Browsing by Author "Muller, Anna-Marie"

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    Strategies to reduce stunting in South Africa and the case of KwaZulu-Natal
    (Stellenbosch : Stellenbosch University, 2015-12) Muller, Anna-Marie; Du Plessis, Lisanne Monica; Daniels, Lynette Carmen; Stellenbosch University. Faculty of Economic and Management Sciences. School of Public Leadership.
    ENGLISH SUMMARY : The aim of this thesis is to frame nutrition as a key driver for sustainable development. Since malnutrition, and specifically the disorder ‘stunting’, has ranging detrimental implications for development, the argument was made that optimal foetal and child nutrition and development must be rigorously pursued with collective efforts. Stunting can have both physiological and cognitive effects on an individual. The persistently high prevalence of this disorder has been a long-time feature of child health profiles in developing countries, including Sub-Saharan Africa. Hence the issue transcends the individual to include communities and national levels with a global nutrition target set to reduce stunting by 40% in children under five by 2025. Intervention strategies aimed at the most significant window of opportunity during the first 1000 days of life (the period from conception to a child’s second birthday) should be prioritised. Nutrition specific and nutrition sensitive interventions are multi-sectoral in nature. To facilitate the success of implementation, an enabling environment (political and policy processes that shape and sustain momentum for intervention implementation), is fundamentally important. Two sets of questions emerged from this problem statement. Firstly, developing a clear understanding of stunting magnitude and trends in South Africa, contextualised the question: which strategies are in place to reduce the prevalence of stunting? Documented strategies in the form of national policies were summarised and the approaches to stunting were highlighted. These policies are implemented in a range of sectors: The Roadmap for Nutrition, the Infant and Young Child Feeding Policy and the Strategic Plan for Maternal, Newborn, Child and Women’s Health and Nutrition are the main responsibility of the National Department of Health; the National Policy on Food and Nutrition Security is the joint effort of the National Department of Social Development and the Department of Agriculture, Forestry and Fisheries; the Draft Early Childhood Development Policy will be coordinated by the Department of Social Development and the National Development Plan, the current comprehensive national strategy, was developed by the National Planning Commission situated in the Presidency. The second question explored the Nutrition Director’s role in reducing stunting in the Provincial Department of Health in KwaZulu-Natal. The Nutrition Programme is responsible for the development of policy and the implementation thereof in the province. Due to early indications that KwaZulu-Natal has been successfully reducing the prevalence of stunting, this individual’s leadership approach was qualitatively investigated. The key findings were that access to high-level decision-making processes is important to programmatic success and advocacy was identified as a key method to secure commitment to reducing child undernutrition. This research responded to a call to identify nutrition leaders and describe their work - an emerging field in public health nutrition. It is concluded that optimal nutrition is central to the creation of sustainable communities which should be adequately reflected in relevant policies and pursued by inspiring leadership.