National Food and Nutrition Security Plan for South Africa (2018-2023)

NATIONAL FOOD AND NUTRITION SECURITY PLAN FOR SOUTH AFRICA 2 0 1 8 - 2 0 2 3 THE GOVERNMENT OF THE REPUBLIC OF SOUTH AFRICA VERSION: 07 NOVEMBER 2017 CONTENTS ACRONYMS AND ABBREVIATIONS 3 GLOSSARY OF TERMS 4-5 PREFACE TO THE NATIONAL FOOD AND NUTRITION SECURITY PLAN (NFNSP) 2018-2023 6-9 ACKNOWLEDGEMENTS 10-11 CHAPTER 1: EXECUTIVE SUMMARY 12-19 CHAPTER 2: SITUATION ANALYSIS OF FOOD AND NUTRITION SECURITY IN SOUTH AFRICA 20-40 CHAPTER 3: APPROACH TO THE DEVELOPMENT OF THE NFNSP 2018-2023 41-48 CHAPTER 4: GAME CHANGERS IN THE NFNSP 49-60 CHAPTER 5: IMPLEMENTATION OF THE NFNSP 2018-2023 61-97 CHAPTER 6: MONITORING AND EVALUATION (M&E) OF THE NFNSP 2018-2023 98-105 CHAPTER 7: PRIORITY DISTRICTS 106-108 CHAPTER 8: COSTING AND FINANCING THE NFNSP 2018-2023 109-151 BIBLIOGRAPHY 152-158 ANNEXURE 1: PROGRAMMES IMPLEMENTED BY GOVERNMENT DEPARTMENTS TO ADDRESS FOOD AND NUTRITION SECURITY 159-166 ANNEXURE 2: GLOBAL POLICY ENVIRONMENT FOR FOOD SECURITY AND NUTRITION 167-170 ANNEXURE 3: AFRICAN REGIONAL POLICY ENVIRONMENT FOR FOOD AND NUTRITION SECURITY 171 ANNEXURE 4: EXISTING POLICY ENVIRONMENT FOR FOOD AND NUTRITION SECURITY IN SOUTH AFRICA 172-176 ANNEXURE 5: ANNEXURE 5: PARAMETERS FOR THE COSTING OF THE NFNS PLAN 177-213 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 1 ACRONYMS AND ABBREVIATIONS AFF Agriculture, Forestry and Fisheries CASP Comprehensive Agricultural Support Programme CCHIP Community Childhood Hunger Identification Project Index CNDC Community Nutrition Development Centre CoGTA Department of Co-operative Governance and Traditional Affairs CRDP Comprehensive Rural Development Programme DAFF Department of Agriculture, Forestry and Fisheries DoH Department of Health DPME Department of Planning, Monitoring and Evaluation DSD Department of Social Development DRDLR Department of Rural Development and Land Reform DSBD Department of Small Business Development DST Department of Science and Technology DTI Department of Trade and Industry ECD Early Childhood Development ECDs Early Childhood Development Centres EPWP Expanded Public Works Programme FAO Food and Agriculture Organization FHI 360 Family Health International GDP Gross Domestic Product GHI Global Hunger Index GHS General Household Survey GNP Gross National Product HIV/AIDS Human Immune Virus / Acquired Immune Deficiency Syndrome ICT Information and Communications Technology IGAP Inter-Government Action Plan INP Integrated Nutrition Programme IYCF Infant and Young Child Feeding MDGs Millennium Development Goals MIYCF Maternal, Infant and Young Child Feeding MNCWH&N Maternal, New-born, Child and Women’s Health and Nutrition MTSF Medium-Term Strategic Framework NCD Non-Communicable Diseases NDMC National Disaster Management Centre NDP National Development Plan NFNS Plan National Food and Nutrition Security Plan NFNSP National Food and Nutrition Security Plan NGOs Non-Governmental Organisations NGP New Growth Path NPFNS National Policy on Food and Nutrition Security NSNP National School Nutrition Programme PLAS Proactive Land Acquisition Strategy SADC Southern African Development Community SADHS South African Demographic and Health Survey SA GAP South African Good Agricultural Practices SANHANES South African National Health and Nutrition Examination Survey SASSA South Africa Social Security Agency STATS SA Statistics South Africa SDGs Sustainable Development Goals UNICEF United Nations Children’s Fund N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 2 GLOSSARY OF TERMS Agricultural land: Any land used for farming purposes, situated in the area of jurisdiction of a municipal council and classified as agricultural land when the first members of the council were elected. Agri-Park model: A networked innovation system of agro-production, processing, logistics, marketing, training and extension services, located in district municipalities. As a network it enables a market-driven integration of various agricultural activities and rural transformation services. Food accessibility: Refers to the ability of households to obtain sufficient food for all members at all times, either through production for own consumption, intra-household exchange and/or having an income to purchase, and availability of markets/outlets to access food. Food availability: Determined by the total quantities of food available - including domestic food production and international importation - and efficiency of food distribution, and assessed in the light of the food requirements of the population. Food chain: The systematic production and development of food from primary production to the point of consumption. Food control: Mandatory regulatory enforcement by national and local authorities to provide consumer protection and ensure that all foods - during production, handling, storage, processing and distribution - are safe, wholesome and fit for human consumption, conform to safety and quality requirements, and are accurately labelled. Food insecurity: Exists when people are undernourished due to unavailability of food, inability to access food, and/or improper utilisation of food. Food security: A condition in which all people, at all times, have physical, social and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active healthy life. Food utilisation: Refers to the body’s utilisation of various nutrients in food. Sufficient energy and nutrient intake by individuals is the result of diversity of the diet, proper food handling and preparation practices, good child and health care practices, clean water and sanitation. Food: Any substance consumed to provide nutritional support for the human body. It is usually of animal or plant origin and contains essential nutrients such as carbohydrates, fats, proteins, vitamins and minerals. Household: One person or a group of people who occupy a common dwelling and who provide themselves jointly with food and other essentials for living. Hunger: Recurrent involuntary lack of access to food. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 3 Infant: A child from birth to 12 months of age. Malnutrition: People are malnourished if their diet does not provide adequate nutrients for growth and maintenance, or if they are unable to fully utilise the food they eat due to illness (undernutrition). They are also malnourished if they consume too much energy (overnutrition) and are at risk of micronutrient deficiencies. Risk of hunger: The limited or uncertain access to nutritious, adequate and safe foods, including involuntarily cutting back on meals or food portions, or not knowing the source of the next meal. Consistent access to adequate food is limited by a lack of money and other resources. Social protection: All initiatives that: (1) provide income (cash) or consumption (food) transfers to the poor; (2) protect the vulnerable against livelihood risks; (3) “Enhance the social status and rights of the excluded and marginalised” (Devereux and Sabates-Wheeler, 2004, p.9). Vulnerability: Refers to the full range of factors that place people at risk of becoming food insecure. The degree of vulnerability for an individual, household or group of persons is determined by their exposure to the risk factors and their ability to cope with or withstand stressful situations. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 4 PREFACE TO THE NATIONAL FOOD AND NUTRITION SECURITY PLAN (NFNSP) 2018-2023 The challenge of hunger, poverty and malnutrition in South Africa The National Food and Nutrition Security Plan 2018-2023 embodies our collective response to the challenge of food insecurity and malnutrition. Over the two decades of democracy, multidimensional poverty, measured in terms of composite indicators for health, education, standard of living and economic activity, declined significantly, from 17,9% of the population in 2001 to 8% in 2011, and subsequently to 7% by 2016 [Stats SA, 2017]. This is largely attributed to the social wage that government provides to improve the quality of life of vulnerable households. This includes free basic services (water, electricity and sanitation), primary health care, no-fee paying schools, and provision of free housing (Stats SA, 2017). Nonetheless, the levels of poverty are still too high, relative to ou National Development Plan (NDP) targets for 2030. According to Stats SA, the proportion of the population living below the Lower Bound Poverty Line (LBPL) initially decreased steadily from 51% (24,2 million people) in 2006 to 47,6% (23,7 million people) in 2009 and subsequently to 36,4% (18,7 million people) in 2011. However, recent data reflects that the population living below the LBPL subsequently increased from 36,4% in 2011 to 40% in 2015 (21,9 million people). This is attributed to the fact that notwithstanding the social wage that government has provided to households, their financial well-being, measured through the money-metric poverty measures, declined between 2011 and 2015, due to a combination of international and domestic factors, such as stagnant economic growth (Stats SA, 2017). Government’s social protection measures have also cushioned and provided a safety net for 17 million vulnerable people. Why malnutrition matters Malnutrition has devastating consequences for health, livelihoods and the economy as a whole. We know that 45% of the deaths of children under 3 are related to malnutrition. We also know that children who are stunted are less likely than their non-stunted counterparts to do well in school and gain employment, and if they do find work, will have lower wages. When they become mothers, stunted girls are more likely to give birth to malnourished babies. Adults who are diagnosed with obesity and diabetes are estimated to generate economic costs for their families that are the equivalent of 8-16% of their annual income. At the national level it is estimated that, for African countries on average, malnutrition depresses GDP by 11%. In South Africa, the rate of stunting of children under 5 years of age has gone up from 24% in 2005, to 25% in 2012 and to 27% in 2016. This is evidenced by the South African National Health and Nutrition Examination Survey (SANHANES-1), published by the Human Sciences Research Council in 2013, and Stats SA’s South Africa Demographic and Health Survey (SADHS) 2016. Levels of wasting President Cyril Ramaphosa President of the Republic of South Africa N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 5 among children have increased slightly from 2,2% in 2012 to 3,3% in 2016. The SADHS 2016 found that a total of 67% of South African women aged 15 years and above were either obese or overweight. Female adult obesity in South Africa stood at 41% in 2016, a worsening trend from the 24,8% recorded in SANHANES-1. A total of 26,6% of women were obese in 2016, which reflects a decrease from 39% in 2012. Of concern is that South African women might have transitioned from being overweight to being obese. Levels of obesity among men aged 15 years and over remained at 11% in 2016, compared to 11,6% in 2012. Making rapid advances in reducing hunger and malnutrition is possible Malnutrition does not have to be destiny. There are many countries that are rapidly overcoming malnutrition, starting from positions much less favourable than South Africa’s. For example, Ghana halved its stunting rate from 37% to 19% in 8 years. SADC-region countries which also performed well include Tanzania and Malawi, which have recently reported large decreases in stunting rates over a period of 7 years. These countries have raised the political and economic profile of nutrition: it has become a key development priority - not only a health outcome but a key input into the economic growth process. As the President of the African Development Bank put it recently, good nutrition provides the “grey matter infrastructure” that provides the innovation and entrepreneurship needed to supercharge South Africa’s expected demographic dividend. South Africa is committed to ending hunger and malnutrition South Africa is committed to ending malnutrition and hunger by 2030 - as the new Sustainable Development Goals challenge all countries to do. We have over 50 programmes and initiatives which address food security and malnutrition. There have been successes as wasting and severe acute malnutrition rates have declined. Our social assistance programme witnessed its largest expansion yet, and almost 17 million people are benefiting from the programme. Twelve million of the grant recipients are recipients of the Child Support Grant (CSG) while more than 3.2 million receive the Old Age Grants. These and many other achievements bear testimony to our determination to create a fairer society. During 2015/16 Cabinet approved the Early Childhood Development (ECD) policy, which seeks to ensure universal access to ECD services and appropriate nutrition interventions for children in ECDs by 2030. The number of children enrolled in the more than 27 000 ECD centres has grown phenomenally, and almost 1 million children have been subsidised by the state. The National School Nutrition Programme (NSNP) reaches over 9 million learners among the poorer primary and secondary schools around the country. The school feeding programme alleviates short-term hunger, and thus improves concentration in class. Furthermore, it has the potential of increasing attendance and enrolment of children in schools, resulting in improved retention in the schooling system. Through implementation of the NSNP 2018 2023, it is anticipated these achievements will be enhanced, in particular to ensure that the learners receive adequate, safe and nutritious meals. As part of strengthening the Food and Nutrition Security Programme, government is now operating Food Distribution Centres linked to Community Nutrition and Development Centres (CNDCs) in Provinces, to meet the immediate nutritional needs of the most vulnerable and food insecure members of our society. Despite the large number of food and nutrition programmes, some forms of malnutrition continue to exist and grow. This requires us to redouble our efforts. A beacon of hope The National Food and Nutrition Security Plan 2018-2023 (NFNS Plan) is a beacon of hope. Over 24 years of democracy, our country has made significant strides towards surmounting the challenges of food insecurity and nutrition. However, external evaluations reflect that our N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 6 response to this challenge has been largely sectoral and separate, resulting in suboptimal impact levels. In 2013 Cabinet approved the National Policy on Food and Nutrition Security, the Household Food and Nutrition Security Strategy and the Fetsa Tlala Integrated Food Production Initiative. These policy frameworks are intended to streamline, harmonise and integrate the diverse food and nutrition security interventions in South Africa. In 2014, the Diagnostic/Implementation Evaluation of Nutrition Interventions for Children from Conception to Age 5 was undertaken by the Department of Performance Monitoring and Evaluation together with the Departments responsible for implementing the 18 nutrition interventions. The purpose of this evaluation was to assess the implementation of 18 nutrition interventions implemented by South Africa to determine enabling and inhibiting factors for implementation, as well as the level of synergy among sector departments. The evaluation focused on the sufficiency of policy, leadership, resource allocation, management and oversight, and local-level service delivery. It found that South Africa had almost 60 policies, strategies, plans and programmes for addressing hunger and malnutrition, but lacked a single integrated national plan to achieve this goal. Positive findings of the evaluation included the fact that in South Africa, the right to food is entrenched in the Constitution, in Sections 27, 28 and 35. Also positive was the finding that South Africa has a good mix of health and nutrition policies which should address the immediate, basic, and underlying factors associated with poor nutrition. On the negative side, the evaluation found that South Africa has placed emphasis on food production but not nutrition or consumption of nutritious foods. It was further found that nutrition programmes have not been fully effective in reducing malnutrition because they focused primarily on providing food to the needy, and do not effectively address the underlying causes of malnutrition. The evaluation also found that compared to the 5 comparison countries, South Africa does not have a single or coherent strategy, policy or regulatory system to realise the right to food as set out in the Constitution, and to facilitate and ensure food security for all citizens. The National Food and Nutrition Security Plan notes that there are over 50 programmes that national government implements which address food insecurity and malnutrition. This plan serves as a coherent framework to harness all these efforts towards a common direction. The collective and intersectoral interventions outlined in this document are game changers. A new National Food and Nutrition Security Council will be established to provide leadership and oversight for all efforts of government and society to enhance food security and good nutrition. This is significant. All the interventions outlined in this national plan, if implemented appropriately, will maximise the leverage we can obtain from acting in unison, across spheres of government, with our communities, and with our social and development partners. The National Food and Nutrition Security Plan actions are guided by six strategic objectives, derived from an iterative consultative process as described in the plan, as well as directives from Cabinet, recommendations from the Diagnostic/Implementation Evaluation of Nutrition Interventions for Children from Conception to Age 5, and the best evidence in the scientific literature. The biggest game changer will be the assumption of responsibility for food and nutrition improvement at the highest levels of government and the development of processes to help leaders coordinate action and monitor progress, making adjustments as needed and being more accountable to the people on issues of food and nutrition security. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 7 President Cyril Ramaphosa President of the Republic of South Africa Date: My gratitude goes to the Minister in the Presidency for Planning, Monitoring and Evaluation, Minister Jeff Radebe, for the immense political oversight and leadership he provided during the development of this plan, including his periodic reports to Cabinet. I also wish to thank the Ministers in charge of all the 12 government departments that contributed to the development of the plan, namely: Minister S. Zokwana (Agriculture Forestry and Fisheries); Minister A. Motsoaledi (Health); Minister B. Dlamini; (Social Development); Minister G. Nkwinti (Rural Development and Land Reform); Minister A. Motshekga (Basic Education); Minister D. Van Rooyen (Cooperative Governance); Minister M Gigaba (Treasury); Minister N. Mokonyane (Water and Sanitation); and Minister S. Shabangu (Women). Finally, the government officials and development partners who worked tirelessly during this process, ought to be commended. However, the real work starts now, with the earnest implementation of this plan, to improve the lives of our people. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 8 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 9 ACKNOWLEDGMENTS The comprehensive National Food and Nutrition Security Plan (NFNSP) is a product of the intensive labour of diverse stakeholders working in unison. They included government departments; non-governmental organisations; academic institutions and development partners. This work was led by the National Interdepartmental Coordination Committee, led by the Office of the Deputy President of South Africa and the Department of Planning, Monitoring and Evaluation (DPME) which also included development partners. The Interdepartmental Coordination Committee consisted of the following officials from National Government Departments: • Dr. Nono Princess Simelela (Special Advisor, Social Policy, Office of the Deputy President) • Mr. Thulani Masilela (Outcome Facilitator: Health, DPME) • Dr. Tsakani Ngomane (Outcome Facilitator: Rural Development and Land Reform, DPME) • Ms. Lynn Moeng-Mahlangu (DoH) • Mr. Mortimer Mannya (DAFF) • Mr. Roger Tuckledoe (DAFF) • Mr. Steve Mohlabi (DAFF) • Dr. Jermina Moeng (DAFF) • Mr. Molatelo Mamadi (DAFF) • Mr. Mondli Mbhele (DSD) • Mr. Peter Netshipale (DSD) • Ms. Mamokhele Maduna (DBE) • Ms. Neo Rakwena (DBE) • Mr. Michael Gama (DBE) • Mr. Sibongiseni Ndimande (DRDLR) • Mr. Clive Magagula (DRDLR) • Ms. Rebone Ntsie (DoH) • Dr Shuaib Kauchali (DoH) • Mr. Lugisani Mutangwa (DPME) • Ms. Anne Dibakwane (DPME) • Mr. Bheki Dlamini (DTI) External technical support for the development of the plan was provided by the following United Nations Agencies and Development Agencies: • Dr. Alison Feeley (UNICEF) • Dr. Sanjana Bhardwaj (UNICEF) • Ms. Nomajoni Ntombela (FHI 360) • Ms. Sophy Modise (FHI 360) • Ms. Phyllis Baxen (FHI 360) • Ms. Nerisa Pilime (FHI 360) • Dr. Mercy Chikoko (FAO) • Dr. Cuthberth Kambanje (FAO) • Dr. Tobias Takavarasha (FAO) • Ms. Pontso Sepoloane (World Food Programme) • Mr. Peter Shivute (World Food Programme) • Dr. Taskeen Khan (WHO) Representatives of academic institutions who contributed to the development of the national plan were as follows: • Prof. Sherly Hendricks [University of Pretoria (UP)] • Prof. Hettie Schonfeldt (UP) • Dr. Nic Olivier (UP) Contributors to the one-week workshop held in October 2015: Agri SA - Christo van der Rheede; ARC Patrick Adebola; Ian du Plooy, Willem Jansen van Rensburg, Erika Van Den Heever, Sonja Venter, Sunette Laurie, David Modise; Civil Society Pauline Kuzwayo, COGTA - David Madurai, DAFF - Rowena Joemat, Tozamile Lukhalo, Caroline Makgopa, Khumo Morake, Ditiro Oganne, Roger Tuckledoe, Garfield Whitebooi; DALRD - Clive Magagula, N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 10 Sibongiseni Ndimande; DBE - Sijabule Behane, Jabulani Gama, Mamokhele Maduna, Carina Müller; DoH - Ann Behr, Nonhlanhla Dlamini, Lynn Moeng; DPME - Thulani Masilela, Anne Dibakwane, Bukiwe Lupindo, Boitumelo Moima, Lugisani Mutangwa, Tsakani Ngomane, Jeanette Sprinkhuizen; DRDLR - Maria Mphahlele, Lillian Senosi; DSD Mondli Mbhele, Joe Molifi, Peter Netshipale, Dikeledi Nkan, DWS - Trevor Balzer; EEO Zethu Diko, Sunelani Mahlangu, Mandla Jwili, Mpho Mthembu, Sandile Nombani; FAO Mercy Chikoko, Cuthbert Kamabanje, Tobias Takavarasha; FFO - Steven Nkabinde fhi 360 Phyllis Baxen, Mjabuliseni Ngidi, Nomajoni Ntombela; Free State:Education - Patricia Leripa, Maria Ngogodo, FS:Health - Joe Mokgatie; Gain - Pumla Dlamini; Independent/ Private - Phumzile Dlamini, Jacintha John; KZN:Health- Leonore Spies; LP-DARD - Silas Sitholimela; LP: Health - Mapoleon Makgoga, Daddy Matthews, Rebone Ntsie; LP:OTP Michael Maseko, MP: Health - Gilbert Tshitaudzi ; Naledi – Melisizwe Tyso; National Treasury Owen Wilkox; NC: Education - Agnes Mompati: NC: Health - Maretha Le Roux; NDA Nkhesani Mthembi;Oxfam - Ayanda Baloyi, Nokuthula Dlamini, Gugu Nkabinde; RAEIN Africa - Doreen Mnyulwa; SA Human Rights Commission Rober Tyrrell; SA-MRC - Ali Dhansay, SA MRC; SASSA - John Tsalamandris; Stats SA - Isabel Schmidt; UNICEF - Sanjana Bhardwaj, Piers Cross, Alison Feeley, Latasha Terger- Slavin, Lerato Tsebe; University of North West- Johann Jerling, Chantell Witten, Salome Kruger; University of Pretoria Magalie Bourblanc, Elizabeth Mkandawie, Maria Molokomme, Lihle Ngwane; University of South Africa - Maggi Linington, Lesego Sejosengoe, Lizandri Swanich; University of Stellenbosch - Lisanne Du Plessis; University of Western Cape - David Sanders; USAID William Benjamin, Tafadzwa Ngorima, Nerisa Pilime; WC: Premier’s Office - Sibonile Khoza; WFP - Margit Bach, Leigh Hildyard, Peter Shivute; WHO - Taskeen Khan; Women - Ntsiki Sisulu-Singapi, Editors Dr. Lawrence Haddad, co-author of the annual Global Nutrition Reports and Ms. Jane Badham edited earlier drafts of this report, and their assistance is duly acknowledged. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 11 CHAPTER 1: Executive Summary 1.1 Introduction The National Food and Nutrition Strategic Plan (NFNSP) 2018-2023 describes how South Africa will combat the silent crisis of malnutrition and reverse its growth in the next 15 years. 1.2 Vision The Vision of the NFNSP is: optimal food security and enhanced nutritional status for all South Africans. 1.3 Mission The Mission is to significantly improve food security and reduce malnutrition in all its forms to afford South Africa’s people opportunities to lead healthy and productive lives. 1.4 Goals The Goal of the NFNSP is to implement a priority set of actions and establish the necessary institutional architecture to lead, coordinate, budget and monitor the implementation of these actions to deliver significant improvements in food and nutrition status by 2030. Expectations for the impact of the NFNSP are guided by the findings of the Stats SA General Household Survey (2016) about the state of food security in South Africa, and the WHO 2025 global targets for six nutrition indicators. The NFNSP has set targets for 2023, rather than 2025, to accentuate the urgency of South Africa’s response to food insecurity and malnutrition challenges. The NFNSP 2018-2023 seeks to significantly improve food security and nutritional status. It therefore sets out impact targets covering interventions to address vulnerability to hunger; undernutrition and under overweight and obesity, which are at least as ambitious as the global targets and in some cases (e.g. stunting and exclusive breastfeeding rates) more ambitious. The selection of 17 indicators was inspired by three imperatives: (a) Key national goals to reduce poverty, inequality and unemployment, as set out in the National Development Plan 2030; (b) The six World Health Assembly indicators for nutrition1 and (c) Food security indicators from the General Household Survey. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 12 Table 1: SMART impact targets for the NFNSP Impact Indicators Baseline Target for 2023 Data Source Reduced experience of hunger 1 Percentage (%) of households vulnerable to hunger 11.8% 5.7% General Household Survey (GHS) 2016 2 % of individuals vulnerable to hunger 13.4% 6.6% GHS 2016 Additional indicators 3 % of households experiencing hunger New TBD GHS 2018 4 % of individuals experiencing hunger New TBD GHS 2018 Decrease in months of food shortages among the poor, vulnerable and marginalised 5 % of households with inadequate or severely inadequate access to food 22.3% <10% GHS 2016 6 % of individuals with inadequate or severely inadequate access to food 24.9% <5% GHS 2016 Additional indicators 7 Number of months (and actual months) in which the household experienced food shortages New TBD GHS 2018 Reduced prevalence of under-nutrition in children (acute) 8 Wasting: Proportion of children below 5 years of age with height for weight <-2 Z-scores of the median WHO child growth standards 3% (increase from 2.2% in 2012, SANHANES-1, HSRC 2013) <20% in 2020 <15% in 2023 SADHS 2016 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 13 Impact Indicators Baseline Target for 2023 Data Source 9 Stunting: Proportion of children below 5 years of age with height for age <-2 Z-scores of the median WHO child growth standards 27% (was 26,9% amongst children aged 1-3 years SANHANES-1, HSRC 2013) <20% in 2020 <15% in 2023 SADHS 2016 Reduced prevalence of over-nutrition in children 10 Overweight: Proportion of children less than 5 years of age with height for weight >+2 Z-scores of the median WHO child growth standards 13% in 2016 (decrease from 14% in 2012, SANHANES-1 2013) No increase in child overweight by 2020, 10% reduction by 2022 SADHS Reduced prevalence of Low Birth Weight 11 Prevalence of infants born <2500g (%, proportion of total live births) 13% (117 510 of 901 652 live births) 30% reduction By 2023 DHIS 12 Prevalence of exclusive breastfeeding (%) at 6 months 32% 50% by 2023 SADHS 2016 Reduced prevalence of over-nutrition in adults (Women aged 15 years and above)) Overweight: Women 13 Body Mass Index (BMI): Weight in kilograms divided by the square of height in metres (kg/m2 26.6% in 2016 decreased from 39% in 2012 (women over 15 years and above) 10% reduction by 2020 15% reduction by 2023 SADHS 2016 SANHANES 2012 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 14 Impact Indicators Baseline Target for 2023 Data Source Obesity: Women 14 BMI 41% in 2016 worsened from 24.8% (women aged 15 years and above) 10% reduction by 2020 15% reduction by 2023 SADHS 2016 SANHANES 2012 Reduced prevalence of over-nutrition in adults (Men aged 15 years and above)) Overweight: Men (aged 15 years and above) 15 BMI 20.3% in 2016 (was 19,6% in 2012) (men aged 15 years and above) 10% reduction by 2020 15% reduction by 2023 SADHS 2016 SANHANES 2012 Obesity: Men (aged 15 years and above) 16 BMI 11% in 2016 (was 11.6% in 2012) 10% reduction by 2020 15% reduction by 2023 SADHS 2016 SANHANES 2012 Reduced prevalence of Vitamin and Mineral Deficiencies 17 Percentage (%) of women of reproductive age (16 35 years) who have a haemoglobin level of less than 11g/dl 23.1% (SANHANES 2013) 25% reduction by 2020 (to 17.3%) 50% reduction by 2023 (to 11.5%) SADHS 1.5 What are the NFNS Plan’s objectives? of Nutrition Interventions for Children from Conception to Age 5 (2014), which compared South Africa to Brazil, Colombia, Malaysia, Malawi and Mozambique. The six strategic objectives and their accompanying key interventions are summarised in Table 2. The NFNSP actions are guided by 6 strategic objectives derived from a consultative process. The plan also takes into account the recommendations from Cabinet; the Policy on Food and Nutrition Security, and the Diagnostic/Implementation Evaluation N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 15 Table 2: The Strategic Objectives of the NFNSP, their rationale, and key actions to achieve them NFNSP Strategic Objective Rationale Key Action and what is different 1. Establish a multi sectoral Food and Nutrition Security Council to oversee alignment of policies, coordination and implementation of programmes and services which address food and nutrition security • All successful efforts to reduce malnutrition have a single leadership and governance structure for food security and nutrition. • A single national plan of action is essential. • Stakeholders in the civic and private sectors are critical stakeholders in the food system. It is important that the council engages with external stakeholders. • Responsibility for food security and nutrition improvement at the highest political levels: national, provincial, district. Accountability of different departments, at each level, to one body. 2. Establish inclusive local food value chains to support access to nutritious and affordable food. • Access to nutritious, safe and affordable food is es sential to reduce all forms of malnutrition. • The strategic intervention to stimulate markets for smallholder farmers will consider how local mar-kets (at municipal and dis-trict level) can be support-ed as a point of market ac-cess for smallholder farm-ers to sell produce directly to consumers. • Focusing on local food value chains increases employment opportunities and reduces dependence on imports. • The local food value chains have many other elements besides the smallholders such as agro-processing, retail and waste - which determine whether people have access to food or not. • Commercial farmers are critical to ensuring household food security, and the plan must engage with the role of commercial farmers to ensure affordable • food production. • Greater focus on raising the productivity of Smallholder Producers as a way of increasing local access to nutritious foods. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 16 NFNSP Strategic Objective Rationale Key Action and what is different 3. Expand targeted social protection measures and sustainable livelihood programmes • Social protection and sustainable livelihoods are essential for access to safe and nutritious food, safe water, sanitation and health care. • Enhanced livelihood assets are the basis for sustainable livelihoods, health and well being. • Promote early registration of children born in public health facilities, within the prescribed 30-day period. • Achieve a universal child grant registration for eligible children born in public facilities. • Integrate social protection registration with food and nutrition education. • Improve provision of nutritious meals to targeted learners in schools through the NSNP • (at least 3 food groups per meal). 4. Scale up high impact nutrition interventions targeting women, infants and children • There are a set of high- impact, nutrition-specific interventions targeting women, infants and children, which have improved nutrition outcomes globally. The coverage rates of these programmes in South Africa are low. • Improve nutrition training and focus of community health workers and food handlers in community nutrition centres (ECDs, schools and CNDCs); increase availability of micronutrient supplements, deworming tablets and fortified porridge. • Improve advocacy around exclusive breastfeeding. • Improve ability of ECDs to address nutrition issues. 5. Influence people across the life cycle to make informed food and nutrition decisions through an integrated communications strategy • The enabling environment for nutrition improvement needs to be stronger / more conducive. • Better communication to improve consumer choices. • Better regulations to incentivise businesses towards food and nutrition security. • Better capacity for front- line workers. 6. Develop a monitoring and evaluation system for FNS, including an integrated risk- management system for monitoring FNS related risks • A simple, unified monitoring system needs to be established to guide action and hold stakeholders accountable. • Food and nutrition outcomes are sensitive to shocks related to weather, prices, • crop and animal diseases and conflict. • Develop a unified system for tracking inputs and outcomes. The monitoring system should track food and nutrition status, but also indicators related to the other six strategic objectives. • Establishment of a risk register to guide action. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 17 Figure 1: Logical framework of the NFNSP 2018-2023, showing the 6 Strategic Objectives, outcomes and impacts on children and adults Reduced sickness and death SO 5: Influence people across the life cycle to make informed food and nutrition decisions through an integrated communications strategy SO 4: Scale up of high impact nutrition i n t e r v e n t i o n s targeting women, infants and SO 6: Develop a monitoring and evaluation system for FNS in South Africa Establish an integrated risk management system for monitoring FNS related risks SO 1: Establish a multisectoral FNS Council to oversee alighnment of policies, legislation and programmes, coordination and implementation of programmes and services, which address FNS, and draft new policies and legislation where appropriate. Breast-feeding, feeding and care giving practices, parenting, healthy eating Access to health services, safe and hygienic environment Low burden of infectious diseases Feeding and care giving resources (maternal and c o m m u n i t y levels) D i v e r s i f i e d nutient-rich foods Food security, i n c l u d i n g a v a i l a b i l i t y , economic access and use of food SO 2: Estab l i shment of inclusive local food value chains to support access to nutritious affordable food SO 3: Expand targeted social protection measures and s u s t a i n a b l e l i v e l i h o o d programmes Children Improved nutrition status Improved coordination, policy and governance. Knowledge and evidence Leadership, capacity, financial resources. Social, economic, political and environmental context (national and global) Adults Improved cognative and social emotional development Improved school performance and learning capacity Reduced obesity and non communicable diseases & death Increased adult height (stature) & intelligence Improved work capacity and productivity N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 18 1.6 How will the NFNSP work? The NFNSP will work through existing departments and agencies. There will be some new activities - such as more nutrition focused training for community health workers; up-scaling of training for school based stakeholders for the NSNP, ECD centres and CNDC, public works programmes that are nutrition sensitive, a focus on expanding the coverage of existing nutrition-specific programmes - and some potential game changers. The biggest game changers will be the assumption of responsibility for nutrition improvement at the highest levels of government and the development of processes to help those leaders coordinate action and monitor progress, making adjustments as needed and being more accountable to the people. 1.7 Who will be accountable for progress? At each level of government (National, Provincial and District) the NFNSP 2018-2023 recommends setting up a council for various key activities. These will include planning, coordination, mobilisation of resources for investment, and monitoring progress. In addition, Forums will be established at each level to engage with civil society and make the planning and reporting process as participatory as possible. Accountability for steering the NFNSP 2018-2023 towards success will lie with the Office of the Deputy President, the Provincial Premiers and District Mayors. Where provincial and local governments have mechanisms and institutions fulfilling the role of the proposed council, they should be allowed to leverage their existing structures. 1.8. What are the evidence and data gaps? South Africa has a paucity of data on key food security and nutrition-related research. A number of key indicators are not routinely collected in South Africa. These include indices such as changes in stunting prevalence over time, by wealth quintile; adolescent and adult anthropometry (% population); overweight and obesity; and micronutrient status of population, including anaemia among children and women of reproductive age. Public research funding should be increasingly geared towards evaluating key components of the NFNSP. Researchers and policy makers together need to agree on research priority areas around health, nutrition, food security and social policy including ECD. 1.9 What will success look like? The metrics of success are specified in detail in the main report and correspond to each of the strategic objectives. The process targets lead to the attainment of the 17 targets in Table 1. At a more basic level, success is reflected by a society-wide thirst for knowledge about the status, consequences and solutions to malnutrition; and optimism that it can be reduced rapidly; a determination of government and all stakeholders to act for food security and nutrition; the willpower needed to stick to the NFNS Plan 2018-2023; and the openness and confidence to report on it in a timely and transparent way. Success will be measured by the improved ability of children to survive, thrive and become productive as adults, helping to build a stronger, fairer and more prosperous society. This will be the legacy of the NFNS Plan 2018 2023 and of those who made it a reality. