New study reveals alarming rates of malnutrition among children in the Western Cape

A recent study led by the University of Cape Town (UCT) has uncovered a concerning double burden of malnutrition among young children in the Western Cape, with both stunting and overweight/obesity occurring at alarming levels.

The findings, published in the journal Development Southern Africa, highlight the urgent need for comprehensive nutrition policies.

The research, spearheaded by Marjanne Senekal, an Emeritus Professor in UCT’s Faculty of Health Sciences, was conducted in collaboration with Stellenbosch University, the DG Murray Trust, and the Western Cape Department of Health and Wellness.

The aim was to provide robust, provincial-level data to support more effective planning and implementation of nutrition policies for children under the age of five.

Using rigorous sampling methods, the research team surveyed a representative sample of 1,214 children under five years old in the Western Cape. Each child's weight and height or length were meticulously measured, and structured interviews were conducted with primary caregivers to gather essential socio-demographic information.

Key Findings:

• Stunting (chronic undernutrition) affects 17.5% of children under five, representing a medium public health concern.
• Overweight/obesity (chronic overnutrition) affects 15.1% of children, a level considered a very high public health concern.
• A prevalence of 2.4% was observed for concurrent stunting and overweight, indicating that some children are both stunted and overweight.
• Wasting (acute malnutrition) prevalence was recorded at 3.4%, which represents a low public health concern.

The study identified several socio-demographic risks for stunting, including:

• Being aged one to under two years.
• Having a father who is unemployed or only employed part-time.
• Having a mother who is unemployed or only employed part-time, particularly at the time of the child's birth.
• Running out of money for food in the past month.
• A child in the household going hungry in the past week.
• Living in a rural town.

Conversely, the study found that higher educational status of both parents, a higher Wealth Index score, and certain income brackets were protective factors against stunting. For overweight, risks included being aged one to under three years and having a low birth weight, while household amenity indicators reflecting higher income served as protectors.

Professor Senekal stated, “Chronic malnutrition in the form of stunting and overweight/obesity is a greater concern in the Western Cape province than acute undernutrition (wasting).”

While the prevalence of stunting in the province is lower than national levels and may be on the decline, Senekal expressed doubts about the feasibility of achieving the WHO/UNICEF target of reducing stunting by 50% by 2030.

She also questioned whether the aim of reducing overweight/obesity prevalence to less than 3% by 2030 could be realised.

Senekal emphasised the need for nutrition interventions to address both stunting and the rising rates of overweight/obesity in young children.

“To meet WHO/UNICEF targets for the reduction of stunting and overweight/obesity, we recommend urgent measures to identify, review, and adapt current policies and interventions targeting malnutrition in the Western Cape province,” she said.

The lessons learned from this study could also inform a critical reassessment of malnutrition policies and interventions in other provinces, underscoring the need for a comprehensive approach to child nutrition.

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