Malnutrition is a major underlying cause of death in 64 per cent of children under the age of five in South Africa. One in five children is stunted and many are deficient in the vitamins and minerals vital to good health and optimal development.
South Africa is making efforts to fight malnutrition. Key vitamins and minerals have been added to wheat flour, maize flour and retail sugar in accordance with mandatory regulations that came into effect in 2003. Salt for human consumption is also iodised. Birth defects have dropped by more than a third as a result of folic acid fortification.
Malnutrition, especially among younger children, is a public health challenge in South Africa and requires a systematic approach to improving nutrition services and promoting behaviour change. UNICEF is helping the Department of Health to improve policies, strengthen capacities of health workers and implement essential nutrition services in under-served communities.
One of South Africa’s greatest challenges is to encourage women to breastfeed exclusively for six months from birth. A mere 25 per cent of infants less than six months old are exclusively breastfed, according to the HSRC, 2010 report. Of greater concern is that 53 per cent of children under six months were mixed-fed. Many mothers and caregivers introduce babies to food of poor nutritional value and questionable safety. These poor infant feeding practices contribute greatly to the high levels of malnutrition, diarrhoea and poor growth and can increase the risk of HIV transmission. HIV/AIDS-related illnesses are the second leading cause of death in young children.
In 2011, UNICEF’s advocacy and technical expertise was catalytic in South Africa’s adoption of the WHO/ UNICEF recommendations for a single infant feeding strategy. The strategy promotes breastfeeding in the context of HIV and is based on new evidence showing that when mothers living with HIV and their babies take antiretroviral medicines (ARV) the risk of HIV transmission is almost entirely prevented. Exclusive breastfeeding, up to the age of six months, is the most effective way to ensure babies reach their full potential, but this has not been common practice.