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 19 1.10 Government’s commitments, resolutions, policies and actions towards food and nutrition security 1.10.1 Global and regional commitments and resolutions related to food security and nutrition As a UN member state, South Africa has signed various global resolutions and commitments on food and nutrition. A summary of these commitments is appended as Annexure 2. In addition to global commitments and resolutions, there are various African instruments containing provisions addressing the right to adequate food (and by implication to food security and nutrition) that provide a platform for regional commitments and resolutions. An overview of African regional obligations and commitments applicable to South Africa is appended as Annexure 3. 1.10.2 National policies related to food and nutrition security South Africa has an enabling policy environment for national food security and nutrition. This begins with a strong constitutional framework upon which fundamentals of the country have been built. In addition several laws, regulations, policies and strategies make reference to food security and nutrition. A table of these is appended as Annexure 4. 1.10.3 Fulfilling global, regional and national commitments to food and nutrition security Despite strong support of global and regional commitments at the highest level South Africa, like many countries, is still struggling to address the complexity of food security and nutrition. The adoption of the 17 Sustainable Development Goals (SDGs) reiterated the importance of nutrition and provides a good opportunity for renewed efforts to combat issues of malnutrition and food insecurity. 1.10.4 Sustainable Development Goals In September 2015, the UN adopted a set of 17 new Sustainable Development Goals (SDGs), following the review of global progress towards the Millennium Development Goals (MDGs). The UN emphasised that all 17 SDGs and their 169 associated targets are integrated and indivisible. The NFNS Plan 2018-2023 seeks to contribute directly to implementation programmes aimed at advancing the following goals: Goal 1. End poverty in all its forms everywhere Goal 2. End hunger, achieve food security and improved nutrition and promote sustainable agriculture Goal 3. Ensure healthy lives and promote well being for all, at all ages Goal 5. Achieve gender equality and empower all women and girls Goal 10. Reduce inequality within and among countries South Africa also has a plethora of good policies, but their translation into coherent and coordinated implementation has been a challenge. The NFNS Plan 2018-2023 seeks to contribute to addressing this gap by creating a roadmap for implementation of effective food and nutrition security interventions. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 20 CHAPTER 2: Situation Analysis of Food and Nutrition Security in South Africa 2.1 Introduction This chapter lends insight into the current state of food and nutrition security in South Africa. It focuses on three broad, intertwined themes of food security, nutrition and social protection measures being implemented to provide a safety net. 2.2 International perspectives The Global Nutrition Report 2014 estimated that Asia and Africa lose 11% of Gross National Product (GNP) every year owing to poor food security and nutrition, and their Gross Domestic Product (GDP) totals are less than 90% of what they would be in the absence of undernutrition. The World Bank estimates suggest that South Africa loses over US$1.1 billion annually in lost productivity as a result of vitamin and mineral deficiencies alone2. In addition, the impact on the future potential of South Africa’s children is significant. Box 1 illustrates the economic costs of malnutrition. Eleven of the 17 underlying causes of premature mortality and morbidity experienced in South Africa are directly related to malnutrition3. Furthermore, childhood undernutrition predisposes children to overweight and non-communicable diseases (NCDs) later in life4 (See Box 3 below on the South African nutrition situation). High levels of premature mortality contribute to reduced life expectancy and have major negative impacts on individuals, families and the national economy. 2.3 Current food security situation in South Africa Food security is defined as a situation where “All people, at all times, have physical and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active healthy life”5. Food security is achieved when households are able to access, through production or purchasing, sufficient food to meet their daily nutritional requirements. It includes four foundational elements: availability, access, nutrition and stability of supply (resilience). This section discusses the progress to date and the challenges faced in ensuring food security for all. 2.3.1 Areas of good progress in food security According to Stats SA (2017), household access to food in the country has improved since 2002, however it has remained static since 2011. The Household Food Insecurity Access Scale, aimed at determining households’ access to food, illustrated that the percentage of South African households with inadequate or severely inadequate access to food decreased from 23.9% in 2010 to 22.3% in 2016 (Stats SA, 2017). Between 2010 and 2016, the percentage of individuals at risk of food insecurity decreased from 28.6% to 24,9%. Numerous national policies recognise the important role of agriculture as a driver of rural economic growth and rural revitalisation, yet urgent action is needed to overcome sluggish growth and job losses. 2 World Bank 2009 3 These include high blood pressure, excess body weight, high cholesterol, diabetes, low fruit and vegetable intake, childhood and maternal underweight, vitamin A deficiency, iron deficiency anaemia, physical inactivity and unsafe water, sanitation and hygiene (Bradshaw et al., 2007). 4 WHO, 2003 5 CFS (2012) as per the FAO 1996 definition N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 21 Box 1: Progress on food and nutrition security to date in South Africa PROGRESS TO DATE Although income inequality remains a challenge, South Africa can celebrate progress towards achieving some reductions in poverty and hunger: • The South African MDG country report showed that South Africa achieved three (universal primary education, gender parity in education, access to water and sanitation) of the nine. • Between 2001 and 2011 the proportion of households which are multi-dimensionally poor fell from 17.9% to 8.0%; • Coverage of social grants increased from just over 2.5 million beneficiaries in 1997 to approximately 16.6 million in February 2015; • Access to basic education has continued to increase, with high enrolment rates suggesting that the No-Fee School Policy and the National School Nutrition Programme have an impact. • Improved coverage of key child-survival interventions such as immunisations, Prevention of Mother to Child Transmission (PMTCT), antiretroviral therapy (ART) and the treatment of common childhood illnesses (for example, diarrhoea and pneumonia) using the Integrated Management of Childhood Illness (IMCI) approach have contributed to the decline in childhood mortality. • Latest estimates show that more than 80% of all HIV-positive pregnant women received treatment; in 2015, all pregnant women who tested HIV-positive were placed on lifelong antiretroviral treatment. 2.3.2 Key challenges and constraints There are some challenges and constraints to South Africa achieving national food and nutrition security that need to be considered and addressed. These are outlined below. 2.3.2.1 Access to food and hunger remain a challenge. The 2012 South African National Health and Nutrition Examination Survey (SANHANES-1) used the Community Childhood Hunger Identification Project Index (CCHIP) to assess the frequency of experiencing hunger. It showed that on average, 45.6% of the population was food insecure, 28.3% were at risk of hunger and 26% experienced hunger. The largest percentage of people experiencing hunger lived in urban informal settlements (32.4%) and in rural formal settlements (37%). The same localities showed the highest prevalence of being at risk of hunger: urban informal settlements 36.1% and rural formal settlements 32.8%. The lowest rate of hunger was found in urban formal areas (19.0%)6. The General Household Survey (GHS) conducted by Stats SA in 2016 found that the percentage of the population that experienced hunger decreased from 23,9% in 2002 to 13,4% in 2016. This figure has remained static at 13% from 2011 to 2016. With respect to households, the proportion that experienced hunger decreased from 23,8% in 2002 to 11,8% in 2016. This figure has also hovered around 11% from 2011 to 2016 (Stats SA 2017). Around 16,2% of the South African population experienced severely inadequate access to food, while 6,1% experienced inadequate food access in 2016. Table 3 below shows the provincial location of this population. 6 Shisana et al. 2013 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 22 Table 3: Individuals with severely inadequate access to food in 2015 Province Food access inadequate (% of provincial population) Food access severely inad equate (% of provincial population) Western Cape 14,8 7,5 Eastern Cape 20,5 5,9 Northern Cape 20,9 12,7 Free State 17,8 5,8 KwaZulu-Natal 18,2 5,8 North West 25,5 11,1 Gauteng 13,4 4,0 Mpumalanga 19,8 11,3 Limpopo 6,3 2,0 South Africa 16,2% 6,1% Source: Stats SA, General Household Survey, 2016 This impacts on dietary diversity, which is low, with the general diet made up predominantly of a micronutrient-poor staple - maize meal porridge - served with a side dish, such as cabbage, that is also relatively low in nutrition. 2.3.2.3 Increase in population and urbanisation compounds the many factors making up the poverty trap that many South Africans find themselves in. South Africa is urbanising rapidly and is growing larger and younger. The UN estimates that 71.3% of South Africa’s population will live in urban areas by 2030, and nearly 80% by 2050. Two-thirds of South African youth live in urban areas. 2.3.2.2 Poverty and inequality inhibit households’ capacity to access affordable, nutritious, diverse diets. According to the 2011 Income and Expenditure Survey 7, 21.7% of South Africans live in extreme poverty and are not able to pay for basic nutritional requirements, 37% do not have enough money to purchase adequate food and non food items, while 53.8% survive on less than R779 per month. In 2017 (quarter 3), the official unemployment rate in the country was 27,7%. As a result, despite South Africa being regarded as food secure at the national level, it is still a major problem for most households to access an affordable and nutritious diet. 7 Stats SA (2011) N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 23 2.3.2.4 Agricultural and land reform challenges. The combination of slow-to modest growth and declining employment continues a longer-term trend, evident since at least the 1970s8, and transformation of the agricultural sector post-1994 has been slow and tentative. The sector is characterised by significant inequalities in levels of production and productivity, access to markets and profitability. The Agriculture, Forestry and Fisheries (AFF) sectors and the Department of Rural Development and Land Reform (DRDLR) play a strategic role as potential drivers of economic growth and employment creation, food security, agrarian transformation, rural development and support to industrial development. However, the challenges facing the sector are numerous: rising input costs, an uneven international trade environment, lack of access to infrastructure (rail, harbour, electricity), and a rapidly changing policy and production environment. 2.3.2.5 Between 1994 and 2012 the real contribution of the sector to GDP increased by 29%. However, over the same period employment declined by 30% to 40% in both primary production and agro-processing. Employment in agriculture fell from 1.09 million to 661, 000 between 2006 and 2012. Twenty per cent (20%) of the country’s commercial farmers contribute 80 per cent of total food production even though between 1950 and 2015, the number of commercial farming units in primary agriculture has declined from almost 120 000 to around 38 000.Since 2012 agricultural employment in agriculture has increased (from 661000 in Q3 of 2012 to 881000 in Q3 of 2016- QLFS, Stats SA). This is an increase of 220000 jobs (33%) over this period 2.3.2.6. Over 4 million small-scale farmers need support to contribute meaningfully to national food security in the future. The production gap between commercial and smallholder producers in South Africa is significant, with commercial maize farmers producing 4.4 tons per hectare (t/ha) compared with 1.1t/ha on average for smallholders in the 2012/2013 harvest. 2.3.2.7 Improved market participation of the emerging agricultural sector9: Growing the smallholder sector is closely tied to making smallholder agriculture more remunerative – presently, more than half of all smallholder households live below the poverty line10. The stimulation of the sector can be facilitated by Government food purchase programmes such as the NSNP. This programme provides meals on an average of 190 school days to an average of 9 million learners; in 2015/16 financial year the cost of meals was around R5.1 billion. If the procurement favoured smallholder producers it could benefit both farmers and schools by timeous provision of sufficient vegetables of good quality11. However, issues such as seasonality in smallholder production show that allowance should be made for the specific circumstances of smallholders. Very few of them have the ability to access government’s increasingly complicated procurement system. 2.3.2.8 While the focus of agricultural production and marketing programmes in South Africa has shifted to smallholder production, legislative and policy measures for creating an enabling environment for smallholders to establish sustainable and competitive production and marketing systems have not been provided. Many of the elements that helped establish commercial farmers (input subsidies, infrastructure, security of tenure, market protection, credit and public research, development and extension) and ensured national food security are no longer available (or are non-functioning) for both the commercial and smallholder sectors12. 8 DAFF, 2014 9 Republic of South Africa. (2013). The National Food and Nutrition Policy, Inter-governmental Working Group on Food and Nutrition Security. Pretoria. Republic of South Africa. 10 DAFF, 2014 11 DPME (2016). Report on the Implementation Evaluation of the National School Nutrition Programme. Pretoria. RSA. 12 Hendriks, 2014 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 24 2.3.2.9 Transformation of the rural economy is essential for growth, poverty reduction, employment creation and overcoming inequalities in the country. How to achieve pro-poor growth in South Africa drives the need for a census of smallholders to create the necessary database to understand the smallholder landscape, character, opportunities, constraints and the most appropriate programme options. 2.3.2.10 Volatile and high international food and input prices between 2007 and 2013 have put additional pressure on the South African food system, particularly as consumer preferences have shifted from maize, the key locally-produced staple, to rice, processed foods and ‘fast foods’. 2.3.2.11 South Africa’s food networks have negatively affected the affordability of food. Corporatisation of the food and trade networks, leads to the production of nutrient deficient foods and, market dominance and profiteering leads to high food prices, and job losses. 2.3.2.12 A large percentage (estimated at 60-70%) of the social grant is spent on food, making a case for social grants to be conditioned to stimulate procurement of food locally. There is a need for strengthening the Agri-park model (See Box 2 below, Agri-Parks explained). The Agri-park model will also ensure job creation, local food processing and creation of a demand for local producers. 2.3.2.13 Localising food networks and contributing to local trade will facilitate wealth creation, local economic development, improved food access and dietary diversification. At the same time responsible citizenship can be cultivated as communities take charge of their own environments and destinies. However, the characteristics of specific commodities and geographic areas need to be considered. Box 2: Agri-parks An Agri-park is a networked innovation system of agro-production, processing, logistics, marketing and training and extension services, located in District Municipalities. As a network it enables a market-driven integration of various agricultural activities and rural transformation services. Agri parks comprise three basic units: 1. The Farmer Production Support Unit, which is a rural outreach unit connected with the Agri hub. The unit undertakes primary collection, some storage, some processing for the local market, and extension services including mechanisation. 2. The Agri-Hub Unit is a production, equipment hire, processing, packaging, logistics and training (demonstration) unit. 3. The Rural Urban Market Centre Unit, which has three main purposes: (a) Linking and contracting rural, urban and international markets through contracts. (b) Acting as a holding facility, releasing produce to urban markets based on seasonal trends. (c) Providing market intelligence and feedback to the Agri-Hub and Farmer Production Support Unit, using the latest information and communication technologies. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 25 2.3.2.14 Climate change is a key factor. According to reports from the Intergovernmental Panel on Climate Change, climate change will lead to an increase in weather extremes, including droughts. Regular droughts are already a part of our semi-arid climate, and their increased occurrence and intensity necessitates altered crop systems to mitigate this threat. Currently South Africa is experiencing its worst drought since 1992, the impact of which is expected to endure for at least 2-4 years. 2.3.2.15 Livestock and agriculture livelihoods are worst affected, resulting in unemployment and thus increasing the number of individuals vulnerable to food insecurity. 2.3.2.16 The cost of a food basket has increased by at least 20% since 2015. Limpopo province had a vulnerability risk assessment completed in 2015 and KwaZulu-Natal is undergoing the same assessment. 2.3.3 What is to be done? 2.3.3.1 Alternative production systems for home-based, community and smallholder production are needed to ensure availability of affordable, nutritious food at the household level. What are necessary are novel, low cost, low-input production systems such as small hydroponic units, container production, small shade-net systems and production under protection, including adapted hydroponic systems for smallholders and home gardens. 2.3.3.2 Biofortification is recognised to be among the highest value-for-money investments for economic development. This is due to its improvement of the nutrient quality of crops through the use of agricultural methodologies, making nutrients bio-available to the body after ingestion. Biofortified foods reduce the need for costly supplements, especially among the most vulnerable target groups. Biofortification should be further explored in South Africa. 2.3.3.4 The value of fish in the diet has been neglected and the opportunities offered by South Africa’s 320 inland dams have been ignored. Fish can provide income and livelihoods as well as being an important source of protein and other nutrients valuable in increasing dietary diversity. South Africa should investigate the potential of scaling up inland fish farming. 2.3.3.5 Government’s social and community development interventions to address drought range from immediate to medium- and long term interventions, categorised as follows: (a) Social relief measures Short-term measures seek to provide social relief to drought-affected provinces over an 8-month period using the current Department of Social Development disaster response and feeding programmes. These include expanding the Social Relief of Distress (SRD) grants and network of Food Distribution Centres to all drought-affected areas, but this requires additional resources. The current network of Community Nutrition Development Centres (CNDCs), 166 as at 2016, is insufficient to address the affected areas. It is proposed that an additional 113 CNDCs be established in all affected areas (local Municipalities), which should be operated 7 days a week. (b) Household food production support Through this programme the Department of Agriculture, Forestry and Fisheries (DAFF) intends to support household/subsistence food production. The household production support package includes drilling boreholes and equipping them to provide water for irrigation and livestock, including poultry and small stock that is adaptable to drought. (c) Enhancing access to drought-tolerant seeds The DAFF, in partnership with the Agricultural Research Council (ARC) and the South African National Seed Producers Organisation, has distributed drought-tolerant seeds to framers and farming communities. An investment of about R37 million in researches and technology development is required to expand this to cater for crops other than just the staples. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 26 (d) Health implications The health implications of drought are numerous and far reaching. Drought and water scarcity can impact negatively on health in numerous ways, i.e. through compromised food and nutrition security; compromised quality and quantity of potable water for domestic and recreational use; compromised sanitation and hygiene; and increased disease incidence, i.e. infectious, vector-borne and zoonotic diseases. Importantly, vulnerable groups already at risk of malnutrition, especially young children and elderly people, are at greater risk of malnutrition during drought. Vulnerability assessments have been conducted in Limpopo and KwaZulu Natal Provinces to determine those at risk of moderate- and severe-acute malnutrition. This will enable health facilities to be prepared with appropriate nutritional supplements, and will also identify those at risk so that social relief interventions can be provided. 2.4 Current nutritional status of South Africans 2.4.1 Areas of good progress 2.4.1.1 South Africa has achieved improved health outcomes with respect to conditions sensitive to primary health care. (a) Case fatality rate for severe acute malnutrition amongst children under 5 years decreased from 13.3% in 2011/12 to 8.9% in 2015/16. (b) The 2012 SANHANES-1 su rvey published by the Human Sciences Research Council (HSRC) in 2013 found that vitamin A deficiency among children under five years of age had decreased from 63.6% in 2005 to 43.6% in 2012. (c) The survey also showed that anaemia and iron-deficiency anaemia in children under 5 years of age had decreased by 63% and 83.2% respectively, compared to the findings of the National Food Comparison Survey of 2005. It found no cases of severe anaemia. (d) The survey also identified a significant decrease in wasting and being underweight in children under five. 2.4.1.2 SANHANES-1 attributes these significant achievements to the beneficial impact of the mandatory national Food Fortification Programme that came into effect in October 2003. This programme was introduced by the national Department of Health in response to the findings of the 1999 National Food Consumption Survey, which showed that one out of two children aged one to nine years did not meet half their daily requirement for several nutrients. The programme developed regulations for the mandatory fortification of all maize meal, and white and brown bread flour, with six vitamins and two minerals, (vitamin A, thiamin, riboflavin, niacin, pyridoxine, folic acid, iron and zinc). 2.4.2 Key challenges and constraints 2.4.2.1 While strides were made in reducing poverty and hunger in the country post 1994, on average the nutritional status of children is declining. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 27 Box 3: The nutrition situation in South Africa THE NUTRITION SITUATION The South African Health Review, published by the Health Systems Trust in 2016, determined that: • Close to one in four children in South Africa is stunted. • Almost half (43.5%) of children under 5 years of age are vitamin-A deficient. • Iron deficiency prevalence in children under 5 is 8.1%. • Anaemia prevalence in children under 5 is 10.7%. • Nearly a quarter (23.1%) of women of reproductive age are anaemic. • NCDs impose a large and continuously growing burden on the health, economy and development of South Africa, and currently accounts for a staggering 43% of recorded deaths. • In the year 2000, an estimated 7% of all nationally recorded deaths were attributed to excess body weight, while in 2004 NCDs linked to dietary intake, together with respiratory diseases, contributed 12% to the overall disease burden. • Approximately 2 out of 5 deaths in South Africa are attributable to non-communicable diseases (NCDs). • Mean body mass index (BMI) has increased between 1998 and 2012, for all ages, sexes and population groups. • Over a quarter (26.3%) of adults over the age of 15 have raised blood pressure. • Almost 10% of South Africans over the age of 15 have diabetes. 2.4.2.2 Although the number of nationally representative surveys is low, evidence from three national surveys (1999, 2005 and 2012) shows a concerning increase in malnutrition – both undernutrition and over-nutrition, which is clearly shown in Figure 1. Box 3: The economic costs of malnutrition The Economic Impact of Malnutrition The 2014 and 2015 Global Nutrition Reports show the economic impact of malnutrition: • Poor school performance and school attainment. Improving linear growth for chil-dren under the age of 2 by 1 standard deviation adds about half a grade to school at-tainment. • Lower productivity. Prevention of undernutrition in early childhood leads to hourly earnings that are 20% higher and wage rates that are 48% higher • Stunting. The cost of the existing stunting in Malawi was estimated to be 10% of an-nual GDP and it is estimated that stunted children earn 20% less as adults compared to non- stunted individuals. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 28 2.4.2.3 Stunting (-2 Standard Deviations (SD)), severe stunting (-3 SD), and severe wasting (-3 SD) among children have increased post 1994. According to the SANHANES-1, 26.9% of boys and 25.9% of girls aged 0-3 years old are stunted. The incidence of severe underweight (-3DS), the rates initially dropped between 1999 and 2005, but in 2013 have increased to above the 1999 level. In 2016, the South Africa Demographic and Health Survey (SADHS) conducted by Statistics South Africa (StatsSA) and the National Department of Health, found that stunting levels among children aged 0-59 months (<5 years) had reached 27%. 2.4.2.4 SANHANES-1 reflected that amongst South Africa’s preschool children (2-5 year olds) the prevalence of overweight, was 18.2% and that of obesity 4.7%. SANHANES-1 reported that 16.5% and 7.1% of girls were overweight and obese and 11.5% and 4.7% of boys were overweight and obese respectively. The average South African diet is energy dense but micronutrient poor13, putting individuals at risk of ‘hidden hunger’. SANHANES-1 found that 43.6% of the children under-5 years of age have vitamin A deficiency (a decrease from previous years). SANHANES-1 reflected that 33% of the children between 10 and 14 years of age had no food in the house to eat for breakfast and 29.8 % had nothing at home to put in the lunchbox to take to school. 2.4.2.5 In 2016, the SADHS found that the rate of overweight in children under-5 was 13%. 2.4.2.6 Female adult obesity (i.e. amongst females15-years of age and above) now stands at 41% (SADHS 2016), an increase from 24,8% in 2012 (SANHANES-1, 2013). A total of 26,6% of women were overweight in 2016. 2.4.2.7 Male adult obesity (i.e. amongst males15-years of age and above) was 11% in 2016 (SADHS 2016), compared to 11,2% in 2012 (SANHANES-1). A total of 20,3% of men were overweight in 2016. 13 Shisana et al., 2013 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 29 Box 4 Stunting – a key indicator for tracking nutrition and food security STUNTING Stunting as an indicator of chronic undernutrition is also an indicator for child poverty, as it reflects economic and social deprivation and whether children’s basic needs have been adequately met in their early years. Levels of stunting in South Africa have reflected 27% of children under 5. Without proper and timely intervention stunting is largely irreversible and the effects are long term and intergenerational. Stunting begins during pregnancy, results in life-long damage and may be passed onto the next generation. Women who are stunted are more likely to have obstructed labour, and are more likely to deliver low-birth weight. Stunted children have lower levels of educational attainment, reduced physical capacity, and poor resistance to infection and disease. In adulthood, stunting translates into diminished work capacity and a higher propensity to diseases such as diabetes, heart disease and hypertension. Stunting is correlated with levels of income, and low-income countries generally have higher rates of stunting. Those in the poorest sectors of these countries were at least three times as likely to be stunted as those in the richest. The Lancet Nutrition Series of 2008 concluded that 13 known interventions could reduce stunting at 35 months of age by 36%; mortality between birth and 36 months by 25% and; disability adjusted life years (DALYs) due to stunting, severe wasting, intra-uterine growth retardation (IUGR) and micronutrient deficiencies by 25%.If these estimates are applied to the South African data, the large-scale implementation of key evidence-based nutrition interventions country-wide could save an estimated 18 000 children under the age of 5 years from dying and contribute significantly to lowering maternal and neonatal mortality. Investing in nutrition will improve the gross domestic product (GDP) of the country through better school performance and increased productivity at work. Empirical evidence reflects the economic benefits of improving the nutritional status of the population in low and middle income countries, with a benefit cost ratio of 16:1 and a compound rate of 10%. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 30 2.4.2.8 Poor breastfeeding and complementary feeding practices. Both stunting and the increasing prevalence of overweight and obesity and poor intake of many micronutrients during the critical first 6 to 24 months period of life are, in part, a consequence of poor breastfeeding and complementary feeding practices and the poor quality of foods used during the complementary feeding period. 2.4.2.9 South Africa’s rate of initiation of breastfeeding within 24 hours of delivery increased from 45% to 83% since 1998 to 2013. However, the exclusive breastfeeding rate for infants <6 months in 2008 was recorded at 8%. In 2016, the South African Demographic and Health Survey (SADHS) conducted by the National DoH and StatsSA estimated exclusive breastfeeding rates at 6 months to be at 32%. 2.4.2.10 The IFPRI Global Hunger Index (GHI), based on (a) insufficient energy intake, (b) child underweight and (c) child morbidity, rates the severity of hunger in South Africa as moderate (GHI 12.4)14. 2.4.2.11 Adult nutritional status is also poor and requires attention. With respect to adult health profiles, SANHANES-1 concluded that Non Communicable Diseases (NCDs) require intensified national action including a strategic plan that addresses prevention, early detection, behavioural change and universal treatment. This was based on the following findings of this study: (a) Women of reproductive age had a vitamin A Deficiency (VAD) prevalence of 13.3%, reflecting a moderate public health problem of VAD. (b) Iron deficiency was present in 15.3% of women. (c) SANHANES-1 reported that 39.2% of adult women and 10% of men are classified as obese. (d) Amongst participants aged 15 years and older 10.4% were pre‐hypertensive and a further 10.2% had hypertension. (e) At the national level, one out of four participants 15 years and older had an abnormally high serum total (23.9%) and LDL‐cholesterol (28.8%), and one out of two (47.9%) an abnormally low HDL‐ cholesterol. (f) Diabetes was diagnosed in 9.5% of participants 15 years and older and almost one out of five participants (18.4%) had impaired glucose homeostasis. 2.4.2.12 In 2013, the health sector published and begun implementing the Strategic Plan for the Prevention and Control of Non Communicable Diseases 2013-2017, which outlines a comprehensive response to the growing contribution of NCDs to the burden of disease. 2.4.2.13 An independent evaluation of nutrition interventions for children under-5, commissioned by the DPME in 2014, compared South Africa’s response to nutrition with 5 countries which have successfully improved nutrition namely, Brazil, Colombia, Mozambique, Malaysia, and Malawi. The positive findings of the evaluation were that in South Africa, the right to food is entrenched in the Constitution of Republic of South Africa (No 108 of 1996) in (i) Section 27 (Bill of Rights): 1(b), (i) Section 28 (1c) and iii) Section 35 (2e). The evaluation acknowledged the importance of these sections of the Constitution, which deal with issues of access to food and nutrition. Also positive was that the evaluation found that South Africa has a good mix of health and nutrition policies which should address the immediate, basic, and underlying factors associated with poor nutrition. 14 Global Hunger Index, 2015 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 31 2.4.2.14 However, the evaluation found that South Africa has placed emphasis on food production and not nutrition or consumption of nutritious foods. It was further found that nutrition programmes have been not fully effective in reducing malnutrition because they focused primarily on providing food to the needy and do not effectively address the underlying causes of malnutrition. 2.4.2.15 The evaluation compared South Africa against five countries that have made substantial progress towards enhanced food security and nutritional status – Brazil, Columbia, Malaysia, Malawi, and Mozambique. All five countries were found to have a five fold competitive edge over South Africa, and had the following characteristics in common: (a) A single national leadership and governance structure for food security and nutrition; (b) A single national plan for food and nutrition security; (c) A single national budget for implementation of food and nutrition security Programmes; (d) A single national monitoring and evaluation system; (e) A single national set of indicators. 2.4.2.16 South Africa was found that have diverse legislation, policies, strategies, and programmes related to Food and Nutrition Security. A similar review undertaken by the University of Pretoria also found a plethora of government legislation, policies, strategies and programme, which were not integrated. These are reflected in Annexure 2. 2.4.2.17 The effectiveness of nutrition interventions for children under 5 in South Africa were assessed against the WHO High-Impact Interventions. Nine out of18 interventions scored positively for implementation effectiveness – mostly clinical interventions from DoH and ECD food support. The remaining 9 interventions scored significantly lower - mainly DoH behaviour change interventions and food access and agricultural interventions. This is reflected in Table 4 below. Factors contributing to strong implementation include: nutrition sensitivity/ specificity; nutrition expertise in health sector; clear targets for pregnant women/children under 5; and standard operating procedures/ guidelines. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 32 Table 4: High-impact nutrition interventions from the diagnostic evaluation of nutrition interventions for children under 5 years of age High Impact Interventions (Responsible Government Department) Total Effectiveness Score 1 Basic ante-natal care (BANC) – Education, supplements, timing (DoH) 81.3% 2 Food Fortification – vitamin A, Iron and Iodine (DoH) 80.0% 3 Early childhood Development (ECD) – Food in ECD centres 75.0% 4 Management of moderate malnutrition including targeted supplementary feeding (DoH) 68.8% 5 Oral Rehydration Salts (ORS) and Zinc (DoH) 68.8% 6 Micronutrient Supplementation including Vitamin A (DoH) 66.7% 7 Deworming (DoH) 66.7% 8 Management of severe acute malnutrition (SAM) (DoH) 66.7% 9 Integrated Management of Childhood Illnesses (IMCI) (DoH) 66.7% 10 Growth Monitoring and Promotion including use of mid upper arm circumference (MUAC) measurements (DoH) 50.0% 11 Access to (nutritious) food, food prices (DAFF,DSD) 50.0% 12 Breastfeeding support (DoH) 44.4% 13 Complementary feeding (DoH) 37.5% 14 Food access including food parcels, soup kitchens (DSD) 33.3% 15 Food security (DRDLR, DAFF) 25.0% 16 Nutrition education and counselling (part of all of these) (DoH) 22.2% 17 Improving hygiene practice including in relation to water and sanitation (DoH, DWAS, local government) 18.8% 18 Household food production and preservation (home gardening) DAFF,DSD) 18.7% Note: Using a scoring system that provided points for “yes” or “partially”, an implementation score for each intervention was obtained shown above. Half the interventions (N=9), received implementation effectiveness scores over 66%, mostly “clinical” interventions implemented by the DoH, along with ECD food. The remaining 9 had scores below 50% and these include all the DoH behaviour change interventions, food access, and agriculture interventions. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 33 2.4.3 What is to be done? 2.4.3.1 NFNSP 2018-2023 identifies nutrition specific interventions to address the immediate needs of the nutritionally vulnerable as well as those who require sustained efforts in order to achieve impacts on health. The provision of targeted high-energy and nutrient-dense nutritional supplements for women of reproductive age, people living with HIV & TB, and undernourished infants and children, have an immediate effect by improving nutritional status, reducing risk of infections, and improving ART adherence and efficacy. Maternal multiple micronutrient and energy supplementation have been associated with 32% reduction in small gestation births, 45% reduction in risk of stillbirths and an increase in birth weight. Supplementing pregnant women with iron is associated with a reduction in incidence of low birth-weight by 19%. Among infants and children under 5, the appropriate prevention and management of SAM could avert around 52 000 new cases of SAM each year in South Africa. 