Malnutrition still a killer among children
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Cape Town - Severe Acute Malnutrition (SAM) remains a serious fundamental cause of child deaths in South Africa, accounting for one quarter of child in-hospital deaths.
This was one of the findings in the report of Food and Nutrition Security, South African Child Gauge 2020.
In a case study conducted by Unicef’s Nutrition Specialists Mariame Sylla and Gilbert Tshitaudzi, SAM remains a significant underlying cause of child mortality in South Africa.
“While prevalence is low at 2.5%, mortality rates in children with SAM are nine times higher than those in well-nourished children. For much of the past few years, provincial efforts to address acute malnutrition have primarily focused on providing treatment for severely malnourished children in healthcare facilities,” read the study.
It added that in 2019, more than 11 000 children were admitted for treatment for SAM out of the estimated national burden of 151 798 children. The proportion of SAM children accessing treatment remains unacceptably low due to missed opportunities in identifying children with SAM at community level. It is therefore critical to intensify active case finding and to recognise and treat children with acute malnutrition before they become severely wasted.
Tshitaudzi said SAM mainly affects children under the age of five, and those who come from poor households and communities.
He said it is caused by poor food intake, mainly a diet that does not provide essential vitamins, minerals and other nutrients, or diseases such as diarrhoea, pneumonia and infections affecting young children.
“These are mainly influenced by food insecurity at household level and non-availability of Health, Water, Sanitation and Hygiene services,” he said.
Tshitaudzi said the government has done a lot with regards to the provision of treatment to children who are admitted into healthcare facilities with SAM.
“This is demonstrated by the reduction in the number of children who died in hospitals as a result of SAM from 19% in 2009/10 to just 7.7% 2019/2020. More still needs to be done by actively finding children with acute malnutrition at community level and ensuring that they receive appropriate care and treatment on time,” he said.
He added that prevention efforts also need to be strengthened to ensure that acute malnutrition is prevented before it happens by ensuring that children receive nutritious diets and care they need.
Communication and Education Specialist at the Children’s Institute at UCT Lori Lake said over the past year as a result of lockdown, they saw the loss of employment, rise in food prices escalate child hunger.
“One in six households reported that a child has gone hungry in the last seven days by the end of 2020,” she said.
Lake said they need to foresee that this rise in hunger is going to have an impact on children’s nutrition status.
She said society needs to strengthen its surveillance systems, early warning systems and the key to that is the growth monitoring that should take place at every clinic.
“Families that can’t put food on the table need to be referred to the Department of Social Development, Sassa and to community-based feeding programmes,” she said.
Dr Claudine Bill, of Philani Maternal, Child Health and Nutrition Trust, said the mother’s mental health is also important because depression is also significantly associated with malnutrition.
She said breastfeeding is a very important protector for under-nutrition.
“Breastfed children have better nutrition and it also helps to develop their immune system so they are better protected against diseases,” she said.