Context Matters: child growth within a constrained environment

On 16 March the CSDA hosted the first webinar of the year. This webinar was titled “Context Matters: child growth within a constrained environment” and formed part of the Community of Practice for Social Systems Strengthening to Improve Child Well-being Outcomes (CoP).

Prof Shane Norris, from the Centre of Excellence for Human Development at Wits University set the scene by introducing how child growth is influenced by environmental factors. Prof Leila Patel, South African Research Chair in Welfare and Social Development provided an introduction to the overall CoP project and the larger study in which this research was conducted.

Dr Lukhanyo Nyati delivered the main presentation that interrogated how a child’s context impacts on their growth. His presentation highlighted that child growth often provides a good indication of the conditions in society and that many low and middle-income countries experience the double burden of malnutrition and over nutrition. He noted that South Africa has performed poorly in addressing stunting when compared with other low and middle-income countries.

When looking at the research results from the study he highlighted that poor growth is associated with both short and long-term health and economic outcomes and in addition increased risk of infection impairs growth.

The research undertaken by the team sought to identify the factors that are associated with child growth and development in order to identify potential levers for interventions to support child growth and development.

Some of the key findings that he shared included that 12,7% of participants had stunting, 7,5% were underweight and 28,2% were over-weight.

He also provided an in-depth analysis of the factors associated with child growth including caregiver education, additional income sources as well as factors like access to a bed or mattress and if the child’s home protects them from rain. His presentation shared the factors associated with child resilience including factors like sex, mental health of caregivers, stress, additional income and education.

Some of his conclusions include that:

• Increasing social dependency is a threat to achieving the goal of reducing malnutrition
• Improving education of girls may provide extra protection to malnutrition
• Reducing crowding in homes (possibly through acceleration of low-cost housing projects) may provide some protection
• However, macro-economic factors such as economic growth and employment are major drivers.

Prof Lauren Graham was the discussant. Her first observation was that the levels of stunting in this study matched the national levels and that this was interesting considering that the study took place in relatively poor areas. She pointed to the possible protection offered by the Child Support Grant and the National School Nutrition programme.

Her second point was how clear the double nutrition burden is in the data presented on the day and that this is a clear correlation between poverty and this double nutrition burden.

She also highlighted the complexity of poverty and that studies like this shine a light on how complex that pathways to and out of poverty are. This presents a challenge for social development practitioners to unpack how these factors are linked to growth outcomes and how to devise interventions that respond to these complex pathways.

She also posed a question to Dr Nyati about the role caregivers mental health plays in child resilience and if this has any impact on child growth and this provides insight on the kinds of interventions that could be piloted.

She said: “It really points to the ‘systemic nature’ of poverty and how one intervention like the child support grant is important but insufficient to break the cycles of poverty. When we have grant income it doesn’t necessarily lead to better growth outcomes, there are other factors that influence growth outcomes.”

Her final point looked at the recommendations Dr Nyati made. Prof Graham focused on the role that stakeholders at the local level can play in children and caregivers lives. “When we understand that a child is struggling in a particular domain, what are the suite of interventions that the child and caregiver needs?” She highlighted the need for an accessible suite of services and interventions that can holistically address child and caregiver well-being at the local level.

You can watch the full webinar here.