The First Five Years | How malnutrition is robbing South Africa's children of their future

The first 1,000 days of a child’s life, from conception to their second birthday, are the most critical window for brain development. 

In South Africa, that window is being systematically violated. For two decades, the nation has failed to lower its stunting rate, leaving more than 1.5 million children under five years old, equating to one in four, trapped in a cycle of undernutrition that creates a future of poverty.

The data from the South African Early Childhood Review 2024 shows that we are losing the battle for a healthy nation’s future.

Malnutrition, stunting and overweight

South Africa faces a triple burden of child malnutrition: undernutrition (stunting), micronutrient deficiencies, and overweight.

Stunting is more than just being too short for one’s age; it is the physical manifestation of chronic undernutrition and environmental failures.

It is a developmental scar that is, sadly, difficult to reverse and carries lifelong consequences: developmental delays, poor school performance, and a heightened risk of chronic conditions like obesity and hypertension in adulthood.

Being overweight is often a sign of poverty, where households must prioritise cheap, starchy foods high in calories but low in nutritional density.

This is rooted in deep poverty, with 2.7 million young children living in households where the lack of income makes basic nutritional needs impossible.

Child Support Grant

The financial tool meant to address this, the Child Support Grant (CSG), is simply too small.

At R530, it falls substantially below the R760 food poverty line. The gap between state support and the reality of rising food inflation now determines a child’s potential future.

Because the grant is not keeping pace with costs, over one in ten children under six live in households where they are reported to go hungry because there is not enough food. This statistic confirms that our primary social safety net is failing.

The environment compounds the nutritional crisis

Poor sanitation is a silent killer of potential. Nearly a third of all children under six lack piped water or a flush toilet at home, relying instead on pit toilets or other inadequate systems. 

This exposure makes young children particularly susceptible to diarrhoeal diseases and other infections. When a child is constantly ill, their body cannot absorb nutrients, making malnutrition worse and tragically increasing the risk of preventable death - a reality for the 1,000 children who lose their lives to acute malnutrition each year.

Early school years

The damage is most apparent when children enter the world of learning. The Thrive by Five Index confirms that the stunting epidemic is sabotaging school-readiness. 

Only 42% of enrolled children meet the standard for being developmentally on track in early learning.

The researchers found that moderately or severely stunted children are five months behind their non-stunted peers in cognitive tests.

Even children who recover from early stunting perform poorly compared to their counterparts and the developmental clock cannot be rewound.

Early learning programmes

A solution lies in our Early Learning Programmes (ELPs). The Thrive by Five Index noted that children attending ELPs showed significantly lower stunting rates (just 5.7%) compared to the general population (15.6%). 

This proves that ELPs are not just educational centres; they are critical access points for nutrition and health services, where 90% provide at least one daily meal and many facilitate health interventions like immunisations.

With the Department of Basic Education now coordinating early childhood development, there is an  opportunity to strengthen these nutrition programmes. 

Poverty is rising, grants are failing, and the health of our environment is poor. To break the intergenerational cycle of poverty, we must first win the war against stunting.

If we continue to allow food prices and grant inadequacy to dictate a child's health and learning, we risk losing the potential of a third of our population.

IOL 

Get your news on the go. Download the latest IOL App for Android and IOS now.