Child-centred food system for a healthy future
Children’s needs must be at the heart of a sustainable, affordable and healthy food system. The 2020 Child Gauge contends that the current food system is driving the double burden of malnutrition and damaging both children’s health and the environment.
This is because it does not consider children or their health and is flooded by cheap, unhealthy food. Powerful actors shape and continuously reshape the food system, increasing the distance between consumers and the source of their food. The result is increasing access to processed food and food that is less healthy for humans and the environment.
Current food systems push children to grow up in obesogenic environments, where food choices in homes and early childhood development centres and programmes contribute to nutrition-related disease and death. This adversely affects national development, drives up health costs and costs billions in GDP. Covid-19 has shown up the failures of the food system to provide sufficient, healthy, nutritious food. It is not serving the most vulnerable in SA, including children of all ages.
Our goal should be to enable all people, especially the marginalised, to participate in their own decisions about food practices and behaviours. This requires reorienting flows of food towards healthy diets for children. The Child Gauge offers practical suggestions to do this.
Because malnutrition affects future generations, a life course approach unveils opportunities to focus on women of child-bearing age, pregnant women, infants and young children and schoolaged children. Government policies acknowledge these groups but fall short in drawing in those needed to recalibrate the system.
Interventions should start before preconception to help women optimise their health, micronutrient status and weight before they become pregnant. The availability of dietary counselling through schools and every point of contact with the health-care system should be the norm. Marketing techniques, so powerfully used by the private sector, should be harnessed to raise awareness of the long-term benefits of preconception and maternal health and nutrition.
While breastfeeding is recognised as the optimal feeding option for young children, SA has not created an enabling environment for mothers to successfully breastfeed.
Challenges remain with nutritional and psychosocial support programmes for pregnant and breastfeeding mothers, and the provision of paid maternity leave for at least six months. Despite paediatric food-based dietary guidelines established in 2013, SA has not endorsed them.
Guidelines, however, fall short when the broader system fails to enable the choices people need to make. Individual food choices are limited by poverty and rising food prices.
The 2015 national integrated early childhood development policy defines an essential bundle of services to promote children’s optimal development. These services includes health care, support for primary caregivers and early learning programmes. Their potential has yet to be realised.
Beyond early childhood, schools provide an important platform for improving the nutritional status of older children and adolescents. The life orientation curriculum, pupil support materials and school health services should all be leveraged to identify and respond to poor health and nutrition. The regulation (backed by enforcement) of the marketing and sale of unhealthy foods in and around schools is crucial.
Coherence in government policy and unfolding programmes is essential to address undernutrition and overweight.
The Child Gauge proposes leveraging existing policies, including more stringent regulation of food retailers and restrictions on child-directed marketing of food and beverages. Sectors such as agriculture should play a role.
We need to make the production of healthy food more attractive to farmers and improve the availability of more nutritious food.
Social protection such as the child support grants should be increased to the level of the foodpoverty line and the national call for a permanent basic income support for working-age adults who are unemployed should be prioritised.
To ensure effective implementation of interventions, a centralised body with authority should be galvanised to act across sectors and spheres of government and increase the budget transparency of child nutrition policies.
A whole-society approach will enable and sustain an irresistible momentum to transform the food system. If we don’t commit ourselves to shaping and acting on food systems, to make them better serve the diet and nutritional needs of children, SA will pay an extraordinary price for generations to come.