Child Gauge 2019: Child and Adolescent Health - Leave no one behind

Abstract

This 14th issue of the South African Child Gauge is a comprehensive review of the current situation for children and adolescents in South Africa. This issue is divided into three parts, and makes a powerful case for investing in child health - by highlighting recent legislative developments affecting children, examining the importance of early childhood for life-long health trajectories in an 11 chapter series, and lastly by providing informative and detailed statistics on child health, demographics, nutrition, housing, education and access to basic services in an 8 chapter series. The chapters are written by South African academic experts from various universities, in collaboration with directors of research units and facilities, directors of NGOs, medical and allied medical professionals, as well as staff from UNICEF, SAMRC, and other agencies. This review thus provides a multi-faceted approach to understanding where we stand in terms of child health, where to target interventions, and how to prioritise policy making in order to implement sustainable change in this critical, and vulnerable population. The theme of this issue is “Leave no one behind” – a clear message that in order to effect the greatest change in our country, investment must be made to protect ALL children, and to allow the next generation of South Africans to not only survive, but also to thrive. The science clearly shows that if we want to prevent the intergenerational cycles of poverty and violence that are pervasive in our country – focus on the first 1000 days of a child’s life (pregnancy and the first two years of life) as well as on adolescence (and thus the preconception period) is key. These two periods of life are sensitive to change, and are thus critical for future health returns. Health promotion in these period of life is essential for improving later life cognitive development, for prevention of non-communicable diseases, and for halting the rising obesity epidemic we are facing. All chapters are well written and up to date, but Part 3: Children Count, is particularly intriguing and useful as a go-to guide on children statistics in South Africa. This section provides in-depth, and well summarised data on the demography of South African children, income, poverty and social grants, child health, nutrition, and children’s access to education, basic services and housing. This rich data source, in combination with the science provided in part two into the importance of this period of life, will be useful for researchers, policy makers, agencies and health care professionals alike. Ultimately, given that South Africa has committed to the 2030 SDGs, particularly improving maternal and child health and reducing childhood mortality, this Child Gauge is a valuable tool for monitoring progress, and also for identifying key target areas for improvement. As Nelson Mandela knew and proclaimed nearly 40 years ago, “There can be no keener revelation of a society's soul than the way in which it treats its children”. The importance of children for the future of our country cannot be understated – let us learn from our mistakes and shortcomings that have been so clearly laid out in this issue, and from those that came before; and start providing our children with a country that they can be proud of. Dr Alessandra Prioreschi, PhD, MSc, BSc(Hons)