South Africa's people should breathe a sigh of relief following the Constitutional Court's ruling guaranteeing uninterrupted payment of social grants in South Africa. There may also be praise following the slight increase in monthly social grant payments for more than 17 million South Africans announced in February's national budget. However, these increases are not enough to address South Africa's persistent malnutrition challenges.
South Africa's social protection system has expanded dramatically since 1994. Nearly a third of South Africans, and in some provinces more than half of all households, receive at least one social grant from the state. The largest of these social assistance schemes is the Child Maintenance Grant, which reaches her 12 million children. This equates to almost her two to three children under the age of 18.
In his latest budget, outgoing South African Finance Minister Pravin Gordhan announced a small increase in social grants. The Disability and Care Dependency Grant will increase from R90 to R1,600 per month, the Foster Care Grant will increase from R30 to R920 per month, and the Child Support Grant will increase from R20 to R380 per month.
In theory, expanding social assistance systems should lead to improved food security indicators. More money will be spent on food, more people will eat in a day, and poor people will have a more varied diet.
Unfortunately, this is not necessarily reflected in the fight to reduce child malnutrition, i.e. the proportion of children who are too thin (underweight or underweight) or too small for their age (stunted).
Our research in collaboration with Maastricht University found that this is also the case in South Africa. And a small increase in subsidy payments will not necessarily change the status quo.
There are two reasons for this. The first is that grants are so small that they are often distributed to more people than the recipients. Second, the causes of malnutrition are complex, and reducing them requires a comprehensive package of interventions, not just social subsidies.
persistent malnutrition
We found that food insecurity has decreased significantly over the past 20 years. As the number of children receiving social grants increased, the number of families reporting that their children went hungry in the past 12 months fell.
However, even if this scale levels out, challenges remain. That means rates of chronic malnutrition among children remain high. More than one in five of her children still suffer from growth problems. The 2016 World Nutrition Report ranks South Africa 70th out of 132 countries on this indicator. South Africa's child stunting rate is worse than some poor African countries such as Gabon, Ghana and Senegal, and only slightly better than many other countries such as Congo, Swaziland and Somalia.
Evidence shows that the proportion of children with growth problems in South Africa has decreased only slightly over the past two decades. In the first nationally representative survey in 1993, 24.5% of children suffered from stunting. By 2012, when the most recent survey was conducted, this figure had reached her 21.5%.
This creates two contradictions. First, South Africa's extensive social subsidies have failed to eradicate malnutrition. And second, despite improving food security, as measured by families reporting hunger, nutritional outcomes, as measured by child stunting rates, have stagnated. are doing.
So why aren't South Africa's massive social subsidies eradicating malnutrition?
what is missing
Maintaining good nutrition requires having enough food, or enough cash to buy enough food, but it also requires good health and good eating and care practices. Can social subsidies afford the poor enough to buy food? And what about their health, eating, and care practices?
There are two problems.
First, increases in subsidy payments have not kept pace with inflation. Food prices in South Africa have increased by more than 10% in recent years, while social subsidies have slowly increased. From 2016 to 2017, the cost of nutritionally adequate meals increased by an estimated 16%, while child support payments increased by just 9%.
The second problem is that social grants, especially child grants, are not spent solely on children's meals, and even if the amount does not cover children's nutritional needs.
In reality, social grants are “diluted” across many needs and among many people. There are multiple “uses” and multiple “users”. They make up a portion of household income and are spent on the non-food needs of everyone living in the household, not just the children.
Even if the full amount of the child support subsidy is used only for the child's food costs and not shared with other household members, the R350 subsidy will only cover the cost of the child's nutritionally adequate meals. Less than two-thirds. .
Another factor is the difference between food security, which focuses on food availability and access, and nutritional security, which is a broader concept that also includes health and dietary practices. Insufficient access to food, or food insecurity, is just one of the factors that causes malnutrition. Other factors include illness, poor hygiene, and inadequate child care.
While social subsidies improve access to food by increasing household incomes, many of the other factors that cause malnutrition remain unaddressed. For example, children suffering from diarrhea and parasites caused by living in unsanitary conditions or drinking unclean water can become weak and stunted, even if they are eating a nutritious diet. It may become.
Another factor is the fact that most mothers do not breastfeed their children, which can compromise the child's nutritional status from birth. As recommended by the World Health Organization, fewer than 1 in 10 South African mothers exclusively breastfeed for the first six months, one of the lowest rates in the world. It's one.
Tackling malnutrition requires addressing these non-food factors.
Requires broader intervention
It would be dangerous and wrong to conclude that social subsidies in South Africa have no impact on the welfare of the poor. Without subsidies, millions of people living in poverty would be far worse off.
Over the past 23 years, social grants have contributed to reducing food insecurity and hunger. However, a more comprehensive approach is needed to address the continuing high levels of child malnutrition in South Africa.
Social grants are a key element of South Africa's fight against poverty and hunger. But they are not high enough and social subsidies alone are not enough.
