28 November 2025

Honourable Chairperson

Honourable Members,

The 2024 National Food and Nutrition Security Survey notes that about 28.8% of children aged 0 – 5 years are stunted and that this has remained relatively unchanged over the past 10 years. These are not merely statistics in a report; they are a crisis that threatens the future of our children and the prosperity of our communities. Malnutrition can cause irreversible developmental delays, stunting physical growth, impairing cognitive development, and limiting educational achievements. In extreme cases, severe acute malnutrition leads to death, robbing families of their children and our nation of its future. Malnutrition is also a national crisis as it perpetuates cycles of poverty, reduces economic productivity, and strains our healthcare system. Every malnourished child represents not just a health failure but a failure to protect our most vulnerable citizens and invest in our collective future.

To effectively address severe acute malnutrition, we must dramatically scale our outpatient care programs. Hospital-based treatment alone cannot reach the thousands of children who need intervention. Community outreach must become the frontline of our response, bringing services to where children live rather than waiting for families to reach distant health facilities. To this end, we commend the Department of Health for scaling up outpatient care programmes beyond hospitals to Primary Health Care facilities and through community outreach. Screening for early detection of malnutrition has been expanded through community health workers, who use a simple colour-coded mid-upper arm circumference tape to screen, identify, and refer children with moderate or severe malnutrition.

Pilot initiatives such as those in Gauteng and KwaZulu-Natal are imperative in equipping community health workers to train mothers at the household level to screen for acute malnutrition using a mid-upper arm circumference tape. These initiatives bring life-saving care closer to communities, allowing children to receive treatment while remaining with their families, maintaining crucial bonds, and reducing the burden on hospital infrastructure. These programs must be adequately resourced with ready-to-use therapeutic foods, regular monitoring protocols, and clear escalation pathways for when children require more intensive care.

Honourable Chairperson, Community Health Workers are the backbone of any successful nutrition intervention strategy. They are trusted members of communities who can reach into homes, identify at-risk children, and provide ongoing support. However, we cannot expect community health workers to fulfil this critical role without proper training and support. We must invest in comprehensive training programs that equip them with the skills to screen for malnutrition using mid-upper arm circumference measurements and other tools.

This is why the current initiatives in the Eastern Cape are essential insofar as they build capacity to expand screening into early childhood and community nutrition development centres, involving traditional practitioners and other community development workers. Such initiatives must be scaled up to include continuous investment in refresher training, adequate compensation, and sufficient supplies. A community health worker without measuring tapes, without therapeutic foods to distribute, without a functioning referral system is set up to fail.

We also note the positive strides being made, as articulated in the revised 2025 Integrated Management of Acute Malnutrition, which provides updated, evidence-based treatment approaches aligned with global recommendations. In high-risk areas, children with moderate acute malnutrition benefit from combining nutrition education and counselling with supplementation with highly specialised ready-to-use therapeutic foods, as well as food supplementation to prevent deterioration into severe acute malnutrition. A consistent supply of supplements and food parcels is essential to ensure standardised care. In contrast, the need to strengthen food systems to provide access, affordability and availability of nutritious foods cannot be ignored. This also highlights the role of other relevant government departments in improving food systems.

Honourable Chairperson, Malnutrition does not occur in a vacuum. Maternal depression and psychosocial stressors profoundly impact infant feeding practices and child nutrition outcomes. A mother struggling with depression may lack the energy or capacity to prepare adequate meals or respond to feeding cues. Household stress, poverty, and social isolation all influence whether children receive proper nutrition. Our nutrition interventions must therefore include psychosocial support. We need to screen mothers for depression, provide mental health support, and address the social determinants that undermine good nutrition. This requires integration among nutrition programs, social services, mental health support, and poverty alleviation initiatives. Treating the child’s malnutrition while ignoring the mother’s depression or the family’s food insecurity is addressing symptoms while ignoring root causes.

Honourable Chairperson, prevention remains more effective and cost-efficient than treatment. We must implement universal screening at every healthcare touchpoint. Whether a child visits a clinic for immunisation, illness, or routine check-up, that visit must include a nutritional assessment. Too often, moderate malnutrition progresses to severe malnutrition because warning signs are missed or dismissed. Early screening protocols must be standardized across all facilities, with clear action protocols when moderate malnutrition is detected. Healthcare workers at every level must understand that addressing malnutrition early prevents the far more costly interventions required when children deteriorate to severe acute malnutrition.

In essence, addressing malnutrition requires comprehensive action across prevention, screening, treatment, and follow-up. It demands investment in community health workers, integration of services, attention to psychosocial factors, and robust systems that ensure no child is left behind. This is not merely a healthcare challenge; it is a moral imperative and an investment in our nation’s future. Let us commit today to building the systems and providing the resources necessary to ensure every child has the nutrition they need to thrive.

Thank you.