2.4.3.2 Despite significant progress in reducing infant mortality, South Africa has some way to go in lowering these figures to an acceptable rate. By simply ensuring that all newborns are breastfed within the first 24 hours, about 5 400 neonatal deaths can be avoided. The longer-term benefits of breastfeeding include reduction of infant morbidity and mortality, increases IQ score, improved school achievement, and boosted adult earnings - all essential for reducing poverty. It also contributes to equity by giving all children a nutritional head start for success in life.15 New estimates from the Lancet Breastfeeding series (2016) reveal that increasing breastfeeding to near- universal levels for infants and young children may save over 800 000 children’s lives a year worldwide, or equivalent to 13% of all deaths in children under two. 2.4.3.3 The timely introduction of safe and nutritional complementary foods to infants from 6 months reduces both stunting and underweight. Handwashing with soap is one of the most inexpensive ways of preventing diarrhea and lower respiratory tract infections. It has been estimated that diarrhea can be reduced by 45% if hand washing with soap at critical times is practiced. 2.4.3.4 Obesity in South Africa is ranked fifth as a risk factor for early death and years of life lived with the disability or disability adjusted life years (DALYS), this is followed by diabetes and hypertension, ranking 6 and 7 respectively. The cost of chronic disease, including obesity on the South African fiscus is said to have cost USD1.9 billion by 201516. The prevention of diseases resulting from poor lifestyle choices is critical. 2.4.3.5 A multifaceted approach starts with improving the nutritional status of adolescent girls and women to ensure that once they become pregnant they give birth to healthy children. It entails: (a) Strengthening support for early initiation of breastfeeding and exclusive (first 6 months) and continued breastfeeding (to 2 years or beyond); (b) Introduction of sufficient, high-quality and safe complementary feeding at 6 months; (c) Ensuring an adequate, safe water supply and proper sanitation for mothers and their children; (d) Healthy caregiving practices including hygiene behaviours are also vital. (e) These intervention areas will improve overall nutritional status and children will stand a better chance of reaching their full potential, and this will translate into economic benefits. 15 Victora CG, Bahl R, Barros AJD, et al, for The Lancet Series Group. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong eff ect. Lancet 2016; 387: 475–90. and Rollins NC, Bhandari N, Hajeebhoy N, et al, on behalf of The Lancet Breastfeeding Series Group. Why invest, and what it will take to improve breastfeeding practices? Lancet 2016; 387: 491–504. 16 Abegunde D et al. 2007. The Burden and Costs of Chronic Diseases in Low-Income and Middle-Income CountriesThe Lancet 370: 1929–38. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 34 2.4.3.6 School nutrition. An implementation evaluation of the NSNP (DPME, 2016) found that high proportion of learners eat the meals provided in schools regularly, 72.7% ate on the day of visiting schools. This implies that there is need to ensure that the quality of food is retained such that the learners receive the RDAs (30%) that the meals are required to provide. The evaluation, however, established for the schools that participated in the evaluation that: (a) 18.2% of schools served between 81% and 100% of the required amount of starch. This reflects notable improvement from the 6,1% of schools that were found to be providing the required levels of starch during the implementation evaluation conducted in 2008 by the Public Service Commission. (b) 8.6% of schools served between 81% and 100% of the required amount of vegetables in 2016, compared to 5,2% in 2008. (c) 21.4% served between 81% and 100% of the required amount of protein, an improvement from 3,4% in 2008 2.4.3.7 To influence a positive change in the nutrition and health of South Africans, a paradigm shift is required, from the facility based health service delivery model to greater community-based service delivery, as well as community ownership and participation. This will be implemented through a greater reliance on Community-based Workers, supported by Ward-Based Outreach Teams. 2.4.3.8 One of the contributory factors to the suboptimal nutritional status in South Africa is weaknesses in human resources. The current curricula for trainee dietitians and nutritionists are not aligned to the current disease burden in the country at a community level, as it fosters a therapeutic approach. 2.4.3.9 Greater emphasis must be placed on nutrition education and training. The identification of existing cadres of community based workers to be trained in nutrition and Water, Sanitation and Hygiene (WASH) practices, e.g. ECD and school-based food handlers; CHWs, CDWs, EPWP participants, Home-based Care Workers and, Masupatsela is necessary. This training must specify their roles and functions in relation to health and nutrition screening, and recording and referral in the community needs to be identified and strengthened. In addition, the in-service training in health and nutrition for current workers involved in nutrition needs to be scaled up to focus on prevention of ill health. It must be needs-specific, and role players from all sectors (e.g. food security and social protection) need to be capacitated in nutrition and WASH counselling. Therefore, the delivery of nutrition interventions needs a paradigm shift away from curative care to preventative, with decreased emphasis from facility-based to community-based support. 2.4.3.10 It is essential to reverse the shift in dietary patterns of the increasingly urban population. There is evidence of poor access to adequate nutritious foods at household level accompanied with poor food choices, including a decreased intake of legumes and vegetables combined with an increased intake of low cost energy dense foods, including added sugars and vegetable oils that are low in micronutrients, and limited dietary diversity. 2.4.3.11 Despite 26% of households experiencing hunger, 18.3 % of the respondents were found to be consuming high fat diets. 19.8% of respondents were found to be consuming high sugar diets. 2.4.3.12 SANHANES-117 reported that 64.5% of women stated that the price of food determined their food choices and that South Africans had poor dietary diversity scores, indicative of micronutrient deficient diets. 17 Shisana, et al., 2013 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 35 2.5. Current social protection measures to enhance food security and nutrition 2.5.1 Areas of good progress The right to Social protection of every South African is enshrined in the South African Constitution18 through the provision of social security for those who are unable to support themselves and their dependants. Other provisions with direct relevance to food and nutrition security are the rights to water and the progressively realisable right to food. In the case of children, special provisions that are articulated relate to social assistance and more specifically social grants have played a significant role in reducing poverty and the experience of hunger among a large proportion of South Africa’s households. However, it is widely accepted that although social grants assist in the short to medium term, they do not alleviate poverty. The NSNP is a state-funded social protection programme and an intervention to scale-up high impact nutrition targeting school-going children. The success of the programme relies on a range of stakeholders. Since so many children attend school, schools are excellent vehicles for health (nutrition) and education interventions. The DBE recognises that societal and other barriers have a direct bearing on poor education. Its vision as articulated in the Action Plan to 2014 wherein Goal 25 says that “schools should be used as locations to promote and provide access amongst children to the full range of health and poverty reduction interventions”.19 The NSNP provides one school meal daily to all the learners in Q1-3 primary and secondary as well as some special and Q4-5 primary and secondary schools. The programme has additional mandate of promoting schools food gardens and nutrition education for school communities and ensuring that the role players receive required knowledge and skills. 2.5.2 Key challenges and constraints 2.5.2.1 In general, Social Protection Programmes are constrained by lack of coordination and integration of systems, limited funding and significant deficit in human capacity and resources20. Within the context of food and nutrition security, programmes are spread across a number of government departments notably; the NSNP in the Department of Basic Education; nutrition supplementation in the Department of Health; social grants in the South Africa Social Security Agency (SASSA); food production support in the Department of Agriculture. Fisheries and Forestry and early childhood development (ECD) in the Department of Social Development. 2.5.2.2 Weak tracking, targeting, referral and monitoring and evaluation systems that have resulted in inefficiency, duplication and overlaps are a result of the fragmentation of existing systems and programs across a number of service delivery departments. 2.5.2.3 Birth registration at public health facilities is currently possible through mobile registration units, but the process is not streamlined and is often not utilised because the parents do not have valid identity numbers . 2.5.2.4 There is insufficient coverage of children receiving social grants within the age group 0 – 36 months. This exposes a large number of them to malnutrition because the mothers are not able to provide the required nutrition during this critical child development phase. An analysis of the costs of social grants found that Child Support Grant uptake for children aged 0-4 years is well below the expected levels and that of other age groups21. It is possible that poor registration of children aged 0- 4 years may be a contributing factor to poor social grant uptake. 18 Constitution, 1996 19 Department of Basic Education. (2010). Action Plan 2014: Towards the Realisation of schooling 2025 20 NPC, 2009 21 Baberton, 2015 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 36 2.5.2.5 If registration at birth, coupled with provisional registration for a Child Support Grant at the same location (a public health care facility), can be promoted and streamlined, mothers and children will have enhanced access to resources and by implication food during the first 1000 days. 2.5.2.6 An enhanced ability to track beneficiaries / end users will make it easier to refer individuals and households vulnerable to food insecurity and malnutrition to other programs and interventions that can contribute towards more sustainable changes of food and nutrition security interventions. 2.5.3 What is to be done? 2.5.3.1 Enhanced coordination of programmes across government, private sector and civil society through an integrated tracking system will reduce duplication and contribute towards more effective use of resources (human, financial, infrastructure). Furthermore, reduced ‘competition’ within and between departments and greater communication and participation is needed. An appreciation by all South Africans of the complementarities of roles and responsibilities and the shared ultimate target of reduced poverty and inequality are necessary. 2.5.3.2 Integration and coordination in service delivery is necessary to avoid wasteful duplication, but is a challenge given the multitude of players involved22. This is particularly true when integration is sought using paper-based technologies for example the piloting of the transition from multiple registers to a family folder in Ethiopia23. Technological advances have made it increasingly possible to overcome some of these complexities as evidenced by progress made in relation to IT-enabled social and economic transitions24. The use of health information technology is considered one of the key requirements for increasing the quality and efficiency of health care and there is evidence that this is indeed the case25. 2.5.3.3 Poor transport, other infrastructure limitations and limited service coverage especially in remote rural areas hampers the widespread application of technology in developing countries. This is particularly true in relation to computers and computer networks as well as telecommunication. The practise of transmitting basic information into central databases, using smart phones and other mobile devices, is increasingly being used to overcome these challenges26: (a) The most widely used application in health sciences is the use of mobile technology by consumers to obtain health information27; by health professionals to aid diagnoses and continued learning28 and by health workers to transmit basic health information to a central point29. (b) In the field of agriculture, mobile technology is being used to enhance marketing processes30 and as a source of technical information31. A study conducted in India found that more than 75% of the farmers participating in the study indicated an improvement in services since the introduction of mobile phone technologies as part of agricultural extension32. (c) Other applications include the use of mobile device technology for commerce, the transfer of money, banking and other economic transactions33. 22 Bodenheimer, 2008 23 Damtew and Moges, 2013 24 Aker and Mbiti 2010, Tenhunen 2008 25 Chaudry et al., 2006, Hillestad et al., 2005 26 Paris21 2014, OECD 2013 27 Zhaohua et al., 2015 28 Chaudry et al. 2014, Ajiboye et al., 2014 29 Sanner et al., 2014 30 Aker, 2010 31 Simpson and Calitz, 2014. 32 Fua and Akterb, 2012 33 Mallat and Tuunainen, 2008 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 37 (d) One of the reasons why social protection initiatives in South Africa have not reached optimal coverage in especially rural areas has been because of the difficulties of reaching populations in remote areas because of poor infrastructure e.g. transport difficulties. It is believed that a mobile-device-based information system will improve the ability of community and institution-based workers, working in the field of nutrition and food security, to achieve greater connectivity, improve tracking, targeting and referrals, provided that work is based on unique identifiers for example an end user/ beneficiaries identity number. Once ID numbers become a prerequisite for accessing social protection services, complimentary activities for example the process to update and obtain birth certificates and identity numbers need to be further streamlined. (e) If registration of births at public hospitals is promoted prior to a mother giving birth, it is believed that uptake of social grants amongst children 0-3 years will improve in addition to enhancing the use of the integrated information system through the use of unique identifiers such as an identity number. (f) The DOH and DHA have established an important initiative to ensure real time registration of births. It is imperative that all hospitals and health facilities that conduct deliveries in the public sector are eventually linked to the DHA server and to Stats SA systems to improve real time birth registration. Alternative ways of encouraging registration at birth system will also need to be devised for South African mothers without documentation and for those not giving birth at a public health facility. 2.5.3.4 A process of mapping and evaluating current systems and registers with the view of making them more food and nutrition security sensitive must precede the actual development of an integrated system. (a) This will require not only IT and data management technical expertise, but also food and nutrition security related expertise. (b) Once implemented the proposed programme will also require that health care workers and professionals acquire new skills and behaviours that will facilitate the technological transition. (c) It is envisaged that a continual investment in process improvements and business process managers may be required34. 2.5.3.5 Linkages between the Child Support Grant and the Learner Unit Record Information and Tracking System (Lurits) database will enable schools to do in- school targeting for the NSNP. (a) This will result in savings which can then be deployed towards extended nutritional support to poor and vulnerable children over weekends and school holidays. (b) Once children are in the system, additional support packages such as the distribution of seed and tool packages for food production can be channelled more effectively towards them and their households. (c) Children that are currently treated for malnutrition at health care facilities are not always linked during rehabilitation phase with other food and nutrition security related support mechanisms. These mechanisms that exist in the communities could enhance mother’s nutrition education or provide additional food and nutrition security support to the household. This could be either through civil society organisations, community support programs or public programs. (d) The Integrated Food Security and Nutrition Programme (INFIS) will provide a referral mechanism that will maximise support and care to the child, mother and household. 34 Walker and Carayon, 2009 and Blumenthal, 2009 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 38 2.5.6. Better coordination with the Expanded Public Works Programme is necessary to ensure integration of this registration system with social protection opportunities to improve food and nutrition security. 2.6. Provision of safe food as a pillar to food security and response mechanisms to unsafe food South Africa is known for numerous agricultural and associated health challenges. Some of these challenges include: high post harvest losses, limited processing, inadequate access to markets and finance as well as low investment into food and agricultural research, training and extension services. Basically, various populations in sub-Saharan Africa are exposed to health hazards in their diets, directly and/or indirectly through the consumption of unsafe foods or the unavailability of safe foods as evidenced by the world’s largest outbreak of Listeriosis in South Africa in 2018. In 2015, Oxfarm estimated that a staggering third of all the food produced in South Africa is wasted, at a cost of R60-billion a year, equal to 2% of South Africa’s gross domestic product (GDP). Food safety and food security are interrelated concepts with a profound impact on quality of human and animal life and there are many external factors that affect the two areas. The interrelationship between food safety and food security is shown in figure 2. The strengthening of food safety as a pillar of food security seek to protect animals and the public from public health hazards, without creating unnecessarily stringent regulations which would hamper, in particular, small agricultural production and market access. Figure 2: Interrelationship of food safety and food security Poverty Food Safety Food Security Climate Change Food Utilisation Food Access Food Availability Raw Materials Pathogens Processing Cross Contamination 2012 Nature Education N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 39 Transforming the nation’s food safety system by shifting the focus from responding to foodborne illness to prevention has become the focus of governments and the food industry. The realization that preventable foodborne illness is both a significant public health problem and a threat to the economic wellbeing of the food system has led to domestic and international respond to the dramatic changes in the global food systems. The safety of food derived from agricultural products is an important component of food security with a complex interconnectivity between the institutions sharing the regulatory responsibilities in South Africa. The complex interconnectivity requires a collective effort in the development, implementation and enforcement of food control. Confidence in the safety and integrity of the food supply chain is an important requirement for consumers. Consequently, consumers expect protection from hazards occurring along the entire food chain from farm-to-table continuum. The responsibilities for the food safety control in South Africa lies between different regulatory Departments and agencies within the different tiers of Government. Consequently, implementation of food safety measures suffers a lot of challenges and set backs due to challenges in overall coordination, sometimes misunderstanding over jurisdiction of the Institutions. Effective food safety control system involves enforcement of mandatory safety and quality requirements along with training and education, and community outreach program. Consumer protection will only be effective if all sectors involved in the food control system operate in an integrated way and the food control system addresses all stages of the food value chain. A well planned and structured food control system would give rise to a suitable national system developed in line with international best practices and harmonized with Codex Alimentarius Commission standards and WTO requirements taking cognisance of the country situation. An integrated national food safety control system that covers all food produced, processed and marketed domestically, including imported and exported food, having statutory basis and mandatory in nature is therefore needed for South Africa. Effective national food control should contain key components such as food legislation and regulation, policy and institutional framework, food inspection and monitoring, laboratory services with involvement of all stakeholders and dissemination of information to them. The principles based on Hazard Analysis and Critical Control Point (HACCP) system supported by robust Good hygiene practices and pre-requisite programs should be applied during the preparation, production, handling, storage, processing, preservation, transportation and distribution of foods. The current national food safety system is fragmented and in some instances legislation is outdated, consequently putting lives at unnecessary risk. Weaknesses and gaps in the inter and intra-departmental cooperation on food safety and fraud prevention and the maximization of personnel and resources related to examination and inspection of food products of agricultural origin in line with the domestic and international law have not been addressed. In South Africa, the full extent of the burden and cost of foodborne diseases associated with foodborne illness in human and animals is still unknown and there are no defined public health goals for the commonly known food safety issues. 2.6.1. What is to be done? To ensure safe food that guarantee food security in the context of production, handling, processing, storage, import, export, marketing and service in food, the following response mechanisms and multistep interventions will be implemented, led by the Department of Agriculture, Forestry and Fisheries (DAFF) working with other departments N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 40 2.6.1.1. Establishment of an interim National Food Safety Council of South Africa under the Presidency to assist in conducting a feasibility study for the establishment of modern institutional arrangement(s) for national food control that consolidate all food control components to provide focused centralized leadership, a primary voice on national food control and enforcement of standards, better allocation of resources, and clear lines of responsibility and accountability. 2.6.1.2. Development of an integrated food and feed control policy and the harmonization of all legislation for food of agriculture origin along the entire value chain; 2.6.1.3. Innovation of the entire food chain with emerging technology to ensure sustainable contribution of food of agricultural origin to rural development. 2.6.1.4. Establishment and implementation of food control good practices including: (a) Establishment of an integrated centre(s) on Sanitary and PhytoSanitary risk analysis in South Africa; (b) Development and implementation of a food product identification and traceability system; (c) Establishment and implementation of a program for revitalization of national laboratory infrastructure and accreditation to ensure that South African food testing laboratories meet high- quality standards. (d) Establishment of mandated systems of inspection, records access, mandatory recall, expanded administrative detention, third party certification, qualified importer program and importer accountability and accreditation requirements of inspection bodies. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 41 CHAPTER 3: Approach to the Development of the NFNSP 2018-2023 3.4 Mission To significantly improve food security and reduce malnutrition in all its forms to afford South Africa’s people opportunities to lead productive and healthy lives 3.5 NFNSP goals The immediate goal is the establishment of a governance and leadership system to mobilise the both the government and non-state actors behind a single integrated national plan to address food and nutrition security in South Africa. 3.6 NFNSP 2018-2023 Strategic Objectives 3.6.1. Establish a multi-sectoral Food and Nutrition Security Council to oversee alignment of policies, coordination and implementation of programmes and services which address food and nutrition security 3.6.2. Establishment of inclusive local food value chains to support access to nutritious and affordable food. 3.6.3. Expand targeted social protection measures and sustainable livelihood programmes 3.6.4. Scale up high impact nutrition interventions targeting women, infants and children. 3.6.5. Influence people across the life-cycle to make informed food and nutrition decisions through an integrated communications strategy 3.1 Background The development of the National Food and Nutrition Security Plan (2018-2023) was mandated by the Cabinet of South Africa following the approval by Cabinet of: (a) The Food and Nutrition Security Policy for South Africa, developed jointly by various departments under the leadership of the DAFF and (b) The report on the Evaluation of Nutrition Interventions for children under-5 in April 2015, commissioned jointly by the Department of Planning Monitoring and Evaluation (DPME) and the Department of Health (DoH), as part of the National Evaluation System. 3.2 Approach to the NFNSP 2018-2023 The NFNSP 2018-2023 is a culmination of consultations and deliberations undertaken through a number of processes that included a wide range of stakeholders. In response to directive from Cabinet in April 2015, an Intersectoral Central Planning Team was established in May 2015 to develop the Plan. The Team was led by the Office of the Deputy President and the DPME. It was comprised of relevant government departments, UN agencies and development partners. Several workshops were convened to consider the available evidence; reach consensus on the key challenges and opportunities; assess available policies, programmes and strategies from the various national departments and; draw lessons from international best practice. 3.3 Vision of the NFNSP 2018 2023 Optimal food security and enhanced nutritional status for all South Africans. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 42 3.6.6. Develop a monitoring and evaluation system for FNS, including an integrated risk management system for monitoring FNS related risks 3.7 Focus of the NFNSP 2018 2023 In accordance with the directives from the Government of South Africa, the Plan focuses on the following imperatives: 3.7.1 Ensure visible leadership; improved integration across government departments and; strengthening the management of existing food and nutrition security programmes at all levels; 3.7.2 Draw comprehensive lessons from international best practices on successful interventions addressing food security and nutrition challenges; 3.7.3 Draw lessons and expanding best practices from integrated approaches for addressing hunger, malnutrition and micronutrient deficiencies in South Africa, such as Operation Sukuma Sakhe in KwaZulu Natal Province; 3.7.4 Consistent improvement of hygiene practices associated with improving nutrition (such as the washing of hands); 3.7.5 Include food and nutrition security in school curricula and ensuring that key food security and nutrition messages are incorporated into education programmes aimed at communities; 3.7.6 Provide continuous skills development for food and nutrition security, health and development workers; 3.7.7 Fast-track the finalization and implementation of a regulatory framework for restricting marketing of unhealthy foods to children and households; 3.7.8 Effectively implement food security and nutrition interventions as part of the package of Social Protection measures provided by the State; 3.7.9 Strengthen referral systems between government departments to ensure seamless provision of food security, nutrition, health and social support to children and households. 3.7.10 Establish a National Food and Nutrition Security Commission (or equivalent structure), which includes all key government departments responsible for preventative and promotive components of the country’s nutrition response, to proactively steer the implementation of the Plan; 3.7.11 Ensure that the Commission extends its’ work beyond the current health and social development interventions and incorporates all determinants impacting on nutrition outcomes (including but not limited to poverty, water and sanitation, human settlements and, agriculture). The Plan has been designed to address food and nutrition security issues holistically, while paying special attention to the pre conception period, the first 1000 days of life, Early Childhood Development (ECD), and Grade R. It also addresses all nutrition issues pertinent to children, in various environments, including households, communities, schools and Primary Health Care settings. The NFSN Plan 2018-2023 will be implemented nationally, but will focus largely on the most deprived districts across the 9 Provinces, in keeping with the principles of equity. Several assumptions have been made in setting the Plan and it is acknowledged there are risks associated with the commitment and accountability of various stakeholders and that the country’s economic and political stability and weather-related shocks may impact on the implementation of the Plan. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 43 3.8 Theory of Change This section provides two theories of change, the first focuses on food security and the second on nutrition related lifestyle behaviours. 3.8.1 Food security pathways There are three main pathways of nutrition sensitive agriculture to nutrition outcomes: food production, agricultural income and empowerment of women. These pathways are themselves interrelated, are also linked with other interventions and interact with enabling environments such as the natural resource base and cultural practices. Figure 2 below, designed by Feed the Future, provides a schematic view of these pathways. They consist of: (a) Food production, which is essential for sustained food availability for household consumption (diet quality and quantity) as well the price of diverse foods; (b) Agricultural income which enables expenditure on food and non-food items. Based on the assumption that increase in income from agriculture related activities (including processing and sale of agriculture products or wages earned) will be used to purchase nutritious food for the household; (c) Empowerment of women in the agricultural sector, which affects income, caring capacity and practices, and female energy expenditure. Many interventions will affect one or more aspects of women’s empowerment. Figure 2: Conceptual pathways between agriculture and nutrition The Plan focuses on two pathways, namely food production and agricultural income. Emphasis is on increasing small scale food production and the establishment of inclusive local food value chains that would enable households to access nutritious affordable foods and earn an income. 3.8.2 Conceptual Framework: benefits of optimal nutrition Figure 3, adapted from UNICEF, provides a schematic representation of the benefits of optimal nutrition during the life course, influenced by both nutrition-sensitive and N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 44 nutrition-specific interventions. These benefits include decreased childhood morbidity and mortality; enhanced cognitive, motor, and socio-emotional development; improved school performance and learning capacity; decrease in obesity and Non-Communicable Diseases (NCDs), as well as improved work capacity and productivity. The pathway to the benefits of optimal nutrition entails a dynamic interaction between nutrition- sensitive and nutrition specific interventions. Nutrition-sensitive interventions include agriculture and food security, social safety nets ;early childhood development, maternal mental health, women’s empowerment, water and sanitation, childhood protection, and health and reproductive services. Nutrition-specific interventions, on the other hand, encompass a package of interventions along the entire life cycle. These include adolescent health and preconception nutrition, micronutrient supplementation, breastfeeding and complementary feeding, treatment of severe acute malnutrition, and disease prevention. The dynamic interaction between these interventions requires an enabling environment, which includes leadership, capacity and financial resources; proper governance; and use of knowledge and evidence. This enabling environment facilitates the implementation of nutrition sensitive interventions, which results in improved food security; feeding and care-giving resources; access to and use of health services, as well as hygienic practices. These in turn result in enhanced breastfeeding, availability of nutrient-rich foods; improved feeding and caregiving practices, and a low burden of disease. Figure 3: Conceptual Framework: Benefits of optimal nutrition N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 45 3.8.3 Nutrition-related ill-health Optimal child-growth requires adequate energy and nutrient intake, absence of disease and appropriate care practices. Poor living conditions, including household food security, low parental education, lack of access to quality health care and an unhealthy living environment are among the main determinants of stunted growth. Poverty has been shown to have a more detrimental effect on linear growth than on body weight (Black et al, 2008). Child stunting is associated with higher morbidity and mortality, shorter stature in adulthood, lower education attainment and reduced productivity in adulthood. The first 1000 days, from conception to child’s second birthday, is the critical period for growth and development, having a significant influence on adult height and brain development. Investment during this period have the highest returns, with an average of between 7 and 10% greater than investment made at older ages (Carneiro and Heckman, 2003). Investing in early childhood nutrition interventions offers a window of opportunity to significantly increase human capital; mitigating the deleterious effects of poverty and social inequality; ultimately leading to long-term benefits for children, their families and society as a whole. Thus WHO and UNICEF recommended the following optimal feeding practices to ensure optimal growth and development: early initiation of breastfeeding within 1 hour of birth; exclusive breastfeeding for the first 6 months of life; and introduction of nutritionally-adequate and safe complementary (Solid) foods at 6 months together with continued breastfeeding up to 2 years of age or beyond. In addition, care practices, good hygiene and safe food handling ensure reduced risk of infection and diarrhoeal episodes. Improving maternal nutrition is key to reduction of stunting and the focus should be scale up maternal nutrition intervention, which also targets adolescents. Intervention targeting women of reproductive age such as iron and folate supplementation, as well as the prevention and treatment of infections and nutrient supplementation during pregnancy are key. According to Black and Bhutta, 2013; intrauterine growth restrictions due to maternal undernutrition (estimated by low birth weight) accounts for 20% of childhood stunting. Unhealthy diets, especially those high in saturated fats, sugar and salt, are one of the risk factors for non-communicable diseases. The risk starts in childhood and builds up throughout life. Improving nutrition in the first 1000 days (the period from conception through the first two years of life) has a profound impact on child health and development by averting stunting, overweight and obesity. Poor infant-feeding practices due to limited parental knowledge, coupled with exposure to advertising of unhealthy foods to children, can influence parents and children’s food preferences. Several strategies specifically targeting promotion, protection and support of exclusive breastfeeding, appropriate complementary feeding practices and the monitoring of growth (weight and height) in childhood have been implemented in South Africa. Furthermore, Government has promulgated regulations concerning the labeling and advertising of foods which address, among other things, the advertising and marketing of foodstuffs to children. However, these initiatives are not widely communicated and their coverage is limited to events and workshops, leaving most of the population without correct nutrition information. The escalating prevalence of obesity in South Africa has occurred in conjunction with urbanisation and an increase in sales of sugar-sweetened beverages (SSBs) and high caloric, energy-dense foods. A mathematical model by academics from the University of the Witwatersrand indicated that a 20% tax on SSBs could positively impact on the burden of obesity in South Africa, particularly in adults, as one component of a multi-faceted N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 46 effort to prevent obesity.35 The government has announced that it intends to introduce a tax on SSBs on 1 April 2017 in a bid to help reduce excessive sugar intake. Mexico enacted taxation on SSB in January 2014 and according to the Mexican National Institute of Public Health and the University of North Carolina, the tax resulted in a reduction in purchases of SSB by an average of 6% in 2014. Despite various interventions such as regulations, policies and healthy lifestyle campaigns, obesity prevalence has continued to escalate in South Africa. This is because the efforts were not matched with transformative actions that intend to change behaviour and the food environment in various settings such as schools, ECD centre and public spaces. This warrants a radical adoption of interventions that will influence change in these and settings. 3.9 Target population groups for the NFNSP The NFNS Plan 2018-2023 seeks to benefit all South Africans. However, special emphasis will be placed on the preconception period or the first 1000 days of life; Early Childhood Development and Grade R learners; and children of all ages, in various environments including households, communities, schools and primary health care settings. Geographically, interventions will be concentrated in the 27 most deprived districts, identified by COGTA and DAFF, and approved by Cabinet. 