The burden of malnutrition remains unsolved, particularly in low- and middle-income households representing the most vulnerable populations, where about an average of 30 – 35% of children are affected by stunting or wasting and almost twice as many suffer from deficiencies in vitamins and other essential micronutrients. At the same time, the number of children with overweight and obesity continues to rise, increasingly affecting children from poorer households. Together, these problems can be characterised as a triple burden of malnutrition facing South Africa’s children: undernutrition, in the form of stunting and wasting, widespread micronutrient deficiencies, and a growing prevalence of overweight and obesity. The backdrop of nutrition has changed/evolved, and new forces drive the nutrition situation of South Africa − globalisation, urbanisation, inequities, environmental crises, health epidemics and humanitarian emergencies − posing critical challenges to feeding children sustainably today and for generations to come.

The evolving nature of malnutrition demands a systems approach: one that addresses the inequities within the everyday structures and living conditions that hinder access to affordable and sustainable nutrition care. The response must also acknowledge the central role of nutrition-sensitive systems (health, education, food, water & sanitation and social protection) within their local context. Everyday circumstances, environment, social position, human capital, and social context all jointly determine a person’s likelihood of becoming malnourished. These society-wide effects are differential, usually disproportionately affecting poorer, more vulnerable or more service-excluded communities and populations.  It is no coincidence therefore that many forms of malnutrition affect the most socially and politically powerless groups: women, children, ethnic minorities and those less educated or living in poverty. Exposure to these inequity determinants and their impact on people’s well-being is often long-term and cumulative, rather than episodic.

In its 45 years of working, Operation Hunger has a history of positive action in the fight against hunger and malnutrition in South African communities. We’ve developed a systematic approach that delivers context-specific programming, which is informed by an analysis of the nutrition situation of children, adolescents and women in a given context (determinants, drivers and potential impact pathways) and the human and financial resources and partnerships available. The triangulation of needs, resources and partnerships allows Operation Hunger to identify the results areas and programmatic priorities that are relevant to a given context. This keeps OH nutrition programmes coherent across provinces,  regions and local programming contexts.