Back to top

Extensive social grants failing to end malnutrition – researchers say

11 May 2017

South Africa’s social protection system has expanded dramatically since 1994. Almost one-third of South Africans, and more than half of all households in some provinces, now receive at least one social grant from the state. The largest of these social assistance schemes is the Child Support Grant (CSG), which reachesmore than 11 million children – almost two in every three children under 18 years.

However, Professor Stephen Devereux, the SA-UK Research Chair in Social Protection for Food Security (SARChI) says despite the country’s extensive social grants programme, child malnutrition persists. Social grants in South Africa can be spent on whatever the recipient chooses. Because food is a basic necessity and poverty and hunger are closely associated with each other, poor people tend to spend a high proportion of any additional income they receive on food.

“So any expansion of social assistance schemes is expected to lead to improvements in food security indicators and a reduction in malnutrition rates. Is this true in South Africa?” asked Professor Devereux. A Working Paper published by the DST-NRF Centre of Excellence in Food Security (CoE-FS) finds that this prediction is only half-true. According to available evidence, the prevalence of food insecurity has fallen substantially since the 1990s (see Figure 1). However, rates of chronic malnutrition among children remain stubbornly high, at around 20% or above.

As the number of children receiving social grants goes up, so the number of hungry children goes down. So far, so good. But the number of children going hungry is a self-reported indicator. What if children’s weights and heights are actually measured?

Anthropometric evidence suggests that there has been only a negligible fall in the proportion of children in South Africa with stunted growth, between the first nationally representative survey in 1993 (24.5% stunting) and the most recent in 2012 (21.5% stunting). Instead of falling steadily over time alongside the self-reported food insecurity indicator, this scientifically measured indicator of food insecurity has flat-lined for the past 20 years (see Figure 2).

This raises two paradoxes says Devereux:

  1. Why are South Africa’s extensive social grants failing to eradicate malnutrition?
  2. How can nutrition outcomes be stagnating if food security is improving?

Why are South Africa’s extensive social grants failing to eradicate malnutrition?

Food prices in South Africa are high and rising at around 10% a year, and social grants are not adequate and are not keeping pace with inflation. Also, social grants are part of household income, so they are spent on the food and non-food needs of all household members. Even if all the CSG cash is spent only on food for the child and none of this food is shared with other household members, the CSG of R350 can cover less than two-thirds of the child’s food needs. In practice, though, social grants are ‘diluted’ among many needs and many people – multiple ‘uses’ and multiple ‘users’.

How can nutrition outcomes be stagnating if food security is improving?

‘Food security’ and ‘nutrition security’ are not the same thing. Inadequate access to food (i.e. food insecurity) is only one driver of malnutrition. Raising household incomes through social grants automatically improves access to food, but it does not address the other drivers. For example, a child can become wasted or stunted even if she is eating enough nutritious food, if she suffers from diarrhoea or worms due to living in an unsanitary environment or drinking dirty water.

Poor feeding practices can damage children’s nutrition status almost from birth: fewer than one in ten mothers in South Africa follow exclusive breastfeeding for the first six months, as recommended. Tackling malnutrition requires addressing these non-food factors.

Nevertheless, Devereux cautions that it would be dangerous and wrong to conclude that South Africa’s social grants are failing to have any impact on the wellbeing of poor people. “Without the grants, millions of people who are living in poverty would be even worse off. Social grants are helping to reduce food insecurity and hunger, but a more comprehensive approach is needed to tackle the persistently high levels of child malnutrition in South Africa,” he said.

The problem is that the social grants are not high enough, and social grants alone are not enough.

Issued by DST-NRF Centre of Excellence in Food Security