Cape Town – Severe Acute Malnutrition (SAM) remains a serious root cause of child deaths in South Africa, accounting for a quarter of child deaths in hospital.
This was one of the findings of the food and nutrition security report, South African Child Gauge 2020.
In a case study conducted by UNICEF nutrition specialists Mariame Sylla and Gilbert Tshitaudzi, SAM remains a significant underlying cause of child mortality in South Africa.
“While the prevalence is low at 2.5%, the death rates among children with SAM are nine times higher than those of well-nourished children. For much of the past few years, provincial efforts to tackle acute malnutrition have mainly focused on providing treatment to severely malnourished children in health facilities, ”the study reads.
He added that in 2019, more than 11,000 children were admitted for treatment for SAM out of the estimated national burden of 151,798 children. The proportion of SAM children accessing treatment remains unacceptable due to missed opportunities to identify children with SAM at the community level. It is therefore essential to step up active case finding and to recognize and treat children with acute malnutrition before they become severely wasted.
Tshitaudzi said SAM primarily affects children under five and those who come from poor households and communities.
He said this was due to poor nutrition, mainly a diet that does not provide essential vitamins, minerals and other nutrients, or illnesses such as diarrhea, pneumonia and infections affecting young children.
“These are mainly influenced by food insecurity at the household level and the unavailability of health, water, sanitation and hygiene services,” he said.
Tshitaudzi said the government has done a lot in providing treatment for children admitted to health facilities with SAM.
“This is demonstrated by the reduction in the number of children who died in hospital as a result of SAM from 19% in 2009/10 to just 7.7% in 2019/2020. Much remains to be done in actively finding children with acute malnutrition at the community level and ensuring that they receive appropriate care and treatment on time, ”he said.
He added that prevention efforts should also be stepped up to ensure that acute malnutrition is prevented before it occurs by ensuring that children receive the nutritious food and care they need.
Communication and education specialist at UCT Children’s Institute Lori Lake said that over the past year, following the lockdown, they have seen job loss, rising food prices worsen hunger among children.
“One in six households said a child was hungry in the last seven days at the end of 2020,” she said.
Lake said they had to predict that this increase in hunger would impact children’s nutritional status.
She said the company needs to strengthen its surveillance systems, its early warning systems, and the key to that is tracking the growth that should take place in each clinic.
“Families who cannot put food on the table should be referred to the Sassa Social Development Ministry and community feeding programs,” she said.
Dr Claudine Bill, of Philani Maternal, Child Health and Nutrition Trust, said maternal mental health is also important because depression is also significantly associated with malnutrition.
She said breastfeeding is a very important protector of undernutrition.
“Breastfed children have better nutrition and this also helps build their immune systems so that they are better protected against disease,” she said.