Adequate nutrition during the first 1,000 days of a child’s life are crucial to his or her survival, optimal growth, development, and cognitive and social-emotional functioning. Investing in effective infant nutrition also has long-term benefits in school outcomes and economic productivity.
This publication, authored by Michael K. Hendricks (School of Child and Adolescent Health, UCT) and Sipho Dlamin (UCT, formerly DGMT), outlines the main nutritional problems affecting
young children in South Africa and describes key evidence-based interventions that are required to tackle the crisis of infant and maternal undernutrition. Policies and guidelines that support such interventions are described, the barriers to implementation are briefly outlined, and recommendations are made for the reinforcement of nutritional interventions in the public health system.
International research has shown that the management of severe acute malnutrition, preventive zinc supplementation and the promotion of exclusive breastfeeding in the first six months all contribute to the reduction of under-five mortality rates. All of these interventions could be delivered effectively through community-based organisations or centre-based programmes.
The South African Nutrition Roadmap is a five-year plan focusing on adequate nutrition during the first 1,000 days. The plan links nutrition intervention to priority conditions such as HIV and TB and proposes an integrative strategy. A package of interventions including breastfeeding, complementary feeding, iron, folate, vitamin A and zinc supplementation could cost-effectively be delivered.
Links between malnutrition and HIV infection are well documented, and improving access to ARV treatment for pregnant women can help in reducing low birth weight and mother- to-child transmission of HIV, maternal morbidity and mortality.
While there is no doubt that nutrition interventions can improve child survival, reduce malnutrition and improve the developmental outcomes of children, there are nevertheless a number of barriers constraining the effective implementation of such interventions. In the short term, existing programmes need to be strengthened and key nutrition interventions scaled up using health facility- and community-based delivery platforms and early childhood development services.
Addressing long-term, systemic problems within the health system will also help to improve the coverage of nutrition interventions, translating into better health and developmental outcomes for children nationally.
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