South Africa has a hunger crisis.  More than 11% of households in the country experience hunger. The COVID-19 pandemic exacerbated an already dire situation. Now the availability of food in the country is influenced by factors such as high unemployment, the cost of living crisis, and extreme weather events. 

What’s more concerning is that homes with young children are more likely to experience food insecurity. More than half a million homes with children younger than five experience hunger or inadequate access to food. Families in this desperate situation have come up with various coping strategies ranging from skipping meals to begging for food. 

In a recent study, researchers from the University of Witwatersrand, explored what impact these coping strategies have on people’s mental health. Health-e News spoke with lead researcher, Dr Siphiwe Dlamini about the findings. 

1. Why did this research focus on mental health?    

We have long known that food insecurity has a negative impact on one’s mental health, and this issue is widely recognised all over the world. Even before the onset of the COVID-19 pandemic, many studies had demonstrated that the more food insecure an individual is, the higher their risk of experiencing anxiety and depression. 

In South Africa and many other countries, the increase in food insecurity caused by the COVID-19 pandemic was accompanied by increased levels of anxiety and depression. However, the complex relationship between food insecurity and mental health is influenced by a web of interconnected factors. Within this context, our previous research has shown that socioeconomic factors like education level, employment status, monthly income, and rural residence play pivotal roles in shaping both food insecurity and mental health in South Africa.

Given that South Africa is the most unequal country globally, we used a nationally representative study design to test the relationship between food insecurity and the risk of anxiety and depression among households with children. It was important that we focused on households with children because they are the most vulnerable when it comes to the impact of food insecurity and on mental health. This is also because food insecurity can significantly affect the child’s nutritional status, leading to negative impacts on physical, emotional, and cognitive development.

2. What are some of the most common coping strategies your research identified?    

In our study, we included eleven common coping strategies, which we adopted from a standard questionnaire called the Coping Strategy Index tool. These coping strategies are ranked below from the most used to the least used by South African households with children.

To deal with issues of inadequate food access, most households (51.2%) relied on less preferred and less expensive foods. The least used strategy was sending household members to beg for food. But this strategy was used by 17% of the South African households with children. Our study also reported that 67% of the households used at least one coping strategy. And more than half (50.6%) used at least three of the above-listed strategies.

3. Which of these had the most significant mental health impact? 

The use of each coping strategy was associated with higher levels of anxiety and depression. But sending household members to beg for food had the strongest associations. On the other hand, relying on less preferred and less expensive foods was the least associated with impaired mental health. 

Our study also suggested that the more coping strategies used, the more likely higher levels of anxiety and depression. The prevalence of probable anxiety (22.6%) and depression (33.7%) was higher among household members who used three or more coping strategies compared to those who used less. In these cases the probability of anxiety was 9.1% and 15.9% for depression. 

4.  What are your recommendations to address food insecurity and its impact on people’s health?   

High rates of food insecurity among households with children is a major issue in South Africa. Collaborative efforts involving government, non-government organisations, and civil society are essential to eradicate this issue. However, these efforts should prioritise the most vulnerable – poorer households with children, including households with unemployed parents and household heads. 

In our study, we make the following key recommendations:

1. Rethinking Child Support Grants: To offer more realistic support, child support grants need re-evaluation. The November 2023 Household Affordability Index revealed that it costs an average of R5,300 to feed one South African family – far more than what government grants provide.
2. School Feeding Schemes: While school-based nutrition programmes, such as the government’s National School Nutrition Programme, help reduce food insecurity during school hours, additional solutions are needed to improve food access at home.
3. Permanent Food Aid Programmes: Consider introducing permanent food aid programmes for all households with children, like those used during lockdown restrictions. These programmes can provide immediate relief to the affected households.
4. Learning from Developed Nations: Drawing inspiration from countries like the United States, explore solutions such as food stamp programmes, pop-up kitchens, and discount vouchers. These approaches have shown promise in enhancing food access among poorer households.

By implementing these targeted strategies, South Africa can work towards a more food-secure future for households with children. – Health-e News