President Cyril Ramaphosa has committed South Africa to ending child stunting by 2030, placing child nutrition firmly on the national agenda. The announcement, made during the State of the Nation Address (SONA) on 12 February, followed Cabinet’s approval of the National Strategy to Accelerate Action for Children (NSAAC), which outlines 10 priorities to improve the lives of children and teenagers.
By Lebogang Mashala, Editor at African Farming
“Now, attention turns to Finance Minister Enoch Godongwana and whether Treasury will allocate funding to interventions proven to reduce stunting, particularly during the first 1 000 days of life, from conception to a child’s second birthday. Evidence shows that this window is critical for brain development, immune strength and long-term growth,” said the DG Murray Trust (DGMT) in a statement.
A Worsening National Crisis
Child stunting is caused by chronic malnutrition before birth and during early childhood. Its consequences are lifelong, affecting learning ability, health outcomes and future earning potential.
According to the Human Sciences Research Council (HSRC), 28.8% of children under five were stunted in 2024, an increase from 27% recorded in a previous major survey. This means that more than a quarter of South Africa’s young children are not reaching their full physical and cognitive potential.
David Harrison, CEO of DGMT, said low birth weight is a key driver of stunting. Babies born weighing less than 2.5kg face a significantly higher risk of developmental setbacks.
“Research shows that the risk of stunting increases when babies are born with a low birth weight and never catch up because their mothers were malnourished or drank alcohol while pregnant,” Harrison said.
South Africa also faces one of the highest rates of foetal alcohol syndrome globally. Over the past decade, an estimated 800 000 babies were born underweight and brain-damaged because of alcohol exposure in the womb, compounding the nutrition crisis.
Funding the Most Effective Interventions
DGMT has called on National Treasury to prioritise four high-impact measures in the medium term: a Maternal Support Grant, improved antenatal supplementation, making protein-rich foods more affordable and strengthening alcohol harm-reduction policies.
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Maternal Support Grant
Pregnant women in low-income households currently receive no dedicated income support until after their babies are born and registered for the Child Support Grant (CSG). This creates a critical nutritional gap during pregnancy, when maternal dietary needs increase substantially.
DGMT proposes a Maternal Support Grant equal to the CSG, paid from the second trimester of pregnancy until three months after birth. The intervention is estimated to cost about R2 billion annually and is aimed at reducing low birth weight and improving early childhood outcomes.
Although the CSG provides support to more than 13 million children every month, it has not kept pace with rising food prices and currently reaches about 81% of eligible children. Nearly half of eligible infants miss out in their first year, often because of documentation barriers. Harrison argued that the grant’s value should rise from R560 per month to the food poverty line of R855, starting with younger children.
Multiple Micronutrient Supplementation
More than 63% of households in South Africa are food insecure, with 17.5% experiencing severe food insecurity. Rising food prices have forced many families to substitute nutrient-dense foods with cheaper, energy-dense options that lack essential vitamins and minerals.
Liezel Engelbrecht, nutrition lead for the Hold My Hand Accelerator incubated by DGMT, warned that this shift leads to “hidden hunger” – micronutrient deficiencies that harm foetal development even when caloric intake appears sufficient.
Engelbrecht said transitioning from iron and folic acid supplements to multiple micronutrient supplementation (MMS) in the public health system would improve pregnancy outcomes. MMS combines 15 essential vitamins and minerals in a single tablet and has been shown internationally to reduce low birth weight, preterm birth and early infant mortality.
Although MMS costs slightly more than iron and folic acid alone, improved birth outcomes are expected to offset the marginal increase in expenditure.
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Affordable Protein-rich Foods
Beyond pregnancy and infancy, sustaining nutritional gains requires improving access to affordable protein-rich foods.
DGMT proposes a targeted double discount on a basket of 10 protein-rich foods, potentially including eggs, beans, tinned fish and amasi, funded jointly by government, retailers and manufacturers. The intervention is estimated to cost between R4 billion and R5 billion per year.
Advocates argue that this approach would have a greater impact than expanding VAT exemptions, as it would channel more value directly to low-income households and strengthen purchasing power where it is needed most.
Alcohol Policy Reform
Maternal malnutrition and alcohol consumption both contribute to low birth weight. Strengthening alcohol harm-reduction measures, including higher excise taxes and minimum unit pricing, could reduce heavy drinking by increasing the cost of cheaper alcohol products.
International experience, including Scotland’s minimum unit pricing model, has shown measurable reductions in alcohol-related harm. Supporters believe similar reforms in South Africa could protect children’s development while lowering long-term social and health costs.
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Civil Society Calls for Urgency
The advocacy organisation FairPlay has welcomed President Ramaphosa’s commitment, describing child stunting as a national crisis that demands urgent attention.
FairPlay founder Francois Baird noted that ending child stunting by 2030 aligns with targets set in South Africa’s National Development Plan and the United Nations Sustainable Development Goals, commitments that have existed for more than a decade with limited progress.
FairPlay has proposed removing the 15% VAT on chicken portions most consumed by low-income households as an immediate intervention, arguing that VAT-free chicken could provide a direct nutritional boost while broader programmes are rolled out.
A Coordinated National Programme
Experts agree that achieving the 2030 target will require coordination across government departments. Although the National Food and Nutrition Council is meant to oversee nutrition policy, it is currently not functioning effectively.
DGMT has called for the appointment of a dedicated “nutrition leader” to drive a cross-departmental programme focused on reducing low birth weight, improving access to protein-rich foods and lowering alcohol-related harm.
President Ramaphosa has indicated that funding details will be announced in the Medium-Term Budget Policy Statement.
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