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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

Triumph in the face of adversity
2016-04-29

Description: Glory NSH Tags: Glory NSH

Glory, one of fourteen NSH bursary recipients during the UFS Autumn Graduations.

At the University of the Free State (UFS) Autumn Graduation Ceremony held from 12-15 April 2016, on the Bloemfontein Campus, a record number of fourteen beneficiaries of the No Student Hungry (NSH) Bursary Programme received their degrees. This is an achievement they all feel they could not have reached, were it not for the support by NSH.

The NSH food bursary is awarded to students on the basis of financial need, academic excellence, and a commitment to serve the community. The UFS has helped over 650 students since 2011, when Prof Jonathan Jansen, Vice-Chancellor and Rector, started NSH.

These students are true beacons of inspiration and determination. Indeed, they have triumphed in the face of adversity. This is what can be said about their determination and will to succeed.

Glory, a previous recipient of the NSH bursary and a mother of two, graduated on Tuesday morning, receiving a BEd degree (intermediate phase). She stated that the NSH bursary changed her life drastically when she started receiving it.

“I used to constantly worry about my children and what they would eat. So I would sacrifice my own meals throughout the day just to make sure they have food to eat,” says Glory.

“The NSH bursary really gave me peace of mind, my school work was suffering and once I started receiving food each day, I could focus on what really mattered: my degree.”

“My goals for this year are to get a permanent job, and start receiving a stable salary. I am currently working as a temporary teacher at a primary school in Bloemfontein.

Description: Katlego NSH Tags: Katlego NSH

Katlego, one of fourteen NSH bursary recipients during the UFS Autumn Graduations.

“I never would have thought that I could have made it this far. I want to pursue my postgraduate studies, to inspire my children and other students who have been in my shoes. There is help and hope. My faith also gave me refuge. Nothing that is given to me is taken for granted,” says Glory.

Another student Katlego, who graduated on 14 April 2016, receiving her BCom Human Resource Management degree. At present, she is busy with her BCom Industrial Psychology Honours. She heard about the NSH food bursary, through a friend in 2014, and has been immensely grateful for all she has received. 

“There is no shame in asking for help. There can only be hope and relief,” she said.

“I am so thankful for NSH. As part of the bursary programme, we commit to serving the community. We receive but we are also encouraged to give back. The community service projects have helped me to get out of my comfort zone, to look beyond myself and acknowledge that I am also required to give back my time to others who appreciate and cherish it.”   

The NSH students are offered not only a food bursary; they participate in student wellness and development programmes, and they are motivated and exposed to opportunities for personal growth. Students are also encouraged to be involved in university or community projects as a way of ploughing back into the community, thus creating a reciprocal cycle of giving and receiving within their community.

 

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