Tackling hunger and malnutrition: It's about coordination, empowerment and sustainability

The health and economic impact of the COVID-19 pandemic casts a sharp spotlight on the food and nutrition status of poor and vulnerable South African families. The National Development Agency, with research support from HSRC experts, has invested in identifying ways to combat hunger and malnutrition in the country. Recently, the two organisations hosted a virtual public dialogue to discuss this challenge. Antoinette Oosthuizen reports.

Achieving food and nutrition security is not only about producing enough food for a country's needs, but also about access and affordability. Photo: Andrea Teagle

One of the sustainable-development goals of the United Nations is to eradicate hunger and food insecurity by 2030. Even before the impact of COVID-19, the world was not going to make this target.

Also, achieving food and nutrition security is not only about producing enough food for a country’s needs, but also about access, affordability and many other factors that influence the way food is produced, prepared and consumed in different parts of the world.

This is why food-and-nutrition-security experts also focus on progress relating to several other sustainable-development goals, for example, those related to the environment, education, energy, water and sanitation, conflict, and the reduction of poverty and inequality.

In the context of COVID-19, the goal to ensure sustainable production and consumption patterns is particularly important.

Therefore, how to make South Africa’s already struggling agriculture and food systems more resilient to future shocks similar to the COVID-19 pandemic was one of the central questions discussed at a dialogue, Food for all through resilient food and nutrition systems in South Africa, hosted by the HSRC and National Development Agency (NDA) on 13 October 2020, shortly before World Food Day 2020.

Vulnerable groups
Research findings during the COVID-19 lockdown highlighted hunger and access to food as central to the mental trauma that many South Africans experienced in the autumn and winter months of 2020.

According to the Statistics South Africa (Stats SA) General Household Survey of 2018, more than a fifth of households already had inadequate or severely inadequate food access in 2018. The COVID-19 crisis therefore had the potential to worsen an existing problem of food insecurity.

At the dialogue, Lindiwe Zulu, minister of social development, said South Africa produces enough food but it is not accessible and affordable for a large proportion of its population.

Globally, an estimated 135 million people suffer from acute hunger due to conflicts, climate change and economic downturns. Experts believe COVID-19 could almost double that number, said Stats SA’s Dr Nathaniel Dlamini.

He said poor households in South Africa, typically characterised by few income earners and many dependants, are particularly vulnerable to economic shocks. In 2018, 15% of households reported inadequate access to food and another 5,2% severely inadequate access. The data showed that 22.4% of black African households had inadequate and severely inadequate access to food, compared with only 3.9% of white households, highlighting the pervasive inequality in the country (Figure 1).

Figure 1: Percentage distribution of households by level of adequacy in accessing food by population group of the household head (2018)

More than one in five (22,4%) of black African households had inadequate or severely inadequate access to food, compared with 3,9% of white households. Source: Stats SA (2018)

The number of households that experienced hunger, declined however, from 2.7 million in 2002 to almost 1.6 million in 2018. The largest proportion of households (61.9%) that experienced hunger lived in urban areas.
In South Africa, 4.7 million households have young children aged five or younger and, of them, 541 097 experienced hunger, with the highest proportion in KwaZulu-Natal and the Northern Cape. Also, 10.6% of black African households with children under the age of five experienced hunger, compared with 2.3%, among white households. The higher the number of children, the higher the chances were that they experienced hunger.

Health impact
Elaborating on the government’s National Plan for Food and Nutrition Security 2018–2023 (NFNSP 2018–2023), Thulani Masilela from the Department of Planning, Monitoring and Evaluation mentioned some successes but warned that indicators show a double burden of malnutrition in the country. By 2016, undernutrition had caused growth stunting in 27% of children under the age of five, up from 24% in 2005. Of women over the age of 15 years, 41% were obese, which is a term used for a severe level of overweightness with associated health risks. This was up from 24.8% in 2012 (Figure 2)

Figure 2

Grants and protection
Grants play an important role in the efforts to combat hunger, said Dlamini. “In 2002, when access to grants was low, the proportion of households and persons experiencing hunger was high. This vulnerability to hunger has declined as access to grants increased,” he said.

