “pregnancy grant,” is a social protection measure designed to provide “income support to pregnant women.” This directly addresses the aim of SDG 1 to implement social protection systems for the poor and vulnerable.

2. What specific targets under those SDGs can be identified based on the article’s content?

• Target 2.2: End all forms of malnutrition. The article is explicitly focused on this target. It highlights that “stunting due to chronic malnutrition affects more than a quarter of children under the age of five” and discusses the need to address the nutritional needs of pregnant women to prevent babies from being “born too small (under 2.5kg).” The call to fast-track the maternal support grant is a direct strategy to combat malnutrition from conception.
• Target 3.2: End preventable deaths of newborns and children under 5 years of age. The article provides a stark statistic that “at least 1 000 children have died from severe acute malnutrition in hospitals over the past 18 months.” This directly relates to the goal of reducing under-5 mortality, as these deaths are described as preventable.
• Target 1.3: Implement nationally appropriate social protection systems and measures for all. The main policy proposal discussed is the “maternal support grant (MSG),” which is described as an extension of the existing “child support grant.” This is a clear example of a social protection system aimed at achieving substantial coverage for a vulnerable group (pregnant women living in food poverty).
• Target 3.4: Promote mental health and well-being. The article mentions that Doctors Without Borders (MSF) has “integrated mental health support into nutrition care, combining psycho-stimulation, counselling, and emotional healing for both children and caregivers.” This is in response to mothers battling “crushing stress and guilt,” directly addressing the need to promote mental health.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• Indicator 2.2.1: Prevalence of stunting among children under 5 years of age. The article explicitly states this indicator by reporting that “stunting due to chronic malnutrition affects more than a quarter of children under the age of five in South Africa.” This percentage is a direct measure of the problem.
• Indicator related to Under-5 Mortality Rate (Indicator 3.2.1). While not providing a formal rate, the article gives the raw data used to calculate it: “at least 1 000 children have died from severe acute malnutrition in hospitals over the past 18 months.” This figure serves as a direct measure of preventable child deaths.
• Indicator related to low birth weight. The article mentions the problem of “babies born too small (under 2.5kg)” as a consequence of food insecurity during pregnancy. The prevalence of low birth weight is a key indicator for measuring maternal and child nutrition.
• Indicator related to social protection coverage (Indicator 1.3.1). The article implies this indicator through its focus on the “maternal support grant.” The implementation and coverage of this grant would be a direct measure of the proportion of pregnant women covered by a social protection system.

4. Table of SDGs, Targets, and Indicators

Source: citizen.co.za