First ever provincial Stunting Baseline Survey shows gains | Western Cape Government



First ever provincial Stunting Baseline Survey shows gains

31 May 2023

First ever provincial Stunting Baseline Survey shows gains as we invest in the future of our children on International Children’s Day


“Children are our future - The more we invest in them, the greater our future will be.” 


June is annually acknowledged as Youth month. 1 June commemorates International Children’s Day, which should  galvanise  everyone’s efforts to be geared towards enriching children’s lives from an early age, so they can prosper later.

Sadly, the reality is that our socio-economic and living conditions impact on many children’s ability to grow into their full potential in South Africa. The 2020 Child Poverty Report in South Africa (Statistics SA) concluded that South Africa continues to be plagued by poverty and inequality with six (6) out of 10 children, or 62.1%, are multidimensionally poor. According to the Report, children under five are most deprived in the dimensions of housing (61,3%), child development (57,9%)  and health (54,4%). Among children aged 5-17 years old, the highest deprivation rates are observed for the dimensions education, housing and health. (Full report here:


The Department of Health and Wellness have an existing initiative (The first 1000 days) including programmes of early childhood interventions for nutrition, which show good indications of making a positive difference.

While many of these factors contributing to stunting are socio-economically driven, the Western Cape Department of Health and Wellness in collaboration with the DG Murray Trust (DGMT), commissioned the University of Cape Town and Stellenbosch University, to conduct a baseline survey to compile a comprehensive malnutrition profile and investigate drivers of childhood malnutrition of infants and children under five years of age in the province. This proactive approach is aligned to this year’s theme for International Children’s Day: “Children are our future - The more we invest in them, the greater our future will be.” 


The reports help us to better understand the status of the problem and enables the Department to engage multiple role players to yield effective interventions. The rationale is that by improving the quality of life of children at a young age, we are ensuring a better chance for them to prosper.

It is the first-ever baseline stunting survey commissioned by a provincial health department in the country, which also investigated potential causes of malnutrition, including direct causes (dietary intake and disease) and underlying causes (food security, caring capacity of caregivers and environmental hygiene).


The survey concluded that the existing interventions probably helped reduce the overall prevalence of stunting in the province from 22.9% in 2016 to 17.5%. It also found that 19.7% of children under the age of two are stunted, which is a grave cause for public concern. In collaboration with relevant stakeholders in child health, the recommendations from this survey will be taken forward and additional interventions will be developed to further prevent and control malnutrition in children under-5-year-old. In addition, the Western Cape Education Department’s School Nutrition programme provides nutritious breakfast and lunch meals every school day to approximately 517 000 learners. R557 million has been budgeted for this programme in the 2023/24 financial year, with 1 038 schools, representing 67% of our public ordinary schools, benefitting from this pro-poor and extremely important initiative.


The Department’s First Thousand Days (FTD) initiatives is a key intervention which raises awareness of the crucial first 1 000 days of a child’s life, from conception to two years old. The Department continues to work within communities and with its partner organisations to actively engage care givers in communities and empower them on:

  • Good health and nutrition (eating and living healthy by not smoking, drinking alcohol or using drugs during pregnancy or breastfeeding;
  • love and attention babies need, and all the support moms need through establishing support systems; and
  • play and stimulation for learning as well as the protection of a safe environment.


These recommendations feed directly into a Whole of Society Approach (WoSA) of the Western Cape Government and the collective response is expected to include:

  • Build a map of all initiatives/interventions – whether governmental, civil society organisations, universities and research institutions – that aim to improve the nutritional status, early childhood development and general well-being of children under-5-years-old.
  • Conduct a series of workshops with multi-sectoral stakeholders to consider the outcomes and recommendations of this research within the context of the current intervention map to plan the way forward to address the malnutrition risks for under-5-year-old children.


Dr Nomafrench Mbombo, Western Cape Minister of Health and Wellness says, “The latest findings tell us that we need to do more to broaden access to affordable and nutritious foods. We need to work together to improve the health outcomes of our young children so that they can thrive, which is why I will be taking these findings forward and discussing them with my counterparts within the Provincial Government.”

Dr Keith Cloete, Head of the Department, says, “We commissioned this baseline survey to determine if our existing interventions are working. While there is an overall reduction, more needs to be done, which is why we will take the recommendations of the survey forward and engage all relevant partners, both civil, private and governmental in enhancing our interventions, especially focused on the first one thousand days of a child’s conception to second birthday.”

“We need to accelerate the gains that have been made over the past seven years to ensure children are getting the nutrition, safety, care and support they need to thrive by the age of five,” says Anna-Marie Müller, an Innovation Manager at DGMT and a co-investigator in the survey.