Poor nutrition in early childhood has a number of negative consequences for people later in life, according to Professor Daniela Casale, from Wits University’s School of Economic and Business Sciences.

Prof Casale analysed data from the National Income Dynamics Study (NIDS) and found a link between child health and education outcomes.

The NIDS is a longitudinal survey that collects detailed information on the health status of children, including anthropometric data (body measurements), and on their progression through school.

Stunted cognitive function

“Using South Africa’s first national longitudinal study, which follows participants over time, this work highlighted how children who were stunted in early childhood had poorer educational outcomes later on,” said Prof Casale. “The likely mechanism is through poorer cognitive function in malnourished children.”

She analysed the sample of children aged between six months and seven years in 2008. She then followed their outcomes in in 2014/15, when the children were aged seven to 14 years.

The children who were initially stunted had completed fewer years of schooling by 2014/15 compared to non-stunted children, both because they started school later and were more likely to fail the grades they were enrolled for.

Prof Casale’s analysis suggest that the timing of good nutrition is key in the child’s development, and global research shows that the first 1 000 days, from conception to the child’s second birthday, are critical.

“Policy-makers need to find more creative ways of accessing children and their caregivers in the early childhood period,” said Prof Casale.

“This is a largely under-researched area of analysis for South Africa, and much more work needs to be done on the biological and socio-economic factors that determine malnutrition in the first instance and subsequent recovery,” she said.

Importance of mother’s education

Even though school feeding scheme plays an important role in the child’s nutrition, the prevalence of stunting reaches a peak between two and three years of age, before a child gets to school.

“So clearly something more needs to be done to reach children and their caregivers earlier on. While the child support grant is an important policy intervention, and it has been shown to have many benefits, it appears not to be sufficient to prevent stunting,” said Prof Casale.

Research suggests that, in addition to economic resources, mother’s education is an important protective factor in reducing the chances of stunting

“Policy-makers will need to find ways of reaching mothers early on to ensure that they are well nourished during pregnancy and that they know how to care for and feed their children appropriately,” she said.

According to Prof Casale, clinic interactions during the antenatal and postnatal periods may be one area where policy could be strengthened. “Mothers, and of course fathers, need to be educated and supported, and children’s weight and height need to measured repeatedly in the early period to monitor progress.”

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Thabo Molelekwa