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17 September 2020 | Story Prof Corina Walsh | Photo Sonia du Toit (Kaleidoscope Studios)
Prof Corinna Walsh is from the Department of Nutrition and Dietetics and an NRF C-rated researcher at the University of the Free State.

The COVID-19 pandemic highlighted the challenges of food insecurity, hunger, and malnutrition that existed prior to the outbreak, but which are now affecting more individuals and households. During June 2020, three organisations – the Nutrition Society of South Africa (NSSA), the Association for Dietetics in South Africa (ADSA), and Dietetics-Nutrition is a Profession (DIP) – joined forces to call on the government to address malnutrition in all its forms. Prof Corinna Walsh from the Department of Nutrition and Dietetics at the University of the Free State (UFS) is the President of the Nutrition Society of South Africa, which aims to advance the scientific study of nutrition to promote appropriate strategies for the improvement of nutrition well-being. 

The call confirms that good nutrition is an essential part of an individual’s defence against disease and explains that malnutrition, in the forms of both over- and undernutrition, is closely related to an increased risk of illness and death, which has a considerable economic and societal impact. The Coronavirus pandemic has emphasised the importance of food security and nutritional well-being for all South Africans and has exposed the vulnerability and weaknesses of our food systems. 

How big is the problem of malnutrition in South Africa and what impact has the Coronavirus had on this situation?

The call highlights that undernutrition co-exists with the rising incidence of overweight and obesity (frequently in the same household) and resultant non-communicable diseases (NCDs) such as type 2 diabetes mellitus and hypertension. In South Africa, more than a quarter of the female adult population is overweight and more than a third is obese; it is estimated that 269 000 NCD-related deaths occur in the country annually. Obesity and NCDs are regarded as major risk factors for COVID-19 hospital admissions and complications. Over the past 20 years, the prevalence of chronic undernutrition in children has not improved, with 27% of children under the age of five being chronically undernourished. Chronic undernutrition in children manifests as impaired growth, referred to as stunting. By the age of two, this impaired growth and deficits in development become more difficult to reverse, resulting in intellectual impairment that compromises children’s school performance and employment prospects. Chronic undernutrition in children furthermore increases their future risk of obesity and non-communicable chronic diseases in adolescence and adulthood.

Although the nutrition situation in the country had been of concern prior to the pandemic, the acute nature and vast extent of the lockdown brought the plight of individuals and communities to the forefront. In addition to hunger and food insecurity and the resultant undernutrition, the pandemic also placed a focus on non-communicable chronic diseases such as obesity, hypertension, and diabetes. These comorbidities, mostly related to overnutrition, are seen to be associated with a more severe form of COVID-19 infection, as well as an increased risk of hospitalisation and death.

 With South Africa’s current economic challenges and the rise of unemployment, is the situation of malnutrition and food insecurity bound to worsen?

Food, water, sanitation, and social security are under severe pressure due to the pandemic. All of these factors are directly related to an increased risk of malnutrition. Further underlying causes of malnutrition include poverty, unemployment, and inequality, which require interventions over the medium and long term. 

The initial hard lockdown had an immediate and acute impact on households and communities in many ways. With regard to food and nutrition, these include interrupted access to food due to restrictions on travelling and informal trading; discontinuation of food and nutrition social programmes such as the National School Nutrition Programme and feeding at early childhood development programmes; increases in food prices and food expenditure; and reduced or lost income.

The pandemic came at a time when global food security and food systems were already under strain due to natural disasters, climate change and other challenges, exacerbating the need to transform food systems to be sustainable and resilient. 

What interventions are suggested to address the problem of malnutrition?

Food relief and social relief interventions, such as food parcels and social grants, could address the more immediate needs, but broader actions are required to address the underlying causes of malnutrition. 

