The South African Child Gauge is the flagship publication of the Children’s Institute and the 2024 issue brought together over 50 contributors from across the country to track progress since the inception of the National Integrated Early Childhood Development (ECD) Policy in 2015 and set an agenda for 2030. The editorial team was led by our Director, Associate Professor Wiedaad Slemming, and Dr Linda Biersteker with support from the broader advisory committee that included national and global thought leaders in the field, as well as representatives from the Departments of Health and Basic Education, and the National Planning Commission, to ensure our thinking was informed by – and aligned to – the needs of policymakers. In the same way, the convening of the authors provided an opportunity to transcend disciplinary silos and engage in deep discussion about what is needed to enhance ECD.

This 17th issue of the Child Gauge was published in partnership with UNICEF South Africa; the DSI-NRF Centre for Excellence in Human Development, University of the Witwatersrand; the Standard Bank Tutuwa Community Foundation; and The LEGO Foundation.

The series of 12 chapters help unpack the science of ECD, outlining the policy vision and the status of ECD, before identifying opportunities to enhance healthcare, early learning and support for families and caregivers, and for strengthening the building blocks of the ECD system to address the systemic challenges that so often hamper implementation.

We were honoured to have the First Lady of South Africa, Dr Tshepo Motsepe, deliver the opening address at the launch, with her presence helping to elevate and amplify our call to action. The high-profile launch helped to reframe national dialogue about the development of our youngest children. A series of ongoing policy engagements are helping ensure that the findings and recommendations gain traction with key decision makers.

Key findings and recommendations

The  2024 Child Gauge highlights critical gaps in services that are compromising the health and development of our youngest children: one in five infants are not fully immunised by their first birthday; one in six children living in poverty do not receive a Child Support Grant (CSG); only two in three children aged three to five-years-old are accessing an early learning programme; and less than half of four to five-year-olds attending early learning programmes are developmentally on track for their age.   

In recent years we have also seen an increase in child poverty, malnutrition and under-five mortality, with one in 25 children dying before their fifth birthday. These adverse outcomes are likely to intensify as austerity cuts further erode children’s access to health, education and social services.

It is therefore of grave concern that the suite of ECD interventions remain chronically underfunded, with investments skewed towards older children. Urgent action is needed to reverse these trends and safeguard children’s health, survival and development.

Key recommendations include:

• Strengthening care and support for pregnant women – by intervening early through the health system to address challenges such as domestic violence and introducing income support to improve maternal nutrition and mental health as well as foetal growth and brain development.
• Enhancing support for parents and caregivers – by ensuring early access to the CSG, introducing affordable childcare, and encouraging men to play an active role in the care of young children.
• Addressing the growing burden of under- and overnutrition – by increasing the value of the CSG to the food poverty line so that it meets the costs of feeding a child.
• Improving the quality of early learning programmes – by streamlining the registration of early learning programmes, increasing the value to the ECD subsidy, and investing in the professional development of ECD practitioners and principals.
• Intervening as early as possible to support children in need of extra care and protection – by building the capacity of frontline workers to respond to danger signs and strengthening referral systems to address multiple forms of adversity.

At a time when South Africa is seeking solutions to complex societal challenges, the findings of the 2024 Child Gauge remind us that the answers lie in early childhood – as it is these early investments that offer the highest returns.