It’s Monday morning in Langa, Cape Town. Siziwe Kasa, 32, sits on the bed of her one room shack cradling her 8-month-old toddler while a community healthcare worker enquires about the baby’s health and wellbeing.
The health worker checks the baby’s card to see if Kasa is keeping up with all the necessary inoculations.
“Good,” the health worker says encouragingly before asking if Kasa still sings for the baby.
Satisfied, she turns her attention to Kasa’s 3-year-old daughter, wanting to know if she is doing well in pre-school.
The health worker looks around the house: the electricity sockets are out of reach for the children, there is no broken glass inside the house or in the small, well-kept yard and, much to her approval, the small vegetable patch is being used to grow spinach.
“It’s important for children to eat well,” the community healthcare worker declares before asking Kasa to sing lullabies to her toddler.
From Kasa’s house, the community healthcare worker visits three other mothers, each with children who are toddlers or aged under five years.
Her visits are the same: check on their health, encourage their mother and other caregivers to create a safe and mentally stimulating environment, and most importantly, ensure that the children are eating well.
In this case, these children are getting all the necessary nutrients that the World Health Organisation (WHO) has identified as necessary for children to be well nourished and avoid stunting — the impaired growth and development that children experience from poor nutrition, repeated infection, and inadequate psychosocial stimulation.
But not every family in South Africa is meeting the nutrition standards required to keep their children healthy and developing properly.
Why stunting is a critical issue
Children who are stunted often have poor health and miss out on opportunities for education. They are also likely to suffer from chronic diseases and be economically disadvantaged as adults, hurting the overall economic development of the country.
This is why the health workers' visits in Langa are so important — it’s a practical solution to ensuring that children have a better chance of surviving and thriving.
The healthcare workers operate side-by-side with the Nelson Mandela Children’s Fund (NMCF) to help families and the community take better care of their children.
A report by Statistics South Africa found that 6.8 million South Africans experienced hunger in 2017.
Meanwhile, the State of the South African Child report by the Nelson Mandela Children’s Fund found that 14% of South African children go to bed hungry every night, and 27% of children under the age of three experience stunted growth due to a lack of nutrients and vitamins.
This is higher than countries with a similar income level, according to the World Bank’s Human Capital Index (HCI), which measures the knowledge, skills, and health that people gain throughout their lives to enable them to realise their full potential as productive members of society.
The HCI ranks countries on the probability of a child’s survival to age five, a child’s expected years of schooling, harmonised test scores as a measure of quality of learning, adult survival rate, and the proportion of children who are not stunted.
Many African countries rank at the bottom of the list, with South Africa at number 126 out of 157 countries.
A comprehensive solution
Shadi Nyokong, the manager of the Child Survival and Development programme at the NMCF, tells Global Citizen that ensuring children live past the first 1,000 days of life requires more than vaccinations: it's also about ensuring that everything a child needs to thrive is available at home, and around the community.
Child Survival and Development is a comprehensive programme formulated by the NMCF after research found that South African children are facing problems that are exacerbated by social issues like poverty and unemployment.
Even though the programme is primarily aimed at helping children access life-saving vaccinations, it’s all-encompassing.
“We engage with healthcare systems, but also factor in limited nutrition and access to water and sanitation,” Nyokong explained.
The NMCF runs the Child Survival and Development programme with community-based partners in Western Cape, North West, Northern Cape, Limpopo, and KwaZulu-Natal.
“These provinces have the highest number of children affected by malnutrition,” said Nyokong.
As well as helping mothers keep track of their children’s immunisation programme, families are also educated on the importance of access to quality nutrition and health services.
The initiative offers support through mum clubs that bring together women in the communities.
The clubs meet twice a month to identify pregnant women, breastfeeding women, and new mothers, and ensure that they have social support.
There are currently 29 clubs with more than 1,220 members. Each member receives eggs — which contain essential proteins — at every meeting, and members are encouraged to establish a vegetable garden at home.
“We empower families with information that will help them look after their child’s life,” Nyokong adds.
“We work with the community to prioritise care, whether it’s encouraging fathers to be supportive, or teaching mothers about the health benefits of exclusive breastfeeding or the advantage of feeding their child porridge, which is cheaper and healthier, instead of processed foods that are seen to be cool,” she says.
Nyokong estimates that the Child Survival and Development programme has already helped 7,000 children and 4,000 families in better supporting their child’s health.