The first comprehensive study of early childhood development has revealed that close to 4million children under six are not getting the services, nutrition and care they need.
Research shows that one-fifth of malnourished children suffer from stunting.
Stunting affects brain development, which is hard to reverse, say researchers from Ilifa Labantwana, the University of Cape Town's Children's Institute and the Department of Planning, Monitoring and Evaluation in the Presidency.
More than 40% of children are deficient in Vitamin A, which means they are more prone to infection and illness.
A quarter of women of reproductive age are anaemic, which creates high risk for death during delivery and low birth weight in babies.
Katherine Hall, a senior researcher at the Children's Institute, said the safety of children was "possibly" one of the biggest issues exposed in the review.
"Only one in nine cases of sexual abuse is reported to police," she said, adding that many were left in "risky situations" without the therapy or intervention they needed.
Hall also flagged unequal access to early learning facilities.
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