Severe acute malnutrition (SAM) is an extreme form of wasting, measured a weight that is too low compared to a child's height. It is the extreme outcome of a much larger malnutrition challenge in South Africa.
1 For every child who suffers from SAM, approximately 135 children are affecting by stunting.
2
SAM is associated with 30.9% of audited under-five deaths among children in South Africa.
3
The number of children under 5 years identified with SAM dropped steadily from over 10 per 1000 nationally in the early 2000s to below 5 by 2010 and then declined further to 1.5 per 1000 in 2020.
Recent trends in the incidence (new cases) of SAM are alarming, with a 33% nationwide increase between 2020/21 and 2021/22.
4 More recently, the Department of Health reported that by mid-2023, the SAM incidence had increased by a further 20%, from a ratio of 2 per 1000 children under 5 years in 2021/22 to 2.4 per 1000 in 2022/23.
5
The highest rates of SAM are in the Free State (6.4 per 1000) and the Northern Cape (6.2).
1 Hall K, Almeleh C, Giese S, Mphaphuli E, Slemming W, Mathys R, Droomer L, Proudlock P, Kotze J & Sadan M (2024)
South African Early Childhood Review 2024. Cape Town: Children's Institute University of Cape Town and Ilifa Labantwana.
2 National Department of Health (NDoH), Statistics South Africa (Stats SA), South African Medical Research Council (SAMRC), and ICF. 2019.
South Africa Demographic and Health Survey 2016. Pretoria, South Africa, and Rockville, Maryland, USA: NDoH, Stats SA, SAMRC, and ICF.
3 Bamford L, McKerrow N, Barron P, Aung Y. Child mortality in South Africa:
Fewer deaths, but better data are needed. South African Medical Journal. 2018;108(3):25–32.
4 Ndlovu N, Gray A, Mkhabela B, Myende N, Day C. (2023). Health and Related Indicators 2022. In: Padarath A, Moeti T, (Eds), South African Health Review 2022. Health Systems Trust.
5 National Department of Health (30 June 2023). Response to Parliamentary Question 2501.