3.10. Risk analysis and implications In an attempt to predict what the South African food system would look like in 2030, the FoodLab36 conducted a participatory workshop with 50 stakeholders from the South African food industry, government, civil society and academia. The aim was to conceptualise four different transformative scenarios, taking into account the current realities and predicting the future of our food system, summarised below: (a) Scenario 1: Root of the matter: Food as a natural resource explores a case where a severe dry-weather cycle makes the natural system upon which food production depends even more vulnerable. The scenario is driven by climate change, a crisis in water quality and quantity, and energy insecurity, resulting in compromised quality of export crops; job losses in agriculture sector, endangered honeybee species threaten crop pollination, state expenditure on food is diverted to nuclear infrastructure, decreased crop yields, global drought pushes up the prices of staple foods and air quality damaging crops. (b) Scenario 2: Seeds of possibility: Food production considers a situation where land reform does not move fast enough, resulting in land invasions. The scenario is driven by land ownership pressures, climate variability and currency volatility – resulting in the depreciation of the rand pushes up farmers’ input costs; electricity, water and wage costs have a negative impact on poorer farmers; the variable climate affects the production of farmers who are less able to adapt; land reform uncertainties discourage commercial farmers’ investment in fixed assets; land invasions and political uncertainty prompts an exodus of commercial farmers; the production of staples declines globally and locally due to warmer weather. (c) Scenario 3: Kernels of truth: Food in the political economy explores a situation where rising living costs and broken government promises catalyse a powerful and organised national response from those most affected by hunger. This scenario is driven by food prices and the affordability of food in the South African context, hunger, organised social movements and the relationship between 35 Chola et al. 2014 36 http://www.thefutureoffood.co.za/ N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 47 the market and the state. The results being a depreciating rand and rising oil and electricity prices push up food prices beyond affordable thresholds. (d) Scenario 4: Empty husks: Food as nutrition considers a case where the crisis of malnutrition significantly dents South Africa’s economic growth and social prosperity. It is driven by urbanisation, low education outcomes, a growing burden of lifestyle diseases, increased nutrition awareness and increased food regulation by the state. The scenario predicts an acceleration of urbanisation and the spread of informal settlements; more research and advocacy on food security and nutrition produce a burgeoning body of evidence on the shortcomings of the current approach; a growing lifestyle disease burden, underperformance in education and low workplace productivity, despite major investments in each, turn the spotlight on nutritional deficits and the unhealthy eating habits of South Africans, across class. The risks highlighted in the above four scenarios accentuate the importance of Government developing appropriate risk mitigation strategies, in collaboration with its stakeholders. The current drought in South Africa and the consequent increases in food prices that impact most severely on the poor can catalyse a powerful and organised national response. Through the disaster relief funds of government, resources have been provided to farmers to counteract the impact of the drought. Constant and consistent risk monitoring and mitigation systems must be developed for the long term. Improving the food and nutrition security status of South Africans is fundamental to achieve the three core aspirations of the National Development Plan (NDP): to end poverty, inequality and unemployment. Malnutrition is a significant drain on individuals, households, communities and societies. Under-nutrition leads to the intergenerational perpetuation of poverty and under- development. Over weight and obesity place significant drain on health systems and predispose individuals to a range of health risks. Micronutrient deficiencies deprive people of productive energy and well-being. 3.11 Responding to the risks The case for investing in food and nutrition security is strong. The economic benefits of improving food and nutrition security in low and middle income countries, has a cost benefit of 1:1637. While the costs of not acting are far higher at all levels, if one considers the economic cost of lost productivity and income at individual, household and community levels and to the country as a whole, as well as the cost associated with ameliorating the consequences of food insecurity and malnutrition. For the purposes of efficiency and to ensure that investments have an impact, high-level coordination and leadership is essential. Coordination of programmes and activities and a sound monitoring and evaluation process that leads to continual reflection, assessment and adjustment of the Plan are vital. 37 Global Nutrition Report, 2015. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 48 CHAPTER 4: Game Changers in the NFNS Plan (d) Use of community-based workers to extend the reach of services and nutrition education to households and communities where appropriate; (e) Best practices exist of coordinated case management at local level for food insecure and malnourished households and individuals (e.g. OSS); (f) Use of mass media communications and road shows to spread nutrition messages. These practices should be expanded, strengthened and replicated across the country. 4.3 Challenges to be addressed by the NFNSP The NFNS Plan 2018-2023 seeks to address the following concerns arising from the evaluation of nutrition interventions for children under-5 years: (a) South Africa has placed emphasis on food production (quantity) and not nutrition or consumption of nutritious foods (quality and diversity); (b) Compared to 5 comparison countries, South Africa does not (yet) have a single or coherent strategy, policy or regulatory system to realise the right to food as set out in the Constitution, to facilitate and ensure food security for all its citizens; (c) There is also no coordinating body above line ministries which can hold them accountable in terms of their contribution to nutrition; (d) There is no annual mechanism to track progress, highlight bottlenecks, raise the profile of issues and hold stakeholders accountable; In summary, South Africa does not yet have the following factors that are considered best practice in ensuring food and nutrition security: 4.1 What is unique about the NFNSP? The Plan builds on the key interventions of government and its social partners which have proved successful to date, but also reflects a radical departure from the inefficiencies of the past. The plan adopts an evidence based approach that reviews good practices of government and its social partners over the 21 years of democracy, but also proposes rationalization and amalgamation of existing programmes, and discontinuation of programmes that are duplicated or not yielding the desired results. As a sign of its commitment to food and nutrition security, the development, implementation and monitoring of the Plan by the National Council on Food and Nutrition Security falls under the jurisdiction of the Deputy President. 4.2 Existing good practices The independent Diagnostic Evaluation of Nutrition Interventions for children under 5, completed in 2014, identified the following best practices: 4.2.1 South Africa has a good mix of health and nutrition policies which have the potential to significantly step up the contributions to the immediate, basic, and underlying factors to accelerate improvements in nutrition. 4.2.2 Existing enabling factors for implementation include the following: (a) Nutrition is strategically important and an integral part of provincial war on poverty (Sukuma Sakhe Model) (b) Common understanding exists on the central role nutrition plays in poverty alleviation (e.g. in KZN); (c) A common operational plan and approach across sectors (as seen KZN with Operation Sukuma Sakhe - OSS); N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 49 (a) One national leadership and governance structure for food security and nutrition (such as SANAC for HIV); (b) One comprehensive, integrated National Food and Nutrition Security Plan; (c) One budget for food security and nutrition; (d) One Monitoring and Evaluation (M&E) framework for food security and nutrition; (e) One set of indicators for food security and nutrition; (f) One set of coherent legislation pertaining to food and nutrition security. 4.4 Approach taken by the NFNSP 2018-2023 As a result of extensive review and consultation, the new Plan adopts the following approach: (a) Review of existing programmes; (b) Identification of gaps in implementation; (c) Development of new interventions, where this is necessary; (d) Identification of short-term; medium term and long term intervention measures; (e) Acknowledgement that the Development of the Plan occurs against the backdrop of a crisis - the worst drought experienced in South Africa in a century; (f) Taking cognisance that the Plan needs to respond to the immediate needs but must also put in place measures for the future to ensure sustainability. 4.5 Six levels of analysis adopted by the NFNSP 2018-2023 Drawing on the work of the UN agencies [e.g. Food and Agriculture Organisation (FAO); the World Health Organisation (WHO) and UNICEF], the development of the Plan examined food and nutrition security issues in South Africa at six levels: (a) Policy level with the objective of analysing the food and nutrition security policy framework; (b) Institutional level with the objective of analysing the major institutions and stakeholders in the public, private and academic institutions that deal with various aspects of food and nutrition security, focusing on their roles; (c) Programmatic level with the objective of analysing the different interventions for addressing food and nutrition security being implemented by different institutions; (d) Food and nutrition security statistics and information with the objective of creating an enabling environment to deliver a structured food and nutrition security information system that provides a timely and robust analysis of the food and nutrition security situation at all levels; (e) Governance structures for coordinating food and nutrition security with the objective of analysing the structural reporting and accountability mechanisms with respect to food and nutrition security matters, including the involvement of civil society: (f) Alignment with the objective of ensuring alignment of policies, institutions, programmes, information management systems and governance systems to global and regional processes directed at achieving food and nutrition security. 4.6 Primary areas of focus The establishment of inclusive local food value chains aims to support access to nutritious affordable food The six primary strategic objectives of the Food and Nutrition Security Plan are intertwined focal areas that seek to create a balanced livelihood system for the benefit of households and communities. The envisaged outcome of such an intervention will be self-employment, participation in the local economy and reducing the negative impact of poverty while promoting the right to food. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 50 The Department of Agriculture Forestry and Fisheries is implementing a myriad of interventions based on a demand and supply principle. It is thus imperative, if the local economies are to be strengthened, to initiate supply consolidation interventions to optimise current initiatives and the following key principles and outcomes will be consolidated to attain the self-employment, participation in the local economy and reducing the negative impact of poverty in both the rural and urban spheres. 4.6.1 Localisation of interventions (a) The objective of developing inclusive local value-chains is to increase internal production and thus lessen importation of produce into a defined economic radius (an optimal radius for most agricultural produce is estimated at 60km to, in extreme cases, 100km). Thus, promoting the provision of additional production infrastructure and secondary infrastructure to aid the flow of produce within a confined space is paramount to limit the distribution costs and handling costs of produce. The primary focus of the operation is to enable communities and producers to take advantage to government market platforms and by extension distribute and store food for the benefit of local households and communities. (b) The impact of minimal costs will translate into reduced produce prices and thus easier access by most community households. The capacity to exploit communal production sites will be enhanced over time through vocational training and behavioural change management, especially when niche production possibilities are identified and taken advantage of. The latter will be based on opportunity cost analysis. (c) The introduction of climate-smart agriculture (production optimisation technologies and ecological adaptation practices, etc.) and of adaptive species into value chains will further aid in mitigating the impact of the drought phenomenon. It is thus imperative to scale up the implementation of production technologies (open pollination seeds, water harvesting and recycling, etc.) for the benefit of communities and consumers. (d) Rapid urbanisation (interpreted as increase in residential sites in rural spaces) has a direct impact on the rangelands (animal grazing fields) and less cultivation activities. Thus extensive production systems will constantly be challenged to produce more from less land hence the need to opt for intensive production systems. The latter will include production tunnels (increase of production season), artificial pasture (increase the forage and development of forage bank); solar energy or any alternative energy (reduction of input cost) and these activities if effectively implemented will positively impact on the retail price of produce. Given that there are initiatives already funded and implemented; the change management focus should be used to spearhead the entry point into communities, with the aim of ensuring optimal participation and understanding by participants. It is further important to be mindful of designing exit strategies which will ensure that ownership of activities is with communities or households. The increase of produce, place utility and optimisation of inputs, and provision of supporting infrastructure for storage and distribution will contribute towards ensuring availability and access, while ensuring a steady income flow into households for better livelihood management systems. Strategic Objectives 1, 2 and 6 will be reinforced to accommodate the key areas as defined by Cabinet resolution: (a) The terms of reference, especially the composition and focus of the District Municipality Councils should allow for constitution of a technical team to ensure inclusion of proposed supply driven interventions in the Integrated N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 51 Development Plans and the Municipal Infrastructure Grants (MIGs). (b) The Strategic Objectives should ensure inclusion of producer registration (physical position, production capacity, expansion probability, etc.) and mapping of current interventions. The data should further be used to determine placement of secondary infrastructure to ensure collection and distribution channels of procured produce. (c) The determination of risks as outlined in Strategic Objective 6 should be enforced, to minimise possible losses or to enhance the implementation of mitigation strategies to be defined during area-wide risk assessment activities. 4.6.2 Factoring in rapid urbanisation and consequent poverty There are currently high levels of food insecurity in South African cities. The General Household Survey, 2016 found national prevalence of households at risk of hunger to be 11.8% and individuals experiencing hunger, 13.8%. The equivalent figures in urban informal areas were 32% and 36% respectively. The figures are reinforced by case studies which consistently show high levels of food insecurity. With regard to trends: nationally, food insecurity was in decline, but it appears to have plateaued. Ever-increasing food prices and other price shocks suggest that levels of urban food insecurity are unlikely to improve. Urban food insecurity is characterised by low dietary diversity, high malnutrition and obesity, and distinct hunger seasons. This is caused by both household and extra-household scale factors including: Household income, income stability, household structure, and household asset base. The extra-household scale factors include geographic access to a range of sources of food, access to transport and stability of food prices. Households themselves engage in strategies to mitigate food insecurity, which may increase household vulnerability to food insecurity in the longer term. These include consumption smoothing and accessing credit. 4.6.3 Food systems Food insecurity is fundamentally linked to the structure of the food system. This provides an increased scope for municipalities to develop food security policies and programmes as the food system is clearly impacted by work conducted under existing mandates. South Africa is food secure at a national scale, meaning that it currently either produces sufficient food or can import sufficient food to meet the food needs of its residents. However, the food system has become increasingly consolidated in the last two decades. South African agriculture has become more export oriented and is increasingly dependent on imports. There are concerns about the increased presence of highly processed foods as a result of this, and about exposure to price fluctuations. A further concern is that the deregulation of the food system has made it harder to track food within the system, thus generating critical data gaps which make governance more difficult. Much of the focus on food security at the national scale has been on production, despite this being only one aspect of the system that delivers food to the urban poor. Many components of the food system operate in and around urban areas (production, warehousing, logistics, Fresh Produce Markets, processing, retail). There is therefore a major opportunity for local government to influence the food system. Peri-urban agriculture (commercial and subsistence) potentially plays a role in generating food system conditions that can enhance food security. However, this land is under considerable development pressure. There is a need for local government to pro actively include food production and the food system in land-use decision making. Local government should view food production along a continuum from household production to commercial agriculture and develop an understanding of the role that agricultural land can play in achieving broader municipal objectives. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 52 Households depend on a range of formal and informal retailers to access food at different points in order to maximise their potential food security. It is therefore imperative that both formal and informal retail are viewed as critical nodes in the food system; planned for and supported accordingly. The food system is dependent on several other systems (energy, water, transport, space) and is therefore vulnerable to a number of mega-trends. Strategies to increase food system resilience at the local scale should be supported. 4.6.4 Policy An overview of key national policies which inform Provincial and Local Government responses to food insecurity is part of the NFNS plan. These national policies and strategies focus on production-based or safety net-based solutions, with some focus on addressing food choice. These policies gear municipalities to develop appropriate responses. However, the NDP 2030 seems to elevate the role of local government. A review of the 2016/17 IDPs of municipalities finds a dependence on national framing approaches of enhancing food production and social safety nets. However, a number of municipalities attempt innovative approaches such as: (a) Recognising the role of the Fresh Produce Market as a means to generate a more inclusive food system (Buffalo City) (b) Recognising the municipal role in the characteristics of value chains (Ekurhuleni and Johannesburg) (c) Recognising the need for planning to consider the generation of food networks (Ekurhuleni), and the need to understand the spatial determinants of food insecurity (Johannesburg, Mangaung) (d) Connecting food security to climate change mitigation strategies (eThekwini, Cape Town) (e) Developing a co-ordinated multi pronged approach to food security (Johannesburg) (f) Engagement of stakeholders outside of municipal government (Johannesburg) (g) Conducting baseline evaluations to determine different levels of food security in different municipal wards (Johannesburg) A review of constitutional mandates reveals a far broader set of responsibilities regarding the food system, which enables municipalities to generate novel policy approaches. Because food security and food systems are complex, their challenges cannot be addressed by any spheres of government alone. The National Food and Nutrition Security Plan has two important roles to play in stakeholder engagement - a Convening role and a Mediating role, to ensure that no single perspective dominates. This is important in the context of systemic inequalities in South African municipalities and in the South African food system. The stakeholder engagement process is therefore a) mapping of key stakeholder groups representing all stages of urban food systems, b) development of key stakeholder groups for ongoing engagement, c) identification and engagement with stakeholders specific to planned areas of policy and programme focus. 4.6.5 Investigation of food prices by the Competition Commission The Competition Commission has undertaken a number of investigations into the agriculture and agro-processing sectors to address anti competitive behaviours and business practises that restricted competition in the market. Rising food prices experienced by consumers nationally and globally in 2008, combined with the uncovering of alleged collusive behaviour by companies in the bread, milling, dairy and poultry sectors, has increased suspicions about possible collusion, abuse of dominance and other anti-competitive behaviour throughout the entire food value-chain. This has thus brought sharp focus onto agricultural value-chains and increased calls for more intervention by Government and competition N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 53 authorities to ensure fair competition and market transparency across food value chains. The Competition Commission has recently identified food and agro-processing as a priority area and has already undertaken a number of investigations in the groceries retail market covering a number of food value chains, including the poultry industry and other staple foods markets. DAFF has over the years worked closely with the Commission on a number of investigations on mergers and acquisitions in the agricultural sector, the latest being an investigation into the fresh produce markets looking into price setting approaches followed in those markets. 4.7 Collaboration with the International Trade Administration Commission (ITAC) on the possibility of reviewing current food-price tariff regimes Attention is currently focused on the review of the formula-based tariff dispensation for maize, sugar and wheat. This review is already underway through ITAC, with DTI, DAFF and National Treasury involvement. ITAC will provide an indication of how the reviewed tariff dispensation will affect food prices, with particular focus on the prices of imported maize, wheat and sugar. 4.8 Food Price Monitoring Unit (National Agricultural Marketing Council) High food prices experienced in 2008 prompted DAFF to establish a Ministerial Committee to undertake a comprehensive assessment of the underlying causes of high and volatile food prices, and to make recommendations on how to deal with food prices to mitigate their negative impact on consumers, and more specifically on poor households. Key among the Committee’s recommendations was the establishment of the Food Price Monitoring Unit under the National Agricultural Marketing Council (NAMC), to be supported by Statistics South Africa. This recommendation was approved by Cabinet and the unit was duly set up, and has been tracking food prices and issuing a quarterly Food Price Monitoring Report since it was established in 2008. In the August 2016 issue the cost of an urban food basket consisting of 23 items increased from R525.31 to R610.92, an increase of R85.61 or 16.3% 4.9 Anti-competitive market structure The reporting years 2014/15, 2015/16 and 2016/17 were marked by a severe El Nino induced drought, which affected agriculture significantly. This resulted in just under 200 000 livestock deaths, affecting about 246 631 farmers. Drought had major impacts in the sector, fanning inflationary pressures including food-price escalations. The Competition Commission was consulted on the food prices and responded in the following manner: “It is now clear that liberalisation has not necessarily created competitive markets but, in many areas, it appears as if state intervention has been supplanted by private regulation in the form of anti-competitive conduct. The existence of barriers to entry in the value chain is significant in that anti-competitive conduct would not be sustainable if entry was easy. Barriers include the significance of research and biotechnology in the provision of seeds, and economies of scale in other major inputs such as fertilizer, through to the costs of establishing large grain silos and large-scale milling operations.” There are many factors contributing to the recent food-price increases in South Africa, as internationally. These include exchange-rate movements, especially for internationally traded foodstuffs such as maize; increasing input costs, such as fertiliser; fuel costs; developments in biofuels; and growth in GDP per capita, which is a variable driving the demand for food. The implications of anti competitive market structures and conduct N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 54 is not that they cause the price increases, but they may indicate that food prices were already at a higher, supra- competitive level, and that the pressures listed above may have a bigger impact to the extent that supply is constrained by low levels of competition. It was expected that under de- regulated conditions, free competition would prevail and prices would on average be lower; and also that firms would be more efficient as competitive rivalry spurred them to cut costs. Instead, it would be fair to infer that market structures have directly impacted on maintaining prices above the competitive level, and on producers’ profitability and viability. Price-fixing cartels are being uncovered by the Commission in investigations into products such as bread, mealie-meal, dairy and poultry. Alleged anti-competitive practices have also been uncovered in some vital agricultural inputs and services, such as fertiliser and silo storage, where cases are pending before the Competition Tribunal. High prices of such products and services achieved through anti competitive practices impact on the overall high prices for basic foodstuffs, and squeeze the margins of farmers, forcing out marginal farmers and inducing a shift in land use, such as to game farming thus reducing the overall quantity of food produced in South Africa. The Commission’s approach to the wider study of food, as a priority sector, has been to identify the main staple food products consumed by the large proportion of South Africans living on low incomes. In identifying the staple food basket the Commission assessed consumption patterns through looking at the food items in the basket of goods for the calculation of the Consumer Price Index (“CPI”), the latest Household Income and Expenditure. Survey conducted by Statistics South Africa, as well as data on food consumption patterns in the Living Standards Measurement (“LSM”) categories. 4.10 Measures developed to ensure that agricultural land is used for agricultural purposes only Measures provided for in the Preservation and Development of Agricultural Land Policy and Bill, developed by DAFF, include the following: (a) Demarcation of agricultural land - to strengthen the protection of agricultural land the Department demarcate high value and best available agricultural land to ensure that such land is protected against non-agricultural land uses. (b) Establishment of Agricultural Sector Plans - to ensure the preservation of agricultural land across the country and prevent unilateral actions by different organs of state in respect of the sustainable use and preservation of agricultural land that is prejudicial to national interest. The demarcation of agricultural land will separate the agricultural land from the land that is considered as non-agricultural land and guide agricultural land uses within the local municipality to support agricultural growth and development within the respective provinces (c) Agricultural Land Register - to provide for a national repository that contain geo- referenced data and information on land capability classification, suitability, current state of and the use of agricultural land. (d) Agro-ecosystem Reports - Compulsory reports to accompany all applications and to be compiled by agricultural scientists registered with South African Council for Natural Scientific Professions (SACNSP) justifying the change of land use application. (e) Taxation on the change of agricultural land use - to discourage the conversion of agricultural land to other uses while ensuring that with the funds collected, a trust fund is initiated to be utilised for promoting agricultural production activities. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 55 The DAFF has engaged the public for comments where the first round of public engagement on the draft Preservation and Development of Agricultural Land Policy and Bill was held during March 2015.The second round of public engagement were held in all the nine provinces during September 2016. DAFF also regulate and promotes the rehabilitation of degraded agricultural land through the Conservation of Agricultural Resources Act and LandCare programme. With all of the above measures effectively implemented, the Department will be able to ensure that in future farming land is used for agricultural purposes. 4.11 Collaboration between DAFF and DSD on social protection measures 4.11.1 Food banks: The Food Bank of South Africa is working closely with the Department of Social Development. The South African food banking network initially was aimed at supporting existing feeding programmes and the establishment of new ones in areas where there was dire food needs to address food insecurity in the country. There were an Agreements (MoU) developed that Food Bank SA will buy produce from smallholders for the CNDCs, ECDs, Drop-in Centres, etc. This Agreement has since been revised. An improved integrated model is being investigated and will be deliberated upon by the interdepartmental structure. 4.11.2 Improved coordination between the State and NGOs Various departments contributing to the food and nutrition security initiatives have engagement with various NGO’s. NGOs and CBOs have been engaged during the drafting of the plan. It will be essential to develop the database of the NGOs involved in food production, nutrition and poverty reduction programmes. It will include their contributions and how government will partner with them in implementing the programmes. The NGO fraternity will have representation of the Food and Nutrition Security Council once it is established. 4.11.3 Involvement of the Department of Science and Technology (DST) in food production The DST is involved in improving food production by sponsoring research conducted by the Agricultural Research Council (ARC). It is through this involvement that ARC developed the nutrient-dense Orange-Fleshed Sweet Potato (OFSP) variety, which is being commercialised for wider distribution and consumption. The ARC is distributing OFSP vines in provinces as a pilot to interested farmers towards a drive to commercialisation The ARC has also developed a drought resistant maize variety which is adaptable to most areas in South Africa. However, its cultivation has not yet gained popularity among farmers. These developments are reported to the DST. The Department engages with centres of excellence that contribute to technology and information concerning food production and food and nutrition security, and a more structured long-term relationship is being developed with various universities on research advisory panels. The DST is considered instrumental in supporting these engagements. 4.11.4 Clear allocation of responsibilities of Government departments within the NFNSP Leadership for the development and implementation of the NFNS Plan 2018 2023 is provided by the Office of the Deputy President, working together with 12 government departments. The Plan assigns clear responsibilities to these Government departments. It specifies the department that will lead the implementation of each of the 6 core pillars, as well as those that will be required to contribute. It also seeks to involve municipalities and civil society in its implementation, monitoring and reporting (See Table 6 below). N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 56 Table 5: NFNSP priorities, lead departments and contributing departments Priorities Lead De-partment Other key departments and social partners 1 Establish a multisectoral Food and Nutrition Security (FNS) Council to: oversee alignment of policies, legislation and programmes; coordinate and implement programmes and services addressing FNS; and draft new policies and legislation where appropriate Office of the Deputy President, DPME DAFF, DSD, COGTA, DBE, DTI, RDLR, Provinces, local government, civil society, organised labour, development partners 2 Establish inclusive local food value-chains to support access to nutritious, affordable foods DAFF RDLR, Water & Sanitation, DTI, National Treasury, Correctional Services, civil society, development partners 3 Expand targeted social protection measures and sustainable livelihood programmes DSD DOH, Home Affairs, DBE, Provinces and local government, civil society, development partners 4 Scale up of high impact nutrition interventions targeting women, infants and children DOH DBE, DSD, DHA, civil society, development partners 5 Influence people across the life-cycle to make informed food and nutrition decisions through an integrated communications strategy DOH/GCIS DBE, DSD, DAFF, COGTA, DHA, development partners 6 Develop a monitoring and evaluation system for FNS in South Africa and establish an integrated risk management system for monitoring FNS- related risks Stats SA, DAFF DPME, DAFF, DOH, DBE, Statistics SA, COGT N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 57 4.11.5 Enabling factors (a) The enabling factors that will assist in implementation of the NFNSP include the following: (b) Leveraging funding (c) Empowerment through affirmative procurement (d) Coordination roles by relevant stakeholders (e) Improving on efficiencies of post-harvest losses (f) Modeling/projections (g) Consider tapping into unemployed graduates (h) Agreement with all partners (i) Involvement of financiers e.g. land bank. 4.12 Human resources for implementation of the NFNSP 4.12.1 Development workers (extension practitioners) Extension practitioners are qualified personnel in different agricultural fields, e.g. animal health, extension and development, agricultural marketing, agricultural management, horticulture. They are deployed by Provincial Departments of Agriculture in all nine provinces across South Africa. The Provincial Departments of Agriculture play an important role in implementation of support programmes and therefore the human capacity is at District and local level to achieve their mandate. Thus, the mandate for extension personnel is as follows: (a) Advise farmers on sustainable agricultural production The specialisation that an extension practitioner holds determine the kind of advisory services that will rendered to the farmer e.g. if a producer has challenges with regard to maize production, information from a agronomist will be rendered. If it happens that the extension practitioner of that producer is not a specialist in that regard, a fellow colleague will assist in that regard (b) Land Reform Specialists provide pre- and post-settlement support to land reform applicants and beneficiaries This process where extension practitioners provide support to farmers that will occupy a government farm property acquired through the Department of Rural Development and Land Reform (c) Assist farmers to form commodity groups or legal business entities Advice farmers on the positive impacts of forming a commodity groups or legal business entities according to the enterprise they produce. This has a positive impact especially when buying production inputs in bulk and the benefits of bulk acquisitions and business principles are applied at the lowest levels apply. (d) Assist farmers to access markets This mandate is important in the extension process as it assists farmers to become sustainable and independent of government support. This assistance is over a period of time as more than one market opportunity is needed to make a farmer sustainable. (e) Facilitate training for farmers in groups and as individuals When frequent visits are made by extension practitioners to different producers, they are able to identify gaps that a certain producer experience and if there is a common problem thereof, training through formal and non formal means are made. Extension advisors will facilitate through study groups, formal sessions, the use of subject matter specialists, mentorship and classroom sessions using experts from different entities. (f) Link farmers to research-related information This will depend on the relevance of the research information to the commodities they produce. (g) Enhance the resilience and coping capacity of farmers The importance of this aspect is to equip farmers for the realities of farming as a business and a science. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 58 Extension practitioners are the backbone of agricultural development at the local community level for the DAFF. They are at the coalface of development within various communities in South Africa, the biggest human resource that the department has in reaching farming communities at local level with information for farmers. They also perform the vital and critical role of monitoring specific plans for farmer development. They are familiar with challenges that farmers face on a daily basis, and are in most cases the first people farmers contact when they experience problems. 