Grow Great is a new campaign – the first of its kind – that aims to galvanise all of South Africa towards a national commitment to eliminate the silent epidemic of stunting by 2030 and to achieve a stunting free generation.

Stunting is a condition that is prevalent among children in South Africa and it affects 1 in 4 of our country’s children under the age of five. “Stunting robs young children from reaching their full potential. Stunted children on average perform worse at school than their non-stunted counterparts, are more likely to be unemployed as adults, are at higher risk of getting diseases like diabetes and hypertension and are vulnerable to being trapped in inter-generational cycles of poverty, which is unjust and completely preventable,” explains Dudu Mkhize, communications specialist for Grow Great.

In order to achieve their goal of Zero stunting by 2030, the campaign which is now only a year in operation has identified four priorities to address the drivers of stunting, which includes issues such as clean water, good sanitation, access to health care, maternal healthcare before, during and after pregnancy. They plan to use data to mobilise policy makers, stories to inspire the public, communities of practice to support health practitioners, and mom and baby classes to support parents.

The four main campaign activities, some of which are already active, include:

• A national social franchise Flourish
• A focus on Community Health Workers (CHWs)
• A mass media campaign
• Conducting community-based surveys

Flourish in the first 1 000 days

Grow Great is already running Flourish – a national social franchise, which seeks to support, celebrate and empower pregnant and new mothers through the first 1 000 days, which forms the most critical period of development throughout a person’s lifespan.

Flourish runs mom and baby classes that provide support for pregnant moms and moms with small babies and helps address maternal healthcare before, during and after pregnancy, which is an underlying driver of stunting.

Through the Flourish programme, the campaign aims to reach 20 000 pregnant women and young babies by 2021, says Mkhize.

A group of moms from the Flourish antenatal classes.

Special focus on CHWs

CHWs will form a vital part of the Grow Great Campaign as they are community leaders and heroes, says Mkhize. “They are the critical workforce best placed to support pregnant mothers and young children in homes and communities in the first two years of life when children are most vulnerable to stunting.”

Pregnant mothers and children will gain access to skilled health professionals in the home through the CHWs programme and the CHWs will also give access to health care through the referral system.

Grow Great has found that developing countries that have achieved significant reductions in stunting credit much of their success to CHWs who have played a central role in stunting reduction strategies. “If one considers that a healthy child typically only interacts with the health system for approximately 20 of the first 1 000 days, a strategy that includes interacting with the child and the primary caregiver in the home is critical to the prevention of stunting.”

Grow Great’s strategy for involving CHWs is centred on supporting and empowering CHWs through a national Community Health Worker Club and community of practice, which will transform this workforce to become Champions for Children. It is about using the already existing service of a skilled workforce to effect change. “CHWs are already entering the home, as champions for children. As part of the campaign, they will perform growth monitoring activities on children under 5 years in the homes they are already entering, which will help in identifying children whose growth is faltering and get them referred early to prevent stunting,” she explains.

The CHWs who join the Champions for Children Club will become part of a community of practice and virtual resource centre for CHWs that:

• Provides access to a dedicated national information line, ongoing mentorship and resources that enable CHWs to provide ongoing support to the families they care for
• Provides opportunities to receive training on the first 1 000 days, with a particular focus on the growth monitoring of children
• Gives incentives to continue being everyday heroes in their communities
• Gives access to a social network of other CHWs across the country as a means of peer recognition, friendly competition, and positive reinforcement

Grow Great aims to reach 2 000 CHWs through its Champions for Children Club.

Community-based surveys

The Grow Great campaign is also conducting community-based surveys profiling the prevalence of stunting and its drivers in vulnerable communities, so as to shed greater light on the nutritional status of South Africa’s children and inform policy and local programme implementation, explains Mkhize.

Thus far, they have conducted community surveys in at least 14 vulnerable communities.

The data that they are gathering will be used to mobilise policy makers by illustrating the prevalence of stunting and its effects. They then expect that policymakers will be mobilised to address those drivers, says Mkhize.

Mass media campaign

In addition to the programmatic interventions they are running, Grow Great aims to reach approximately 20-mn South Africans through a mass media campaign (using billboards) and radio public service announcements that they are currently running.

Their mass media campaign is promoting exclusive breastfeeding for babies under the age of six months and promoting eggs as nutritious complementary food for babies older than six months, explains Mkhize.

The approach

The campaign is the first of its kind in SA and draws on what has worked in other contexts (similar to SA’s) like Peru, Maharashtra State in India and Latin America.

“We know that in a number of these contexts, community healthcare workers have been central to these countries’ stunting reduction strategies and so working with and supporting community health workers is central to our campaign,” explains Mkhize.

Other elements in their approach such as ensuring contact with moms in the first 1 000 days and a multisectoral approach also come from proven research and approaches that have worked elsewhere.

“We know that countries that have achieved significant gains on stunting have taken a multisectoral approach and so our advocacy work uses data to encourage South Africans from all sectors to commit to working towards zero stunting by 2030.”

What you can do

The Grow Great campaign, like many others that require real change, cannot only rest on the works and actions of its members. It requires all the different sectors of South Africa to commit to zero stunting by 2030, and the public, as well as policymakers, have major roles to play, explains Mkhize.

The public can help and commit to zero stunting by:

• Spreading the word that 1 in 4 children in South Africa are stunted
• Telling your friends and family just how important it is that children get healthy food and about their need for safe and loving environments in order to grow and reach their full potential
• Supporting, encouraging and celebrating pregnant women in your community
• Supporting, encouraging mothers to exclusively breastfeed for the first six months and to breastfeed for as long as they are able to, and protect their right to breastfeed in homes, communities and the workplace
• Creating safe environments for mothers and children
• Loving, talking and playing with babies and children to stimulate their brains
• Sharing the Grow Great campaign infographics within your networks
• Joining the Grow Great movement

In order to prevent and reduce stunting in South Africa, policymakers need to:

• Ensure commitment and coordination between government ministries, business, and civil society to focus on reducing stunting
• Create targeted policy efforts
• Ensure healthier pregnancies – through strengthening the health system to remove barriers to high quality antenatal and postnatal care
• Remove barriers preventing mothers from breastfeeding and increase community-based breastfeeding support
• Ensure access to clean water and sanitation
• Remove barriers to early uptake of the Child Support Grant

 

About campaign and team

The Grow Great campaign is South Africa’s first stunting campaign. Its strategy is informed by the best practices of other countries that have successfully managed to reduce their own prevalence of stunting. The campaign team consists of 12 experienced individuals that have backgrounds in health, business, media, nutrition, curriculum developing as well as training.

 

A health worker measures an infant’s growth. Image courtesy of Photoshare.

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