​By Thuso Montwedi
 
The Gauteng province has recorded 1 046 cases of severe acute malnutrition (SAM) in the first three quarters of the 2024/2025 financial year, with 99 cases in Tshwane, 90 in Johannesburg and 86 in Ekurhuleni among the most affected areas in the third quarter.
This data has risen a concern among officials in the Gauteng Department of Health (GDoH) as most of these children are aged below five (5) years. Food insecurity, poor dietary practices, and a lack of nutrition education are some of the attributes that continue to put children at risk of life-threatening malnutrition. 
According to Nomonde Motsoeneng, Deputy Director for Clinical Nutrition at the GDoH, SAM is not just about hunger but also about the quality of food children receive. "Food insecurity and poverty remain the biggest contributors. Many households struggle to provide adequate nutrition, children are fed unhealthy foods that replace nutritious meals," she said. 
Poor feeding practices, such as introducing solids too early or replacing meals with unhealthy snacks, also contribute to malnutrition.
SAM is a severe form of malnutrition that leads to extreme weight loss, muscle wasting, weakened immunity, and developmental delays. Children suffering from it are also more vulnerable to infections such as diarrhoea and tuberculosis, which can further worsen their condition. If untreated, malnutrition can have long-term effects, including stunted growth, impaired cognitive development, and an increased risk of chronic diseases in adulthood.
To combat the disease, the department has strengthened early detection and intervention programs at different levels of healthcare. Community Health Workers visit homes and screen children at Early Childhood Development Centres using Mid-Upper Arm Circumference measurements. Those identified with SAM are referred to clinics for early intervention to prevent complications that could lead to death.
At clinic level, health professionals provide nutrition education, breastfeeding support, and therapeutic food supplements such as Ready-to-Use Therapeutic Foods, as well as micronutrient supplementation and deworming. Cases with complications are referred to hospitals, where children are managed under the World Health Organisation's 10-Step Management Plan. Upon discharge, children continue to receive nutritional rehabilitation and monitoring at their nearest clinics to ensure sustained recovery.
While February is observed as Healthy Lifestyle Awareness Month, the department emphasises that nutrition should be prioritised throughout the year, as poor feeding habits and food insecurity remain an ongoing challenge. Families are encouraged to embrace affordable, locally available nutritious foods such as vegetables, beans, soya, nuts, fortified porridge, and healthy fats to prevent malnutrition. Exclusive breastfeeding for the first six months and continued breastfeeding with complementary feeding beyond two years is also recommended to promote healthy child growth. Nutritious food does not have to be expensive. Parents can use food available in their households and fortify it with additional nutrients to improve its quality.
Motsoeneng urged parents and caregivers to watch for early signs of SAM, including extreme thinness, loss of appetite, swelling in the feet or hands, and developmental delays. 
"Caregivers who suspect a child may be malnourished should visit their nearest clinic or hospital immediately to receive proper medical attention. Malnutrition is preventable, and early intervention can save a child's life," she said. 
Through early detection, proper feeding practices, and sustained intervention, the GDoH remains committed to reducing malnutrition cases and ensuring the well-being children.