Question NW2501 to the Minister of Health

2018/2019

2019/2020

2020/2021

2021/2022

2022/2023

South Africa

1,9

1,9

1,5

2,0

2,4

Eastern Cape

0,7

0,9

1,6

2,0

2,7

Free State

4,9

5,9

4,2

5,5

6,4

Gauteng

1,6

1,4

1,1

1,6

1,9

KwaZulu-Natal

2,1

2,0

1,3

1,6

1,9

Limpopo

1,2

1,1

1,5

2,2

2,9

Mpumalanga

1,6

0,8

0,7

1,0

1,3

Northern Cape

5,5

6,9

4,6

6,1

6,2

North West

3,7

4,2

2,1

2,7

3,7

Western Cape

1,7

1,6

1,0

1,3

1,5

2018/19

2019/220

% increase

2020/21

% increase

2021/22

% increase

2022/23

Over five year period

South Africa

1,9

1,9

0,0%

1,5

-21,1%

2,0

33,3%

2,4

26,3%

Eastern Cape

0,7

0,9

27,1%

1,6

79,8%

2,0

25,0%

2,7

285,7%

Free State

4,9

5,9

20,4%

4,2

-28,8%

5,5

31,0%

6,4

30,6%

Gauteng

1,6

1,4

-12,5%

1,1

-21,4%

1,6

45,5%

1,9

18,8%

KwaZulu-Natal

2,1

2,0

-4,8%

1,3

-35,0%

1,6

23,1%

1,9

-9,5%

Limpopo

1,2

1,1

-8,3%

1,5

36,4%

2,2

46,7%

2,9

141,7%

Mpumalanga

1,6

0,8

-50,6%

0,7

-15,2%

1,0

49,3%

1,3

-18,8%

Northern Cape

5,5

6,9

25,5%

4,6

-33,3%

6,1

32,6%

6,2

12,7%

North West

3,7

4,2

13,5%

2,1

-50,0%

2,7

28,6%

3,7

0,0%

Western Cape

1,7

1,6

-5,9%

1,0

-38,8%

1,3

32,7%

1,5

-11,8%

Eastern Cape

• A mother and child development programme forum was established, facilitated by the Department of Social Development to foster collaboration by all departments to play their part in addressing child malnutrition.

• Growth monitoring at community level by the Ward Based Outreach Teams (WBOT’s) with periodic door to door campaigns in areas identified with high malnutrition incidence.

• Implementation of a multi-sector action plan to address prevention and management of acute malnutrition.

Free State

• Provision of nutrition supplements to eligible children to improve their nutritional status.

• Immediate reporting of children with SAM to the district nutrition managers to conduct disease surveillance for further management.

• Community health workers conduct tracing and tracking of SAM patients who are treated at home.

• Ongoing efforts on screening, assessments and referrals of malnourished children for care and support.

• Collaboration between Health, Social Development and Agriculture to ensure that identified malnourished children benefit from social protection support measures on malnutrition, hunger and food insecurity.

Gauteng

• Implementation of the food supplementation programme in all registered ECD in collaboration with the Department of Basic Education

• Continuous capacity building of health workers on infant and young child feeding, nutrition assessment classification and support.

KwaZulu-Natal

• Implementation of poverty eradication focusing on the most deprived municipalities (Operation Sukuma Sakhe).

• Ongoing online training and competence assessment for all clinicians on inpatient management of severe acute malnutrition, led by the provincial office.

• Capacity building has been conducted on infant and young child feeding to prevent malnutrition in children under 5, and optimise nutritional status.

• A draft multi-sectoral Food and Nutrition Security Plan 2022-2025 has been developed and implementation is monitored and reported on quarterly.

Limpopo

• Provincial Child health and Nutrition Strategy for 2023-2027 was developed.

• Nutrition assessment counselling and support at all facilities including Primary Health Care and hospital level.

• Monitoring of the SAM incidence at all levels of the province, district, sub-district and facility

Mpumalanga

• Anthropometric equipment (length boards and height metres) were procured for all hospitals.

• Annual capacity building of clinicians on the Integrated Management of Common Childhood Illnesses (IMCI) was conducted in all districts which include growth monitoring and promotion and management of children with SAM, as well as ongoing Breastfeeding and Infant and young child feeding training at district level.

• Nutrition assessment counselling and support at PHC and hospital level.

• Implementation of the provincial multi-sector Food and Nutrition Security Plan to address malnutrition, hunger and food insecurity.

Northern Cape

• Community nutritional screening and classification through community outreaches and outreached to ECD centres for early identification of acute malnutrition and referral for care and support.

• Severe acute malnutrition is included as discussion point at perinatal mortality meetings.

• Auditing and reporting of all SAM deaths to identify factors influencing the occurrence of malnutrition to inform prevention strategies.

• Malnutrition and early identification has been included in the Provincial multi-sector Food and Nutrition Security plan that is still being finalized.

North West

• Community-based nutritional screening of all children under 5 years of age by CHWs

• Continuous capacity building of front-line staff in the initial management of children with SAM including on emergency triage and treatment.

• Collaboration between the districts WBOT’s with other government departments such as DSD, DHA, SAPS and SASSA to address social determinants of health.

• Implementation of Food and Nutrition Security plan to address malnutrition in collaboration with other Departments.

Western Cape

• Continuous capacity building of front-line staff in the initial management of children with SAM including on emergency triage and treatment.

• Nutrition assessment counselling and support at PHC and hospital level

• Community Based growth monitoring using MUAC tapes.

• Skills development for facility-based staff to improve growth monitoring practices and frequency. Endorsement of District trainers to cascade growth monitoring and promotion (GMP) training in the districts.

• Training of health care workers

• Implementation of Nutrition Therapeutic Programme across the service platform including in secondary and tertiary hospitals.

• Implementation of the Multi-sectoral plan to address food insecurity, malnutrition and hunger.

Cross-provincial interventions implemented

In 2020-2022, the National Department of Health in collaboration with centre for Rural health, University of KwaZulu-Natal supported five Districts in Gauteng (City of Johannesburg, Ekurhuleni and Tshwane) and KwaZulu-Natal (Zululand and Umzinyathi) to roll-out a pilot project to build capacity of community health workers to train mothers to screen for acute malnutrition at household level to encourage early health seeking behaviour. This project has been formally evaluated. The 2 provinces developed plans to scale up this intervention in other districts.

• 6 districts (Ekurhuleni, City of Johannesburg and Tshwane), North West (Dr Ruth Sekgomotsi Mompati), Eastern Cape (Oliver Tambo) and KwaZulu-Natal (eThekwini) are currently conducting an evidence-based planning bottleneck analysis to analyse barriers in scaling up and delivery of quality services for maternal and child malnutrition and plan interventions to address the gaps with support from National Department of Health and UNICEF.