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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

Fundraising campaign launched to help feed hungry students
2012-03-28

 

From the left is Dr. Carin Buys (Patron of NSH), Ms. Nicky Abdinor (guest speaker), Mrs. Grace Jansen (patron of NSH) and Redi Tlhabi (master of ceremonies).
Photo: Johan Roux
28 March 2012

Video clip (YouTube)

The University of the Free State (UFS) received over R200 000 for its No Student Hungry (NSH) Programme at the NSH launch dinner on Friday 23 March 2012 in Bloemfontein.

Prof. Jonathan Jansen, Vice-Chancellor and Rector of the UFS as well as founder of the NSH Programme donated R100 000 from the proceeds of his book We Need to Talk to this programme. Standard Bank also donated R30 000.

An additional amount of about R90 000 was raised by means of pledges made by guests and the auctioning of several items. These items were donated by local companies and university staff.

The No Student Hungry Programme (NSH) aims to raise funds to provide modest food bursaries for needy students and give them daily access to a balanced meal.
Prof. Jansen started the NSH programme in 2011 with the proceeds of his book, We Need to Talk.

The NSH funds more than 100 students in the hope of helping them to excel in their academic endeavours and, ultimately, to obtain their degrees.

In 2011, Prof. Jansen discovered that a significant number of students were studying without eating on a regular basis. These were often students with strong academic records but without adequate funding to sustain themselves with regular meals.

The project was established in January 2011 when the NSH Team started to develop the structure and processes of the programme. The first 100 students who were awarded the food bursaries started using their student cards for daily meals on campus on 1 April 2011.

“The No Student Hungry Campaign is not only about creating a university campus that cares. It is about creating a country where being human matters. Our students on the NSH project are amazing young people. They struggle to get by, but they have great potential and achieve good marks," Prof. Jansen said on Friday.

Prof. Jansen’s wife, Grace, and Dr Carin Buys, wife of Mr Rudi Buys, Dean of Student Affairs, volunteered to drive the programme and raise funds to address the problem. They are supported by various divisions within the university.

Students apply for the bursaries and are selected on the basis of their financial needs, good academic results, active participation in student life programmes and commitment to give something back to the community.

The raising of funds is a continuous process involving awareness campaigns, seeking of partnerships with companies and institutions and support from the general public, staff and individuals.

An agreement has been made with several food outlets/restaurants on campus who offer healthy, balanced meals to NSH students when they swipe their student cards that are funded by the programme.

At the end of the year the process is reviewed and students who still qualify are reinstated on the programme, whilst those whose circumstances have changed or are no longer in need of the bursaries, make way for new applications.

The NSH Team meets with students on a regular basis with the purpose of offering training, motivation and opportunities for personal growth and career development. Students are also expected to become involved in projects as a way of ploughing back into the community.

The goal is to expand the project annually as support for it grows.
Ms Nicky Abdinor, a clinical psychologist from Cape Town, who was born without arms and with shortened legs, provided an entertaining motivational speech at the launch. Ms Abdinor, founder of the Nicky's Drive organisation, also visited the UFS’ Unit for Students with disabilities where she delivered a talk on independence for people living with disabilities.

To become involved with the NSH Programme, please contact Mrs René Pelser on +27(0)51 4019087 or e-mail pelserr@ufs.ac.za.


Media Release
28 March 2012
Issued by: Lacea Loader
Director: Strategic Communication
Tel: +27(0)51 401 2584
Cell: +27(0)83 645 2454
E-mail: news@ufs.ac.za

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