Nearly 4,500 children younger than five years old died in South Africa in the past five years due to malnutrition. KwaZulu-Natal recorded the most deaths and the Western Cape the fewest.
This startling data was disclosed by health minister Aaron Motsoaledi in reply to a parliamentary question. Motsoaledi said since 2020, 4,447 children under the age of five died, their deaths being associated with “but not necessarily caused by moderate acute malnutrition severe acute malnutrition”.
Nearly 3,000 of the deaths reported in public hospitals had evidence of severe acute malnutrition. KwaZulu-Natal accounted for 1,205 deaths, with the Eastern Cape also faring badly with 599 deaths associated with malnutrition. The Western Cape reported 68 deaths.
According to the World Health Organisation, malnutrition refers to deficiencies or excesses in nutrient intake, imbalance of essential nutrients or impaired nutrient use.
Reducing malnutrition in young children requires multiple actions implemented by multiple stakeholders and it is difficult to measure and attribute success or failure to isolated interventions.
— Aaron Motsoaledi, health minister
The double burden of malnutrition comprises undernutrition and overweight and obesity, as well as diet-related noncommunicable diseases.
Motsoaledi said the government had taken several steps to reduce the occurrence of acute malnutrition, including identifying and treating children affected by it.
“Community healthcare workers screen and refer children identified at household level in all provinces. All children under five years admitted for inpatient care and those attending primary healthcare facilities in all provinces are routinely assessed and classified for acute malnutrition to facilitate early identification,” said Motsoaledi.
“All children are managed according to existing clinical guidelines and protocols including provision of specialised therapeutic foods in all provinces.”
Business Day reported a year ago that the rate of severe acute malnutrition in children under the age of five had risen 26% in the past five years, with the Eastern Cape reporting the largest surge.
Poor children are overwhelmingly located in rural areas and live in the traditionally poor provinces of the Eastern Cape, KwaZulu-Natal and Limpopo, the provinces that also account for most child-headed households.
The latest general household survey by Stats SA placed the Eastern Cape and Limpopo high in the rankings of child-headed households.
A 2024 Unicef study found South Africa is one of 20 countries that account for 65% of all children with severe child food poverty globally and 23% of children in South Africa are classified in that category and at risk of life-threatening malnutrition and related health complications.
The report on the UN agency’s study said 46% of cases of severe child food poverty were among poor households where income poverty was likely to be a major driver and that in parts of South Africa, such as the Eastern Cape, insufficient access to nutritious food is compounded by a lack of access to safe water and sanitation.
“Child nutrition issues are also compounded in South Africa and other countries by easier access to cheap, nutrient-poor and unhealthy ultra-processed foods and sugar-sweetened beverages that are aggressively marketed,” said the report titled “Child Food Poverty: Nutrition Deprivation in Early Childhood”.
“These unhealthy foods and beverages are consumed by an alarming proportion of young children experiencing food poverty and displace more nutritious and healthier foods from their daily diets.”
Motsoaledi said the government was making progress in reducing malnutrition after it peaked after the outbreak of Covid-19 in 2020.
“Reducing malnutrition in young children requires multiple actions implemented by multiple stakeholders and it is difficult to measure and attribute success or failure to isolated interventions. The prevalence of acute malnutrition increased in the post-Covid-19 period. The prevalence is declining once more, though close monitoring and ongoing efforts to ensure further reductions are required.”
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