In South Africa, a staggering 1 in 4 children are affected by stunting, an irreversible condition marked by physical and cognitive impairments due to persistent undernutrition. Stunting arises from a complex combination of factors, including poor maternal health, nutritional deficiencies, and limited access to healthcare. The long-term consequences of stunting significantly hinder a child’s cognitive development, academic performance and future economic prospects while also increasing the risk of developing chronic diseases in adulthood. These pervasive impacts entrench families and communities in cycles of poverty and health inequities, yet, crucially, stunting is entirely preventable.

We implement a comprehensive zero-stunting strategy from conception until the child is six. Our interventions start by providing pregnant mothers with essential prenatal support, such as vitamins and supplements for healthy foetal development, nutritional advice, breastfeeding training, alcohol harm screening, and connecting families to assistance to apply for the Child Support Grant.

Breastfeeding training for pregnant mother with Nomakhaya (community health worker) during routine prenatal home visits.

After birth, our Nomakhayas (community health workers) provide postnatal care on a weekly basis, including breastfeeding support, to ensure that infants receive optimal nourishment from day one. Central to our approach is regular growth monitoring so that we can track each infant’s development closely. This frequent monitoring ensures that deviations from expected growth patterns are identified early, enabling timely interventions. Additionally, our Nomakhayas facilitate ECD@home and playgroup initiatives to promote early physical and cognitive development. 

Deworming and vitamin A provision at Jujurha ECD Centre

Once a child is three, they attend one of our Early Childhood Development centres, where health is integrated into the curriculum. This includes bi-annual deworming and vitamin-A provision, dental health promotion, annual eye exams, and two daily hot-cooked, nutritious meals. Our ECD Centres conduct annual comprehensive growth and developmental assessments to monitor a child’s progress and identify any developmental concerns.

We are digitising the Road to Health Book, a comprehensive hardcopy record documenting a child’s developmental growth. Despite the existing use of these booklets and regular monitoring, the high prevalence of stunting remains a pressing issue. By transitioning to a digital approach with an integrated alert mechanism within our data management system, we further enhance our ability to identify any child at risk of stunting promptly.

Our zero-stunting strategy is a proactive defence against the risk of stunting within our community, enabling swift action against emerging cases. This approach has demonstrated that stunting is preventable, even in the most rural and under-resourced communities.