4.12.2 Community Development Practitioners (CDPs) A CDP facilitates activities that enable households and communities to manage their own development in order to achieve sustainable livelihoods. The roles and responsibilities of CDPs will vary according to their level of operation. However, all CDPs must have a clear understanding of their area of operation – be it a community, ward, municipality, district or province. Please note that the activities indicated below are iterative and not linear. The roles of CDPs in community development include: (a) Understanding stakeholders and developing effective partnerships with ward committees, community development workers, CBOs and other community-based stakeholders. (b) Understanding the community, using a variety of tools such as household and community profiles or community-based planning; understanding their livelihoods; performing service delivery analysis, mapping community issues and dis aggregating households. (c) Developing community-based plans. (d) Helping communities to identify livelihood opportunities, working with different stakeholders at community level, and linking to external stakeholders such as municipalities. (e) Assisting communities to mobilise and manage resources to support their priorities (f) Supporting initiatives, projects and services and conflict resolution in the community; (g) Where they have compiled community based plans, helping communities to implement their plans. (h) Helping communities to reflect on what is happening in their community, monitoring progress, and holding service providers accountable. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 59 CHAPTER 5: Implementation of the NFNSP 2018 2023 5.1 Introduction The six strategic objectives of the Plan and their accompanying key interventions, were derived from an iterative consultative process (described in Chapter 2). This process took into account the Food and Nutrition Security policy approved in 2013; the recommendations from Cabinet and the Diagnostic/Implementation Evaluation of Nutrition Interventions for Children from Conception to Age 5 (2014). 5.2 Strategic Objective 1: Establish a multisectoral Food and Nutrition Security Council to oversee alignment of policies, legislation and programmes, coordination and implementation of programmes and services which address food and nutrition security Despite the high number of FNS policies and programmes, household food insecurity, hunger and malnutrition levels are unacceptably high. Institutional mechanisms have been established to drive and facilitate coordination, integration, collaboration and accountability amongst different role players, but these have proved to be less effective than anticipated. By contrast, all successful efforts to reduce malnutrition have a single leadership and governance structure and a single national plan of action for food and nutrition security. It is imperative that responsibility for improvement of food and nutrition security is placed at the highest political levels: at the national, provincial and district levels. All the departments must be accountable to one oversight structure. The Strategic Objective 1 therefore focuses on strengthening national leadership and governance for food and nutrition security. 5.2.1 Proposed institutional framework The implementation of the NFNS Plan 2018-2023 is dependent on, among others, the establishment, operationalisation and effective functioning of a co-coordinating institutional framework, involving entities both in and outside of government. The proposed institutional framework has the following components: 5.2.1.1 The National Council on Food and Nutrition Security (chaired by the Deputy President of South Africa). This council is modelled on the South African National AIDS Council (SANAC), also chaired by the Deputy President; 5.2.1.2. Nine Provincial Sub-councils on Food and Nutrition Security (chaired by of the Premier of the Province); 5.2.1.3 District/Metropolitan Sub-councils on Food and Nutrition Security (chaired by the Mayor of the District or Metropolitan Municipality). 5.2.2 Composition of Inter-Governmental structures 5.2.2.1 The National Council on Food and Nutrition Security will consist of: (a) The Deputy President (as Chairperson); (b) Ministers of Planning, Monitoring and Evaluation; Agriculture, Forestry and Fisheries; Basic Education; Cooperative Governance; Trade and Industry; Health; Social Development; Rural Development and Land Reform; Water and Sanitation; Statistics SA; Women and Trade and Industry. (c) Provincial Premiers or their delegates (MECs); (d) Private Sector and NGO/CBO representatives. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 60 (e) Senior officials (of at least at DG/DDG level) from core national government departments, who serves as the secretariat. (f) Experts outside government, each qualified and experienced in at least one of the following domains, with other fields still to be identified: agriculture, food security, nutrition, health, food safety, policy, law, markets and trade, public administration, and monitoring and evaluation. 5.2.2.2 Provincial Councils The Provincial Sub-council on Food and Nutrition Security will be chaired by the Premier. It will consist of Members of Executive Councils (MECs) and senior provincial government officials and experts. It will meet quarterly to discuss all issues relating to food and nutrition security in the province concerned, and report bi-annually to the National Council on Food and Nutrition Security 5.2.2.3 Metropolitan/District Municipality Councils The District/Metropolitan Sub-council on Food and Nutrition Security will be chaired by the Mayor of the District or Metropolitan municipality. It will consist of senior municipal officials and experts. It will meet quarterly to discuss all issues relating to food and nutrition security in the District/Metropolitan municipality concerned, and report monthly to the relevant Provincial Sub-council. 5.2.3.4 Consultative Forums The National Consultative Forum on Food and Nutrition Security (chaired by the Deputy President) will consist of (a) the members of the National Council on Food and Nutrition Security, and (b) stakeholders representing interest groups and civil society. This forum will meet once every six months to discuss all matters relating to food and nutrition security. The recommendations emanating from its discussions will be forwarded to the National Consultative Forum on Food and Nutrition Security for consideration. Similarly, Provincial and District/Metropolitan Consultative Forums on Food and Nutrition Security will also meet once every six months to discuss all matters relating to food and nutrition security and attrition in the province or District/Metropolitan municipality concerned, and make recommendations to the National Council or Provincial Sub-council for consideration. 5.2.6 Core functions of the proposed implementing institutions Core functions of the National Council on Food and Nutrition Security include, but are not limited to, the following: (a) Provide leadership and oversight for the implementation of the National Food and Nutrition Security Plan 2018-2023. (b) Ensure overall coordination of all food and nutrition security programmes and projects including planning, funding and implementation. (c) Mobilise and track investment and support. (d) Ensure development of a comprehensive data base of statistical information relating to food and nutrition security. (e) Commission mid-term and end- term evaluations and impact assessment. (f) Ensure adjustment of existing programmes in order to incorporate evaluation findings and enhance impacts. (g) Ensure quarterly publication of the status of food and nutrition security in South Africa; (h) Approve and make recommendations on proposed Intergovernmental coordination mechanisms. (i) Oversee the general governance of the structure to ensure attainment of the outcomes as described in the implementation plans. (j) Monitor the impact of interventions on food access by households, income generation and promotion of partnerships with both international and national development partners. (k) Make decisions on and monitor integrated planning and implementation regarding food and nutrition security. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 61 (l) Monitor alignment of government interventions with objectives of the National Food and Nutrition Security Plan 2018-2023 and the National Development Plan 2030. 5.2.7 Standing committees The National Council on Food and Nutrition Security will establish standing committees for each of the above and other fields, as required, to carry out its activities. Relevant committees could include: (a) Nutrition Committee (b) National Food Security: Risks and Emergencies Committee (c) Livelihoods and Household Food Security Committee (d) Policy and Legislation Committee (e) Monitoring, Evaluation, Reporting and Intervention Committee (f) Systems and Operations Committee; (g) Finance Committee. The Provincial and the District/Metropolitan Sub-councils on Food and Nutrition Security will be responsible for performing similar functions as the National Council on Food and Nutrition Security, but at subnational levels, and may also establish standing committees. The National, Provincial, and District/Metropolitan Consultative Forums on Food and Nutrition Security will be responsible for, amongst others, inclusive public participation (stakeholders and civil society) in discussions on matters pertaining to food and nutrition security at national, provincial or municipal level. Expected outcomes (a) Improved coherence in FNS policies (b) Improved coordination in implementation of programmes and services which address FNS (c) Improved resources and capacity to implement NFNSP N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 62 Table 6: Strategic interventions, specific activities, outputs, output indicators and targets for Strategic Objective 1. S tr a te g ic O b je ct iv e 1 : E st a b lis h a m u lt i se ct o ra l g o ve rn a n ce a n d l e a d e rs h ip s tr u ct u re f o r co o rd in a ti n g F N S p o lic ie s a n d p ro g ra m m e s S tr at eg ic in te rv en ti o n S p ec ifi c ac ti v it ie s R es p o n si b ili ty O u tp u t O u tp u t in d ic at o r B as el in e 20 16 T ar g et 2 0 20 T ar g et 2 0 23 E st a b lis h a m u lt is e c to ra l F N S c o u n c il F a c ili ta te t h e e st a b lis h m e n t th e F N S C o u n c il, c h a ir e d b y th e D e p u ty P re si d e n t a n d co n si st in g o f: • 12 M in is te rs • P re m ie rs / P re m ie rs ’ d e le g a te s • P ri v a te se c to r • N G O s • C B O s O ffi ce o f th e D e p u ty P re si d e n t D e p a rt m e n t o f P la n n in g , M o n it o ri n g a n d E v a lu a ti o n (D P M E ) F N S C o u n c il e st a b lis h e d , c h a ir e d b y th e D e p u ty P re si d e n t F N S C o u n c il co n ve n e d a n d re co rd s o f p ro ce e d in g s co m p ile d F N S C o u n c il n o t y e t in p la ce . F N S C o u n c il e st a b lis h e d b y M a rc h 2 0 19 F N S C o u n c il co n ve n e s b i a n n u a lly (t o p ro v id e o ve rs ig h t a n d e n su re a cc o u n ta b ili ty fo r th e d e liv e ry o f F N S p ro g ra m m e s) Im p ro ve d co o rd in a ti o n o f G o ve rn m e n t F o o d a n d N u tr it io n S e c u ri ty p ro g ra m m e s re su lt in g f ro m : • F N S C o u n c il co n ve n in g b i a n n u a lly t o p ro v id e o ve rs ig h t fo r th e d e liv e ry o f F o o d a n d N u tr it io n S e c u ri ty p ro g ra m m e s • F N S C o u n c il h o ld in g g o ve rn m e n t d e p a rt m e n ts a cc o u n ta b le f o r co h e re n t d e liv e ry o f F o o d a n d N u tr it io n S e c u ri ty p ro g ra m m e s a c ro ss a ll g o ve rn m e n t d e p a rt m e n ts N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 63 S tr a te g ic O b je ct iv e 1 : E st a b lis h a m u lt i se ct o ra l g o ve rn a n ce a n d l e a d e rs h ip s tr u ct u re f o r co o rd in a ti n g F N S p o lic ie s a n d p ro g ra m m e s S tr at eg ic in te rv en ti o n S p ec ifi c ac ti v it ie s R es p o n si b ili ty O u tp u t O u tp u t in d ic at o r B as el in e 20 16 T ar g et 2 0 20 T ar g et 2 0 23 • F N S C o u n c il le a d in g r e so u rc e m o b ili sa ti o n e ff o rt s fo r th e d e liv e ry o f F N S p ro g ra m m e s E st a b lis h a n d o p e ra ti o n a lis e a n i n te g ra te d F N S d e liv e ry st ru c tu re F a c ili ta te t h e e st a b lis h m e n t o f th e P ro v in c ia l C o u n c ils , c h a ir e d b y P re m ie rs O ffi ce s o f th e P re m ie rs R o le p la y e rs P ro v in c ia l C o u n c il e st a b lis h e d , c h a ir e d b y th e O ffi ce s o f th e P re m ie r D is tr ic t; M e tr o M a y o rs ; N G O ’s , c iv il so c ie ty , b u si n e ss , la b o u r, o rg a n is e d a g ri c u lt u re , S O E ’s P ro v in c ia l F N S C o u n c il a p p ro ve d b y th e O ffi ce s o f th e P re m ie rs P ro v in c ia l F N S C o u n c ils n o t y e t in p la ce P ro v in c ia l F N S C o u n c ils e st a b lis h e d b y S e p te m b e r 2 0 19 P ro v in c ia l F N S C o u n c ils p ro v id e o ve rs ig h t a n d e n su re a cc o u n ta b ili ty fo r th e d e liv e ry o f fo o d a n d n u tr it io n se c u ri ty • Im p ro ve d d e liv e ry o f • G o ve rn m e n t F o o d a n d N u tr it io n S e c u ri ty p ro g ra m m e s re su lt in g f ro m t h e e ff e c ti ve n e ss o f P ro v in c ia l F N S C o u n c ils N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 64 S tr a te g ic O b je ct iv e 1 : E st a b lis h a m u lt i se ct o ra l g o ve rn a n ce a n d l e a d e rs h ip s tr u ct u re f o r co o rd in a ti n g F N S p o lic ie s a n d p ro g ra m m e s S tr at eg ic in te rv en ti o n S p ec ifi c ac ti v it ie s R es p o n si b ili ty O u tp u t O u tp u t in d ic at o r B as el in e 20 16 T ar g et 2 0 20 T ar g et 2 0 23 F a c ili ta te t h e e st a b lis h m e n t o f D is tr ic t C o u n c ils , c h a ir e d b y M a y o rs O ffi ce o f th e M a y o rs R o le p la y e rs D is tr ic t F N S C o u n c ils e st a b lis h e d , c h a ir e d b y th e O ffi ce s o f th e M a y o rs N G O ’s , c iv il so c ie ty , b u si n e ss , la b o u r, o rg a n is e d a g ri c u lt u re , S O E ’s D is tr ic t F N S C o u n c il a p p ro ve d b y th e O ffi ce s o f th e M a y o rs D is tr ic t F N S C o u n c ils n o t y e t in p la ce D is tr ic t F N S co u n c ils e st a b lis h e d in 2 7 p ri o ri ty d is tr ic ts b y D e ce m b e r 2 0 19 D is tr ic t F N S C o u n c ils co n ve n e d i n 4 4 d is tr ic ts (e xc lu d in g M e tr o s) t o tr a c k p ro g re ss w it h t h e im p le m e n ta ti o n o f F N S P ro g ra m m e s Im p ro ve d d e liv e ry o f G o ve rn m e n t F N S p ro g ra m m e s in 4 0 D is tr ic ts , re su lt in g f ro m th e e ff e c ti ve n e ss o f D is tr ic t F N S C o u n c ils Table 6: Strategic interventions, specific activities, outputs, output indicators and targets for Strategic Objective 1. - continued N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 65 5.3 Strategic Objective 2: Establishment of inclusive local food value-chains to support access to nutritious, affordable food Access to nutritious, safe and affordable food is essential to reduce all forms of malnutrition. Transformation of the rural economy is essential for growth, poverty reduction, employment creation and overcoming inequalities in the country. Greater focus is on raising the productivity of Smallholder Holder Producers as a way of increasing local access to nutritious foods. Focusing on local value food chains increases employment opportunities and reduces dependence on imports. Outcomes The outcomes expected from the implementation of the identified strategic interventions are as follows: (a) Market stimulation for smallholder producers to participate in local value chains. (b) Improved policy environment to enhance participation of small holder producers in local food value-chains. (c) Improved access to nutritious, affordable food. (d) Improved access to production and marketing infrastructure. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 66 Table 7: Strategic interventions, specific activities, outputs, output indicators and targets for Strategic Objective 2 S tr a te g ic O b je ct iv e 2 : E st a b lis h m e n t o f in cl u si ve l o ca l fo o d v a lu e c h a in s to s u p p o rt a cc e ss t o n u tr it io u s, a ff o rd a b le f o o d S tr at eg ic in te rv en ti o n S p ec ifi c ac ti v it ie s R es p o n si b ili ty O u tp u t O u tp u t in d ic at o r B as el in e 20 16 T ar g et 2 0 20 T ar g et 2 0 23 1. In cr e as e d p ro d u ct io n o f va lu e d ag ri cu lt u ra l p ro d u ct s an d n u tr it io u s cr o p s In cr e a se d f o o d p ro d u ct io n b y sm a llh o ld e r a n d su b si st e n ce p ro d u ce rs D A F F D R D L R , D W S , D T I, N at io n a l T re a su ry , C o rr e ct io n a l S e rv ic e s, C iv il S o ci e ty , D ev e l o p m e n t P a rt n e rs , D S T, D S B D P ro d u ce rs N A M C C o m m o d it y o rg a n is a t io n s, D S T C e n tr e s o f E xc e lle n ce D o H , D S D , D B E F o o d p ro d u ce d b y s m a llh o ld e r a n d su b si st e n ce p ro d u ce rs Q u a n ti ty o f fo o d p ro d u ce d b y sm a llh o ld e r a n d su b si st e n ce fa rm e rs b y t y p e o f p ro d u ce (t o n n e s) 1 0 6 8 9 0 4 to n n e s p e r a n n u m o f fr u it a n d v e g e ta b le s p ro d u ce d 2 m ill io n t o n n e s o f fr u it a n d ve g e ta b le s p e r a n n u m 5 m ill io n t o n n e s o f fr u it a n d ve g e ta b le s p e r a n n u m 4 7 9 9 9 0 to n n e s o f m a iz e a n d b e a n s p ro d u ce d a n n u a lly 3 m ill io n t o n n e s o f m a iz e a n d b e a n s p e r a n n u m 6 m ill io n t o n n e s o f m a iz e a n d b e a n s p e r a n n u m N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 67 S tr a te g ic O b je ct iv e 2 : E st a b lis h m e n t o f in cl u si ve l o ca l fo o d v a lu e c h a in s to s u p p o rt a cc e ss t o n u tr it io u s, a ff o rd a b le f o o d S tr at eg ic in te rv en ti o n S p ec ifi c ac ti v it ie s R es p o n si b ili ty O u tp u t O u tp u t in d ic at o r B as el in e 20 16 T ar g et 2 0 20 T ar g et 2 0 23 In cr e as e d p ro d u ct io n o f va lu e d ag ri cu lt u ra l p ro d u ct s an d n u tr it io u s cr o p s In cr e a se d f o o d p ro d u ct io n b y sm a llh o ld e r a n d su b si st e n ce p ro d u ce rs D A F F, D R D L R , D W S , D T I, N at io n a l Tr e a su ry , C o r re ct io n a l S e r v ic e s, c iv il so c ie ty , d ev e l o p m e n t p a rt n e rs , D S T, D S B D P ro d u ce rs N A M C C o m m o d it y o rg a n is at io n s, D S T C e n tr e s o f E xc e lle n ce D o H , D S D , D B E F o o d p ro d u ce d b y s m a llh o ld e r a n d su b si st e n ce p ro d u ce rs N u m b e r o f In d ig e n o u s fo o d c ro p s d ev e lo p e d a n d p ro d u ce d 5 A fr ic a n ve g e ta b le cu lt iv a rs d ev e lo p e d a n d p ro d u ce d 6 A fr ic a n ve g e ta b le cu lt iv a rs d ev e lo p e d a n d p ro d u ce d 8 A fr ic a n ve g e ta b le cu lt iv a rs d ev e lo p e d a n d p ro d u ce d To n n a g e o f T ila p ia a n d C at fi sh p ro d u ce d b y su b si st e n ce a n d sm a llh o ld e r p ro d u ce rs C u rr e n tl y n o t b e in g p ro d u ce d a t m e a n in g fu l le ve ls 70 0 t o n n e s o f T ila p ia a n d 1 5 0 0 t o n n e s o f C at fi sh 1 70 0 t o n n e s o f T ila p ia a n d 3 3 0 0 t o n n e s o f C at fi sh In cr e a se d f o o d p ro d u ct io n b y h o u se h o ld p ro d u ce rs D A F F D R D L R D S D S ta ts S A H o u se h o ld s in vo lv e d in a g ri cu lt u re N u m b e r o f h o u se h o ld s in vo lv e d in a g ri cu lt u re 2 3 2 9 0 4 3 2 ,5 3 5 ,3 7 1.1 8 2 ,8 7 9 ,6 8 3 H o u se h o ld fo o d p ro d u ct io n N u m b e r o f h o u se h o ld s w it h ve g e ta b le g a rd e n s 8 73 3 5 5 1 0 0 4 3 5 8 1, 4 8 ,0 2 6 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 68 S tr a te g ic O b je ct iv e 2 : E st a b lis h m e n t o f in cl u si ve l o ca l fo o d v a lu e c h a in s to s u p p o rt a cc e ss t o n u tr it io u s, a ff o rd a b le f o o d S tr at eg ic in te rv en ti o n S p ec ifi c ac ti v it ie s R es p o n si b ili ty O u tp u t O u tp u t in d ic at o r B as el in e 20 16 T ar g et 2 0 20 T ar g et 2 0 23 2 . S ti m u la te m ar ke ts f o r sm al lh o ld e r p ro d u ce rs C e rt if y in g sm a llh o ld e r p ro d u ce rs fo r S o u th A fr ic a n G o o d A g ri cu lt u ra l P ra ct ic e s (S A G A P ) D A F F P P E C B A R C S m a llh o ld e r p ro d u ce rs S A G A P c e rt ifi e d to a cc e ss lo ca l m a rk e ts N u m b e r o f sm a llh o ld e r p ro d u ce rs ce rt ifi e d f o r S A G A P 2 0 s m a llh o ld e r p ro d u ce rs S A G A P c e rt ifi e d 5 0 s m a llh o ld e r p ro d u ce rs S A G A P c e rt ifi e d 10 0 s m a llh o ld e r p ro d u ce rs S A G A P c e rt ifi e d S m a llh o ld e r p ro d u ce rs su p p ly in g n u tr it io u s fo o d in to in st it u ti o n a l m a rk e ts D A F F D B E D S D N A M C P ro v in ci a l D e p a rt m e n ts D R D L R D ev e lo p m e n t p a rt n e rs D ev e lo p m e n t b a n ks In st it u ti o n a l m a rk e ts p ro cu ri n g d ir e ct ly f ro m sm a llh o ld e r p ro d u ce rs T h e n u m b e r o f sm a llh o ld e r p ro d u ce rs su p p ly in g fo o d t o in st it u ti o n a l m a rk e ts 3 4 6 sm a llh o ld e rs (W F P m a rk e t) 5 % o f 16 0 0 0 sm a llh o ld e r p ro d u ce rs su p p ly in g f o o d to in st it u ti o n a l m a rk e ts 10 % o f 16 0 0 0 sm a llh o ld e r p ro d u ce rs su p p ly in g f o o d to in st it u ti o n a l m a rk e ts Table 7: Strategic interventions, specific activities, outputs, output indicators and targets for Strategic Objective 2 - continued N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 69 S tr a te g ic O b je ct iv e 2 : E st a b lis h m e n t o f in cl u si ve l o ca l fo o d v a lu e c h a in s to s u p p o rt a cc e ss t o n u tr it io u s, a ff o rd a b le f o o d S tr at eg ic in te rv en ti o n S p ec ifi c ac ti v it ie s R es p o n si b ili ty O u tp u t O u tp u t in d ic at o r B as el in e 20 16 T ar g et 2 0 20 T ar g et 2 0 23 T h e v a lu e o f fo o d b e in g p ro cu re d fr o m sm a llh o ld e r p ro d u ce rs . R 2 1 m ill io n (W F P m a rk e t B u d g e t o f D B E : S ch o o l F e e d in g P ro g ra m m e : R 6 . 2 b n ( 3 0 % = R 1. 6 b n ) D e p a rt m e n t o f S o ci a l D ev e lo p m e n t: C N D C B u d g e t – R 9 7 m ( 4 6 % = R 4 4 6 2 0 0 0 0 ) 3 0 % o f R 4 4 6 2 0 0 0 0 m u st b e s e t a si d e f o r p ro cu re m e n t fo r sm a llh o ld e r p ro d u ce rs D S D : E C D R 1b n ( 3 0 % s e t a si d e = R 3 0 0 m ill io n ) 3 0 % v a lu e o f th e f o o d p ro cu re m e n t b u d g e t sp e n t o n s m a llh o ld e rs 5 0 % v a lu e o f th e f o o d p ro cu re m e n t b u d g e t sp e n t o n s m a ll h o ld e r p ro d u ce rs N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 70 S tr a te g ic O b je ct iv e 2 : E st a b lis h m e n t o f in cl u si ve l o ca l fo o d v a lu e c h a in s to s u p p o rt a cc e ss t o n u tr it io u s, a ff o rd a b le f o o d S tr at eg ic in te rv en ti o n S p ec ifi c ac ti v it ie s R es p o n si b ili ty O u tp u t O u tp u t in d ic at o r B as el in e 20 16 T ar g et 2 0 20 T ar g et 2 0 23 Q u a n ti ty o f fo o d b e in g p ro cu re d fr o m sm a llh o ld e r p ro d u ce rs 4 3 7 2 t o n n e s (W F P m a rk e t) 6 0 0 0 0 0 to n n e s p e r a n n u m o f fo o d s u p p lie d in to g o ve rn m e n t d e p a rt m e n ts p ro cu ri n g f o o d 1, 2 0 0 0 0 0 to n n e s p e r a n n u m o f fo o d su p p lie d in to g o ve rn m e n t d e p a rt m e n ts p ro cu ri n g f o o d 3 . E st ab lis h , an d st re n g th e n p ro d u ce r d ev e lo p m e n t in st it u ti o n s S tr e n g th e n co lle g e s o f a g ri cu lt u re a n d c e n tr e s o f ex ce lle n ce fo r p ro d u ce r d ev e lo p m e n t D A F F D B E D H E D R D L R D S T S e ta ’s D ev e lo p m e n t p a rt n e rs C e n tr e s o f ex ce lle n ce fo r p ro d u ce r d ev e lo p m e n t a n d A g ri cu lt u ra l Tr a in in g In st it u te s N u m b e r o f ce n tr e s o f ex ce lle n ce a n d A g ri cu lt u ra l Tr a in in g In st it u te s fo r p ro d u ce r d ev e lo p m e n t 11 T ra in in g co lle g e s o f a g ri cu lt u re 6 A g ri cu lt u ra l Tr a in in g In st it u te s (A T Is ) a s o p e ra ti n g a s C e n tr e s o f E xc e lle n ce 11 A g ri cu lt u ra l Tr a in in g In st it u te s (A T Is ) o p e ra ti n g a s C e n tr e s o f E xc e lle n ce P ro v is io n o f ca p a ci ty d ev e lo p m e n t D A F F In cr e a se d n u m b e r o f ex te n si o n p e rs o n n e l N u m b e r o f ex te n si o n o ffi ce rs 2 8 0 0 3 5 0 0 5 6 0 0 Table 7: Strategic interventions, specific activities, outputs, output indicators and targets for Strategic Objective 2 - continued N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 71 S tr a te g ic O b je ct iv e 2 : E st a b lis h m e n t o f in cl u si ve l o ca l fo o d v a lu e c h a in s to s u p p o rt a cc e ss t o n u tr it io u s, a ff o rd a b le f o o d S tr at eg ic in te rv en ti o n S p ec ifi c ac ti v it ie s R es p o n si b ili ty O u tp u t O u tp u t in d ic at o r B as el in e 20 16 T ar g et 2 0 20 T ar g et 2 0 23 4 .E m p lo ym e n t in lo ca l ag ri cu lt u ra l va lu e c h ai n s L o ca l va lu e c h a in e m p lo y m e n t D A F F D R D L R P ri va te s e ct o r ro le p la ye rs D O L S TA T S S A D T I D O W In cr e a se d e m p lo y m e n t a n d p a rt ic ip at io n in lo ca l a g ri cu lt u ra l va lu e c h a in s N u m b e r o f p e o p le e m p lo ye d in t h e a g ri cu lt u ra l se ct o r 8 8 2 0 0 0 p e o p le e m p lo ye d a cr o ss t h e a g ri cu lt u ra l se ct o r in p ri m a ry p ro d u ct io n –a s a d ir e ct re su lt o f D A F F su p p o rt 8 8 2 0 0 0 a re e m p lo ye d in p ri m a ry a g ri cu lt u re a lo n e 9 0 0 0 0 0 p e o p le e m p lo ye d a cr o ss t h e a g ri cu lt u ra l se ct o r a s a d ir e ct r e su lt o f D A F F s u p p o rt 1 m ill io n p e o p le a cr o ss t h e a g ri cu lt u ra l se ct o r N u m b e r o f w o m e n a g ro p re n u e rs a n d p a rt ic ip a n ts 24 1 w o m e n a g ro p re n u e rs (D A F F F E A 2 0 12 2 0 16 ) 3 0 % w o m e n o f 16 0 0 0 sm a ll h o ld e r p ro d u ce rs su p p o rt e d 5 0 % w o m e n o f 16 0 0 0 sm a llh o ld e r p ro d u ce rs su p p o rt e d N u m b e r o f yo u th p a rt ic ip a n ts 13 2 12 y o u th p a rt ic ip at e d 3 0 % o f sm a ll h o ld e r p ro d u ce rs su p p o rt e d a re yo u th 5 0 % o f sm a ll h o ld e r p ro d u ce rs su p p o rt e d a re yo u th N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 72 Table 7: Strategic interventions, specific activities, outputs, output indicators and targets for Strategic Objective 2 - continued S tr a te g ic O b je ct iv e 2 : E st a b lis h m e n t o f in cl u si ve l o ca l fo o d v a lu e c h a in s to s u p p o rt a cc e ss t o n u tr it io u s, a ff o rd a b le f o o d S tr at eg ic in te rv en ti o n S p ec ifi c ac ti v it ie s R es p o n si b ili ty O u tp u t O u tp u t in d ic at o r B as el in e 20 16 T ar g et 2 0 20 T ar g et 2 0 23 5 . C re at e a n e n ab lin g p o lic y e n vi ro n m e n t F in a lis e a n d a lig n P C P D S t o e n a b le t h e e st a b lis h m e n t o f lo ca l f o o d va lu e c h a in s D A F F D R D L R D T I D S D D B E D S B D D o H D C S P o lic y o n C o m p re h e n si ve P ro d u ce r a n d D ev e lo p m e n t S u p p o rt P C P D S a p p ro va l b y C a b in e t F ra g m e n te d co m p re h e n si ve p ro d u ce r su p p o rt P C P D a p p ro ve d b y C a b in e t C o m p re h e n si v e P ro d u ce r D ev e lo p m e n t S u p p o rt B ill N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 73 S tr a te g ic O b je ct iv e 2 : E st a b lis h m e n t o f in cl u si ve l o ca l fo o d v a lu e c h a in s to s u p p o rt a cc e ss t o n u tr it io u s, a ff o rd a b le f o o d S tr at eg ic in te rv en ti o n S p ec ifi c ac ti v it ie s R es p o n si b ili ty O u tp u t O u tp u t in d ic at o r B as el in e 20 16 T ar g et 2 0 20 T ar g et 2 0 23 D ev e lo p , a n d u p sc a le in st ru m e n ts to s u p p o rt p ro d u ct io n a n d a cc e ss t o m a rk e ts f o r sm a llh o ld e r p ro d u ce rs • in ce n ti ve s sc h e m e s • m at ch in g g ra n ts sc h e m e • cr e d it g u a ra n te e sc h e m e , • co m m o d it y a p p ro a ch • a q u a cu lt u re d ev e lo p m e n t sc h e m e • m a ri n e fu n d in g D A F F, D R D L R , D T I, D S B L a n d B a n k In st ru m e n ts th at s u p p o rt p ro d u ct io n a n d a cc e ss to m a rk e ts d ev e lo p e d a n d im p le m e n te d N u m b e r o f In st ru m e n ts d ev e lo p e d 6 in st ru m e n ts (A P A P, C A S P, Ili m a L e ts e m a , M A F IS A , R E C A P, a n d C o m p e ti ti ve E n h a n ce m e n t P ro g ra m m e (M C E P ) 1 A g ro P ro ce ss in g In ce n ti ve sc h e m e d ev e lo p e d 1 A g ro P ro ce ss in g In ce n ti ve sc h e m e o p e ra ti o n a l N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 74 S tr a te g ic O b je ct iv e 2 : E st a b lis h m e n t o f in cl u si ve l o ca l fo o d v a lu e c h a in s to s u p p o rt a cc e ss t o n u tr it io u s, a ff o rd a b le f o o d S tr at eg ic in te rv en ti o n S p ec ifi c ac ti v it ie s R es p o n si b ili ty O u tp u t O u tp u t in d ic at o r B as el in e 20 16 T ar g et 2 0 20 T ar g et 2 0 23 N u m b e r o f m at ch in g cr e d it g ra n t sc h e m e s 1 m at ch in g cr e d it g ra n t sc h e m e w it h L a n d B a n k 5 m at ch in g cr e d it g ra n t sc h e m e s a lig n e d t o A P A P co m m o d it ie s 9 m at ch in g cr e d it g ra n t sc h e m e s a lig n e d t o A P A P co m m o d it ie s C re d it g u a ra n te e sc h e m e M ic ro A g ri cu lt u ra l In st it u ti o n s o f S o u th A fr ic a R ev is e d a g ri cu lt u ra l cr e d it s ch e m e O p e ra ti o n a l cr e d it g u a ra n te e sc h e m e se rv ic in g 3 0 % o f sm a llh o ld e r p ro d u ce rs N u m b e r o f a g ri cu lt u ra l co o p e ra ti ve s b e n e fi ti n g fr o m t h e in st ru m e n ts 10 0 a g ri cu lt u ra l co o p e ra ti ve s 16 0 a g ri cu lt u ra l co o p e ra ti ve s re ce iv in g in ce n ti ve s 3 0 0 a g ri cu lt u ra l co o p e ra ti ve s re ce iv in g in ce n ti ve s N u m b e r o f co m m o d it y o rg a n is at io n s b e n e fi ti n g fr o m t h e in st ru m e n ts 4 c o m m o d it y o rg a n is at io n s (r o u n d t a b le s) 5 c o m m o d it y o rg a n is at io n 9 c o m m o d it y o rg a n is at io n b a se d Table 7: Strategic interventions, specific activities, outputs, output indicators and targets for Strategic Objective 2 - continued N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 75 5.4 Strategic Objective 3: Expand targeted social protection measures and sustainable livelihood programmes Social protection and sustainable livelihoods are essential for access to safe and nutritious food, safe water, sanitation and health care. Social protection programmes provide an important safety net for South Africans of low socio-economic status, who would otherwise have been forced deeper into poverty. Without these programmes, the country’s GINI coefficient is 0.69. When these programmes are factored in, the GINI coefficient decreases to 0.67. Social protection is thus crucial in addressing food and nutrition security. Key actions include promoting the early registration of children born in public health facilities within the prescribed 30-day period; achieving a universal child grant for eligible children born in public facilities; and making public works programmes more nutrition sensitive; integrating social protection registration with food and nutrition education and improving provision of nutritious meals to targeted learners in to include at least 3 food groups per meal. Outcomes The outcomes expected from the implementation of the identified strategic interventions for Strategic Objective 3 are as follows: (h) Increased access of nutritious food among PVM (i) Improved coverage of children of PVM households by the child grant (j) Improved coverage of PVM by social protection programmes (k) Improve coverage of PVMs receiving food from food distribution centres (l) Enhanced livelihoods assets/Enhanced assets for resilient and sustainable livelihoods (m) Enhanced agency of PVMs for sustainable livelihoods development N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 76 Table 8: Strategic interventions, specific activities, outputs, output indicators and targets for Strategic Objective 3 S tr a te g ic O b je ct iv e 3 : E x p a n d t a rg e te d s o ci a l p ro te ct io n m e a su re s a n d s u st a in a b le l iv e lih o o d p ro g ra m m e s S tr at eg ic in te rv en ti o n S p ec ifi c ac ti v it ie s R es p o n si b ili ty O u tp u t O u tp u t in d ic at o r B as el in e 20 16 T ar g et 2 0 20 T ar g et 2 0 23 1. Im p ro ve t h e ch ild g ra n t re g is tr at io n sy st e m D H A , D O H , D S D R ev ie w a n d im p ro ve re g is tr at io n sy st e m o f in fa n ts a t b ir th In cr e a se in n u m b e r o f ch ild re n re g is te re d a t p u b lic h e a lt h f a ci lit ie s w it h in 3 0 d ay s N u m b e r o f in fa n ts b o rn in p u b lic h e a lt h fa ci lit ie s re g is te re d . (7 0 % in fa n ts re g is te r w it h in 3 0 d ay s o f b ir th ) R ev ie w o f re g is tr at io n sy st e m co m p le te d . N /A In cr e a se d n u m b e r o f ch ild re n re g is te re d w it h in 3 0 d ay s at p u b lic h e a lt h f a ci lit ie s. % o f in fa n ts b o rn in p u b lic a n d p ri va te h e a lt h fa ci lit ie s re g is te re d w it h in 3 0 d ay s in p o p u la ti o n re g is te r. 70 % o f 1 0 0 0 0 0 0 in fa n ts b o rn in p u b lic a n d p ri va te h e a lt h fa ci lit ie s. 8 0 % (5 % in cr e m e n t/ a n n u m 9 5 % D ev e lo p a ri g o ro u s re g is tr at io n st ra te g y o f in fa n ts a t b ir th S tr at e g y li n ki n g p re a n d p o st b ir th re g is tr at io n d ev e lo p e d R e g is tr at io n st ra te g y d ev e lo p e d D o H & H o m e A ff a ir s b ir th a n d ID re g is tr at io n sy st e m s C o m p re h e n s iv e p o lic y o n p re g n a n cy a n d m at e rn it y b e n e fi ts A p p ro ve d p o lic y o n p re g n a n cy a n d m at e rn it y b e n e fi ts . N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 77 S tr a te g ic O b je ct iv e 3 : E x p a n d t a rg e te d s o ci a l p ro te ct io n m e a su re s a n d s u st a in a b le l iv e lih o o d p ro g ra m m e s S tr at eg ic in te rv en ti o n S p ec ifi c ac ti v it ie s R es p o n si b ili ty O u tp u t O u tp u t in d ic at o r B as el in e 20 16 T ar g et 2 0 20 T ar g et 2 0 23 Im p le m e n t a u n iv e rs a l c h ild g ra n t re g is tr at io n f o r e lig ib le c h ild re n U n iv e rs a l C h ild G ra n t re g is tr at io n sy st e m s N u m b e r o f re g is te re d in fa n ts (< 1 ye a r) fr o m P V M h o u se h o ld s 5 1 7 1% o f e lig ib le c h ild re n re g is te re d f o r C h ild S u p p o rt G ra n t 10 % in cr e a se o f ch ild re n re g is te re d 15 % in cr e a se o f ch ild re n re g is te re d . 