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Doctor and novelist discusses the Grow Great Campaign and its aim to reduce stunting

“It is a social justice issue [in] that, even before you are born because often the drivers of stunting begin in pregnancy, you already begin your life disadvantaged, and that is unjust,” Dr. Kopano Matlwa Mabaso says, with a tonality which demonstrates the deep conviction she feels about stunting.

The World Health Organization defines stunting as “the impaired growth and development that children experience from poor nutrition, repeated infection, and inadequate psychosocial stimulation.” According to the global health body, in 2017, 151 million children under the age of five had stunted growth.

In Mabaso’s home country of South Africa, one in five children is stunted. Stunting has “long-term effects on education outcomes, economic outcomes, intergenerational poverty, and so it is a real travesty for a country like ours that is an upper middle-income country,” she says. Mabaso is the executive director of the Grow Great Campaign, an initiative that aims to eradicate hunger and reduce stunting by 2030 in line with the second Sustainable Development Goal: zero hunger.

Mabaso is one of more than 50 participants from around the world who has convened at Schloss Leopoldskron in Salzburg, Austria to discuss and strategize on the theme: ‘Healthy Children, Healthy Weight.’

The Grow Great Campaign is hinged on four pillars: a national social franchise of mother and baby classes; support for community health care workers; advocacy; and a mass media campaign aimed at changing cultural norms around breastfeeding and balanced diets. The first 1,000 days (from conception to a child’s second birthday) are crucial if the battle against stunting is to be won. To achieve this and to avoid reinventing the wheel, the campaign has been looking at success stories around the world from Peru to India for inspiration and ideas that can be transposed into South Africa’s context.

However, “poverty isn’t necessarily the reason not to overcome stunting,” says Mabaso. “There are countries with smaller economies than ours, that have achieved significant gains in stunting. Peru being an example... There are simple things that can be done, such as improving breastfeeding rates [and] delaying the introduction of solid foods, that don’t require a lot of resources but can have significant gains for children.”

Reducing food waste so that everyone has access to affordable, nutritious meals is also another strategy.

Aside from the obvious health benefits, there is a real economic imperative for taking on stunting. A report by the World Bank in 2018 labeled South Africa as the most unequal country on the planet. While significant strides have been made since the end of apartheid, wealth is still disproportionately distributed along racial lines.

However, Mabaso is optimistic that if South Africa gets the upper hand over stunting, it will set all of its young people up for a fairer society. “It is a low hanging fruit,” Mabaso says.

“There has been lots of modeling to show that reducing stunting has very high returns on investment economically. The money that we spend on this campaign, we make back many times over.” This financial return is possible because children who don’t have stunted growth perform better at school which translates to, among other things, increased chances of high paid work and the breaking of intergenerational poverty. It will also help lower the chances of their children having stunted growth.

The long-term goal of the initiative is to reach a third of pregnant women in South Africa per annum at scale, and since starting their mass media campaign in June 2018, at least half of South Africa’s total population has been reached by its message, Mabaso believes. The initiative has also won some high profile supporters including the country’s first lady, Dr. Tshepo Motsepe.

Born in Johannesburg while racial discrimination was still the law of the land, Mabaso has dedicated much of her adult life to social justice causes. She is the founder of Transitions Foundation, a youth action organization and the co-founder of WREMS (Waiting Rooms Education by Medical Students) which started while she was still in medical school. Her three novels, which have won her notable awards, also serve as social commentaries of a post-apartheid country.

As to how she hopes attending Healthy Children, Healthy Weight will help the Grow Great Campaign, Dr. Mabaso says, “I think this is an opportunity to rejuvenate my mind. Listening to the experiences of others, it is also encouraging to realize that you are not alone. There are many others grappling with similar issues who have had lots of success...and [so] I am learning a lot.”

The program Healthy Children, Healthy Weight is part of Salzburg Global's multi-year series Health and Health Care Innovation. This year’s program is being held in partnership with the Robert Wood Johnson Foundation.