Question NW2294 to the Minister of Health

Reply:

 (1)      (a)       The number of children under-five years of age who died in public hospitals nationally and in each province whose death was associated with (but not necessarily caused by) (i) moderate acute malnutrition, (ii) severe acute malnutrition in the past four years is shown in the table below. No child died in a

Data element	Province	2020	2021	2022	2023
Children under 5 years of age who died who had evidence of moderate acute malnutrition	Eastern Cape	18	23	19	13
	Free State	12	7	15	5
	Gauteng	42	50	39	30
	KwaZulu-Natal	66	75	120	60
	Limpopo	25	18	16	17
	Mpumalanga	20	27	19	31
	Northern Cape	6	6	11	5
	North West	7	17	33	18
	Western Cape	1	5	2	0
Children under 5 years of age who died who had evidence of severe acute malnutrition	Eastern Cape	85	116	115	107
	Free State	53	83	112	64
	Gauteng	71	116	131	106
	KwaZulu-Natal	168	190	206	170
	Limpopo	75	78	123	137
	Mpumalanga	54	51	57	42
	Northern Cape	26	29	52	26
	North West	83	66	71	36
	Western Cape	13	10	18	11

Source: District Health Information System

b) The number of children under five years of age who died in public hospitals nationally and in each province whose death was associated with (but not necessarily caused by) (i) moderate acute malnutrition, (ii) severe acute malnutrition since 1 January 2024, is shown in the table below. No child died in a public hospital as a result of starvation during this period.

Data element	Province	Data
Children under 5 years of age who died who had evidence of moderate acute malnutrition	Eastern Cape	13
	Free State	1
	Gauteng	27
	KwaZulu-Natal	45
	Limpopo	9
	Mpumalanga	24
	Northern Cape	4
	North West	11
	Western Cape	1
Children under 5 years of age who died who had evidence of severe acute malnutrition	Eastern Cape	90
	Free State	56
	Gauteng	71
	KwaZulu-Natal	105
	Limpopo	99
	Mpumalanga	19
	Northern Cape	23
	North West	13
	Western Cape	7

 

Source: District Health Information System

2. (a) The following steps have been taken to reduce the prevalence of acute malnutrition and to ensure that young children with acute malnutrition are identified and treated:

• Working with other sectors including other government departments and non-governmental organisations to address socio-economic factors that contribute to poor household food security and acute malnutrition in young children, and ensuring that vulnerable families and children are accessing available social support services including child support and other grants.
• Continuous implementation of preventive and promotive interventions including support for breastfeeding and successful complementary feeding as well as growth monitoring and promotion at all levels using communication platforms including MomConnect and the Side-by-Side campaign, and annual breastfeeding and nutrition week campaigns.
• Community health care workers screen and refer children identified at household level in all provinces.
• All children under 5 years admitted for inpatient care and those attending primary health care facilities in all provinces are routinely assessed and classified for acute malnutrition in order to facilitate early identification.
• All children are managed according to existing clinical guidelines and protocols including provision of specialised therapeutic foods in all provinces (e.g. Integrated Management of Childhood Illnesses (IMCI), the Integrated Management of Acute Malnutrition (IMAM) and the Essential Medicine List (EML) Standard Treatment Guidelines.
• Ongoing capacity building and mentorship of clinicians on the World Health Organization ten steps on management of acute malnutrition.

b) Programmes are monitored and success measured through the following activities:

• Death reviews are conducted in health facilities to identify and address modifiable factors to inform corrective actions.
• Routine data on child health and nutrition are collected and reported on through the District Health Information Systems.
• Managers and health care workers at national and provincial levels monitor routine data on an ongoing basis to inform key actions required to support provinces and districts.
• The committee on Mortality and Morbidity in Children under 5 years (CoMMiC) analyses child mortality data and formulates recommendations to address modifiable factors. Reports are generated based on existing data sources

c) Reducing malnutrition in young children requires multiple actions implemented by multiple stakeholders, and it is difficult to measure and attribute success or failure to isolated interventions. The prevalence of acute malnutrition increased in the post-COVID period. The prevalence is declining once more, although close monitoring and ongoing efforts to ensure further reductions are required.

END.