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Child Gauge 2024 sounds the alarm, saying South African ‘Children are in crisis’

Child Gauge 2024 sounds the alarm, saying South African ‘Children are in crisis’
Mark Tomlinson, Institute of Life Course Health Research, Stellenbosch University. (Photo: Queen's University Belfast / Wikipedia)
Tamsin Metelerkamp
By Tamsin Metelerkamp
22 Aug 2024
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The key findings in the Child Gauge 2024 suggest that South Africa’s progress towards realising the vision set out in its ECD policy is under threat. Researchers’ estimates indicate worsening trends in poverty, malnutrition and child mortality, suggesting a need for urgent action to safeguard the health and well-being of the country’s youngest children.

The South African Child Gauge 2024, released on Wednesday, is centred on “enhancing early childhood development”. The publication places emphasis on the idea that the future of any society relies on its ability to nurture the health and well-being of the next generation.

Speaking at the launch of the Child Gauge 2024, Dr Tshepo Motsepe – physician, First Lady of South Africa and patron of the South African Civil Society for Women’s, Adolescents’ and Children’s Health – said the publication filled a gap regarding the status of children in the country, and advanced evidence-based policymaking and advocacy on children’s health.

“Success in life is a function of all factors that influence a person’s life, and their prenatal stages and infancy… To build a strong, peaceful and prosperous nation, we need to start by investing in the care of younger citizens – the same as a strong foundation is necessary when you’re building a house,” Motsepe said.

“What does it really mean to invest in early childhood development? It means we need to start early, even before the child is conceived, with investment in safe, supportive homes for the mother; health and nutrition; choice about when to have children; and safety from gender-based violence. We need access to healthcare early in the antenatal period, including a series of clinic visits to monitor the health and welfare of the mother and the baby.”

The Child Gauge 2024, the 17th edition, reflects on progress since the adoption of the National Integrated Early Childhood Development Policy in 2015 and sets an agenda for progress towards ECD objectives for 2030. The editors of the report are Wiedaad Slemming, director of the Children’s Institute at the University of Cape Town (UCT); Linda Biersteker, a psychologist and adult educator focusing on early childhood development; and Lori Lake, communications and education specialist at the UCT Children’s Institute.


Key findings


There are estimated to be just under seven million children under the age of six in South Africa. Some key findings in the report, presented by Slemming, are:

  • One in 25 children die before their fifth birthday;

  • An increasing number of children are living in poverty, with the estimate of the number of children living beneath the upper-bound poverty line increasing from 65% in 2016 to 71% now;

  • 29% of children are stunted or short for their age;

  • 55% of four- to five-year-olds attending early learning programmes are not developmentally on track;

  • Only three-quarters of women attended at least one antenatal visit during their pregnancy in 2022;

  • One in five births is not registered in the first year, which is a key barrier to access to essential support services and the Child Support Grant for children;

  • Nearly one in three children is not attending early learning programmes between the ages of three and five, which means they are not getting the kind of support and learning opportunities that prepare them for schooling; and

  • Only 40% of early learning programmes are registered (as shown in the ECD Census 2021) and of these, only 33% received an ECD subsidy.


“The picture from the data is showing us that progress towards realising the bold vision that we had set out in the ECD policy is under threat. All our estimates are showing trends in poverty, malnutrition and child mortality increasing, and don’t bode well for our youngest children,” Slemming said.

Child Gauge Tshepo Motsepe. (Photo: Chris McGrath / Getty Images)


Children in crisis


The Child Gauge 2024 says what happens in the early years is critical for a child’s developmental trajectory, and affects their physical and mental health and well-being, educational achievement and economic participation throughout life.

Right now, “children are in crisis”, according to Professor Mark Tomlinson, co-director of the Institute for Life Course Health Research in the Department of Global Health at Stellenbosch University. He emphasised the need for action, rather than just talking about action.

One of the threats he identified in relation to the well-being of young children was the climate emergency. He made the example of how increases in air pollution could have disproportionately negative impacts for babies, since they breathe faster.

“In any emergency, the people that suffer the most are vulnerable children. They always have and they always will,” he said.

Tomlinson recommended that the government needed to put children at the centre of everything it did, in policymaking across all sectors.

Linda Richter, distinguished professor in the DSI-NRF Centre of Excellence in Human Development at the University of Witwatersrand, said there was a lot to be proud of in South Africa when it came to ECD. She referenced the introduction of a universal pre-primary school year in the country, as well as the 2012 diagnostic review of ECD and the consultations around it, which led to the foundation of the National Integrated Early Childhood Development Policy.

However, she noted: “We are a country abundantly rich in data analysis but we remain pitifully short on implementation. The ECD policy, like the Nurturing Care Framework [for Early Childhood Development], is widely cited but very few people have actually read it. The main recommendations of the policy are not addressed.”

The release of the Child Gauge 2024 was an opportunity to renew the commitment to making real changes in the early childhood space, said Richter.

Mark Tomlinson of the Institute of Life Course Health Research at Stellenbosch University. (Photo: Queen’s University Belfast / Wikipedia)


Looking ahead


Most investment in young people is currently geared towards school-age pupils and higher education, which is “way too late”, according to Slemming.

“We need to invest early and we need to make sure that any remediations happen early. Without early intervention, our children are always going to be falling behind and they’re not going to reach their optimum potential,” she said.

Some key recommendations Slemming touched on were:

  • Building a continuum of care and support for pregnant women and young children;

  • Increasing investment in community health workers;

  • Strengthening systems to identify and intervene early to support children with additional needs (such as children with disabilities or health conditions, or those living in environments of violence or abuse);

  • Addressing the double burden of malnutrition, which is the coexistence of undernutrition and overnutrition in the same population, and making healthy foods more affordable and accessible;

  • Expanding income support and social assistance, including increasing the Child Support Grant to the food poverty line;

  • Providing nutrition support to early learning programmes;

  • Expanding early learning opportunities, as well as increasing the ECD subsidy and reducing barriers to registration for programmes;

  • Encouraging men to play an active role in childcare; and

  • Providing affordable childcare that enables parents to work.


Janeli Kotzé, acting director of early childhood development in the Department of Basic Education, described ECD as the cornerstone of South Africa’s future. She added that every person in the country had a role to play in ensuring its children succeed.

“Government officials and departments have a very clear role to play, but we cannot do it on our own. The challenge facing our children is much bigger than any government department… or any organisation can [address] on their own,” she said.

“There’s such rich work happening in our country and working together, collaborating together, everyone playing their part in this ecosystem of early childhood development, is the only way in which we’ll be achieving our goals.” DM

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