SACSoWACH is pleased and welcomes President Ramaphosa's leadership in the social relief package announced on 21 April 2020. Here is a summary of this historic R500 billion stimulus package for the economy
R130 billion in the current budget would have to be re-allocated, the rest will come from other sources like the IMF, World Bank, African Development Bank and BRICS Bank.
“Even as we find ourselves at the moment of great peril and danger, we look ahead to a better future. I have faith in strength and resilience of ordinary South Africans who have proven they will rise. We shall recover, we shall overcome, we shall prosper.”
Call To Action for Government to respond to the need and the fight for food during covid-19
Today, UNICEF released the Global Report on Food Crises 2020.
The report indicates that 17 million children suffer from wasting and 75 million children have stunted growth – more than half the undernourished children in the world – live in a country affected by a food crisis.
The report highlights how serious the impact of the Coronavirus pandemic could be for countries facing a food crisis. The pandemic could have a major negative impact on the quantity, frequency and diversity of the food children eat, creating new food crises or worsening the existing ones.
In light of our own, child malnutrition burden in South Africa, SACSoWACH has called on Government to address the food and nutrition needs of households with specific focus on children but supporting the call for the top-up of the child support grant and by ear-marking a specific food package for children under 5 years within the household social relief food packs currently being distributed.
Your help in advocating for these interventions will bring some relief and protection to the most vulnerable in our communities, the children.
Find the Call-To-Action addressed to the South African Government below:
Announcing the WHO/UNICEF e-learning Course on the International Code of Marketing of Breast-milk Substitutes
Department of Nutrition for Health and Development (NHD)
In spite of clear messages on the importance and advantages of breastfeeding, promotion and sales of breast-milk substitutes, such as infant formula, follow-up formula and other products intended to partially or fully replace breast-milk, continues unabated.
Global sales of breast-milk substitutes currently total US$ 44.8 billion, and are expected to rise to US$ 70.6 billion by 2019.
Inappropriate marketing of food products that compete with breastfeeding is an important factor that often negatively affects the choice of a mother to breastfeed her infant optimally.
The International Code of Marketing of Breast-milk Substitutes and the WHO Guidance on Ending Inappropriate Promotion of Foods for Infants and Young Children are important tools in countries’ efforts to create an enabling and protective environment that allows mothers to make the best possible feeding choice, based on impartial information and free of commercial influences.
Translating the Code into effective national legal, regulatory and other suitable measures, and ensuring their proper implementation, requires a good understanding among legislators, policy makers, health practitioners, UN staff and civil society partners, of the Code’s intent, content and requirements.
For this purpose, WHO and UNICEF have developed an introductory e-course on the Code, which is freely accessible to all who work on maternal, newborn and child health, and on infant and young child nutrition.
The training course was developed to strengthen understanding on:
• The importance of breastfeeding and appropriate complementary feeding for the health, development and survival of children;
• International recommendations for optimal feeding of infants and young children;
• What is the International Code and the role it plays in the achievement of optimal feeding of infants and young children including breastfeeding and appropriate complementary feeding;
• The content of the International Code and other WHA resolutions that relate to the marketing of breast-milk substitutes, feeding bottles and teats.
• Implementation of the International Code at the national level and its place among international human rights and other legal instruments.
• How compliance with the International Code and national implementation measures can be monitored and enforced.
The e-course can currently be accessed on UNICEF’s Agora website, and will shortly also be available via the WHO Nutrition e-learning hub at UNITAR.
© WHO 2017
Early Childhood Development Policy: A boost for the Health system
Originally published in the Saturday Weekend Argus on 16 September 2017.
It’s time for a major shift in how we plan for Early Childhood Development (ECD), as a government and a country to ensure the best outcomes for our children. ECD has been one of the government’s development priorities since 2010. Since then, we have seen increased budgets and systems allocated to a massification programme. So, why have we not seen the promised returns, such as improved education outcomes and lower levels of inequality?
