Food insecurity, social welfare and low birth weight: Implications for childhood malnutrition in an urban Eastern Cape Province township

Abstract

Background. Limited information is available regarding the impact of food insecurity, low birth weight (LBW) and the protective effect of the child support grant (CSG) on malnutrition in South Africa (SA).

Objectives. To describe malnutrition in the context of food insecurity, CSG and LBW history among children younger than 24 months from an underprivileged urban settlement in the Eastern Cape Province of SA.

Methods. A descriptive study using a cross-sectional design was used to collect data from a non-probability sample of 400 young children from October 2015 to February 2016. Inferential statistics included t-tests to compare anthropometric data from different birth weight categories and analysis of covariance (ANCOVA) to allow for the effect of covariates.

Results. Of the sample, 9% were stunted, 1% were wasted, 16% were overweight, 23% were food secure, 47% were at risk of hunger, and 31% were classified as hungry. LBW history was significantly associated with stunting but not with wasting. CSG holders and ‘hungry’ households’ children had significantly lower mean height-for-age z-scores (HAZ) than non-CSG holders and food-secure households. Despite these apparent associations, when LBW is considered as a covariate, it becomes apparent that neither the CSG nor CCHIP category is significantly related to any of the anthropometric indicators.

Conclusion. The Department of Health has to recognise the significant impact of LBW on the prevalence of stunting and thus the need to prioritise antenatal care. Policymakers could aim to make the CSG available to mothers as close after birth as possible, or during pregnancy, in order to be more effective in reducing the long-term effects of LBW.