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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

Year-long programme to celebrate the story of life and survival
2009-02-13

 
At the launch of the UFS's year-long programme to celebrate the story of life and survival were, from the left: Prof. Schalk Louw, Department of Zoology and Entomology, Prof. Jo van As, Department of Zoology and Entomology, Prof. Maitland Seaman, Centre for Environmental Management, and Prof. Matie Hoffman, Department of Physics. All four are associated with the UFS.
Photo: Hannes Pieterse

A year-long programme to celebrate the 200th anniversary of the birth of Charles Darwin and the 150th anniversary of the publication of his scientifically important book “The Origin of Species” was launched yesterday (the birth date of Darwin) by the University of the Free State (UFS) on its Main Campus in Bloemfontein.

The UFS is the only university in the country that is presenting such an extensive programme on life and survival. Yesterday’s launch programme entailed a portrayal of the life of Darwin and a presentation on what nature tells us about cosmic history. It was the start of a year-long lecture programme in which various departments at the UFS will take part.

“The lecture programme, called “The story of life and survival”, forms a cycle of the progress of man and does not only focus on Darwin. The programme aims to portray the influence of Darwin’s theory of evolution on a wide range of disciplines. We see this as a good opportunity to promote science in its broadest context,” says Prof. Jo Van As, head of the Department of Zoology and Entomology at the UFS.

The lecture programme will include topics such as the geological evolution of our planet, extinction, Darwinian agriculture, the road to civilisation, the proliferation of technology and communication, human demography and the human impact on the environment. It will be concluded in February 2010 with a lecture on the future of evolution.

The programme is spearheaded by the Department of Zoology and Entomology at the UFS, in conjunction with the National Museum and the Central University of Technology.

“Today evolution is no longer considered to be a theory and is widely accepted by most serious scientists as the process responsible for the diversity of life on our planet,” says Prof. Van As.

Complete programme:

26 February 2009: The geological evolution of our planet
13 March 2009: Origin of life, prokaryotes and eukaryotes
24 March 2009: Extinction
16 April 2009: Evolution and biodiversity of plants
30 April 2009: Evolution and biodiversity of animals
14 May 2009: The mechanisms of evolution: Heredity and Natural Selection
28 May 2009: Origin of humankind
4 June 2009: Darwinian agriculture
30 July 2009: Road to civilisation
6 August 2009: Human demography
20 August 2009: Proliferation of technology and communication
10 September 2009: Human impact: On the environment
8 October 2009: Human impact: Resistance, ectoparasites, HIV/Aids, antibiotics
22 October 2009: How to care for the world
12 February 2009: The future of evolution

Media Release
Issued by: Lacea Loader
Assistant Director: Media Liaison
Tel: 051 401 2584
Cell: 083 645 2454
E-mail: loaderl.stg@ufs.ac.za
13 February 2009

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