ECD massification is the government’s main approach primarily making more centres and ECD subsidies available but it hasn’t worked. South Africa adopted the National Integrated Early Childhood Development Policy in 2016. It says that ECD is a period of development from birth until children enter formal school. During that time, they and their parents must receive appropriate supportive services, especially in the first 1 000 days of life. Why is ECD so important, and especially in the first two years? The brain develops faster in early childhood than at any other period, laying the foundations for learning and education potential later in life. During this phase, exposure to risk and adversity has the most potential for harm, but it is also the period during which preventive and protective interventions have the greatest benefit.
The majority of children in South Africa are exposed to development risks and need appropriate care from birth. Young children require the correct nutrition, caring interactions with parents and caregivers, and a safe and stimulating environment. Parents need support to offer their babies optimal health, growth and development. ECD centres are not best placed to provide care in the first two years. Care at home by a parent or caregiver is better, and where there are no other options, it should be well-supported to ensure good quality of care. Therefore, the ECD massification approach is a poor fit with the science and the country’s needs. Where then should we invest our time and money for quality essential services in the early years?
Early childhood development plans are important for our children’s future.
Investing in our health system’s scope for ECD services during pregnancy and the first two years of life is easier, less costly and more effective than trying to intervene later in preschool and formal education settings. By the time children reach three years old, and enter ECD centres, it is too late. We invest so much time and money in these centres, yet we have missed the window of opportunity. We then face the risk that their brains will not have developed optimally to support future learning and development it is a case of too little too late. The health system, because it already reaches nearly every mother and child, is the most feasible platform from which to launch services. Its extensive primary health care platform includes both home-based and clinic visits just at the right time in a child’s life. Can the health system do this? Yes, the policy and service delivery footprint is in place. The foundations just need to be strengthened.
But, a major gap is parenting support. There is strong evidence that an expanded health package which includes support to parents is feasible, cost-effective and improves outcomes for children. These should be integrated into the standard package of maternal and child health services provided. In addition, health workers should ensure early identification of developmental difficulties and disabilities, as well as access to early intervention for these children and their families. It is for these reasons that the National Integrated ECD Policy requires the Department of Health to develop and implement an integrated and expanded national home, community and facility-based support programme for pregnant women, mothers and infants in the first two years of life. These would strengthen the positive developments already in place: For example, the Road to Health Booklet given to all infants at birth is being revised to ensure that all infants receive developmentally supportive services. But, there are missed opportunities for increasing access to ECD services through the health system.
The Minister of Health recently spoke of two initiatives, the NHI funding model and the Primary Health Care (PHC) re-engineering initiatives which are the department’s responses to ensuring equity in access to health care. In the case of children, there is a strong focus on school health as the entry point for prevention and promotion. In his Budget speech in May 2017, the minister noted that 3.2 million schoolchildren had been screened for language, vision, hearing, and oral health. Of these, 119 340 were identified as having vision problems, 34 094 hearing problems, and 8 891 have speech problems. For these children, this may be the first time these difficulties have been identified and for many it may be too late for effective remediation to overcome the barriers to learning.
Let us take the case of vision as an example. Vision impairment in the early years of a child’s life comes at an enormous cost for the child and the country’s development. Almost all of children’s early development depends on their vision. If they cannot see, their development and learning will, without early identification and appropriate support, be severely compromised. The major health systems-strengthening initiatives that are taking place must be revisited through the early child development lens. Early child development, and not just survival, should be at the centre. The public health system should be re-engineered to ensure the delivery of all essential ECD services through the public health system.
The shifts that should take place within the health system are clear. Achieving them is a more complex task. It requires leadership within the health sector, and at the highest levels of government. To ensure ECD is a priority it should be included in the service delivery agreement between the Presidency and the Minister of Health. Parliament too should be more vocal in profiling and monitoring ECD through the health system. Civil society is an equally important leader. It has moved to play this role more effectively by establishing a child development working group within the South African Civil Society for Women’s, Adolescent and Children’s Health SACSoWACH. This is a national coalition for coordinating civil society’s advocacy for more effective women, children’s and adolescent health and development systems.
Martin, Orbis Africa and Slemming’s Division of Community Paediatrics at the University of the Witwatersrand, write in their capacity as members of SACSoWACH.