Masilela also pleaded for the safeguarding of social-protection measures against looming budget cuts due to COVID-19’s impact on the South African economy. During question time, a delegate expressed a concern that grants created “a dependency syndrome where households lose their coping skills, leaving them even more vulnerable”.

Zulu responded, “We must create a conducive environment for people to sustain themselves. I don’t believe people want to be dependent on the government. But the opportunities are far and wide. The infrastructure is very difficult. Even those who want to do things for themselves find it very difficult to access opportunities.”

Donor fatigue
During lockdown, about R66 million was donated to support government interventions to reach out to poor households affected by hunger, poverty and COVID-19. Zulu said she was concerned about donor fatigue: that many of those who donated money or launched food schemes during lockdown would disappear, leaving the communities in an even more precarious situation post-COVID-19. Also, she emphasised, the distribution of food parcels to poor and vulnerable communities was not sustainable. Long-lasting measures had to be put in place to ensure sustainable livelihoods in communities. “We need to break down the R66 million to see where the money went, how much procurement was done where and from whom. Did this money also find a way of empowering?” she asked.

Empowerment, sustainability and small farmers
One of the strategic goals of NFNSP 2018–2023 is to establish inclusive local food value chains to empower smallholder producers, but Masilela said more of them should be used as suppliers.

“The long-term vision is that the socioeconomic conditions of South Africans should improve, to enable them to be self-sufficient, through enhanced skills, entrepreneurship, access to economic opportunities and access to government support to become successful smallholder or commercial farmers.”

However, the number of South African households involved in agricultural activities has declined. In the Eastern Cape, the decline was the most severe, from 35.4% in 2011 to 20% in 2018, Dlamini said in his presentation (Figure 3).

Figure 3: Proportion of households involved in agricultural activities (2011, 2016 and 2018)

Source: Stats SA (2018)

Coordination challenge
Dr Peter Jacobs, who led the HSRC’s work on the NDA’s 2019 critical review of food and nutrition security, said the report’s findings provide a good benchmark of South Africa’s food and nutrition security status. The researchers analysed local and global data and found that food insecurity interventions in South Africa often fall short of what policy provides for.
“This is as a result of weak or missing coordination mechanisms ... because government departments have different focal areas. Some focus on food production and availability, others on access and utilisation.”

The mandate for food and nutrition security sits within the Department of Agriculture Land Reform and Rural Development, where food production is the emphasis rather than access, distribution and utilisation, Jacobs said.
“The questions around the convening powers of the different ministries is of central importance in the development and implementation of policy and determining who will eventually be accountable.

“But at the heart of policy coordination is the integrated management and administration of policy across independent state and non-state actors. Often, departments do interact and try to integrate but then exclude non-state actors.”

Jacobs added that structures responsible for policy implementation also needed to operate at the subnational level, given the vast variation in food security across the South African population in different provinces, districts and within districts.

It is important to set up multilevel and multisectoral food and nutrition security coordination structures, said Jacobs. “If we had actioned this a year or two ago, we would have been in a much better position to pick up more nuanced information at a localised level. We have to immediately involve non-state actors in deepening coordination across all stages of the policy cycle.”

The country also needs reliable data on food and nutrition status to track the effect of policy. “We have to invest in data collection tools that are representative at the district level. If we don’t do that, we won’t have the information for geographically targeted food and nutrition security interventions,” said Jacobs.

Data collection methods need to be standardised, the frequency of collection decided, and data from different state and non-state actors pooled. “I think COVID-19 has exposed this gap quite glaringly, because we all scrambled over the first couple of months to find access to good quality information, including a host of different stakeholders in all the different dimensions of food and nutrition security. Unfortunately, that situation is still pressing.”

Jacobs says fast-tracking the decentralisation of subnational food and nutrition security coordination committees is a priority. According to a March 2020 HSRC policy brief, the setting up of national and subnational committees — to identify and assess areas where communities were vulnerable to food insecurity — previously failed to gain traction. “To bolster the agility and reliance of the new coordination committees, we must incorporate lessons learnt, otherwise ad hoc and uncoordinated responses will dominate, making it difficult to mobilise resources across all government departments for integrated and proactive assistance to vulnerable communities.”

Author: Antoinette Oosthuizen, science writer in the HSRC’s Impact Centre