2 . D ev e lo p an in te g ra te d so ci al p ro te ct io n in fo rm at io n sy st e m t o im p ro ve a cc e ss to s o ci al as si st an ce p ro g ra m m e s D S D D O H , D H A , D B E , P ro v in ce s a n d lo ca l g o ve rn m e n t, ci v il so ci e ty , d ev e lo p m e n t p a rt n e rs D e si g n a n in te g ra te d a n d co n so lid at e d in fo rm at io n sy st e m w it h in a n d a cr o ss d e p a rt m e n ts In te g ra te d S o ci a l P ro te ct io n In fo rm at io n S ys te m ( IS P IS ) In te g ra te d S o ci a l P ro te ct io n In fo rm at io n S ys te m (I S P IS ) d ev e lo p e d F ra g m e n te d se ct o ra l in fo rm at io n sy st e m s 3 8 In te g ra te d S o ci a l P ro te ct io n In fo rm at io n S ys te m ( IS P IS ) p ilo te d in k ey d e p a rt m e n ts , D O H , D B E , D S D In te g ra te d S o ci a l P ro te ct io n In fo rm at io n S ys te m ex p a n d e d t o 1 0 D e p a rt m e n ts : D O H , D B E : D S D , D A F F, D R D L R , D W S , C o G TA , D P M E , D S B D , S ta ts S A 38 HANIS = DHA; SOCPEN & NISIS = (DSD); EMIS/Lurits = (DBE); NHIS = (DH); Indigent register = (DCG)38 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 78 S tr a te g ic O b je ct iv e 3 : E x p a n d t a rg e te d s o ci a l p ro te ct io n m e a su re s a n d s u st a in a b le l iv e lih o o d p ro g ra m m e s S tr at eg ic in te rv en ti o n S p ec ifi c ac ti v it ie s R es p o n si b ili ty O u tp u t O u tp u t in d ic at o r B as el in e 20 16 T ar g et 2 0 20 T ar g et 2 0 23 3 . E xp an d a n e tw o rk o f fe e d in g an d f o o d d is tr ib u ti o n s D S D & D B E P ro v id e n u tr it io u s m e a ls t h ro u g h co m m u n it y fe e d in g c e n tr e s P V M s a cc e ss n u tr it io u s fo o d N u m b e r o f E C D s p ro v id in g n u tr it io u s fo o d t o ta rg e te d P V M s. 2 7 7 2 8 E C D s 3 7 0 0 0 5 4 0 0 0 P V M s a cc e ss n u tr it io u s fo o d N u m b e r o f sc h o o ls p ro v id in g n u tr it io u s fo o d t o ta rg e te d P V M s 2 1 17 7 s ch o o ls 19 8 0 0 s ch o o ls 19 8 0 0 s ch o o ls P V M s a cc e ss N u tr it io u s fo o d N u m b e r o f C o m m u n it y N u tr it io n a n d D ev e lo p m e n t C e n tr e s (C N D C s) p ro v id in g n u tr it io u s fo o d t o ta rg e te d P V M s 16 7 C N D C s 2 5 7 C N D C s 3 0 2 C N D C s Table 8: Strategic interventions, specific activities, outputs, output indicators and targets for Strategic Objective 3 - continued N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 79 S tr a te g ic O b je ct iv e 3 : E x p a n d t a rg e te d s o ci a l p ro te ct io n m e a su re s a n d s u st a in a b le l iv e lih o o d p ro g ra m m e s S tr at eg ic in te rv en ti o n S p ec ifi c ac ti v it ie s R es p o n si b ili ty O u tp u t O u tp u t in d ic at o r B as el in e 20 16 T ar g et 2 0 20 T ar g et 2 0 23 3 . E xp an d a n e tw o rk o f fe e d in g an d f o o d d is tr ib u ti o n s D S D & D B E P ro v id e n u tr it io u s m e a ls t h ro u g h co m m u n it y fe e d in g c e n tr e s P V M s a cc e ss N u tr it io u s fo o d N u m b e r o f ch ild re n p ro v id e d w it h fo o d t h ro u g h E C D s 9 8 7 6 3 6 ch ild re n 1 5 0 0 0 0 0 1 5 0 0 0 0 0 P V M s a cc e ss N u tr it io u s fo o d N u m b e r o f le a rn e rs p ro v id e d w it h n u tr it io u s fo o d t h ro u g h N S N P 9 7 3 4 6 6 2 L e a rn e rs 9 .9 m ill io n 9 .9 m ill io n P V M s a cc e ss N u tr it io u s fo o d N u m b e r o f p e o p le p ro v id e d w it h fo o d t h ro u g h C N D C s 4 1 75 0 p e o p le re ce iv e d f o o d in C N D C s 6 4 2 5 0 p e o p le 75 0 0 0 p e o p le P V M s a cc e ss S o ci a l R e lie f o f D is tr e ss N u m b e r o f P V M s a cc e ss in g S o ci a l R e lie f o f D is tr e ss 6 0 0 5 5 P V M s. 12 0 0 0 0 P V M s 18 0 0 0 0 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 80 5.5 Strategic Objective 4: Scale up high impact nutrition interventions targeting women, infants and children The situational analysis reflected in Chapter 2 shows the need for scaling up high-impact, evidence-based nutrition interventions, which target vulnerable periods in the life cycle including preconception, pregnancy and lactation, infancy and childhood period. These interventions have improved nutrition outcomes globally. However, coverage rates of these programmes in South Africa are low. Key interventions include: Increased availability of micronutrient supplements, deworming tablets, fortified porridge and improved advocacy around exclusive breastfeeding. Improve ability of ECD centres, schools and CNDCs to address nutrition issues. Improvement of training and nutrition education focusing on community health workers and food handlers in ECD centres, schools and CNDCs. Outcomes The desired outcome is: Improved access, coverage and effectiveness of high-impact, nutrition-specific interventions targeting nutritionally vulnerable groups across the life course, with a focus on the first 1000 days. Key indicators: (a) Increased access and coverage: (i) Increased coverage of micronutrient supplements (folic acid and iron, calcium) for pregnant women and multiple micronutrient supplementation for undernourished (ii) Increased coverage of micronutrient supplements (vitamin A) in children (iii) Improved deworming coverage in children (b) Fostering positive behaviour change and adoption of healthy lifestyle, food and nutrition choices among vulnerable groups across the life course (linked to SO5): To track improvement in dietary diversity among vulnerable groups across the life course and particularly improvement in appropriate feeding practices among infants and young children, focus will be on key indicators such as: exclusive breastfeeding rates, Minimum Meal Frequency, Minimum Acceptable Diet (MAD) and increased dietary diversity for women of reproductive age (WRA), and Maternal Dietary Diversity Scores (MDD). Targeted, focused and needs-based roll-out to scale will be tailor-made for food-secure and food insecure communities, as reflected below: Status “Nutrition Secure” “Nutrition Insecure” Food Secure Sustain interventions • Improve utilization • Nutrition-specific interventions Food Insecure Agriculture, social protection and health interventions Food and Nutrition sensitive synergistic interventions N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 81 Table 9: Strategic interventions, specific activities, outputs, output indicators and targets for Strategic Objective 4 S tr a te g ic O b je ct iv e 4 : S ca le u p o f h ig h i m p a ct n u tr it io n i n te rv e n ti o n s ta rg e ti n g w o m e n , i n fa n ts a n d c h ild re n S T R A T E G IC IN T E R V E N T IO N S S P E C IF IC A C T IV IT IE S R E S P O N S IB IL IT Y O U T P U T O U T P U T IN D IC A T O R B A S E LI N E 20 16 TA R G E T 20 20 TA R G E T 20 23 1. Im p ro ve a cc e ss , co ve ra g e a n d e ff e ct iv e n e ss o f h ig h i m p ac t n u tr it io n s p e ci fi c in te rv e n ti o n s ta rg e ti n g n u tr it io n al ly vu ln e ra b le g ro u p s ac ro ss t h e li fe c yc le W R A a n d p re g n an t an d la ct at in g w o m e n (P LW ) ag e d 15 4 9 ye ar s: 1.1 In cr e as e t h e ac ce ss a n d co ve ra g e o f m ic ro n u tr ie n t su p p le m e n ts (f o lic a ci d a n d ir o n , *c al ci u m ) fo r p re g n an t an d la ct at in g w o m e n D O H In cr e as e d u p ta ke a n d u ti lis at io n o f m ic ro n u tr ie n t su p p le m e n ts fo r ta rg e te d p re g n an t an d la ct at in g w o m e n in p u b lic h e al th fa ci lit ie s P ro p o rt io n o f p re g n an t an d la ct at in g w o m e n re ce iv in g w it h m ic ro n u tr ie n t su p p le m e n ts N ew in d ic at o r: n o t ar g e ts se t fo r m ic ro n u tr ie n t (d at a so u rc e : A n te n at al C ar e (A N C ) re g is te r cl in ic al a u d it s 6 0 % o f p re g n an t an d la ct at in g w o m e n at te n d in g p u b lic h e al th fa ci lit ie s re ce iv in g m ic ro n u tr ie n ts su p p le m e n ts (f o lic a ci d a n d ir o n , c al ci u m ) 9 0 % o f p re g n an t an d la ct at in g w o m e n at te n d in g p u b lic h e al th fa ci lit ie s re ce iv in g m ic ro n u tr ie n t s su p p le m e n ts (f o lic a ci d a n d ir o n , c al ci u m ) 1.2 In cr e as e co ve ra g e o f m u lt ip le m ic ro n u tr ie n t su p p le m e n ta ti o n (M M N S ) am o n g sp e ci al t ar g e t p o p u la ti o n s: u n d e rn o u ri sh e d P LW H IV a n d T B p at ie n ts N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 82 S tr a te g ic O b je ct iv e 4 : S ca le u p o f h ig h i m p a ct n u tr it io n i n te rv e n ti o n s ta rg e ti n g w o m e n , i n fa n ts a n d c h ild re n S T R A T E G IC IN T E R V E N T IO N S S P E C IF IC A C T IV IT IE S R E S P O N S IB IL IT Y O U T P U T O U T P U T IN D IC A T O R B A S E LI N E 20 16 TA R G E T 20 20 TA R G E T 20 23 1.3 .S tr e n g th e n h e al th s ys te m s e ff e ct iv e n e ss to e n su re co n ti n u o u s su p p ly o f (a ) m ic ro n u tr ie n ts su p p le m e n ts (f o lic a ci d a n d ir o n , *c al ci u m ) an d (b ) m u lt ip le m ic ro n u tr ie n t su p p le m e n ts t o re ac h t h e ta rg e te d p o p u la ti o n D O H C o n ti n u o u s su p p ly o f m ic ro n u tr ie n t su p p le m e n ts (i ro n , f o la te an d c al ci u m ) an d m u lt ip le m ic ro n u tr ie n t su p p le m e n ts a t fa ci lit y le ve l E ff e ct iv e n e ss sc o re t o a ss e ss co ve ra g e m ic ro n u tr ie n t su p p le m e n ta ti o n E ff e ct iv e n e ss sc o re 6 6 .7 % f o r m ic ro n u tr ie n t su p p le m e n ts (S o u rc e : U 5 N u tr it io n E va lu at io n , 2 0 14 ) E ff e ct iv e n e ss sc o re 8 0 % E ff e ct iv e n e s s S co re 9 0 % Table 9: Strategic interventions, specific activities, outputs, output indicators and targets for Strategic Objective 4 - continued N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 83 S tr a te g ic O b je ct iv e 4 : S ca le u p o f h ig h i m p a ct n u tr it io n i n te rv e n ti o n s ta rg e ti n g w o m e n , i n fa n ts a n d c h ild re n S T R A T E G IC IN T E R V E N T IO N S S P E C IF IC A C T IV IT IE S R E S P O N S IB IL IT Y O U T P U T O U T P U T IN D IC A T O R B A S E LI N E 20 16 TA R G E T 20 20 TA R G E T 20 23 1.4 M o n it o ri n g cl in ic al e ff e ct iv e n e ss o f m ic ro n u tr ie n t su p p le m e n ta ti o n s (i ro n a n d f o la te an d c al ci u m ) an d m u lt ip le m ic ro n u tr ie n t su p p le m e n ta ti o n am o n g P LW , H IV an d T B c lie n ts D O H Im p ro ve d m ic ro n u tr ie n t st at u s am o n g ta rg e t p o p u la ti o n s P ro p o rt io n o f p re g n an t w o m e n o n ir o n a n d f o la te su p p le m e n t at io n w it h H b > 10 g /d L a t d e liv e ry N ew In d ic at o r: Ta rg e ts a re n o t se t fo r m ic ro n u tr ie n ts am o n g p re g n an t w o m e n (d at a so u rc e : A n te n at al C ar e (A N C ) re g is te r cl in ic al a u d it s (D C S T w o rk p la n ) 6 0 % o f w o m e n w it h H b > 10 g / d L a t d e liv e ry 8 0 % o f w o m e n w it h H b > 10 g / d L a t d e liv e ry N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 84 S tr a te g ic O b je ct iv e 4 : S ca le u p o f h ig h i m p a ct n u tr it io n i n te rv e n ti o n s ta rg e ti n g w o m e n , i n fa n ts a n d c h ild re n S T R A T E G IC IN T E R V E N T IO N S S P E C IF IC A C T IV IT IE S R E S P O N S IB IL IT Y O U T P U T O U T P U T IN D IC A T O R B A S E LI N E 20 16 TA R G E T 20 20 TA R G E T 20 23 1.5 In cr e as e ac ce ss a n d co ve ra g e o f h ig h e n e rg y & n u tr ie n t d e n se n u tr it io n al su p p le m e n ts f o r ta rg e t p o p u la ti o n s ac ro ss t h e li fe co u rs e : u n d e rn o u ri sh e d in fa n ts a n d ch ild re n , W R A (1 5 4 9 ) an d p e o p le le av in g w it h , i n cl u d in g H IV a n d T B cl ie n ts . D O H In cr e as e u p ta ke a n d u ti lis at io n o f n u tr it io n al su p p le m e n ts am o n g u n d e rn o u ri sh e d t ar g e t p o p u la ti o n s P ro p o rt io n o f ta rg e t p o p u la ti o n s re ce iv in g n u tr it io n al su p p le m e n ts U 5 C h ild re n : 6 9 % c h ild re n w it h M A M re ce iv e d n u tr it io n al su p p le m e n ts (S o u rc e : U 5 N u tr it io n E va lu at io n ) W R A , P LW , H IV an d T B : N ew In d ic at o r: Ta rg e ts a re n o t se t fo r n u tr it io n al su p p le m e n ts ac ro ss t h e li fe co u rs e U 5 C h ild re n : 8 0 % o f ch ild re n w it h M A M a n d S A M r e ce iv in g n u tr it io n al su p p le m e n ts W R A , P LW , H IV an d T B : 5 0 % o f th e u n d e rn o u ri sh e d ta rg e t p o p u la ti o n re ce iv in g n u tr it io n al su p p le m e n ts U 5 C h ild re n : 9 0 % o f ch ild re n w it h M A M a n d S A M r e ce iv in g n u tr it io n al su p p le m e n ts W R A , P LW , H IV an d T B : 8 0 % o f th e u n d e rn o u ri sh e d ta rg e t p o p u la ti o n re ce iv in g n u tr it io n al su p p le m e n ts Table 9: Strategic interventions, specific activities, outputs, output indicators and targets for Strategic Objective 4 - continued N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 85 S tr a te g ic O b je ct iv e 4 : S ca le u p o f h ig h i m p a ct n u tr it io n i n te rv e n ti o n s ta rg e ti n g w o m e n , i n fa n ts a n d c h ild re n S T R A T E G IC IN T E R V E N T IO N S S P E C IF IC A C T IV IT IE S R E S P O N S IB IL IT Y O U T P U T O U T P U T IN D IC A T O R B A S E LI N E 20 16 TA R G E T 20 20 TA R G E T 20 23 1.6 S tr e n g th e n h e al th s ys te m s e ff e ct iv e n e ss t o e n su re co n ti n u o u s su p p ly o f h ig h e n e rg y a n d n u tr ie n t d e n se n u tr it io n al su p p le m e n ts t o re ac h t h e ta rg e te d p o p u la ti o n : u n d e rn o u ri sh e d in fa n ts a n d ch ild re n , W R A (1 5 4 9 ) an d P LW , i n cl u d in g H IV a n d T B cl ie n ts . D O H C o n ti n u o u s av ai la b ili ty an d s u p p ly o f n u tr it io n al su p p le m e n ts at f ac ili ty le ve l E ff e ct iv e n e ss sc o re t o a ss e ss co ve ra g e m ic ro n u tr ie n t su p p le m e n ta ti o n N ew In d ic at o r: N o E ff e ct iv e n e ss sc o re m e as u re d in S o u rc e : U 5 N u tr it io n E va lu at io n , 2 0 14 E ff e ct iv e n e ss sc o re 8 0 % E ff e ct iv e n e ss S co re 9 0 % N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 86 S tr a te g ic O b je ct iv e 4 : S ca le u p o f h ig h i m p a ct n u tr it io n i n te rv e n ti o n s ta rg e ti n g w o m e n , i n fa n ts a n d c h ild re n S T R A T E G IC IN T E R V E N T IO N S S P E C IF IC A C T IV IT IE S R E S P O N S IB IL IT Y O U T P U T O U T P U T IN D IC A T O R B A S E LI N E 20 16 TA R G E T 20 20 TA R G E T 20 23 1.6 M o n it o ri n g cl in ic al e ff e ct iv e n e ss o f n u tr it io n al su p p le m e n ta ti o n am o n g t ar g e t p o p u la ti o n a cr o ss th e li fe c o u rs e : u n d e rn o u ri sh e d in fa n ts a n d ch ild re n a n d p e o p le le av in g w it h H IV a n d T B cl ie n ts D H Im p ro ve m e n t in w e ig h t g ai n an d o ve ra ll n u tr it io n al st at u s am o n g st th e t ar g e t p o p u la ti o n U 5 c h ild re n : P ro p o rt io n o f M A M a n d S A M t h at d ie in fa ci lit ie s (c as e fa ta lit y r at e, C F R ) B as e lin e : U 5 S A M in p at ie n t C F R (D H IS , 2 0 15 ): 8 .2 % U 5 M A M C F R : N ew in d ic at o r U 5 S A M in p at ie n t C F R (D H IS ): < 7 % U 5 M A M in p at ie n t C F R (D H IS ): < 6 % U 5 S A M in p at ie n t C F R (D H IS ): < 5 % U 5 M A M in p at ie n t C F R (D H IS ): < 4 % O ld e r ta rg e t g ro u p s: p ro p o rt io n o f ta rg e t g ro u p s re ce iv in g n u tr it io n al su p p le m e n ts ac h ie v in g ap p ro p ri at e w e ig h t g ai n o r im p ro ve m e n t in an th ro p o m e tr ic cr it e ri a O ld e r g ro u p s: N ew in d ic at o r O ld e r g ro u p s: > 5 0 % r e co ve ry ra te s O ld e r g ro u p s: > 8 0 % re co ve ry r at e s Table 9: Strategic interventions, specific activities, outputs, output indicators and targets for Strategic Objective 4 - continued N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 87 S tr a te g ic O b je ct iv e 4 : S ca le u p o f h ig h i m p a ct n u tr it io n i n te rv e n ti o n s ta rg e ti n g w o m e n , i n fa n ts a n d c h ild re n S T R A T E G IC IN T E R V E N T IO N S S P E C IF IC A C T IV IT IE S R E S P O N S IB IL IT Y O U T P U T O U T P U T IN D IC A T O R B A S E LI N E 20 16 TA R G E T 20 20 TA R G E T 20 23 1.7 U n d e rt ak e fa ci lit y a u d it s th ro u g h t h e id e al cl in ic p ro ce ss t o e n su re a va ila b ili ty o f st an d ar d e ss e n ti al an th ro p o m e tr ic e q u ip m e n t (M U A C t ap e s, in fa n t sc al e s, le n g th b o ar d s, st ad io m e te rs , B M I w h e e ls ) at e ac h f ac ili ty a n d m o b ile t e am s (W B O T S a n d sc h o o l h e al th te am s) D O H A ll fa ci lit ie s an d m o b ile t e am s (W B O T S a n d sc h o o l h e al th te am s) w it h fu n ct io n al an th ro p o m e tr ic e q u ip m e n t N u m b e r o f p ri m ar y h e al th ca re f ac ili ti e s re p o rt e d o n th e id e al c lin ic d as h b o ar d w it h f u n ct io n al an th ro p o m e tr ic e q u ip m e n t 3 2 2 P H C id e al fa ci lit ie s w it h fu n ct io n al an th ro p o m e tr ic e q u ip m e n t 2 8 2 3 P H C id e al f ac ili ti e s w it h f u n ct io n al e q u ip m e n t 3 4 7 7 P H C fa ci lit ie s w it h fu n ct io n al e q u ip m e n t N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 88 S tr a te g ic O b je ct iv e 4 : S ca le u p o f h ig h i m p a ct n u tr it io n i n te rv e n ti o n s ta rg e ti n g w o m e n , i n fa n ts a n d c h ild re n S T R A T E G IC IN T E R V E N T IO N S S P E C IF IC A C T IV IT IE S R E S P O N S IB IL IT Y O U T P U T O U T P U T IN D IC A T O R B A S E LI N E 20 16 TA R G E T 20 20 TA R G E T 20 23 IN FA N T S A N D C H IL D R E N A G E D 0 5 9 M O N T H S 1. In cr e as e a cc e ss an d c o ve ra g e o f b re as tf e e d in g an d co m p le m e n ta ry fe e d in g co u n se lli n g a n d su p p o rt am o n g w o m e n w it h C H W /W B O T S D O H Im p ro ve m e n ts in in fa n t an d yo u n g c h ild fe e d in g p ra ct ic e s P ro p o rt io n o f in fa n ts u n d e r 6 m o n th s ex cl u si ve ly b re as tf e d a s m e as u re d in D H IS a t 14 w e e ks (S o u rc e : D H IS ) 3 2 % e xc lu si ve ly b re as tf e d a t 6 m o n th s w e e ks (S A D H S 2 0 16 ) 5 0 % ex cl u si ve ly b re as tf e d a t 14 w e e ks 6 0 % ex cl u si ve ly b re as tf e d a t 14 w e e ks Table 9: Strategic interventions, specific activities, outputs, output indicators and targets for Strategic Objective 4 - continued N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 89 S tr a te g ic O b je ct iv e 4 : S ca le u p o f h ig h i m p a ct n u tr it io n i n te rv e n ti o n s ta rg e ti n g w o m e n , i n fa n ts a n d c h ild re n S T R A T E G IC IN T E R V E N T IO N S S P E C IF IC A C T IV IT IE S R E S P O N S IB IL IT Y O U T P U T O U T P U T IN D IC A T O R B A S E LI N E 20 16 TA R G E T 20 20 TA R G E T 20 23 2 . E st ab lis h h ig h q u al it y K an g ar o o m o th e r ca re (K M C ) u n it s, im p le m e n ti n g al l c o m p o n e n ts o f K M C , b y al lo ca ti n g d e d ic at e d s ta ff an d s p ac e f o r K M C b ab ie s an d in te g ra ti n g K M C in to e xi st in g in it ia ti ve s su ch a s M B F I & N ew b o rn C ar e P la n s D O H Im p ro ve m e n t in t h e q u al it y o f K M C p ro v id e d to lo w b ir th w e ig h t b ab ie s P ro p o rt io n o f L o w b ir th w e ig h t b ab ie s ad m it te d to f ac ili ty b as e d q u al it y K M C w h o s u rv iv e d (d is ch ar g e d al iv e) N ew in d ic at o r (D at a so u rc e : au d it s o f n e o n at al re g is te rs , P e ri n at al P ro b le m Id e n ti fi ca ti o n P ro g ra m m e (P P IP )) 6 0 % o f lo w b ir th w e ig h t b ab ie s in it ia te d o n f ac ili ty b as e d q u al it y K M C s u rv iv e d 8 0 % o f lo w b ir th w e ig h t b ab ie s in it ia te d o n f ac ili ty b as e d q u al it y K M C s u rv iv e d N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 90 S tr a te g ic O b je ct iv e 4 : S ca le u p o f h ig h i m p a ct n u tr it io n i n te rv e n ti o n s ta rg e ti n g w o m e n , i n fa n ts a n d c h ild re n S T R A T E G IC IN T E R V E N T IO N S S P E C IF IC A C T IV IT IE S R E S P O N S IB IL IT Y O U T P U T O U T P U T IN D IC A T O R B A S E LI N E 20 16 TA R G E T 20 20 TA R G E T 20 23 3 . I m p ro ve t h e ac ce ss a n d co ve ra g e o f G ro w th M o n it o ri n g a n d P ro m o ti o n ( G M P ) se rv ic e s an d e n su re e ff e ct iv e an d t im e ly re m e d ia l a ct io n s ar e t ak e n t o p re ve n t an d m an ag e a cu te m al n u tr it io n D O H R e d u ce d n u m b e r o f ch ild re n g ro w th fa lt e ri n g P ro p o rt io n o f u n d e r 5 c h ild re n re ac h e d w it h G M P (c o ve ra g e) 5 0 % G M P co ve ra g e (S o u rc e : U 5 N u tr it io n E va lu at io n ) 70 % G M P co ve ra g e 9 0 % G M P co ve ra g e P ro p o rt io n o f ch ild re n u n d e r 5 9 m o n th s w it h id e n ti fi e d w it h g ro w th f al te ri n g N ew in d ic at o r < 5 0 % o f ch ild re n u n d e r 5 w it h g ro w th fa lt e ri n g < 3 0 % o f ch ild re n u n d e r 5 w it h g ro w th f al te ri n g 4 . I n cr e as e v it am in A a n d d ew o rm in g co ve ra g e in ch ild re n 1 2 5 9 m o n th s D O H Im p ro ve d V it am in A a n d d ew o rm in g co ve ra g e am o n g c h ild re n 12 5 9 m o n th s N u m b e r o f ch ild re n < 12 m o n th s & 12 5 9 m o n th s re ce iv in g o n e d o se o f V it am in A e ve ry 6 m o n th s 57 .0 % 8 0 % o f ch ild re n 12 5 9 m o n th s re ce iv in g o n e d o se o f v it am in A a n d d ew o rm in g ev e ry 6 m o n th s 9 0 % o f ch ild re n 12 5 9 m o n th s re ce iv in g o n e d o se o f v it am in A a n d d ew o rm in g ev e ry 6 m o n th s Table 9: Strategic interventions, specific activities, outputs, output indicators and targets for Strategic Objective 4 - continued N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 91 S tr a te g ic O b je ct iv e 4 : S ca le u p o f h ig h i m p a ct n u tr it io n i n te rv e n ti o n s ta rg e ti n g w o m e n , i n fa n ts a n d c h ild re n S T R A T E G IC IN T E R V E N T IO N S S P E C IF IC A C T IV IT IE S R E S P O N S IB IL IT Y O U T P U T O U T P U T IN D IC A T O R B A S E LI N E 20 16 TA R G E T 20 20 TA R G E T 20 23 5 . I m p le m e n t fo o d an d n u tr it io n in te rv e n ti o n s to co m p ly w it h m in im u m n u tr it io n al st an d ar d s fo r E ar ly C h ild D ev e lo p m e n t (E C D ) (a m o n g o th e r st an d ar d s) t o e n su re ch ild re n ac ce ss in g E C D s it e s re ce iv e g o o d q u al it y a n d q u an ti ty o f n u tr it io u s fo o d s D O H D S D C h ild re n in E C D si te s re ce iv e d g o o d q u al it y an d q u an ti ty o f n u tr it io u s fo o d P ro p o rt io n o f E C D s it e s p ro v id in g g o o d q u al it y an d q u an ti ty n u tr it io u s fo o d s ac co rd in g t o th e m in im u m st an d ar d s “7 5 % o f E C D s it e s p ro v id in g fo o d ” (q u al it y n o t as se ss e d ) (S o u rc e : U 5 N u tr it io n al E va lu at io n , 2 0 14 ). 70 % o f E C D s it e s p ro v id in g g o o d q u al it y a n d q u an ti ty n u tr it io u s fo o d s ac co rd in g to t h e m in im u m st an d ar d s 9 0 % o f E C D si te s p ro v id in g g o o d q u al it y an d q u an ti ty n u tr it io u s fo o d s ac co rd in g t o th e m in im u m st an d ar d s N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 92 S tr a te g ic O b je ct iv e 4 : S ca le u p o f h ig h i m p a ct n u tr it io n i n te rv e n ti o n s ta rg e ti n g w o m e n , i n fa n ts a n d c h ild re n S T R A T E G IC IN T E R V E N T IO N S S P E C IF IC A C T IV IT IE S R E S P O N S IB IL IT Y O U T P U T O U T P U T IN D IC A T O R B A S E LI N E 20 16 TA R G E T 20 20 TA R G E T 20 23 S C H O O L G O IN G C H IL D R E N A G E D 7 1 4 Y E A R S D O H (s ch o o l h e al th ) D B E U N IC E F In cr e as e d n u m b e r o f le ar n e rs re ce iv in g d ew o rm in g in te rv e n ti o n a t sc h o o ls P ro p o rt io n o f ch ild re n in G ra d e R a n d G ra d e 1 in Q 1, Q 2 an d Q 3 S ch o o ls re ac h e d w it h d ew o rm in g m e d ic at io n 57 % ch ild re n re ac h e d th ro u g h ca m p ai g n (I S H P C am p ai g n R e p o rt , M ar ch 2 0 16 ) 75 % d ew o rm in g co ve ra g e 9 0 % d ew o rm in g co ve ra g e 2 . I n cr e as e a cc e ss an d c o ve ra g e o f an th ro p o m e tr ic sc re e n in g f o r p re ve n ti n g a n d m an ag in g m al n u tr it io n (u n d e r an d o ve r n u tr it io n ) am o n g le ar n e rs in Q 1 an d Q 2 sc h o o ls (G ra d e 1 a n d G ra d e 8 ) D O H D B E Im p ro ve d id e n ti fi ca ti o n an d r e fe rr al o f m al n o u ri sh e d ch ild re n P ro p o rt io n o f Q 1 an d Q 2 p ri m ar y sc h o o l c h ild re n sc re e n e d a n d ap p ro p ri at e ly re fe rr e d in G ra d e 1 an d G ra d e 8 G ra d e 1 : 2 5 % (S o u rc e : D H IS , A P P 2 0 15 /1 6 ) G ra d e 8 : 10 % (S o u rc e : D H IS , A P P 2 0 15 /1 6 ) G ra d e 1 : 4 5 % G ra d e 8 : 3 0 % G ra d e 1 : 6 5 % G ra d e 8 : 6 0 % Table 9: Strategic interventions, specific activities, outputs, output indicators and targets for Strategic Objective 4 - continued N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 93 S tr a te g ic O b je ct iv e 4 : S ca le u p o f h ig h i m p a ct n u tr it io n i n te rv e n ti o n s ta rg e ti n g w o m e n , i n fa n ts a n d c h ild re n S T R A T E G IC IN T E R V E N T IO N S S P E C IF IC A C T IV IT IE S R E S P O N S IB IL IT Y O U T P U T O U T P U T IN D IC A T O R B A S E LI N E 20 16 TA R G E T 20 20 TA R G E T 20 23 A D U LT S > 3 5 Y E A R S 1. Im p ro ve t h e q u al it y an d e ff e ct iv e n e ss o f cl in ic al s cr e e n in g an d as se ss m e n t, co u n se lli n g a n d su p p o rt f o r N C D , w it h fo cu s o n o b e si ty p re ve n ti o n a n d co n tr o l a t al l i d e al cl in ic s D O H H e al th , p ar tn e rs an d N G O ’s , p ri va te se ct o r Im p ro ve d id e n ti fi ca ti o n an d ap p ro p ri at e m an ag e m e n t o f N C D (o b e si ty ) P ro p o rt io n o f id e al c lin ic s co n d u ct in g B M I, w ai st ci rc u m fe re n ce an d li fe st y le co u n se lli n g 3 2 2 id e al cl in ic s (I d e al C lin ic d at ab as e, 2 0 15 ) 2 8 2 3 id e al cl in ic s (8 0 % co ve ra g e) 3 4 7 7 id e al cl in ic s (1 0 0 % co ve ra g e) N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 94 S tr a te g ic O b je ct iv e 4 : S ca le u p o f h ig h i m p a ct n u tr it io n i n te rv e n ti o n s ta rg e ti n g w o m e n , i n fa n ts a n d c h ild re n S T R A T E G IC IN T E R V E N T IO N S S P E C IF IC A C T IV IT IE S R E S P O N S IB IL IT Y O U T P U T O U T P U T IN D IC A T O R B A S E LI N E 20 16 TA R G E T 20 20 TA R G E T 20 23 2 . C ap ac it at e h e al th w o rk e rs t o p ro vi d e ap p ro p ri at e n u tr it io n su p p o rt w it h a st ro n g f o cu s o n p re ve n ti n g u n d e r an d o ve r n u tr it io n , in cl u d in g n u tr it io n al co u n se lli n g a n d su p p o rt , g ro w th m o n it o ri n g , co u n se lli n g a n d su p p o rt R o ll o u t e le ar n in g m e th o d s to a ll co m m u n it y se rv ic e h e al th p ro fe ss io n al s (d o ct o rs , n u rs e s, p h ar m ac is t an d d ie ti ci an s) D O H A ca d e m ic U n iv e rs it ie s U N IC E F W F P F H I3 6 0 an d o th e r p ar tn e rs C o m m u n it y se rv ic e h e al th p ro fe ss io n al s co m p e te n t in S A M c as e m an ag e m e n t P ro p o rt io n o f re g is te re d u se rs w h o h av e su cc e ss fu lly co m p le te d t h e e le ar n in g c o u rs e N ew in d ic at o r 5 0 % 70 % Table 9: Strategic interventions, specific activities, outputs, output indicators and targets for Strategic Objective 4 - continued N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 95 5.6 Strategic Objective 5: Influence people across the life cycle to make informed food and nutrition decisions through an integrated communication strategy The communication strategy focuses on the entire lifecycle. However ECD, school- going children, youth and adolescents are prioritised. SO5 is about creating an awareness platform on the tail end of the food value chain but nothing about how people can become more self-sufficient, i.e. at the beginning part of the food value-chain. The South African food system is rapidly changing and the dietary patterns of the increasingly urban population have also shifted. A national Behavior Change Communication (BCC) strategy is necessary to reduce the double burden of malnutrition. This will focus on tackling stunting and overweight through positively affecting the consumption of nutritious foods and promoting healthier lifestyles. Therefore, Strategic Objective 5 and its associated key activities described in Table 9 concentrates on behavioural change and the regulatory environment and the capacities of the outreach workers in the community. Currently the National Department of Health is developing a Breastfeeding Communication Strategy, updating the Road to Health Booklet (RTHB) and developing a RTHB app. It will then roll out a communication plan, targeted at healthcare workers and mothers, to drive more effective use of the RTHB. The South African Civil Society for Women, Adolescent’ and Children’s Health Coalition (SACSoWACH) is also developing an advocacy and communications plan, with DOH, for Maternal and Child Health (MCH). The aim is to incorporate all of these strategies into the national BCC, in addition to developing obesity, non-communicable disease (NCD) and WASH components. Nutrition education has been the role of health workers at hospital, PHC and at community level and teachers in schools Competing priorities, lack of knowledge and skills have all proved to be a hindrance to effective communication and a change in behaviour. New methodologies are required to be developed and a broad range of communication channels should be used. These could include media (TV, radio, social media, mobile phone-based communication, counselling aids and outdoor advertising), community platforms (schools, churches, stokvels, ECDs, home visits), infrastructure development (e.g. improve WASH facilities), existing school heath/departmental platforms (national health calendar, annual health campaigns, imbizos). An in-depth look at what would inspire South Africans to change their eating practices is necessary to create a demand for communication on good nutrition, health and WASH practices, as well as the uptake of government-driven interventions. The communication strategy should get South Africans excited about healthier eating and good health practices including breastfeeding, and should support the social protection, food and nutrition interventions of the public system. The communication strategy will be geared to raise awareness and thus demand regarding health care access, growth monitoring, assisting with birth registration, nutrition advice and hygiene advice. Strategic objective 5: Influence people across the life cycle to make informed food and nutrition decisions through an integrated communication strategy Outcome: Improved knowledge, attitudes and practices on FNS issues N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 96 Table 10: Strategic interventions, specific activities, outputs, output indicators and targets for Strategic Objective 5 S tr a te g ic o b je ct iv e 5 : In fl u e n ce p e o p le a cr o ss t h e l if e c yc le t o m a ke i n fo rm e d f o o d a n d n u tr it io n d e ci si o n s th ro u g h a n in te g ra te d c o m m u n ic a ti o n s tr a te g y S T R A T E G IC IN T E R V E N T IO N S S P E C IF IC A C T IV IT IE S R E S P O N S IB IL IT Y O U T P U T O U T P U T IN D IC A T O R B A S E LI N E 20 16 TA R G E T 20 20 TA R G E T 20 23 D ev e lo p a n d im p le m e n t an in te g ra te d a d vo ca cy an d c o m m u n ic at io n F N S s tr at e g y D o H , D S D , D A F F, G C S I, D P M E , D B E D ev e lo p a n d im p le m e n t an in te g ra te d ad vo ca cy a n d co m m u n ic at io n p la n le d b y th e D e p u ty P re si d e n t o f R S A . (K ey t e ch n ic al m e ss ag e s co lla te d a n d d ev e lo p e d in to a m e ss ag e b ri e fi n g d o cu m e n t) In te g ra te d ad vo ca cy a n d co m m u n ic at io n F N S s tr at e g y (K ey t e ch n ic al m e ss ag e s co lla te d ) in te g ra te d ad vo ca cy a n d co m m u n ic at io n F N S s tr at e g y ap p ro ve d b y o ffi ce o f th e D P (K ey t e ch n ic al m e ss ag e s co m p ile d a n d co lla te d ) D iff e re n t se ct o ra l st ra te g ie s ex is t In te g ra te d st ra te g y ap p ro ve d 2 0 17 In te g ra te d ad vo ca cy a n d co m m u n ic at io n F N S s tr at e g y im p le m e n te d in al l 5 2 d is tr ic ts E m p ir ic al su rv ey s re fl e ct im p ro ve d kn o w le d g e, at ti tu d e s an d p ra ct ic e s o n f o o d a n d n u tr it io n se cu ri ty is su e s In cr e as e d n u m b e r o f m e d ia p la tf o rm s co n ve y in g f o o d an d n u tr it io n m e ss ag e s N o in te g ra te d st ra te g y f o r d e liv e ri n g F o o d an d N u tr it io n S e cu ri ty m e ss ag e s P o te n ti al ly 3 2 .7 m ill io n li st e n e rs in S A ( to p 1 0 b ig g e st r ad io st at io n s) c an re ce iv e F N S m e ss ag e s F N S m e ss ag e s co m m u n ic at e d t h ro u g h al l 2 5 6 C o m m u n it y R ad io S ta ti o n s an d 2 0 co m m e rc ia l ra d io s ta ti o n s F N S m e ss ag e s co m m u n ic at e d th ro u g h a ll 2 5 6 C o m m u n it y R ad io S ta ti o n s st at io n a n d 4 0 co m m e rc ia l ra d io s ta ti o n s N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 97 S tr a te g ic o b je ct iv e 5 : In fl u e n ce p e o p le a cr o ss t h e l if e c yc le t o m a ke i n fo rm e d f o o d a n d n u tr it io n d e ci si o n s th ro u g h a n in te g ra te d c o m m u n ic a ti o n s tr a te g y S T R A T E G IC IN T E R V E N T IO N S S P E C IF IC A C T IV IT IE S R E S P O N S IB IL IT Y O U T P U T O U T P U T IN D IC A T O R B A S E LI N E 20 16 TA R G E T 20 20 TA R G E T 20 23 D S D , D O H , D B E Im p le m e n t n u tr it io n e d u ca ti o n at E C D a n d sc h o o ls ca re g iv e rs in r e g is te re d E C D s ar e kn o w le d g e ab le o n n u tr it io n N u m b e r o f E C D si te s re g is te re d w it h D S D w h e re n u tr it io n e d u ca ti o n is g iv e n 2 7 7 2 8 ( cu rr e n t n o . o f E C D si te s) 5 0 % o f th e to ta l n u m b e r o f E C D ca re g iv e rs in r e g is te re d E C D s 8 0 % o f th e to ta l n u m b e r o f E C D c ar e g iv e rs in r e g is te re d E C D s Y o u th a n d ad o le sc e n ts : I n cl u d e n u tr it io n e d u ca ti o n o n h e al th y fo o d ch o ic e s an d fo o d d iv e rs it y in ad o le sc e n t an d yo u th f ri e n d ly se rv ic e s an d B E W IS E M O B IS IT E A p p D O H , D B E , D H E T P ro m o te t h e N u tr it io n In te ra ct iv e A p p lic at io n am o n g yo u th a n d ad o le sc e n ts N u tr it io n e d u ca ti o n m e ss ag e s in co rp o ra te d in to t h e B E W IS E M O B IS IT E A p p N u m b e r o f yo u th a n d ad o le sc e n ts w h o a re re g is te re d to u se t h e (B E W IS E M O B IS IT E ) 14 2 1 2 3 u se rs (A u g u st 2 0 16 ) 5 0 0 0 0 0 1 m ill io n F o o d a n d N u tr it io n m e ss ag e s fo r A d o le sc e n t in co rp o ra te d in t h e y o u th fr ie n d ly se rv ic e s N u m b e r o f fa ci lit ie s in w h ic h Y o u th F ri e n d ly S e rv ic e s h av e in co rp o ra te fo o d a n d n u tr it io n m e ss ag e s. 0 % 4 0 7 ( 2 5 % ) fa ci lit ie s 57 0 ( 3 5 % ) fa ci lit ie s N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 98 CHAPTER 6: Monitoring and Evaluation (M&E) of the NFNS Plan 2018-2023 6.1 Strategic Objective 6: Develop a monitoring and evaluation system for food and nutrition security, including an integrated risk-management system for monitoring FNS- related risks 6.1.1 Inadequate information systems Improving food and nutrition security is a priority for South Africa. Timely, reliable and accurate data on the status of and trends in food insecurity and nutrition must inform policy, programmes and strategies. However, South Africa does not have a reliable and accurate system for identifying and analysing the conditions of the food insecure. Other challenges include the following: (a) Competing approaches to food insecurity measurement have emerged over time and no generally accepted framework exists on which to base the measurement. (b) Multiple contributing causes such as social norms, individual behaviour and stages in the human life cycle, food availability and quality – make it a problem that requires a comprehensive approach. (c) Nutrition is most accurately measured through costly anthropometric measures and biochemical analysis. The Global Nutrition Report 2015 states that South Africa has 22 missing indicators (listed in Chapter 7). (d) While many state-funded programmes have increased the ownership of productive assets and participation in the economy by food-insecure smallholders, employment levels and engagement in the agricultural sector have not realised the expected results. Although recent efforts to establish a Vulnerability Assessment Committee have explored the development of a national framework through DAFF, efforts are constrained by lack of funding, capacity shortages and inaccessibility of data – particularly when the data is under the custodianship of non-state actors. A simple, unified monitoring system needs to be established to guide action and hold stakeholders accountable. This system will also be utilised for tracking outcomes and inputs. The monitoring system should track food and nutrition status, but also indicators related to the other six strategic objectives. 6.1.2 Benefits of an effective and efficient M&E system A sound monitoring and evaluation system for food and nutrition security is essential, as it will: (a) Provide knowledge management to mobilise existing networks and expertise to assemble the needed capacities and knowledge and provide first rate analytical and advisory services regarding the design, implementation, and evaluation of the Plan; (b) Collect, collate and analyse data to support the implementation, performance appraisal, review and evaluation of the Plan and its components; (c) Generate, disseminate, and provide knowledge products to support implementation of the Plan, particularly shared standards and protocols for the collection, storage, and exchange of data as well as cutting-edge methodologies for policy and strategy analysis and integrated data system management for programmes; (d) Support the review and dialogue process to provide relevant and timely information to guide performance appraisal, review and impact evaluations. 6.1.3 Monitoring and evaluation coordination The effectiveness of the Plan will therefore be monitored through a national monitoring and evaluation system and learning from the lessons of the DPME outcomes-based N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 99 approach and the national evaluation system that will be led by the M&E Unit of the Council. The M&E Unit needs to be appropriately funded and as independent as possible. 6.1.4 Establishing the M&E Unit This will require: (a) Integration of relevant data and knowledge into a coherent knowledge management system; (b) Identifying gaps in information that are critical to decision making; (c) Establishment of a country knowledge network among researchers, policymakers, and other key stakeholders; (d) Synthesis of rural and agricultural information and knowledge; (e) Improving the data-base in the country through better integration and enhanced access to information available at the micro, meso, and macro levels (where possible, spatially referenced); (f) Identifying, applying, and disseminating an array of scientific tools and spatially based information systems to help in generating improved rural strategies and in assessing best investment options available for the country as a whole, for different regions and by development domain; (g) Building the necessary capacity for these tasks. 6.1.5 Functions of the M&E Unit Once established, the M&E Unit will: (a) Be located in DPME and collaborate with Stats SA and various statistical units in the collaborating departments. This will contribute to ensuring the integration of existing information systems. (b) Be accountable to the Food and Nutrition Security Council (c) Be responsible for the establishment, maintenance and delivery of data and knowledge products, reports and information. (d) Operate as per the model for Outcomes Data Management Systems, including a Data Forum for discussion and review of indicators and methods. (e) Be supported by the skills and capacity of researchers at South African Universities and responsible Public Entities in partnership with the private sector (f) Take the responsibility for reporting on SADC Vulnerability Assessments, SDGs, African Union Commission’s Agenda 2063 and CAADP, among others to avoid duplication of efforts, streamline reporting and its content and ensure accuracy. 6.2 Impact Indicators to be monitored The NFNS Plan 2018-2023 aims to achieve a huge positive impact in the lives of South Africans, and has therefore set ambitious targets. Table 11 below reflects a total of 17 impact indicators and the targets for 2023. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 100 Table 11: SMART Impact Indicators Impact Indicators Baseline Target for 2023 Data Source 1 Percentage (%) of households vulnerable to hunger 11.8% 5.7% General Household Survey (GHS) 2016 2 % of individuals vulnerable to hunger 13.4% 6.6% GHS 2016 Additional indicators 3 % of households experiencing hunger New TBD GHS 2018 4 % of individuals experiencing hunger New TBD GHS 2018 Decrease in months of food shortages among the poor, vulnerable and marginalised 5 % of households with inadequate or severely inadequate access to food 22.3% <10% GHS 2016 6 % of individuals with inadequate or severely inadequate access to food 24.9% <5% GHS 2016 Additional indicators 7 Number of months (and actual months) in which the household experienced food shortages New TBD GHS 2018 Reduced prevalence of under-nutrition in children (acute) 8 Wasting: Proportion of children below 5 years of age with height for weight <-2 Z-scores of the median WHO child growth standards 3% (increase from 2.2% in 2012, SANHANES-1, HSRC 2013) No increase in wasting South African Demographic and Health Survey (SADHS) 9 Stunting: Proportion of children below 5 years of age with height for age <-2 Z-scores of the median WHO child growth standards 27% (was 26,9% amongst children aged 1-3 years SANHANES-1, HSRC 2013) <20% in 2020 <15% in 2023 SADHS 2016 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 101 Impact Indicators Baseline Target for 2023 Data Source Reduced prevalence of over-nutrition in children 10 Overweight: Proportion of children less than 5 years of age with height for weight >+2 Z-scores of the median WHO child growth standards 13% in 2016 (decrease from 14% in 2012, SANHANES-1 2013) No increase in child overweight by 2020, 10% reduction by 2022 SADHS Reduced prevalence of Low Birth Weight 11 Prevalence of infants born <2500g (%, proportion of total live births) 13% (117 510 of 901 652 live births) 30% reduction By 2023 DHIS 12 Prevalence of exclusive breastfeeding (%) at 6 months 32% 50% by 2023 SADHS 2016 Reduced prevalence of over-nutrition in adults (Women aged 15 years and above)) Overweight: Women 13 Body Mass Index (BMI): Weight in kilograms divided by the square of height in metres (kg/m2 26.6% in 2016 decreased from 39% in 2012 (women over 15 years and above) 10% reduction by 2020 15% reduction by 2023 SADHS 2016 SANHANES 2012 Obesity: Women 14 BMI 41% in 2016 worsened from 24.8% (women aged 15 years and above) 10% reduction by 2020 15% reduction by 2023 SADHS 2016 SANHANES 2012 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 102 Impact Indicators Baseline Target for 2023 Data Source Reduced prevalence of over-nutrition in adults (Men aged 15 years and above)) Overweight: Men (aged 15 years and above) 15 BMI 20.3% in 2016 (was 19,6% in 2012) (men aged 15 years and above) 10% reduction by 2020 15% reduction by 2023 SADHS 2016 SANHANES 2012 Obesity: Men (aged 15 years and above) 16 BMI 11% in 2016 (was 11.6% in 2012) 10% reduction by 2020 15% reduction by 2023 SADHS 2016 SANHANES 2012 Reduced prevalence of Vitamin and Mineral Deficiencies 17 Percentage (%) of women of reproductive age (16-35 years) who have a haemoglobin level of less than 11g/dl 23.1% (SANHANES 2013) 25% reduction by 2020 (to 17.3%) 50% reduction by 2023 (to 11.5%) SADHS N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 103 6.5 Evaluation of the effectiveness of interventions A follow-up evaluation study will be commissioned in 2020, to assess the country’s progress on the implementation of the high-impact nutrition interventions as recommended in the diagnostic evaluation of nutrition interventions for children under 5 years of age. Strategic Objective 6: Develop a monitoring and evaluation system for FNS, including an integrated risk-management system for monitoring FNS-related risks Intended Outcomes: (a) Improved availability and quality of FNS information (b) Improved accountability for results of FNS interventions (c) Improved FNS risk management (d) Improved utilisation of FNS information in strategic decision-making. