When faced with complex problems that require co-ordination and collaboration, government departments almost instinctively retreat to their silos and predetermined responses. As a result, workable solutions often fall through the cracks and citizens pay the price.

The same may be true in the case of childhood malnutrition in  SA.

Undernutrition is a particularly worrying aspect of this, because of its association with diabetes, hypertension and cardiovascular disease in adulthood.

The United Nations Children’s Fund defines undernutrition as “the outcome of insufficient food intake and repeated infectious diseases”.

It includes being underweight for one’s age, too short for one’s age (stunting), dangerously thin for one’s height (wasted) and deficient in vitamins and minerals (micronutrient malnutrition). These conditions stem from a range of biological and other factors, including malnutrition of pregnant women and babies before and after they are born.

Chronic undernutrition (stunting) also influences physical growth, mental and cognitive ability and the development of the immune system during childhood. Women who were themselves stunted are at higher risk of having stunted offspring.

South Africa’s policies for child nutritional security are similar to those of Brazil and Peru. Those countries have seen improvements in the rate of stunting. Not so in South Africa, where around 25% of children under the age of three years are stunted. The situation has not changed in two decades.

Recent studies point to a possible explanation for this. It is that in South Africa the various actors who are supposed to deliver clean water, safe sanitation and hygiene have not engaged with one another in a systematic way. And even though it’s well known how these facilities are related to health, nutrition and growth, the knowledge isn’t being translated into policy.