Urgent call for maternal support grant to combat child stunting in South Africa

In a compelling push for the health of pregnant women and infants, the MSG Advocacy Coalition — a growing coalition of non-governmental organisations (NGOs) and researchers — has called for the urgent approval of a Maternal Support Grant (MSG).

As South Africa grapples with the pressing challenge of child malnutrition, the proposed grant aims to extend financial support to approximately 800 000 pregnant women during a critical period of their pregnancies. Currently, the social grant system, which allocates R267 billion annually, excludes poor pregnant women from income support until after childbirth. This gap in assistance means that nearly half of eligible infants do not access the Child Support Grant (CSG) in their first year — an especially crucial time for nutrition and development.

Estimated to cost R2 billion per year, or just 0.1% of total government spending, the MSG could not only provide a financial lifeline during pregnancy but also result in substantial savings for the state — projected at R13.8 billion from reduced public health costs associated with low-birth-weight births and childhood stunting.

According to Liezel Engelbrecht, Nutrition Lead for the Hold My Hand Accelerator, the MSG has been under consideration for over a decade. However, a setback occurred when a Cabinet sub-committee sent the draft MSG policy back for further review last year.

“Considering the strong evidence for the MSG and the urgent need to improve maternal and infant nutrition and health, it’s unclear what is holding the policy back,” Engelbrecht lamented, emphasising the necessity for the government to move quickly.

The coalition’s recent policy proposals highlight the significant benefits the MSG would deliver. By providing cash transfers to pregnant women for nine months — starting in the second trimester and extending three months post-birth — the grants could mitigate risks associated with poor nutrition among expectant mothers.

Food insecurity substantially increases the likelihood of low birth weight, which is acutely linked to stunting in children. Statistics reveal that babies born with low weight are 2.5 to 3.5 times more likely to experience stunting, which affects cognitive development and future economic prospects.

“As things stand, poor pregnant women are only eligible for income support from the state after their baby is born and registered to receive the CSG,” Engelbrecht points out. This situation fails to address immediate needs during pregnancy, preventing households from accessing essential resources.

The MSG model proposes an automatic transition to the CSG after the birth is registered, creating an unbroken support system for mothers and their infants. This design is pivotal, as it establishes continuity of support — a crucial element in alleviating the burden faced by low-income families during the early stages of a child’s life.

“The MSG is a realisable opportunity to support pregnant women with a financial lifeline and economic agency when they need it most,” said Julie Mentor, Project Lead of Embrace, a movement advocating for mothers. “Why wouldn’t we want to be a country that does this?”

The MSG Advocacy Coalition believes that swift political will and interdepartmental co-operation are critical to delivering this much-needed assistance. “The MSG is a cost-effective strategy to improve birth outcomes and reduce childhood stunting by protecting women affected by poverty and food insecurity,” stated Nicola Eley, Deputy Director of Grow Great.