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 104 Table 12: Strategic interventions, specific activities, outputs, outputs indicators and targets for strategic objective 6 S tr a te g ic O b je ct iv e 6 : D e ve lo p a m o n it o ri n g a n d e va lu a ti o n s ys te m f o r F o o d a n d N u tr it io n S e cu ri ty i n S o u th A fr ic a a n d e st a b lis h a n i n te g ra te d r is k m a n a g e m e n t sy st e m f o r m o n it o ri n g F N S r e la te d r is k s. S tr at eg ic in te rv en ti o n s R es p o n si b ili ty S p ec ifi c A ct iv it ie s O u tp u t O u tp u t In d ic at o r B as el in e 20 16 T ar g et 2 0 20 T ar g et 20 23 E st ab lis h a c o re se t o f in d ic at o rs fo r m o n it o ri n g F N S p ro g re ss an d r is ks S ta ts S A / D A F F O th e r ke y d e p ar tm e n ts a n d so ci al p ar tn e rs : D P M E , D O H , D B E , C O G TA Id e n ti fy , r ev ie w an d in te g ra te a co re s e t o f F N S in d ic at o rs in n at io n al s u rv ey s fo r co n ti n u o u s su rv e ill an ce o f F N S in te rv e n ti o n s an d t h e ir im p ac ts C o n si st e n t se t o f co re in d ic at o rs in co rp o ra te d in n at io n al s u rv ey s, w h ic h in cl u d e : • % o f h o u se h o ld s e x p e ri e n c in g h u n g e r • % o f in d iv id u a ls e x p e ri e n c in g h u n g e r R e p o rt o f th e G H S 2 0 17 an d s u b se q u e n t su rv ey s in co rp o ra ti n g se t o f co re in d ic at o rs C o re s e t o f F N S in d ic at o rs in cl u d e d in p re v io u s G H S , b u t n o t co m p re h e n si ve G H S 2 0 17 G H S 2 0 18 G H S 2 0 19 co lle ct in g d at a o n t h e ex p an d e d se t o f co re in d ic at o rs F o o d a n d N u tr it io n st at is ti cs p u b lic at io n p ro d u ce d an n u al ly A ll su b se q u e n t G H S co lle ct in g d at a o n t h e ex p an d e d se t o f co re in d ic at o rs F o o d a n d N u tr it io n st at is ti cs p u b lic at io n p ro d u ce d an n u al ly N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 105 S tr a te g ic O b je ct iv e 6 : D e ve lo p a m o n it o ri n g a n d e va lu a ti o n s ys te m f o r F o o d a n d N u tr it io n S e cu ri ty i n S o u th A fr ic a a n d e st a b lis h a n i n te g ra te d r is k m a n a g e m e n t sy st e m f o r m o n it o ri n g F N S r e la te d r is k s. S tr at eg ic in te rv en ti o n s R es p o n si b ili ty S p ec ifi c A ct iv it ie s O u tp u t O u tp u t In d ic at o r B as el in e 20 16 T ar g et 2 0 20 T ar g et 20 23 C o n d u ct ev al u at io n s o f th e N F N S P la n 2 0 18 2 0 2 3 D P M E S ta ts S A D o H D A F F D S D D B E C o n d u ct a n im p le m e n ta ti o n ev al u at io n o f th e N F N S P la n 2 0 18 2 0 2 3 Im p le m e n ta ti o n ev al u at io n o f th e N F N S P la n 2 0 18 2 0 2 3 co m p le te d R e p o rt o n t h e im p le m e n ta ti o n ev al u at io n o f th e N F N S P la n 2 0 18 2 0 2 3 ap p ro ve d b y t h e F N S C o u n ci l N o n e. N F N S P la n 2 0 18 2 0 2 3 n ew ly d ev e lo p e d Im p le m e n ta ti o n ev al u at io n o f th e N F N S P la n 2 0 18 2 0 2 3 co m p le te d b y D e ce m b e r 2 0 2 0 R e su lt s o f th e E va lu at io n o f th e N F N S P la n 2 0 18 2 0 2 3 u se d t o im p ro ve d e liv e ry o f F N S p ro g ra m m e s S u m m at iv e ev al u at io n o f th e N F N S P la n 2 0 18 2 0 2 3 co m p le te d R e p o rt o n t h e su m m at iv e ev al u at io n o f th e N F N S P la n 2 0 18 2 0 2 3 ap p ro ve d b y t h e F N S C o u n ci l N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 106 6.4 Creation of an integrated risk-management system for monitoring FNS- related risks National food security is foundational to ensuring household food security and sound nutrition, and essential for peace and stability. Food and nutrition outcomes are sensitive to shocks related to weather, prices, crop and animal diseases, and conflict. The establishment of a risk register is essential to guide action. The state has an important role in protecting and ensuring national food supply and supporting the self- provisioning of households. This is achieved through various means, including deliberate policies, strategies, legislation and programmes to encourage sustainable food production, technology development and research into production, processing, storage and food safety. Food production, processing, storage, distribution and trade are prone to multiple risks throughout the entire food system (from farm to fork) and across all elements of value chains. These risks need to be identified, mitigation measures need to identified and contingency plans and funds established. Monitoring of risks and analysis of their potential impact is essential to inform preventative measures to reduce risk, early warning systems to alert the state and the population of impending hazards and crises, and emergency response mechanisms. While a national disaster risk unit does exit, it does not currently deal with food insecurity risks except for responding to emergency situations related to natural disasters and diseases. In cases of emergency, survival and management depend on the rapid assessment of the severity and extent (number of people affected) of the impact and having the resources (financial, human and provisions) to respond. Emergency readiness requires careful planning, coordination and mobilisation of a range of services. This demands budgeting for contingency funds. The current drought demands immediate planning for a possible emergency situation with regard to food and water supply. A regional food emergency is possible in the SADC region, which could put significant pressure on the country from both within the country and within the region. Climate change and climate uncertainty increase risk (risks to production as well disease risks) in all agricultural systems. Climate change also creates greater uncertainties for farmers, fisherfolk and foresters, as well as the insurers and financial lending institutions that underpin production. New forms of risk are also emerging related to foreign interest in agricultural production and export of agricultural products, including fresh milk and fish, to meet food demands and food security needs in other countries. Many of these intensive production systems impose additional risks to the environment and livelihoods of local populations. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 107 Ta b le 1 3 : S tr a te g ic i n te rv e n ti o n s, s p e ci fi c a ct iv it ie s, o u tp u ts , o u tp u t in d ic a to rs a n d t a rg e ts f o r S tr a te g ic O b je ct iv e 6 S tr at eg ic in te rv en ti o n s R es p o n si b ili ty S p ec ifi c A ct iv it ie s O u tp u t O u tp u t In d ic at o r B as el in e 20 16 T ar g et 20 20 T ar g et 20 23 E st ab lis h a F N S r is k re g is te r fo r th e c o u n tr y D A F F, D o H , D P M E , N at io n al D is as te r M an ag e m e n t C e n tr e, N at io n al In te lli g e n ce A g e n cy A n al ys e p o te n ti al F N S h az ar d s an d ri sk s an d t h e ir im p ac ts , in cl u d in g c lim at e ch an g e, d ro u g h t, p ri ce in cr e as e s/ fl u ct u at io n s, p e st s, f o o d s af e ty / b io te ch n o lo g y, r is ks f o r n u tr it io n , f o o d in d u st ry ca rt e ls e tc . P ro fi le r is ks t o w h ic h t h e co u n tr y is v u ln e ra b le an d h o w t h ey s h o u ld b e a d d re ss e d a s p ar t o f th e F N S d is as te r p re p ar e d n e ss an d m an ag e m e n t m e ch an is m A n al ys is a n d ra ti n g o f d iff e re n t h az ar d s an d th e ir im p ac ts R e p o rt o n an al ys is an d r at in g o f d iff e re n t h az ar d s an d th e ir im p ac ts N A M C p ri ce m o n it o ri n g re p o rt s, S u p p ly a n d D e m an d C o m m it te e, C ro p E st im at e s C o m m it te e re p o rt s, S ta ts S A R e p o rt s an d o th e r D is as te r re la te d re p o rt s u n d e r S A N at io n al D is as te r M an ag e m e n t C e n tr e R is ks a n d H az ar d s A n al ys is co m p le te d U p d at e d R is ks an d H az ar d s A n al ys is Table 13: Strategic interventions, specific activities, outputs, output indicators and targets for Strategic Objective 6 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 108 Ta b le 1 3 : S tr a te g ic i n te rv e n ti o n s, s p e ci fi c a ct iv it ie s, o u tp u ts , o u tp u t in d ic a to rs a n d t a rg e ts f o r S tr a te g ic O b je ct iv e 6 S tr at eg ic in te rv en ti o n s R es p o n si b ili ty S p ec ifi c A ct iv it ie s O u tp u t O u tp u t In d ic at o r B as el in e 20 16 T ar g et 20 20 T ar g et 20 23 D ev e lo p m e ch an is m s to ad d re ss fo o d a n d n u tr it io n se cu ri ty r is ks a n d h az ar d s b y : 1. E st ab lis h in g a st ra te g ic g ra in . re se rv e f ac ili ty , 2 . In st it u ti n g co n su m e r an d p ro d u ce r p ri ce s u p p o rt m e ch an is m f o r th e b e n e fi t o f th e p o o r. 3 . R ev ie w M ar ke ti n g o f A g ri cu lt u ra l P ro d u ce A ct o f 19 9 6 a n d o th e r re le va n t le g is la ti o n im p ac ti n g o n f o o d se cu ri ty 4 . E st ab lis h e ff e ct iv e s m al lh o ld e r an d c o m m u n it y f ar m in g su p p o rt p ro g ra m m e s, in cl u d in g fa rm e r le d s e e d s ys te m M e ch an is m s o f ad d re ss in g ri sk s an d h az ar d s in cl u d in g g ra in r e se rv e fa ci lit y, p ri ce su p p o rt m e ch an is m an d le g is la ti o n t o e n ab le S ta te p ar ti ci p at io n in t h e f o o d S ys te m R e p o rt s o n im p le m e n ta ti o n o f d iff e re n t m e ch an is m s to a d d re ss F N S r is ks (E st ab lis h in g a g ra in r e se rv e fa ci lit y, In st it u ti n g p ri ce s u p p o rt m e ch an is m e tc , R ev ie w M ar ke ti n g A g ri cu lt u ra l p ro d u ce a ct o f 19 9 6 a n d o th e r re le va n t m ar ke ti n g le g is la ti o n ) 1. S A F E X sy st e m 2 . C u rr e n t le g is la ti o n o n m ar ke ti n g o f ag ri cu lt u ra l co m m o d it ie s 1. G ra in re se rv e f ac ili ty d e si g n e d 2 . F o o d p ri ce s u p p o rt m e ch an is m d e si g n e d 3 . R ev ie w M ar ke ti n g o f A g ri cu lt u ra l P ro d u ce A ct o f 19 9 6 a n d o th e r re le va n t le g is la ti o n 1. G ra in re se rv e f ac ili ty im p le m e n te d 2 . P ri ce s u p p o rt m e ch an is m im p le m e n te d 3 . A m e n d e d M ar ke ti n g o f A g ri cu lt u ra l P ro d u ce A ct im p le m e n te d Table 13: Strategic interventions, specific activities, outputs, output indicators and targets for Strategic Objective 6 - continued N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 109 Ta b le 1 3 : S tr a te g ic i n te rv e n ti o n s, s p e ci fi c a ct iv it ie s, o u tp u ts , o u tp u t in d ic a to rs a n d t a rg e ts f o r S tr a te g ic O b je ct iv e 6 S tr at eg ic in te rv en ti o n s R es p o n si b ili ty S p ec ifi c A ct iv it ie s O u tp u t O u tp u t In d ic at o r B as el in e 20 16 T ar g et 20 20 T ar g et 20 23 E n h an ce ca p ac it y fo r g e n e ra ti n g a n d u si n g F N S a n d ri sk m o n it o ri n g an d e va lu at io n in fo rm at io n S ta ts S A , D A F F, D o H , D P M E , P D A ’s , o th e r d e p ar tm e n ts & ag e n ci e s Id e n ti fy g ro u p s v u ln e ra b le t o d iff e re n t F N S r is ks a n d p ro fi le th e m R is k p ro fi le s fo r v u ln e ra b le g ro u p s co m p le te d R e p o rt s o n t h e R is k p ro fi le s o f v u ln e ra b le g ro u p s S o u th A fr ic an V u ln e ra b ili ty A ss e ss m e n t S ys te m (S A V A C ) in p la ce R is k p ro fi le s fo r v u ln e ra b le g ro u p s co m p le te d an n u al ly In te rv e n ti o n s o f th e F N S 2 0 18 2 0 2 3 m o d ifi e d to p ri o ri ti se p ro fi le d v u ln e ra b le g ro u p s R is k p ro fi le s fo r v u ln e ra b le g ro u p s co m p le te d b i an n u al ly N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 110 6.5 Research South Africa need to develop strong evidence based interventions to effectively guide policy and ensure that it makes the best use of the county’s limited resources. There is a dearth of food security and nutrition-related research being undertaken in the country. Researchers and policy makers together need to agree on research priority areas around health, nutrition, food security and social policy including ECD. Furthermore, a number of key indicators are not routinely collected in South Africa (See Table 14). This makes it difficult to mark progress and assess achievements against other countries. There is a need for specific indicators to be included in future surveys and research agendas where their absence is a constraint to effective action. Table 14 Key indicators not routinely collected in South Africa Indicator 1 Changes in stunting prevalence over time, by wealth quintile 2 Overweight and obesity among children 3 Adolescent and adult anthropometry (% population), overweight, obesity 4 Women of reproductive age, thinness 5 Women of reproductive age, short stature 6 Micronutrient status of population including anaemia among children and women of reproductive age 7 Vitamin A deficiency in preschool-age children (%) 8 Population classification of iodine nutrition (age group 6-12) 9 Intervention coverage and child-feeding practices 10 Continued breastfeeding at 1 year 11 Iodized salt consumption and iodine nutrition 12 Infant and young-child feeding practices (% 6-23 months); Minimum acceptable diet 13 Infant and young-child feeding practices (% 6-23 months); Minimum dietary diversity 14 Aquaponics N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 111 CHAPTER 7: Priority Districts The National Food and Nutrition Security Plan 2018-2023 seeks to achieve a national footprint, in which the identified interventions are consulted and implemented across all Provinces and municipalities. However, the plan takes into acount that the burden of food insecurity and concomitant poor nutrition is not equally prevalent across the entire country. In keeping with the principles of equity and social solidarity, the interventions outlined in the foregoing chapters of the plan will in the immediate term be dedicated to districts that have been identified as priority districts. 7.1 The 27 Priority District areas In June 2011, Cabinet identified 21 Priority District areas having less than 30% access to basic services. This was subsequently extended to 24 district areas, which include Amathole, Xhariep, and uMgungundlovu District Municipalities. An additional 3 Priority District areas have been identified, but the focus for these areas is on ensuring that they develop economically, based on current and potential mining activities. Below is the list of Priority District areas, indicating the number of households below basic level of service (water, sanitation, refuse removal and electricity) as informed by the Census of 2011. Table 15: Original 27 Priority Districts No. Name of Municipality Total households Backlog - Access to Basic Services Below Basic Water Below Basic Sanitation Below Basic electricity Below Basic Refuse Removal 1 Amathole 237 776 86 580 125 438 59 499 156 883 2 Chris Hani 210 852 48 367 80 571 42 698 118 714 3 Joe Gqabi 97 775 31 164 39 170 26 313 56 143 4 OR Tambo 298 229 150 277 131 242 75 566 207 047 5 Xhariep 45 368 1 181 5 758 3 162 10 610 6 Ugu 179 440 48 587 66 435 42 456 99 482 7 uMgungundlo vu 272 666 29 480 54 785 31 366 107 881 8 Uthukela 147 286 36 552 43 461 30 450 73 608 9 Umzinyathi 113 469 41 292 39 595 47 153 69 341 10 Amajuba 110 963 10 454 30 978 14 274 34 854 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 112 No. Name of Municipality Total households Backlog - Access to Basic Services Below Basic Water Below Basic Sanitation Below Basic electricity Below Basic Refuse Removal 11 Zululand 157 748 44 165 56 934 36 428 87 661 12 uMkhanyaku de 128 195 48 535 44 541 63 692 86 334 13 uThungulu 202 976 35 227 64 313 38 146 100 260 14 Ilembe 157 692 38 110 45 477 36 188 75 979 15 Ehlanzeni 445 087 101 653 203 251 42 091 245 953 16 Mopani 296 320 73 387 147 470 29 299 195 163 17 Vhembe 335 276 84 584 165 045 37 676 222 972 18 Capricorn 342 838 53 526 158 292 35 278 180 562 19 Waterberg 179 866 18 015 55 219 17 867 70 776 20 Bojanala Platinum 501 696 59 038 169 403 57 744 160 970 21 Ngaka Modiri Molema 227 001 46 164 97 333 37 747 108 862 22 Dr Ruth Segomotsi Mompati 125 270 21 437 41 260 19 722 69 790 23 Sisonke 112 282 41 819 45 729 35 260 68 890 24 Alfred Nzo 169 261 86 435 82 346 76 534 126 571 25 John Taolo Gaetsewe 61 331 11 061 20 672 6 601 31 829 26 Sekhukhune 263 802 77 765 156 520 30 165 177 479 27 West Rand 267 397 15 333 26 845 40 021 40 316 Total 8 283 239 1 460 759 2 587 477 1 253 444 3 468 183 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 113 Focused implementation of the 6 strategic objectives of the NFNSP 2018-2023 will take place in these 27 districts. Using other criteria inclusive of health indicators, the list was expanded to 32 districts. The NFNSP 2018-2023 was tabled before the Technical Committee of the Department of Cooperative Governance and Traditional Affairs (COGTA), consisting of the Director-General and Provincial Heads of Department (HoDs), in July 2017. It was endorsed. The NFNSP 2018-2023 was subsequently presented to the MinMEC (meeting of the Minister and the Members of the Executive Councils) of COGTA in August 2017. The COGTA MinMEC also endorsed the Plan. Table 16: Priority Districts for implementation of the Food and Nutrition Security Plan No. DISTRICT SEQ LEVEL COGTA PRIORITY DISTRICT IN-FACILITY SEVERE ACUTE MALNUTRITION CASE FATALITY RATE (2015/16) 1. A Nzo: DC44 1 yes High 2. Amathole: DC12 1 yes High 3. C Hani: DC13 1 yes High 4. Joe Gqabi: DC14 1 yes High 5. OR Tambo: DC15 1 yes High 6. uMkhanyakude: DC27 1 yes High 7. uMzinyathi: DC24 1 yes High 8. Zululand: DC26 1 yes High 9. Harry Gwala: DC43 1 yes High 10. Sekhukhune: DC47 1 yes High 11. RS Mompati: DC39 1 yes High 12. iLembe: DC29 2 yes High 13. Ugu: DC21 2 yes High 14. uThukela: DC23 2 yes High 15. uThungulu: DC28 2 yes High 16. Capricorn: DC35 2 yes High 17. Mopani: DC33 2 yes High 18. Vhembe: DC34 2 yes High 19. JT Gaetsewe: DC45 2 yes High N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 114 No. DISTRICT SEQ LEVEL COGTA PRIORITY DISTRICT IN-FACILITY SEVERE ACUTE MALNUTRITION CASE FATALITY RATE (2015/16) 20. Pixley ka Seme: DC7 2 no High 21. NM Molema: DC38 2 yes High 22. S Baartman: DC10 3 no Low 23. Xhariep: DC16 3 yes High 24. T Mofutsanyana: DC19 3 no Low 25. Amajuba: DC25 3 yes High 26. uMgungundlovu: DC22 3 yes High 27. Waterberg: DC36 3 yes High 28. Ehlanzeni: DC32 3 yes High 29. G Sibande: DC30 3 no High 30. ZF Mgcawu: DC8 3 no within national target 31. Bojanala: DC37 3 yes High 32. West Rand: DC48 4 yes Low N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 115 CHAPTER 8: Costing and financing the NFNSP 2018 2023 and when activities will happen and what types of resources will be required. In the absence of this level of detail, the costing exercise makes assumptions about the quantity and prices of inputs. Thus, the estimates in this report provide an approximate cost associated with each of the strategic objectives mentioned in the NFNS Plan, based on estimates of unit costs and quantities. The cost estimates serve two purposes. First, they identify the cost drivers under each strategic objective. Cost drivers are causal factors in programmes that influence the cost of producing a services or product. For instance, a key cost driver in the SA GAP certification process is the number of audits required by the PPECB to reach the certification targets. Second, the cost estimates provide an indication of the resources required to implement each activity. By providing this information, this costing report makes the trade-offs between the different policy options and implementation approaches in the NFNS Plan explicit, so that they can be deliberated and discussed by all stakeholders. The costing model has been created in an Excel Workbook to make it is accessible to a wide range of users. The model contains spreadsheets for each strategic objective and presents the costing results by year according to the various assumptions made. The section below presents the costing results estimated by the model. The cost estimates are based on the overarching assumption that all targets presented in the NFNS Plan’s implementation plan are achieved. Further parameter assumptions underlying the results are presented in Annexure 5. 8.1 Introduction For each of the 6 strategic objectives of the NFNS Plan 2018-2023, the plan has set out several interventions, activities and outputs, with indicators and targets that explain how the objectives will be achieved and what success will look like. To ensure that these targets are realised, the required interventions need to be costed to estimate the resources required to implement the plan. This chapter presents the estimates of the costs of implementing the NFNS Plan. In doing so, it provides policy-makers with the information and evidence they need to make informed choices about the plan’s implementation, and to understand the resourcing requirements and trade-offs associated with the plan’s inherent choices. The estimates presented in this report are based on information gathered in the course of several workshops with the various departments and agencies involved in the NFNS Plan. Over the course of these engagements, additional information has been collected that elaborates on the high level activities and outputs in the NFNS Plan. This level of detail was not only beneficial to the costing exercise, but also provided an opportunity for departments and agencies to think through their approach to implementing the NFNS Plan over the next 5 years. 8.2 Approach to costing Any costing exercise relies on the best available information at the time. The NFNS Plan is a comprehensive plan insofar as it covers a wide range of interventions across various sectors and departments. That said, it lacks the detail of an implementation plan that specifies how N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 116 8.3 Costing results 8.3.1 Aggregate costs Table 17 below displays a summary of the aggregate costs associated with each of the plan’s strategic objectives and an indication of the percentage contribution each makes to the total cost of the plan over the period. Table 17: Aggregate costs R m ill io n s 20 18 /1 9 20 19 /2 0 20 20 /2 1 20 21 /2 2 20 22 /2 3 To ta l % o f to ta l S O 1: E st a b lis h a m u lt i se c to ra l g o ve rn a n ce a n d le a d e rs h ip s tr u c tu re f o r co o rd in a ti n g F N S p o lic ie s a n d p ro g ra m m e s R 2 .3 8 R 3 .3 1 R 3 .8 0 R 4 .3 4 R 4 .9 3 R 18 .7 6 0 .0 2 % S O 2 : E st a b lis h i n c lu si ve lo c a l fo o d v a lu e c h a in s to s u p p o rt a cc e ss t o n u tr it io u s, a ff o rd a b le fo o d R 3 9 5 5 .2 3 R 10 2 7 7. 9 2 R 14 4 5 9 .4 1 R 17 6 2 7. 4 0 R 2 1 5 5 9 .4 3 R 6 7 8 7 9 .3 9 7 8 .2 0 % S O 3 : E x p a n d t a rg e te d so c ia l p ro te c ti o n m e a su re s a n d s u st a in a b le liv e lih o o d p ro g ra m m e s R 6 2 6 .8 4 R 1 4 0 3 .2 8 R 2 1 9 3 .7 0 R 2 9 4 0 .6 3 R 3 9 9 1. 7 3 R 11 1 5 6 .17 12 .8 5 % S O 4 : S c a le u p h ig h im p a c t n u tr it io n in te rv e n ti o n s ta rg e ti n g w o m e n , i n fa n ts , a n d c h ild re n R 3 9 2 .9 1 R 8 16 .2 3 R 1 3 3 5 .3 4 R 1 9 0 8 .11 R 2 5 7 2 .3 3 R 7 0 2 4 .9 2 8 .0 9 % S O 5 : I n fl u e n ce p e o p le a c ro ss t h e l if e c y c le to m a ke i n fo rm e d f o o d a n d n u tr it io n d e c is io n s th ro u g h a n i n te g ra te d co m m u n ic a ti o n s st ra te g y R 9 4 .3 7 R 10 8 .4 1 R 14 2 .3 5 R 15 7. 3 8 R 2 0 1. 2 8 R 7 0 3 .7 9 0 .8 1% S O 6 : E st a b lis h t h e N F N S P la n M & E U n it R 5 .7 1 R 3 .2 5 R 5 .18 R 3 .7 7 R 5 .7 8 R 2 3 .7 0 0 .0 3 % To ta l R 5 0 7 7. 4 3 R 12 6 12 .4 0 R 18 1 3 9 .7 9 R 2 2 6 4 1. 6 3 R 2 8 3 3 5 .4 8 R 8 6 8 0 6 .7 2 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 117 Upon examination, it is evident that not all the strategic objectives contribute equally to the plan’s overall costs. While strategic objectives two, three and four are the largest components, accounting for 99.16% of the total costs between the three of them, the other three objectives contribute just 0.84%. In the subsequent sections, the detailed costs for each of the strategic objectives will be provided. 8.4 Strategic Objective 1 8.4.1 SO1-A: Establish the National FNS Council The tasks required to achieve this objective are presented in table 18 below. Table 18: SO1-A: Establish the National FNS Council Strategic intervention Specific activities Outputs Output indicator Tasks Establish a multisector FNS Council Facilitate the establishment of the FNS Council FNS Council established, chaired by the Deputy President FNS Council as envisioned in the Food and Nutrition Security Policy of 2013 (1) National FNS Council meetings (2) National FNS Council consultative forums (3) National FNS Council international conferences Source: Consultations with the NFNS Plan Coordinating Committee Through the key tasks outlined in Table 18, the National FNS Council seeks to improve the coordination of government FNS programmes. 8.4.1.1 Costing results As per Table 19, the total cost for Strategic Objective 1-A is R4.74 million over the period 2018/19 to 2022/23, which is the second smallest implementation cost of the NFNS Plan’s objectives. The FNS Council consultative forum is the largest cost component, accounting for R2.99 million over the period, due to the relatively large number of national and provincial delegates included in this forum. All public-sector employees appointed to this council are expected to absorb this work within their existing mandates, meaning that the sector experts and logistics-related expenditure (travel, accommodation, catering, etc.) are the main cost drivers. Following the establishment of the council, the costs are forecast to increase in line with inflation as the operational structure of SO1-A is set to remain constant over the period. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 118 Table 19: SO1-A cost estimates R Millions 2018/19 2019/20 2020/21 2021/22 2022/23 Total SO1-A: Establish a national multi-sectoral food and nutrition security council R 0.84 R 0.89 R 0.94 R 1.00 R 1.06 R 4.74 National FNS Council meetings R 0.10 R 0.10 R 0.11 R 0.12 R 0.12 R 0.55 National FNS Council consultative forums R 0.53 R 0.56 R 0.60 R 0.63 R 0.67 R 2.99 International cooperation and knowledge exchange R 0.21 R 0.23 R 0.24 R 0.25 R 0.27 R 1.20 Source: Costing outputs from FNS Costing Model events does increase the cost of this activity, but the benefit in terms of expanding the profile of food and nutrition security in South Africa may be worth it. This is especially true if external funding or sponsorships can be secured to host the events. 8.4.2 SO1-B: Establish the Provincial and local FNS Councils The tasks required to achieve this objective are presented in Table 20 below. 8.4.1.2 Key considerations (a) The DPME needs to ensure that the sector experts working with these councils are willing to do so for an honorarium payment, rather than full consultant rates. This greatly reduces the governance and operational cost of the NFNS Plan. (b) Given the relatively low number of attendees, it is practical and advisable that all meetings are held at internal venues. This will minimise unnecessary expenditure. (c) The option to host international cooperation and knowledge-exchange N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 119 Table 20: SO1-B: Establish the Provincial and local FNS Councils Strategic intervention Specific activities Outputs Output indicator Tasks Establish and operationalise an integrated FNS delivery structure Facilitate the establishment of the Provincial Councils, chaired by Premiers Provincial Councils established, chaired by the Offices of the Premiers, including District Metro Mayors; NGO’s, civil society, business, labour, organised agriculture, SOE’s. Provincial FNS Councils approved by the Offices of the Premiers. (1) Provincial FNS council meetings (2) Provincial FNS council consultative forums Facilitate the establishment of District Councils, chaired by Mayors District FNS Councils established, chaired by the Offices of the Mayors, including NGO’s, civil society, business, labour, organised agriculture, SOE’s District FNS Councils approved by the Offices of the Mayors (1) District FNS council meetings 8.4.2.1 Costing results As shown in Table 21 below, the total cost for Strategic Objective 1-B is R14.02 million over the period 2018/19 to 2022/23. The costs of the Provincial FNS Council meetings and the Provincial FNS Council consultative forums, which take place separately in each province, increase in line with inflation as the structure of these groups is set to remain constant over the 5-year analysis period. The District FNS Councils, however, grow to 27 by the end of year 2 and then to 40 by the end of year 5. This explains the steep increases in the cost of District FNS Councils. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 120 Table 21: SO1-B cost estimates R Millions 2018/19 2019/20 2020/21 2021/22 2022/23 Total SO1-B: Establish Provincial and District Food and Nutrition Security Councils R1.54 R2.42 R2.86 R3.34 R3.87 R14.02 Provincial FNS Council meetings R0.32 R0.34 R0.37 R0.39 R0.42 R1.85 Provincial FNS Council consultative forums R0.48 R0.51 R0.54 R0.57 R0.61 R2.71 District FNS Council meetings R0.73 R1.57 R1.95 R2.37 R2.84 R9.46 Source: Costing outputs from FNS Costing Model role in the success of the NFNS Plan. The costs also appear affordable, especially in light of the important role of these bodies, as most attendees are existing public officials. The few sector experts are justified, given the technical nature of the work and the importance of these sub-national bodies. 8.5 Strategic Objective 2: Establishment of inclusive local food value- chains to support access to nutritious, affordable food 8.5.1 SO2-A: Increase food produced by smallholder producers 8.4.2.2 Key considerations (a) The DPME needs to ensure that the sector experts working with these councils are willing to do so for an honorarium payment, rather than full consultant rates. This greatly reduces the governance and operational cost of the NFNSP. (b) Given the large number of people expected to attend the Provincial FNS Council consultative forums, it may not be possible to host these events at internal venues. If the venues shift to external sites this puts some cost pressure on the activity, but not enough to completely alter its affordability. (c) Given that much of the work will be done at the provincial and district levels, these bodies are expected to play a pivotal N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 121 The tasks required to achieve this objective are presented in Table 22 below. Table 22: SO2-A: Increase food produced by smallholder producers Strategic intervention Specific activities Outputs Output indicator Tasks Increased production of high-value agricultural products and nutritious food Increased food production by smallholder and subsistence producers Food produced by smallholder and subsistence producers Quantity of food produced by smallholder and subsistence producers by type of produce 1) Provision of the required inputs to increase production of fruit, vegetables, maize and beans 2) Provision of land for smallholder producers Source: Government of the Republic of South Africa, 2017, and consultations with DAFF Given the ambitious production targets set by the NFNS Plan for the acquisition of land, the model focuses on government’s land acquisition plans for smallholder farmers in general, as the majority of this land will likely have to be directed towards the smallholder producers of the targeted commodities. For the projection we have used the average cost per hectare and the average hectares of land acquired between 2009/10 and 2015/16 to estimate the total costs of land acquisition for smallholder producers. Table 23 below sets out the cost of support to smallholder producers if the targets in the NFNS Plan are to be reached. 8.5.1.1 Costing results The costing model utilises the production targets in the NFNS Plan as the driver of costs and estimates the additional expenditure required to provide the necessary support to smallholder producers, based on average production costs per tonne per type of commodity. Production costs include the costs of seeds and other plant material, fertiliser, pesticides, labour, irrigation, packaging, marketing, transport, repairs and maintenance. The costing model assumes that support is tapered down over a 3-year period in which 100% support is provided in year 1, 75% in year 2 and 50% in year 3. After this 3-year period, it is assumed that the smallholder farmer is self-reliant. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 122 Table 23: SO2-A cost estimates R Millions 2018/19 2019/20 2020/21 2021/22 2022/23 Total SO2-A: Increase food produced by smallholder producers R2 836.21 R8 480.52 R11 508.66 R13 598.68 R16 227.01 R52 651.08 Provision of support to smallholder producers of fruit and vegetables R1 078.83 R2 421.91 R4 051.98 R5 797.99 R8 314.22 R21 664.93 Provision of support to smallholder producers of maize and beans R1 757.38 R6 058.60 R6 832.35 R7 176.37 R7 288.46 R29 113.16 Provision of land R0.00 R0.00 R624.33 R624.33 R624.33 R1 872.98 Source: Costing outputs from FNS Costing Model smallholder producers in South Africa and potentially decrease costs. (c) The provision of production inputs without the required knowledge and skill transfer will lead to a situation in which smallholder producers are perpetually reliant on the state to provide. Due consideration should be given to the knowledge and skills transfer challenges faced by the current programmes. (d) Implementation of a service-level agreement could therefore be considered, in which the supported smallholder farmer agrees to sell back the produce to government at regulated prices - a quid pro quo relationship. Substantial research would have to be conducted to determine the potential impact and unintended consequences of such an approach. (e) Reducing or postponing targets should be considered. As shown in Table 23, if we assume that the NFNS Plan’s targets are reached, the cost implications are substantial. To reach the targets, the annual tonnes of fruit and vegetables produced would have to increase by 29.3% per year. Similarly, the production of maize and beans would have to increase by 52.3% per year. 8.5.1.2 Key considerations (a) Given the large cost implication of achieving these all-important targets, an analysis that provides the information to prioritise the different types of support and considers the difference between regions and settings is highly recommended. (b) Consider the consolidation of the various agricultural producer support programmes into a single function. This could contribute immensely to the effectiveness of support provided to N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 123 8.5.2 SO2-B: Increase production of aquaculture by smallholder producers The tasks required to achieve this objective are presented in Table 24 below. Table 24: SO2-B: Increase production of aquaculture by smallholder producers Strategic intervention Specific activities Outputs Output indicator Tasks Increased production of high-value agricultural products and nutritious food Increased food production by smallholder and subsistence producers Food produced by smallholder and subsistence producers Tonnage of aquaculture produced by subsistence and smallholder producers Provision of the required inputs to increase production of Tilapia and Catfish 8.5.2.1 Costing results In a study done for the Industrial Development Corporation (IDC), it was estimated that, if it is assumed that feed costs R15 000 per tonne, the Food Conversion Ratio (FCR) equals 1.5 and feed costs are between 50% and 70% of total production costs, then Tilapia could be produced at a cost ranging between R32 000 and R45 000 per tonne41 This is also approximately in line with ongoing feasibility studies for Tilapia production currently being conducted by DAFF. Unfortunately, the same type of study has not been performed for Catfish. The costing model has therefore assumed the same parameters as the IDC study for both Tilapia and Catfish, except that feed cost has been adjusted for inflation at 6% p.a. and feed costs are assumed at 60% of total production costs. Table 25 below sets out the cost estimates based on these parameter values. Table 25: SO2-B cost estimates R Millions 2018/19 2019/20 2020/21 2021/22 2022/23 Total SO2-B: Increase production of aquaculture by smallholder producers R49.12 R104.12 R145.10 R202.17 R281.88 R782.37 Provision of production inputs for Catfish production R15.63 R33.13 R47.21 R67.25 R95.84 R259.05 Provision of production inputs for Tilapia production R33.49 R70.99 R97.89 R134.92 R186.04 R523.32 Source: Costing outputs from FNS Costing Model N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 124 8.5.2.2 Key considerations (a) Although food security is the main objective within the context of the NFNS Plan, profitability is essential for the sustainability of the industry and decreasing the need for government support. Special attention will therefore have to be paid to ensuring the affordability of feed and setting-up operations so that the Food Conversion Ratio (FCR) is kept as low as possible. 