Proper nutrition during pregnancy is still an issue according to the 2016 Demographic and Health Survey.
The growth of 27% of children under five years is stunted, and the low birthweight (2.5kg and under) statistics have remained unchanged over the last decade.
But a group of dedicated women is trying to help alleviate this global epidemic by providing free antenatal classes to expectant mothers, thereby educating the mothers while they are still pregnant and able to implement lifestyle changes to benefit the growth rate and development of their unborn baby.
According to the 2017 South African Child Gauge, published by the Children’s Institute at the University of Cape Town, stunting in South Africa costs the economy around R62 billion a year, and if the statistics are anything to go by, this figure is set to increase every year.
The World Health Organisation estimates that globally, stunting affects about 162 million children under the age of five years.
“It is a largely irreversible outcome of inadequate nutrition and repeated bouts of infection during the first 1000 days of a child’s life.
Stunting has long-term effects on individuals and societies, including: diminished cognitive and physical development, reduced productive capacity and poor health, and an increased risk of degenerative diseases such as diabetes,” according to the WHO.
South African children are particularly vulnerable to the contributing factors, but a social franchise, Flourish, is trying to help communities alleviate this global epidemic.
Khadija Richards is one of the more than 40 Flourish facilitators around the country to host a 10-week antenatal programme.
Her classes take place in Yeoville, Johannesburg. The first five of these classes are free.
“Technically speaking, stunting is just a child that’s small for its size. But that’s the physical representation of stunting. It’s also small for its size in relation to its peers. So we’re not talking about small children that are naturally small, we’re talking about children who are underdeveloped or haven’t grown properly. They also don’t grow in ways that can’t be seen. So cognitively, they have some emotional difficulties, and often stunted children may have difficulties in infancy that stress the mum out, and so bonding becomes difficult,” Richards explains.
The women who attend her classes are primarily expectant mothers who attend check-ups at the local Yeoville clinic, where they are given weekly or bi-weekly updates about their unborn babies.
In order to help facilitate the access to these classes the Yeoville library, which is next door to the clinic, opened its doors to Richards, so that the mothers have easy access to the classes for their convenience.
Numerous studies have proven that with the involvement of dedicated health workers, the outcomes of maternal and childcare improves drastically.
Many of the women who attend Richards’s classes did not attend antenatal classes for their previous pregnancies.
Sophy Mmuri (27) has a five-year-old daughter, and is 21 weeks pregnant.
She says that she did not attend any antenatal classes for her first daughter, and that she has learnt so much more about her second pregnancy and the risks associated with not eating the right food groups during her pregnancy.
“The truth is that the service offered by the public health service is a very important part of medical service, but what pregnant mums don’t get for obvious reasons is support in a group, someone to lean on when they have questions, little techniques of learning to manage pregnancies which lots of privileged people take for granted,” Richards says.
In today’s class, she talks to the women about the importance of eating a balanced diet which includes all the different food groups, including proteins and vegetables.
“It’s important to try and eat an egg a day, because this is a high source of protein and helps with the baby’s development,” she tells the class.
One lady blurts out: “We were told that if you eat eggs while you are pregnant your baby won’t have any hair.”
These are some of the stigmas and myths that face different communities in South Africa.
“It’s amazing to see what the women say about the different food groups. We try to provide them with a guide to the most accessible forms of healthy food options.”
As Richards explains the benefits of eating oranges, another lady says that if someone eats too many oranges, their baby will be born the colour orange.
The women burst out laughing, signalling the comradery of friendships and support that the class provides to the women once a week.
Covenant Phiri (26), a hairstylist by training, is attending her fourth class and glows as she talks.
“I really look forward to attending the classes. It gives me an opportunity to get out of the house and meet the ladies and we can learn about things that we didn’t know before, like about eating the correct food,” she says.
Richards also offers advice on how the mothers can perform certain stretching exercises to help their bodies adjust to the growing baby, and how they can also help alleviate their stress by performing breathing exercises.
“South African women tend to discover quite late that they are pregnant for lots of different reasons, but we encourage women to come as early as possible. The earlier you get the education and knowledge, the better your pregnancy will be.”
She explains that it takes a simple trip to the clinic to try and persuade the women who are waiting in the lines for their check-ups, to attend the classes.
“I think in general, once you come it’s not so foreign and people really love it. I’ve had really good retention in my classes. That’s an indication that people are getting use to the idea of an antenatal class, because its not widely known as an intervention for managing pregnancy, and also just managing daily demands for life,” she says.