The Herald (South Africa)

Pregnant women should be offered social grants it’ll save state money

- SUSAN GOLDSTEIN & AISHA MOOLLA

A baby’s first 1,000 days, from the time of conception until their second birthday, is a crucial window of opportunit­y to optimise their potential — through healthy nutrition for the mother during pregnancy, and then for the child after birth.

Undernutri­tion during this early period can cause stunting, which has major health and social effects later in life.

Stunted children may never reach their full potential, and may suffer from obesity and related diseases for the rest of their lives.

This costs the individual their health and their future, and costs government­s billions in healthcare spending.

Many studies have shown that pregnancy support grants or vouchers improve women’s nutritiona­l status and their ability to access and benefit from antenatal care.

Globally, about 41% of mothers with newborns receive a maternity benefit of some kind.

This rises to more than 80% in Europe and Central Asia, but drops to 16% in Africa.

Currently, pregnant women in SA receive no such benefits. The child support grant, which amounts to R510 a month, is only paid after a child is born and has a birth certificat­e.

In SA, more than a quarter of children under five (27%) are stunted.

Improving pregnant women’s nutritiona­l status — and thus the health of their babies — should be high on the list of priorities for South African policymake­rs.

It would contribute to ending childhood malnutriti­on, reducing poverty and unemployme­nt and raising future generation­s of healthy, productive children who, as adults, will drive economic growth.

As health economists we wanted to establish whether extending the child support grant to pregnancy would be cost effective for the South African government.

Our research found that it would decrease healthcare costs by R31,200 per baby over the first 1,000 days of life, largely as a consequenc­e of mothers attending antenatal care more regularly and reduced neonatal complicati­ons.

Applied to the whole population, this would save the government about R14 billion over the first 1,000 days of children’s lives.

A large proportion of pregnancie­s in SA (69%) occur in impoverish­ed households.

Almost half of all pregnancie­s (46%) occur in femalehead­ed households.

More than one third (35%) of pregnant women run out of money to buy food, and one quarter of them (25%) experience hunger.

Given that 13 million children now receive the child social grant, the number of mothers potentiall­y eligible for a pregnancy support grant is likely to be sizeable.

A 2021 pilot study by GrowGreat, an organisati­on dedicated to achieving zero stunting by 2030, gave 2,618 poor pregnant women in the Western Cape province a R300 digital food voucher every two weeks for 16 weeks and showed that the women used the grant money to buy nutritious foods.

The pilot also highlighte­d the grant’s psychologi­cal benefits. Having the power to make healthier food choices for themselves and their unborn babies not only relieved their financial burden but also gave them hope for the future.

A pregnancy support grant has already been proposed by the SA Law Reform Commission and would prioritise support for the most impoverish­ed and vulnerable people.

Some people argue that the child support grant encourages women to get pregnant.

Numerous studies have shown that this is not the case.

In fact, many women with children who need the grant do not access it — especially teenagers.

Across the globe low- and middle-income countries, such as India, Bangladesh, Mexico, Nepal, Nigeria, Kenya and Brazil, have tried to address the financial burden placed on pregnant women by providing them with pregnancy support grants.

These studies found that such grants promote weight gain during pregnancy, reduce maternal anaemia, increase access to services during pregnancy and childbirth, reduce maternal mortality, and prevent low-birthweigh­t births and infant mortality.

Benefits of extending the child support grant into pregnancy have the potential to enhance the lives of families and communitie­s as well as individual children and save the South African government billions.

The knock-on effects in terms of hope, motivation, learning and employment of women — and thus for the economy — are likely to be immense.

● Susan Goldstein is an Associate Professor in the SAMRC Centre for Health Economics and Decision Science — PRICELESS SA (Priority Cost Effective Lessons in Systems Strengthen­ing SA), University of the Witwatersr­and; Aisha Moolla is Health economist at the University of Sheffield. This article first appeared in The Conversati­on

Newspapers in English

Newspapers from South Africa