Malnutrition Prevention Grant Stalled Amid Uncertainty

JOHANNESBURG – More than a decade after it was first proposed, the Maternal Support Grant (MSG) remains stuck in policy limbo—raising urgent concerns among public health experts, economists, and civil society organisations about the growing malnutrition crisis in South Africa.

Despite mounting evidence linking maternal nutrition to healthy pregnancies, improved child development, and better long-term economic outcomes, the MSG policy is yet to be tabled in Cabinet. Originally proposed in 2012, the grant is intended to provide financial assistance to pregnant women during one of the most nutritionally vulnerable periods of their lives.

Experts say the delay could have far-reaching consequences.

“Children of mothers who are malnourished during pregnancy face a significantly higher risk of poor birth outcomes, including low birthweight, stunting, impaired neurodevelopment, and an increased risk of chronic diseases later in life,” said Dr Wanga Zembe, senior specialist scientist at the South African Medical Research Council.

In South Africa, the statistics paint a grim picture: 29% of children under five are stunted, while 2.5 million children live in households that are food insecure. According to Zembe and other experts, this is not just a health issue—it’s a national development crisis in the making.

This week, the Department of Social Development (DSD) confirmed that the MSG policy has once again hit a wall. Although a draft version of the policy was submitted to the Social Protection, Community and Human Development (SPCHD) Cabinet Committee in November 2024, it was returned for further work and has not been resubmitted.

DSD spokesperson Bathembu Futshane said the committee failed to reach a consensus. “The draft did not receive general support, and several issues were raised,” he said. These included concerns around fiscal sustainability, the risk of creating a “dependency syndrome,” and the need for a joint governmental response to intersecting issues of poverty, inequality, and unemployment.

One of the key points of contention is whether the MSG should be a standalone grant or merely an extension of the Child Support Grant (CSG). Critics argue that linking the MSG to the CSG could delay access to vital support, since the CSG can only be claimed after a child is born. Currently, over half of eligible children only receive the CSG after their first birthday, long after the critical developmental window has passed.

Civil society groups are frustrated by the delays. The MSG Advocacy Coalition, a network of researchers and advocacy organisations, says the evidence in support of the grant is overwhelming. “It has been more than ten years since the DSD commissioned research on the benefits of a pregnancy support grant. That body of evidence has only grown stronger,” the coalition said in a statement.

They argue that the absence of income support for pregnant women is a glaring gap in South Africa’s social safety net. The South African Law Reform Commission has also recommended a pregnancy grant to address this shortfall, calling it a key intervention for addressing maternal and infant malnutrition.

Malnutrition Crisis Deepens as Maternal Support Grant Remains in Limbo

The coalition is calling for urgent leadership from the Presidency and better coordination across departments to ensure the policy is finalised and implemented. Their cost analysis estimates that the MSG would require between R1.89 billion and R3.26 billion annually—but could save the public health system more than R13 billion by reducing complications caused by low birth weight and malnutrition-related conditions.

“These are not acts of charity,” the group said. “Social protections are critical investments in public health, education, and economic resilience.”

Dr Zembe emphasized that maternal nutrition isn’t just important—it is foundational. “A baby’s survival—both in the womb and after birth—literally depends on it. Poor maternal nutrition has far-reaching consequences that ripple across a child’s life, affecting everything from education outcomes to future income and increasing their lifelong vulnerability to malnutrition.”

Her warnings are backed by international research. UNICEF’s 2021 Global Guidance on Maternal Nutrition and a 2024 Global Health Action study both found that cash transfers—conditional or unconditional—significantly improved maternal and child health outcomes. They reduced infant mortality, improved birth outcomes, lowered illness rates, and improved maternal mental well-being.

Nicola Eley, deputy director of the Grow Great campaign, said the government cannot afford to delay. “One in four pregnant women in South Africa have reported going to bed hungry. That’s not just a number—it’s a crisis affecting thousands of women and their unborn babies.”

Eley noted that the first 1,000 days—from conception to a child’s second birthday—are crucial. “Stunting impairs both physical and brain development, compromises learning ability, and weakens immune systems. The damage caused by early malnutrition is often irreversible.”

She criticised the current model, which only allows access to the Child Support Grant after birth. “By that time, the window of opportunity for brain and body development has already closed. It’s like trying to build a house after the foundation has started to crumble.”

The MSG Advocacy Coalition has also pushed back against the idea that the grant would encourage pregnancy or lead to dependency. “That argument ignores both the data and the lived experiences of women,” the coalition said. “This grant is about protecting human potential from the earliest stages of life. It’s about giving every child a fair start.”

As delays drag on, calls for urgent action are growing louder. For many pregnant women living in poverty, the MSG is not a luxury—it’s a lifeline.

Source- EWN