South Africa’s children have some protection from hunger. It comes from the Child Support Grant and from meals served at schools. However, a new study from the University of Johannesburg (UJ) indicates that many children in the country’s richest province lack enough nutritious food. Many children are stunted or underweight because they do not consistently receive the nutritious food needed for healthy growth. Boys in the early school grades are affected far more than girls the same age.
The study found that stunting declined, while the number of underweight children in these communities doubled from 6% to 12% between 2020 and 2022. This means that in three years, the number of underweight children doubled from one in 16, to one in eight.
The study examined data from 129 school learners aged five to 10 years old in Gauteng, in schools with poor resources, between 2020 and 2022. In those years many people lost their income and state support, as COVID-19 regulations and economic shocks took hold.
“Stunting indicates chronic undernutrition that develops over time,” says Dr Matshidiso Sello. Stunting is caused specifically in the first 1000 days of a child’s life, including during pregnancy.”
“On the other hand, underweight indicates that the child is not getting enough food or has recently experienced illness, which is affecting their weight,” she adds.
Dr Sello is a senior researcher at the Centre for Social Development in Africa (CSDA), within the UJ Faculty of Humanities. She is the lead author of the study.
The decline in stunting suggests that long-term investments in child health and nutrition, social protection and school nutrition programmes may have had a positive impact, she says.
However, the study’s other main finding highlights a troubling gap in support for low-income families.
Boys impacted more than girls
“The doubling of underweight children is a warning sign. It suggests that many families are struggling to provide enough nutritious food in the short term, likely because of rising food prices, unemployment and the economic pressures that intensified during and after the COVID-19 pandemic,” says Dr Sello.
“For families and health workers, underweight can be an early warning signal that households are under severe economic stress. Detecting it early allows for early interventions before children experience more serious health and developmental consequences.”
The study found that boys were 5 times more likely to be underweight than girls. They were over 3 times more likely to be stunted. The study was not set up to find the exact reasons, but the pattern is known, she says.
“Our findings are consistent with international research showing that boys may be more biologically vulnerable to nutritional and environmental stress during childhood,” Dr Sello adds.
Low nutrition means low academic achievement
“Nutrition is one of the foundations of early childhood development,” says Dr Sello.
“A child who receives adequate nutrition is more likely to be healthy, attentive in class and able to learn effectively. Poor nutrition can reduce concentration, memory and energy levels, making it more difficult for children to participate in classroom activities, keep up with lessons and perform academically. Over time, this can increase the risk of absenteeism and grade repetition.”
The effects do not stop at school, she says.
“Children who are healthier and better educated are more likely to complete school, access employment opportunities and become economically productive adults.”
Primary school child nutrition as long-term investment
The Child Support Grant of R580 is currently well below the food poverty line of R855, says Dr Sello.
“I hope policymakers will view child nutrition as a long-term investment rather than simply a social expenditure,” says Dr Sello. “This means continuing to strengthen social protection, and reviewing the adequacy of the Child Support Grant in relation to the cost of a basic nutritious diet. We need to be protecting and expanding school nutrition programmes, and improving coordination between the health, education and social development sectors.
“Too often, nutrition surveillance focuses on younger children, yet our findings show that early grade learners remain vulnerable,” Dr Sello adds.
Depressed caregivers, school meals and reaching potential
The lack of support for low-income families also impact caregivers. This then cascades through to the children, Dr Sello notes.
“In our study we found high unemployment levels among caregivers and caregivers with high depressive symptoms,” she adds. “For many children, the school becomes the only place where they receive a nutritious meal.
“School is also the best place to do regular growth monitoring and identify underweight children early. For this, a stronger collaboration between local clinics and schools is needed,” she adds.
“Ensuring that every child has access to adequate nutrition reduces hunger. It also gives every child the opportunity to reach their full potential,” says Dr Sello.
Research article: Trends and Factors associated with Stunting and Underweight among Early Grade Learners in Low-Quintile Schools in Johannesburg, South Africa (2020–2022)