An important first step in the fight against malnutrition will be to recognise the severity of the situation and the need for coordinated strategic efforts to address the underlying factors that contribute to malnutrition, such as insufficient access to food, affordability of fresh foods, poor health services, and a lack of safe water and sanitation. Food security and nutrition should therefore be addressed collectively with interventions aimed at tackling these factors. It will require concerted efforts from the government, the private sector and civil society to address the immediate, underlying, and structural causes of undernutrition. In view of this, the call proposes that interventions include the following:
-           Prioritise nutrition on policy agendas related to health and social security, including a regulatory framework to support access to healthy and affordable foods. Consideration can be given to a basket of subsidised healthy foods and greater regulation of prices of basic foodstuffs.
-           Provide strategic direction and ensure coordinated and aligned programming to address food and nutrition security in collaboration with other sectors, including civil society organisations. Interventions to ensure optimal nutrition should extend beyond the health-care system and should draw on complementary sectors such as agriculture, social protection, early childhood development, education, water, and sanitation.
-           Coordinate an adequate and targeted food and social relief approach, prioritising the most vulnerable and needy for short-term mitigation. Food relief should be standardised and tailored to the nutritional needs of targeted beneficiaries, especially children. 
-           Progress towards universal health coverage to ensure access to quality, essential health care. Focus on delivery of preventive nutrition services as part of the transformation and strengthening of the health system, integrating nutrition into universal health coverage as an indispensable prerequisite for longer-term benefit.
-           Prioritise the challenges faced by specific populations, including the elderly, women (especially women of childbearing age), children, and those with pre-existing medical conditions (most notably HIV/AIDS, TB, and NCDs), drawing on local structures to identify those most in need. 
-           Implement well-funded coordinated strategies to actively address the main drivers of malnutrition, paying attention to food, nutrition, and health, backed by responsive social protection mechanisms.
-           Improve access to quality nutrition care through investment in human resources to increase the number of qualified nutrition professionals, as well as education opportunities for other cadres of workers who provide nutrition services in primary care settings. Each point of contact with the health system should be recognised as an opportunity to direct caregivers to nutrition care and support services, with efficient referral pathways between sectors.
-           Promote nutrition education of the public through targeted and relevant nutrition messaging and communication campaigns.

Opinion article by Prof Corinna Walsh of the Department of Nutrition and Dietetics and an NRF C-rated researcher, University of the Free State.

 

News Archive

Workplace discrimination and unfair practices explored in new book
2017-09-13

 Description: Denine read more Tags: Denine Smit, Labour law, employee relations, bullying, vulnerability, research, Damain Viviers 

Dr Denine Smit
Photo: Supplied

Two law scholars, Dr Denine Smit and Dr Damian Viviers, from the Faculty of Law at the University of the Free State (UFS) recently launched a book titled Vulnerable Employees, which was inspired by their interest in researching, creating awareness and providing a legal exposition in relation to employees who are vulnerable and experience prejudice and dignity violations in the workplace. These include workplace bullying, appearance-based discrimination, those who are gender fluid or have mental-health conditions.
“Dr Viviers, who is also a former student of mine, and I, have been working together for years and share a common understanding in relation to our various topics of interest. We often share the same train of thought. This is how we came to work together to produce this book,” said Dr Smit.


Research focused on employee challenges in the workplace

The book expands on the field of knowledge regarding certain categories of employees who, as a consequence of various mutable, immutable and semi-immutable characteristics, as well as behavioural experiences, are rendered vulnerable in their employment relationships. The book draws on various social, psychological and other empirical considerations, as well as comparative legal research from foreign and international law, in order to expand on the legal position under the South African legal framework governing these conditions. While the book first and foremost constitutes a compendium of research to be used for this purpose, it also serves as a practical guide for all legal practitioners, human resources managers, other labour stakeholders and the judiciary.

Book draws strength in other academic fields
Vulnerable Employees was launched on 28 July 2017 at the UFS library, to an audience of academics and students, with a panel discussion made up of the authors and two other panellists. One of the panellists was Dr Katinka Botha, a leading psychiatrist in the Free State who has a wealth of experience in this field. “Her selection as a panellist was motivated by the various significant inter-disciplinary considerations and intersections between psychology, psychiatry and law, contained in the book,” said Dr Smit. 
“Dr Botha’s expertise was invaluable in shedding light on mental-health considerations during the panel discussion.” 
Mr Lesley Mokgoro, the other panellist, is a leading labour law practitioner, as well as director and head of the Dispute Resolution Practice Group at Phatshoane Henney Attorneys. “His years of experience working with all role players in the employment domain, as well as his extensive legal knowledge and expertise, made him uniquely qualified to serve on the panel and deliver an opinion of the practical and academic value of the book,” said Dr Smit.


Workplace policies key to securing employee rights

There are a number of growing trends in the workplace that could shape the practice of labour law or workplace policies. Dr Smit said the need for employers to regulate workplace culture, particularly in relation to bullying, harassment and unfair discrimination, in line with the South African legal framework, was a fundamental need in all workplaces. Effective workplace policies may be used to clearly outline the relevant “dos and don’ts” to employees, as well as the procedures and processes that may be followed in order to address such conduct. Workplace policies serve to advance legal certainty and efficiency, since the rights and obligations of all role players are clearly demarcated, or should be, in terms of a well-drafted and considered policy. 
The book is one of several publications produced by Dr Smit in collaboration with Dr Viviers on the topic of workplace discrimination and the law. The two scholars are working on another book to be published at the end of 2017.

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