Young children in SA face rising poverty, malnutrition post-Covid – Childhood Review

The Covid-19 pandemic has erased gains made for young children in South Africa, as they are more likely to live in poverty, suffer from food insecurity, and die before their fifth birthday.

This is according to the recently released South African Early Childhood Review 2024, which tracks data on the status of South African children under six years old.

Covid-19 erased gains

“The Covid-19 pandemic erased gains made for young children in South Africa, presenting a massive setback we have not fully recovered from,” said Dr Katharine Hall, Senior Researcher at the Children’s Institute at the University of Cape Town.

The review was jointly published by Ilifa Labantwana, the Children’s Institute at the University of Cape Town, the Department of Planning, Monitoring, and Evaluation in the Presidency, the Department of Basic Education (DBE), the Grow Great Campaign, and DataDrive2030.

During the lockdown, all essential services for young children were affected.

According to the review, although primary healthcare services have recovered, there are still backlogs in birth registration and early access to social grants; pre-school attendance remains below pre-Covid levels; and children’s malnutrition and mortality rates have risen, as have poverty rates.

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More children at serious risk of malnutrition

The executive director of Grow Great, Dr Edzani Mphaphuli, said nearly 40% of children under six live in households below the poverty line, and half a million more children are at serious risk of malnutrition than before the pandemic.

“Children in rural parts of the country have historically been the most vulnerable to poverty and poor nutrition, but now we are seeing a rise everywhere—even in the wealthier urban provinces of Gauteng and the Western Cape,” said Mphaphuli.

According to the review, malnutrition can be fatal, has lifelong consequences, including stunting in the case of chronic malnutrition, and is difficult to reverse. In South Africa, stunting is the most common type of malnutrition, affecting one in four children under five.

“Stunting leads to inequality because stunted children are more likely to grow up to be poor, unskilled, unemployed, and suffer from chronic diseases,” said Dr Mphaphuli.

Access to early learning remains unequal

The 2021 Thrive by Five Index, the Early Childhood Development (ECD) Baseline Assessment of pre-primary learning, and the 2021/22 ECD Census, led by the DBE, have provided data to measure access to quality early learning.

Sonja Giese, executive director of DataDrive2030, said according to the data, nationally, around 1.15 million children under the age of three to five years are not enrolled in any early learning programme, mostly due to poverty.

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“By not attending preschool, poorer children lose out on important early learning opportunities, making it difficult for them to transition successfully into school,” Giese said.

The data also revealed that a three-year-old child in the wealthiest quintile is 1.6 times more likely to attend an early learning programme than their peer in the poorest quintile.

According to the 2021 Thrive by Five Index, only 46% of four-year-olds attending early learning programmes were developmentally on track for their age.

Pandemic hit maternal and child health services hard, but have mostly recovered

Dr Colin Almeleh, director at Ilifa Labantwana, said antenatal attendance, postnatal follow-up, and immunisation rates all dropped during the pandemic, but they had mostly recovered or even improved by 2022.

“But we need to ensure that there is continuity in maternal and child health services even in times of crisis,” said Almeleh.

The Medical Research Council released preliminary figures for 2022 that show 30 out of every 1,000 infants born did not survive to reach their first birthday and that the under-five mortality rate rose from 29 per thousand live births in 2020 to 40 in 2022.

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The review said this is a reversal of the overall improvements in under-five and infant mortality rates in the decade leading up to the pandemic. Although the underlying causes of the rising mortality are unknown, poverty and malnutrition—which also rose during this time—are probably important ones. 

More poor children excluded from Child Support Grant

According to the review, 4.27 million children under the age of six received the Child Support Grant (R530 per month) in 2023, representing 63% of all children in this age group.

Dr Hall said that although the grant has increased annually, the increase has not kept pace with food inflation, and it is no longer able to cover the minimum cost of feeding and clothing a child.

“Worryingly, we have seen a real decrease in grant take-up among infants,” she added. 

Delays in the baby’s birth registration and the mom’s lack of identity documentation are major contributing factors to the reduction.

“The high rates of poverty, malnutrition, and exclusion from services are not new; they are long-term challenges that preceded the pandemic and were exacerbated by it. Recovery is not just about resuming business as usual; it has to be about finding different and better ways of ensuring that a holistic package of services and support reaches all young children,” Hall said.

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