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Malnutrition among young children is a thief — here’s what we can do to make a difference

Malnutrition among young children is a thief — here’s what we can do to make a difference
Kayin Scholtz
By Kayin Scholtz
6 Dec 2023
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With the 2024 elections approaching we urge politicians and policymakers to show us the scale of their ambition for improving the well-being of children across our nation. True commitment cannot purely be rhetorical, and must include increases in funding for young children's nutrition, and ensuring that these investments reach the most vulnerable children.

The pangs of hunger are too familiar for South Africa’s youngest children. Research from the Children’s Institute, Nelson Mandela Children’s Fund and South African Human Rights Commission continue to highlight the inexcusable fact that from birth, our youngest children are having the quality of their lives degraded and even ended by hunger and malnutrition. Few things harm children’s lives more than malnutrition. 

We cannot claim to live in a fair country when a quarter of children experience stunting.

The 2024 elections are fast approaching and access to nutrition is increasingly recognised as an essential concern for many. But what are some of the policy solutions for this tragedy that has been unsolved for too long? 

Read more in Daily Maverick: Adequate nutrition: Fulfilling a young child’s right  

Recent research from the Real Reform for ECD movement emphasises that young children have the immediately realisable right to nutrition, a basic need that our country must meet, and soon. Furthermore, the large network of creches, educares, preschools and playgroups, known as early learning programmes (ELPs), across South Africa is a resource for ensuring that young children receive not only food, but good nutrition. 

Repairing the holes in the food basket


Malnutrition is clearly a problem, but is it one that South Africa can solve? 

History tells us yes. 

The National School Nutrition Programme (NSNP) demonstrates that the government can achieve incredible feats when political will and technical expertise are married. The NSNP is one of the most significant multisite distribution exercises provided by our government. It delivers meals to about 21,000 fee-free public primary and secondary schools (including Grade R), feeding 9.6 million pupils on school days with R9.3-billion allocated for this task in 2024. 

These efforts, despite challenges, showcase our commitment to the phrase “you can’t teach a hungry child”. However, this success also highlights our failure to support children between birth and five years, where no such nutrition support exists outside beyond the mere R6.80 portion of the R17 per child, per day subsidy ringfenced for nutrition. 

Worse yet, only one-third of early learning ELPs actually receive this subsidy. 

With the successes of the NSNP, expanding access to early ELPs might seem a simple proposition. However, with the number of ELPs double that of public no-fee schools, the scale of the delivery challenge is even more complex than in the schooling sector. 

Delivery to ELPs is also more challenging due to less space for food storage, less-secure storage and the hyper-local nature of ELPs, especially in informal settlements and rural areas. We can learn from the successes of the NSNP, but early learning programmes need their own model of nutritional provision. 

Possible implementation models for nutrition support


Real reform for ECD’s research looked at three mechanisms for providing nutrition in ELPs: 

  • Through direct provincial procurement (similar to provinces that have centralised the provision of the NSNP);

  • Through a voucher system, and

  • Through direct transfers to ELPs, the best example of which is the per-child-per-day subsidy.


We evaluated these mechanisms based on:

  • Complexity of implementation;

  • Level of choice and diversity of foods that can be offered;

  • Cost-efficiency;

  • Opportunity to support local food economies; and

  • Risk of fraud.


Our analysis also highlighted the deep skills and strong history of nutrition provision among nonprofit organisations and for-profit partners, who can play the role of strategic implementing partners. They can take on various roles, from verifying beneficiaries to monitoring compliance. Collaborations with NGOs, civil society and the private sector are key. ECD forums and parents are vital partners in supporting ELPs for nutrition provision and monitoring.

Building on what works


In South Africa, more than 42,000 ELPs have emerged, addressing community needs for childcare and education. These programmes are often organised into active ECD forums, fostering networks that facilitate the sharing of information and resources. These programmes and forums are assets in improving child nutrition. Furthermore, the success of the NSNP, along with the networks of nonprofit organisations providing food to ELPs, showcases our capability to ensure that food reaches those in need.

Our analysis suggests that registered ELPs serving children from poor households should receive nutrition support through the per-child-per-day subsidy – currently an estimated 200,000 children do not. With increasing efforts to support registration over time, this should become the primary form of nutritional support provided to ELPs.  

However, increasing access to the subsidy is not enough. Our review of a costed Department of Health ideal menu for young children shows that it is imperative to increase the value of this subsidy to R31 per child, per day to enable programmes to buy nutritious foods. 

And we must not discriminate against eligible children (those who receive the Child Support Grant) attending unregistered ELPs who often stand the most to gain from this nutrition support. For these programmes, direct provision of nutrition may be most appropriate. Unregistered ELPs with kitchen facilities should receive food deliveries. Drawing from learnings from the NSNP and from partners who deliver nutrition to ELPs is critical.   

Learning from the experiences of those who have delivered nutrition to young children for years is crucial, and they are potential strategic implementing partners. Providing the current subsidy, and recommended minimum cost for nutrition of R6.80 per child, per day to all eligible children in ELPs, would cost about R1.65-billion annually – a necessary investment.  

Real Reform for ECD is encouraged to see that the Department of Basic Education has set aside funding for a pilot programme to provide nutrition to ELPs. The learnings from this programme will be critically important to determine the considerations for rolling out nutrition for ELPs more broadly. 

South Africa’s youngest members cannot be overlooked any longer. The evidence is clear, the solutions within reach, and the need urgent. There is a need for all sectors of society – parents/caregivers, the government, private and nonprofit – to rely on each other’s strengths to succeed. 

Read more in Daily Maverick: Right to early nutrition: youngest children must not be left behind 

Real Reform for ECD holds that ELPs are integral to addressing childhood malnutrition, yet we acknowledge that no single proposal is likely to resolve this tragic problem; a combination of strategies is required. 

Promising proposals include: 

Beyond these strategies, comprehensive enhancements in water, sanitation  and hygiene, coupled with improved screening and response to malnutrition within the healthcare system, are essential to effectively combat and ultimately eradicate the scourge of stunting and malnutrition.

With the 2024 elections approaching we urge politicians and policymakers to show us the scale of their ambition for improving the well-being of children across our nation. True commitment cannot purely be rhetorical, and must include increases in funding for young children’s nutrition, and ensure that these investments reach the most vulnerable children. These expenditures are not an expense but rather a crucial investment in our nation’s future. DM

Kayin Scholtz, Project Lead at Umncedi, is one of the researchers of the Implementation Models paper. 

This op-ed is the third of a three-part series written by researchers who worked on three papers that informed Real Reform for ECD’s Right to Nutrition campaign. Advocacy materials produced by the campaign are available here: Real Reform for ECD The full papers are available here: 

Tatiana Kazim, legal researcher at Equal Education Law Centre (Paper 1)

Anna-Marie Müller, former Innovation Manager at DGMT (Paper 2) 

Kayin Scholtz, Umncedi Project Lead (Paper 3)

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