A focus on the health and nutrition of pregnant women and children under the age of two years’ old during the COVID-19 pandemic is essential. World Food Day, observed annually on 16 October, promotes awareness and action for those who suffer from hunger. The theme for this year, ‘Grow, nourish, sustain. Together. Our actions are our future’, reminds us of the role we, as South African citizens, play in our country’s food safety and security.
Nutrition and primary healthcare in the first 1000 days of a child’s life (the period from conception to when children are two years of age) has a proven direct impact on their development and growth, both mentally and physically. This period presents the greatest opportunity for optimal development, and also makes it the most vulnerable and crucial in the context of nutrition. At a public health level, good nutrition of a nation contributes to the economic productivity and development of society.
“The pandemic has undone decades of gains in improving primary healthcare service delivery in South Africa. Concerns about the risks of COVID-19 have led to a delay in caregivers attending to healthcare for childhood conditions. There has been a noted drop in attendance at health facilities in places such as rural KwaZulu-Natal,” says Ms Pumla Dlamini, Nutritionist for Vitamin Angels and Co-Chair of the South African Civil Society for Women’s, Adolescents’ and Children’s Health (SACSoWACH). “Routine maternal and child healthcare services have also been withdrawn or scaled-down, despite the South African Department of Health’s continued efforts to minimise disturbances and restore service delivery,” she adds.
National immunisation coverage has dropped significantly, from 82% in April 2019 to 61% in April 2020. This suggests that other child health services, such as the screening for Severe Acute Malnutrition (i.e. growth monitoring and promotion) have also been affected.
Feeding schemes are not being equipped for breastfeeding mothers and children under the age of two years’ old. “Without a high standard of nutrition within the first two years of a child’s life, he or she is at risk of poor brain development, poor performance at school and poor job prospects,” explains Ms Dlamini.
Poor nutrition during pregnancy and infancy has long-term consequences for the generation of ‘infant-malnourished mothers’ – referred to as the ‘intergenerational transmission of poverty’. Malnourished women are more likely to have low birth weight children, especially in teenage pregnancies. “The survival of infants and young children is largely linked to their mother’s health and nutritional status. Women are more vulnerable to micronutrient deficiencies as they have higher nutritional needs during pregnancy and lactation,” explains Chairperson of SACSoWACH, Ms Precious Robinson.
In South Africa, COVID-19 exacerbates the issues of food insecurity and hidden hunger (food consumed to satisfy hunger but lacking in micronutrients needed for overall health). As problems of malnutrition in the country persist, significant percentages of stunted and malnourished children become more susceptible to a COVID-19 infection and long-term, non-communicable diseases such as hypertension and diabetes.
Dr Chantell Witten from the University of the Free State and Nutrition Lead for SACSoWACH, warns that unless food insecurity is addressed, pregnant women and young children will bear the brunt well beyond the COVID-19 pandemic.
For this reason, SACSoWACH urges government to prioritise:
– Safe-guarding the package of antenatal services to pregnant women, including dietary screening and food support.
– Providing all pregnant women with calcium supplements and the more nutritious Multiple Micronutrient Supplements (MMS) to replace iron and folic acid.
– Encouraging the promotion and support of breastfeeding by healthcare providers and communities.
– Promoting and providing appropriate and nutritious complementary foods for children six months and older in all food support initiatives.
– Safe-guarding the life-saving nutrition interventions such as Vitamin A and Zinc supplementation, deworming, and growth monitoring and promotion for children at primary healthcare level.
– Promoting routine mid-upper arm screening for all children under five years old to prevent severe acute malnutrition.
– Addressing the long-standing issues of food and nutrition security by the relevant sectors and stakeholders.