8.5.3 SO2-C: Increase food produced by subsistence (household) producers Table 26: SO2-C: Increase food produced by subsistence (household) producers Strategic intervention Specific activities Outputs Output indicator Tasks Increased production of value agricultural products and nutritious food Increased food production by household producers Household involved in agriculture % of households involved in agriculture 1) Provision of training 2) Provision of production inputs 3) Provision of land Household food production % increase in the number of households with vegetable gardens Source: Consultations with DAFF 8.5.3.1 Costing results For the provision of training, it is assumed that there will be four information days per annum for every 100 subsistence farmers. Over the period, 502 353 households will be provided with the equipment and infrastructure required to start subsistence farming, on a once-off basis. Each of these households will also be provided with the required consumable production inputs on an annual basis. Based on these assumptions, Table 27 below presents the estimated costs over the period of the NFNS Plan: N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 125 Table 27: SO-2C cost estimates R Millions 2018/19 2019/20 2020/21 2021/22 2022/23 Total SO2-C: Increase food produced by subsistence (household) producers R664.10 R793.53 R1 302.78 R1 586.81 R1 911.10 R6 258.31 Provision of training R9.96 R11.02 R12.19 R13.48 R14.91 R61.56 Provision of production equipment and infrastructure R591.31 R648.87 R883.66 R978.59 R1 083.67 R4 186.10 Provision of production consumables R62.82 R133.64 R294.92 R482.73 R700.50 R1 674.61 Provision of land R0.00 R0.00 R112.01 R112.01 R112.01 R336.04 Source: Costing outputs from FNS Costing Model 8.5.3.2 Key considerations (a) Studies have shown that the costs of consumables input-subsidy programmes often outweigh the costs, while capital related inputs prove to be more effective. Consideration should therefore be given to a stronger focus on capital input provision. (b) Given the large cost implication of achieving these all-important targets, an analysis that provides the information to prioritise the different types of support and considers the difference between regions and settings is highly recommended. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 126 8.5.4 SO2-D: Certify smallholder producers with SA GAP to access local markets The tasks required to achieve this objective are presented in Table 28 below. Table 28: SO2-D: Certify smallholder producers with SA GAP to access local markets Strategic intervention Specific activities Outputs Tasks Stimulate Markets for smallholder farmers Certifying smallholder producers with SA GAP Smallholder farmers SA GAP certified to access local markets 1) Conduct audits 2) Conduct workshops 3) Conduct Water Analysis and Maximum Residue Test 4) Certify complying smallholder producers 8.5.4.1 Costing results The major cost drivers of the activities necessary to achieve the SO2-D target in the NFNS Plan are the cost per audit and workshop, and the number of audits and workshops required to achieve the certification target. Not every smallholder producer that is recommended for audit and audited will necessarily be able to meet the criteria required for certification. Historical results show that one out of every five smallholder producers recommended for audit achieve certification status by the end of the process. For the costing results presented in the table below, we assumed that this ratio remains constant over the period of the NFNS Plan. Lastly, two workshops per type of workshop will be conducted over the period. The types of workshops include: (a) Food safety and responsible use (b) Good Agricultural Practices (c) Legislation (d) SA-GAP audit forms (e) Product quality Table 29 below sets out the costs over the NFNS Plan’s period given these assumptions. Table 29: SO2-D cost estimates R Millions 2018/19 2019/20 2020/21 2021/22 2022/23 Total SO2-D: Certify smallholder producers with SA GAP to access local markets R1.91 R2.67 R3.54 R4.96 R6.61 R20.31 Certify smallholder farmers R1.83 R2.55 R3.37 R4.71 R6.27 R19.26 Conduct Water Analysis and Maximum Residue Test R0.09 R0.12 R0.18 R0.25 R0.34 R1.05 Source: Costing outputs from FNS Costing Model N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 127 8.5.4.2 Key considerations (a) Smallholder producers are being recommended for audit even when they have very little chance of conforming to the criteria for SA-GAP within the allotted time. It is possible that the reasons for this are that extension officers are spread too thin and/or do not have the knowledge to accurately judge the readiness of a smallholder producer for certification. Increasing the number of extension officers employed and improving the agricultural colleges could therefore go a long way to improving the audit-certification ratio. (b) Although we have not looked into how the performance of extension officers is measured, if the number of recommendations are used without any measure of the number of certifications, this will incentivise the recommendation of unlikely candidates. (c) Given the cost implications of auditing smallholder producers that are unable to conform, a further investigation into this phenomenon is highly recommended. 8.5.5 SO2-F: Increase the number of Extension Officers The tasks required to achieve this objective are presented in table 30 below. Table 30: SO2-F: Increase the number of Extension Officers Strategic intervention Specific activities Outputs Tasks included Establish and strengthen producer development institutions Provision of capacity development Increased number of extension personnel Recruit and employ more Extension Officers 8.5.5.1 Costing results For estimation of the cost of increasing the number of Extension Officers, it is assumed that there is a sufficient number of qualified candidates available to fill the positions or that there will be, due to the improvement of agricultural colleges. The only drivers of the costs are therefore the distribution across the levels of employment and the annual operational cost per Extension Officer. The table below presents the status quo of these cost drivers according to information received from the DAFF. Table 31 below presents the additional costs required to increase the number of Extension Officers from 2 800 currently to 5 600 by 2022. It is assumed that the distribution of Extension Officers across the three levels remains the same, and that the costs per Extension Officer per annum increases at an average rate of 6% per annum. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 128 Table 31: SO2-F cost estimates R Millions 2018/19 2019/20 2020/21 2021/22 2022/23 Total Increase the number of Extension Officers R403.89 R897.08 R1 499.34 R2 234.77 R3 132.83 R8 167.92 8.5.5.2 Key considerations If the costs of increasing the number of extension officers is deemed to be too far beyond the current budget, consideration could be given to contracting NGOs and other local service providers to fill the gap39. Although this would require additional funding it is possible that it might be a less expensive option than insourcing and is therefore worth considering. 8.6 Strategic Objective 3: Expand targeted social protection measures and sustainable livelihood programmes 8.6.1 SO3-A: Promote early registration of children born in public health facilities within the prescribed 30-day period The tasks required to achieve this objective are presented in Table 32 below. 39 lder producers. Costing Model SO2-D estimates the costs related Strategic intervention Specific activities Outputs Output indicator Tasks Improve the child grant registration system Review and improve registration system of infants at birth Increase the number of children born in public health facilities that are registered within 30 days Number of infants born in public health facilities registered 1) Development of registration system 2) Roll-out of registration system in health facilities % of infants born in public and private health facilities registered within 30 days in population register 3) Registration of births N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 129 The key activity component of the Strategic Objective of promoting early birth registration is the development of the birth registration system. The cost of this activity drives the total cost of this Strategic Objective. Through this key task, the early registration of children born in public health facilities within the prescribed 30-day period will be promoted. 8.6.1.1 Costing results As shown in Table 33, the total cost for Strategic Objective 3-A is R148.50 million over the period 2018/19 to 2022/23. The majority of this cost (R92.76 million) is borne in 2018/19, due to the large up-front capital expenditure which is required to purchase and develop all of the hardware and software necessary for the operation of the registration system – all of which occurs in the first year of its implementation. For the remaining years, there is no capital expenditure, but only operational expenditure – with the key differential cost driver being the increased number of records stored on the registration system, with each acquiring a unit storage cost. Table 33: SO3-A cost estimates R Millions 2018/19 2019/20 2020/21 2021/22 2022/23 Total SO3-A: Promote early registration of children born in public health facilities within the prescribed 30- day period R 92.76 R 21.57 R 10.35 R 11.09 R 12.73 R 148.50 Development of registration system R 92.76 R 21.57 R 10.35 R 11.09 R 12.73 R 148.50 Source: Costing outputs from FNS Costing Model 8.6.1.2 Key considerations (a) If possible, a shift in government policy to allow for cloud-based storage of personal information would lead to significant cost savings. (b) The departments involved with this activity, notably the DoH and the DHA, will need to coordinate their efforts for this activity to be a success. Policy conversations will likely be required in this regard. (c) This system should be linked with the Integrated Social Protection Information System discussed in SO3-C. If the two systems are developed concurrently, there are important synergies that can lead to significant cost saving. (d) There are also synergies between SO3-A and SO3-B (achieve a universal child grant registration for eligible children born in public facilities). If children born in public health facilities can be registered on-site, this will improve access to the child support grant from an early age. Achieving universal child grant registration requires that all births are registered, and the earlier this is done the better. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 130 8.6.2 SO3-B: Achieve a universal child support grant registration for eligible children The tasks required to achieve this objective are presented in table 34 below. Strategic intervention Specific activities Outputs Output indicator Tasks Improve the child grant registration system Implement universal child grant registration for eligible children Universal child grant registration systems Number of registered infants (<1 year) from PVM households 1) Increased CSG uptake rates 8.6.2.1 Costing results As shown in Table 35, the total cost for Strategic Objective 3-B is R5.15 billion over the period 2018/19 to 2022/23. This cost reflects the additional funds that will be required to accommodate the increased number of CSG recipients. The number of additional CSG recipients is cumulative, with all extra recipients carried throughout the period. There are no additional capital or current costs as it is possible to achieve the outcomes of SO3-B through the capital investment from SO3-A and existing staff capacity. In addition to the standard inflationary impact on costs, the core cost drivers are the increased child support grant payments due, owing to increased uptake rates facilitated by the new registration system. Table 35: SO3-B cost estimates R Millions 2018/19 2019/20 2020/21 2021/22 2022/23 Total SO3-B: Achieve a universal child grant registration for eligible children born in public facilities R 286.35 R 612.23 R 981.75 R 1 399.38 R 1 870.00 R 5 149.71 Increased CSG uptake rates R 286.35 R 612.23 R 981.75 R 1 399.38 R 1 870.00 R 5 149.71 Source: Costing outputs from FNS Costing Model N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 131 8.6.2.2 Key considerations (a) The realisation of SO3-B is linked with the successful development of a system to register children born in public health facilities within the prescribed 30-day period. (b) The cost associated with this activity should not be seen as an extension of a service, but rather enhanced performance of the CSG through a more accurate uptake rate. (c) The option of giving universal access to the CSG to all children below the age of 2 or 3 has the potential to remove the current administrative obstacles preventing access during this critical period in children’s lives. 8.6.3 SO3-C: Develop an integrated social protection information system (ISPIS) to improve access to social assistance programmes The tasks required to achieve this objective are presented in table 36 below. Table 36: SO3-C: Develop ISPIS to improve access to social assistance programmes Strategic intervention Specific activities Outputs Output indicator Tasks Develop an integrated social protection information system to improve access to social assistance programmes Design an integrated and consolidated information system within and across departments Integrated Social Protection Information System (ISPIS) Integrated Social Protection Information System (NISPIS) developed 1) Development of NISPIS 2) Roll-out of ISPIS in departments 3) Registration of births% of infants born in public and private health facilities registered within 30 days in population register. 8.6.3.1 Costing results As shown in Table 37, the total cost for Strategic Objective 3-C is R368.30 million over the period 2018/19 to 2022/23. Similar to Strategic Objective 3-A, this cost is split between annual operating expenditure and capital expenditure – which comprises the majority of the total expenditure for this activity. Like Strategic Objective 3-A, this capital expenditure covers the up-front costs necessary for the purchase and development of the requisite hardware and software for the implementation of the social protection information system. Unlike Strategic Objective 3-A, however, this cost is not borne in a single year of the plan, but rather occurs across a number of years – in 2018/19, 2020/21 and 2022/23 – causing large spikes in the total costs during these years. This additional capital expenditure is necessitated by the increased software and hardware requirements that accrue due to the increased capacity of the information system caused by the addition of further departmental information systems and records to the system. In the years without any capital expenditure, the main differential cost driver is the storage cost of the additional records stored on the system – again driven by the addition of further departmental information systems and records to the integrated system. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 132 Table 37: SO3-C cost estimates R Millions 2018/19 2019/20 2020/21 2021/22 2022/23 Total SO3-C: Develop an integrated social protection information system to improve access to social assistance programmes R 78.73 R 22.23 R 107.83 R 33.06 R 126.45 R 368.30 Development of NISPIS R 78.73 R 22.23 R 107.83 R 33.06 R 126.45 R 368.30 Source: Costing outputs from FNS Costing Model 8.6.3.2 Key considerations (a) The development of ISPIS has been challenging given the diversity of stakeholders involved in the process. To overcome this issue, it is imperative that the different departments all work together and coordinate their data collection, storage, and analysis efforts. There is currently a technical working committee, chaired by the Department of Social Development, who should take responsibility for and drive this process. (b) It is recommended that the initial roll out of the system amongst the first three departments (Health, Basic Education, and Social Development) be used as a pilot phase. Based on the success of this pilot and the lessons learned, the system can be expanded accordingly to accommodate the remaining departments. (c) The most challenging aspect of ISPIS is not the process of setting it up, but rather ensuring that it is maintained and meaningfully used on an ongoing basis. More thought needs to be given to this aspect of ISPIS. 8.6.4 SO3-D: Improve provision of nutritious meals through an expanded network of feeding and food distribution centres The tasks required to achieve this objective are presented in table 38 below. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 133 Table 38: SO3-D: Improve provision of nutritious meals through an expanded network of feeding and food distribution centres Strategic intervention Specific activities Outputs Output indicator Tasks Expand a network of feeding and food distributions Total children provided with meals through ECDCs (total number of ECDCs providing meals) PVMs access nutritious food Number of children provided with food through ECDs 1) ECDC growth and provision 2) NSNP growth and provision 3) CNDC growth and provision 4) SRD uptake growth rateTotal learners provided with meals through schools (total number of schools providing meals) Number of learners provided with nutritious food through NSNP Total number of people provided with meals through CNDCs (total number of CNDCs providing meals) Number of people provided with food through CNDCs Total number of PVMs accessing Social Relief of Distress PVMs access Social Relief of Distress Number of PVMs accessing Social Relief of Distress 8.6.4.1 Costing results As shown in Table 39, the total cost for Strategic Objective 3-D is R5.65 billion over the period 2018/19 to 2022/23. The largest component of this activity is payments made through the social relief of distress grant, which, at R3.42 billion over the whole period, accounts for slightly more than 60% of the total activity cost. The core cost driver in this instance, as it is for all of the items in this activity, is the increased rates of provision that are outlined in the above table. The increases in the number of children being provided with meals at schools and Early Childhood Development centres; the increases in the number of people being provided with meals through Community Nutrition and Development centres; the increases in the number of these facilities; and the aforementioned increase in the number of poor, vulnerable and marginalized people accessing the social relief of distress grant – all of which are core targets of the Plan itself – contribute to the growth in total cost that occurs over the period 2018/19 to 2022/23. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 134 Table 39: SO3-D cost estimates R Millions 2018/19 2019/20 2020/21 2021/22 2022/23 Total SO3-D: Improve provision of nutritious meals through an expanded network of feeding and food distribution centres R 318.92 R 758.46 R 1 093.03 R 1 496.31 R 1 982.55 R 5 649.28 ECDC growth and provision R 92.26 R 195.04 R 321.73 R 471.93 R 652.06 R 1 733.01 NSNP growth and provision R 21.28 R 45.34 R 72.46 R 102.94 R 137.11 R 379.12 CNDC growth and provision R 9.51 R 20.74 R 24.07 R 29.07 R 34.80 R 118.19 SRD uptake growth rate R 195.87 R 497.34 R 674.77 R 892.38 R 1 158.59 R 3 418.95 Source: Costing outputs from FNS Costing Model 8.6.4.2 Key considerations (a) While donations do help to alleviate some of the cost of NSNP, most of the costs are still borne by government. These donations and sponsorships, however, have served as useful pilots to extend the NSNP programme to include breakfast prior to any formal policy decision. (b) The decision to keep school kitchens open on the weekends and during school holidays would go a long way to ensuring vulnerable children are able to regularly access meals outside of school periods. Given that these children still need to access meals, either through CNDCs or other initiatives, this may be a cost effective means to reach these vulnerable children given the school kitchens are already established and staffed mostly by volunteers. The extent of this benefit may, however, be curtailed in areas where children use scholar transport to get to school – which would not be available over weekends and school holidays. (c) The uptake in social relief of distress grants is to some extent limited by the number of social workers. The need for these grants is much higher than the current payment levels suggest, but the issue has been to have social workers evaluate all potential recipients. Addressing this issue, which is currently hampered by the moratorium on new hiring, is key to unlocking more effective application of the grant. 8.7 Strategic Objective 4: Scale up high-impact nutrition interventions targeting women, infants, and children 8.7.1 SO4-A: Improve nutrition training for health promoters and food handlers in community nutrition centres (ECDs, Schools, and CNDCs), and improve the ability of ECDs to address nutrition issues N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 135 The tasks required to achieve this objective are presented in table 40 below. Table 40: SO4-A: Improve nutrition training for health promoters and food handlers in community nutrition centres (ECDs, Schools, and CNDCs), and improve the ability of ECDs to address nutrition issues Strategic intervention Specific activities Outputs Output indicator Tasks Improve access, coverage and effectiveness of high impact nutrition specific interventions targeting nutritionally vulnerable groups across the life cycle Implement food and nutrition interventions to comply with minimum nutritional standards for Early Child Development (ECD) (among other standards) to ensure children accessing ECD sites receive good quality and quantity of nutritious foods Children in ECD sites received good quality and quantity of nutritious food Proportion of ECD sites providing good quality and quantity nutritious foods according to the minimum standards 1) Audit of CNDCs & ECDCs 2) Development of training material for CNDC/ECDC workers 3) Administering training to CNDC/ECDC workers 8.7.1.1 Costing results As shown in Table 41, the total cost for Strategic Objective 4-A is R51.2 million over the period 2018/19 to 2022/23. By far the largest cost component is the audit of Early Childhood Development Centres, comprising nearly 98% of the total cost for the entire activity. This cost component is driven by the number of Early Childhood Development Centres which need to be audited and registered, as per the Plan. The significant jump in costs between 2019/20 and 2020/21 is similarly driven by the increase in the number of newly registered Early Childhood Development Centres added annually, as per the targets set out by the Plan. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 136 Table 41: SO4-A cost estimates R Millions 2018/19 2019/20 2020/21 2021/22 2022/23 Total SO4-A: Improve training on nutrition and focus of community health workers and food handlers in community nutrition centres R5.86 R6.27 R12.16 R13.01 R13.91 R51.21 Audit of CNDCs R0.08 R0.09 R0.03 R0.03 R0.04 R0.27 Audit of ECDCs R5.68 R6.08 R11.93 R12.77 R13.66 R50.12 Development of training material for CNDC/ECDC workers R0.10 R0.10 R0.19 R0.21 R0.22 R0.82 Administering training to CNDC/ ECD workers R0.00 R0.00 R0.00 R0.00 R0.00 R0.00 Source: Costing outputs from FNS Costing Model 8.7.1.2 Key considerations (a) It is important to leverage, to the extent possible, existing training material and internal capacity to either revise or develop new training materials. Much of this material exists, or is part of key staff member and institutional knowledge, which means that consulting costs or reliance on NGOs/NPOs can be avoided. 8.7.2 SO4-B: Increase coverage and availability of multiple micronutrient supplements (MMNS) (folic acid, iron, calcium, vitamin A), deworming tablets, and fortified porridge across the life course for undernourished infants and children, WRA, and people living with HIV and TB The tasks required to achieve this objective are presented in Table 42 below. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 137 Table 42: SO4-B: Increase coverage and availability of multiple micronutrient supplements across the life course for undernourished infants and children, WRA, and people living with HIV and TB Strategic intervention Specific activities Outputs Output indicator Tasks Improve access, coverage and effectiveness of high impact nutrition specific interventions targeting nutritionally vulnerable groups across the life cycle Increase access and coverage of high energy & nutrient dense nutritional supplements for target populations across the life course: undernourished infants and children, WRA (15-49) and PLW, including HIV and TB clients. Increase uptake and utilisation of nutritional supplements among undernourished target populations Proportion of target populations receiving nutritional supplements 1) Cost of provision and increased uptake rates 8.7.2.1 Costing results As shown in Table 43, the total cost for Strategic Objective 4-B is R6.83 billion over the period 2018/19 to 2022/23. The key cost drivers here, over and above the influence of inflation on the price of the supplements provided, are the increased levels of provision, as stated in the Plan’s targets, and spelled out in the table above. Moreover, the significant cost jump between 2019/20 and 2020/21 in the deworming cost component of the activity is caused by the end of a sponsored deworming programme for primary school children, currently provided by Johnson and Johnson, and the shifting of this cost burden over to the Department of Health. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 138 Table 43: Cost estimates to increase coverage and availability of MMNS across the life course for undernourished infants and children, pregnant and lactating women, and people living with HIV and TB R Millions 2018/19 2019/20 2020/21 2021/22 2022/23 Total SO4-B: Increase coverage and availability of MMNS, deworming tablets, and fortified porridge across the life course for undernourished infants and children, pregnant and lactating women, and people living with HIV and TB R 359.68 R 780.03 R 1 296.68 R 1 866.33 R 2 527.13 R 6 829.86 Vitamin A Supplementation R 1.16 R 2.21 R 2.70 R 3.26 R 4.01 R 13.33 Deworming R 4.10 R 7.84 R 40.13 R 46.65 R 54.39 R 153.12 Multiple Micronutrient Supplementation R 23.49 R 51.24 R 83.72 R 121.78 R 166.28 R 446.50 Iron Supplementation R 205.46 R 445.83 R 725.26 R 1 049.39 R 1 424.25 R 3 850.18 Calcium Supplementation R 26.25 R 57.16 R 93.28 R 135.48 R 184.67 R 496.83 Folic Acid Supplementation R 36.12 R 78.10 R 126.67 R 182.61 R 246.81 R 670.30 Fortified Porridge R 63.12 R 137.66 R 224.93 R 327.17 R 446.72 R 1 199.59 Source: Costing outputs from FNS Costing Model N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 139 8.7.2.2 Key considerations (a) If possible, the sponsorship of deworming tablets by Johnson & Johnson should look to be extended. This sponsorship might also be deepened to include children of all ages. (b) Cost savings could be realised for this activity if sponsorship/donor partnerships, similar to that with Johnson & Johnson for deworming tablets, can be forged for other supplements. 8.7.3 SO4-C: Improve access and coverage of breastfeeding, complimentary feeding counselling, and the provision of KMC The tasks required to achieve this objective are presented in table 44 below N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 140 Table 44: SO4-C: Improve access and coverage of breastfeeding, complimentary feeding counselling, and the provision of KMC Strategic intervention Specific activities Outputs Output indicator Tasks Improve access, coverage and effectiveness of high impact nutrition specific interventions targeting nutritionally vulnerable groups across the life cycle Increase access and coverage of breastfeeding and complementary feeding counselling and support among PLW by linking then with CHW/ WBOTS Improvements in infant and young child feeding practices Proportion of infants under 6 months exclusively breastfed as measured in SADHS at 6 months 1) Development of breastfeeding counselling training material 2) Administering training to breastfeeding counsellors 3) Provision of breastfeeding counselling to mothers 4) Provision of breastfeeding counselling materials (see SO5) Establish high quality KMC units (implementing all components of KMC) by allocating dedicated staff and space for KMC babies and integrating KMC into existing initiatives such as MBFI & Newborn Care Plans Improvement in the quality of KMC provided to low birth weight babies Proportion of Low Birth Weight babies admitted to facility based quality KMC who survived (discharged alive) 1) Development of KMC training material 2) Administering KMC training 3) Expansion of KMC services 4) post graduation support for mothers by community healthcare workers N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 141 8.7.3.1 Costing results As shown in Table 45, the total cost for Strategic Objective 4-C is R123.71 million over the period 2018/19 to 2022/23. By far the largest cost component in this activity is the provision of Kangaroo Mother Care binders to mothers of low birth weight babies. At R110.70 million over the period 2018/19 to 2022/23, this component makes up 89% of the total cost of the activity. This is primarily driven by the high number of low birth weight babies, and the Plan’s stated target to increase provision of Kangaroo Mother Care to such babies over the course of the period. Table 45: SO$-C cost estimates R Millions 2018/19 2019/20 2020/21 2021/22 2022/23 Total SO4-C: Improve access and coverage of breastfeeding and complimentary feeding counselling R 20.56 R 22.67 R 24.60 R 26.75 R 29.13 R 123.71 Development of breastfeeding counselling training material R 0.03 R 0.03 R 0.01 R 0.01 R 0.01 R 0.10 Administering training to breastfeeding counsellors R 0.00 R 0.00 R 0.00 R 0.00 R 0.00 R 0.00 Provision of breastfeeding counselling to mothers R 1.67 R 2.25 R 2.57 R 2.93 R 3.38 R 12.81 Development of KMC training material R 0.03 R 0.03 R 0.01 R 0.01 R 0.01 R 0.10 KMC training R 0.00 R 0.00 R 0.00 R 0.00 R 0.00 R 0.00 KMC services provision R 18.83 R 20.35 R 22.01 R 23.79 R 25.72 R 110.70 Source: Costing outputs from FNS Costing Model N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 142 8.7.3.2 Key considerations (a) It is important to leverage, to the extent possible, existing training material and internal capacity to either revise or develop new training materials. Much of this material exists, or is part of key staff member and institutional knowledge, which means that consulting costs or reliance on NGOs/NPOs can be avoided. (b) It is also feasible that existing internal capacity can be utilised to administer all training. There are public officials who regularly visit these facilities to conduct inspections and meet with the relevant staff members. These trips could be combined with training activities, or other internal resources could absorb this task within their current mandates. (c) It is important to ensure community health workers are fully engaged in this activity. Their involvement will be key to realising the desired outcomes. 8.7.4 SO4-D: Improve access and coverage of growth monitoring and promotion services via facility audits The tasks required to achieve this objective are presented in table 46 below. Table 46: SO4-D: Improve access and coverage of growth monitoring and promotion services via facility audits Strategic intervention Specific activities Outputs Output indicator Tasks Improve access, coverage and effectiveness of high impact nutrition specific interventions targeting nutritionally vulnerable groups across the life cycle Undertake facility audits through the ideal clinic process to ensure availability of standard essential anthropometric equipment (MUAC tapes, infant scales, length boards, stadiometers, BMI wheels) at each facility and mobile teams (WBOTS and school health teams) All facilities and mobile teams (WBOTS and School health teams) with functional anthropometric equipment Number of primary health care facilities reported on the ideal clinic dashboard with functional anthropometric equipment 1) Audit of existing facilities 2) Growth in facilities and provision 3) GMP equipment cost N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 143 8.7.4.1 Costing results As shown in Table 47, the total cost for Strategic Objective 4-D is R19.67 million over the period 2018/19 to 2022/23. The number of audits is set to zero over the period as this activity had already been conducted. The entire cost of this activity is therefore captured in a single component, namely the cost of purchasing growth, monitoring and promotion equipment for public health facilities. Over and above the effect of inflation on medical equipment, these costs are driven by the increased number of health care facilities requiring functional growth, monitoring and promotion equipment, as per the targets of the Plan, outlined in the table above. Table 47: SO4-D cost estimates R Millions 2018/19 2019/20 2020/21 2021/22 2022/23 Total SO4-D: Improve the access and coverage of growth monitoring and promotion services via facility audits R 6.67 R 7.10 R 1.85 R 1.96 R 2.09 R 19.67 Audit of existing facilities R 0.00 R 0.00 R 0.00 R 0.00 R 0.00 R 0.00 GMP equipment cost R 6.67 R 7.10 R 1.85 R 1.96 R 2.09 R 19.67 Growth in facilities and provision R 0.00 R 0.00 R 0.00 R 0.00 R 0.00 R 0.00 Source: Costing outputs from FNS Costing Model 8.7.5 SO4-E: Ensure effective and timely remedial actions are taken to prevent and manage acute malnutrition The tasks required to achieve this objective are presented in table 48 below. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 144 Table 48: SO4-E: Ensure effective and timely remedial actions are taken to prevent and manage acute malnutrition Strategic intervention Specific activities Outputs Output indicator Tasks Improve access, coverage and effectiveness of high impact nutrition specific interventions targeting nutritionally vulnerable groups across the life cycle Improve the access and coverage of Growth Monitoring and Promotion (GMP) services and ensure effective and timely remedial actions are taken to prevent and manage acute malnutrition Reduced number of children growth faltering Proportion of under 5 children reached with GMP (coverage) 1) Development of IMAM training material 2) Administering IMAM training 3) Provision of IMAM services 4) Provision of anthropometric screening at schools Proportion of children under 59 months with identified with growth faltering Increase access and coverage of anthropometric screening for preventing and managing malnutrition (under- and over-nutrition) among learners in Q1 and Q2 schools (Grade 1 and Grade 8) Improved identification and referral of malnourished children Proportion of Q1 and Q2 primary school children screened and appropriately referred in Grade 1 and Grade 8 8.7.5.1 Costing results As shown in Table 49, the total cost for Strategic Objective 4-E is R0.21 million over the period 2018/19 to 2022/23. The minimal cost of the entire activity is captured entirely in a single component, namely the development of training material. Granted that the material is, under the baseline scenario, developed and administered entirely by internal resources, this cost comprises only the printing of training materials. The effect of inflation on these printing costs, together with the amount of material required, therefore encompass the cost drivers in this instance. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 145 Table 49: SO4-E cost estimates R Millions 2018/19 2019/20 2020/21 2021/22 2022/23 Total SO4-E: Ensure effective and timely remedial actions are taken to prevent and manage acute malnutrition R 0.06 R 0.07 R 0.02 R 0.03 R 0.03 R 0.21 Development of IMAM training material R 0.06 R 0.07 R 0.02 R 0.03 R 0.03 R 0.21 Administering IMAM training R 0.00 R 0.00 R 0.00 R 0.00 R 0.00 R 0.00 Provision of IMAM services R 0.00 R 0.00 R 0.00 R 0.00 R 0.00 R 0.00 Provision of anthropometric screening at schools R 0.00 R 0.00 R 0.00 R 0.00 R 0.00 R 0.00 Source: Costing outputs from FNS Costing Model 8.7.5.2 Key considerations (a) It is important to leverage, to the extent possible, existing training material and internal capacity to either revise or develop new training materials. Much of this material exists, or is part of key staff member and institutional knowledge, which means that consulting costs or reliance on NGOs/NPOs can be avoided. (b) It is also feasible that existing internal capacity can be utilised to administer all training. There are public officials who regularly visit these facilities to conduct inspections and meet with the relevant staff members. These trips could be combined with training activities, or other internal resources could absorb this task within their current mandates. 8.7.6 SO4-F: Improve the quality and effectiveness of clinical screening and assessment, counselling, and support for NCDs, with focus on preventing under- and over-nutrition (obesity) and control at all ideal clinics The tasks required to achieve this objective are presented in table 50 below. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 146 Table 50: SO4-F: Improve the quality and effectiveness of clinical screening and assessment, counselling, and support for NCDs, with focus on preventing under- and over-nutrition (obesity) and control at all ideal clinics Strategic intervention Specific activities Outputs Output indicator Tasks Capacitate health workers to provide appropriate nutrition support with a strong focus on preventing under and over nutrition, including nutritional counselling and support, growth monitoring, counselling, and support Roll out e- learning methods to all community service health professionals (doctors, nurses, pharmacists, and dieticians) Community service health professionals competent in SAM case management Proportion of registered users who have successfully completed the e-learning course 1) Development of e-learning course material 2) Cost to administer e learning course 8.7.6.1 Costing results As shown in Table 51, the total cost for Strategic Objective 4-F is R0.26 million over the period 2018/19 to 2022/23. Akin to Strategic Objective 4-E, the minimal cost of the entire activity is capture entirely in a single component, namely the development of training material. Granted that the material is, under the baseline scenario, developed entirely by internal resources, this cost comprises only the printing of training materials. The effect of inflation on these printing costs, together with the amount of material required, therefore encompass the cost drivers in this instance. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 147 Table 51: SO4-F cost estimates R Millions 2018/19 2019/20 2020/21 2021/22 2022/23 Total SO4-F: Capacity building to Improve the quality and effectiveness of clinical screening, care and support for over- nutrition at ideal clinics R 0.08 R 0.09 R 0.03 R 0.03 R 0.04 R 0.26 Development of e-learning course material R 0.08 R 0.09 R 0.03 R 0.03 R 0.04 R 0.26 Cost to administer e- learning course R 0.00 R 0.00 R 0.00 R 0.00 R 0.00 R 0.00 Source: Costing outputs from FNS Costing Model 8.7.6.2 Key considerations (a) It is important to leverage, to the extent possible, existing training material and internal capacity to either revise or develop new training materials. Much of this material exists or is part of key staff and institutional knowledge, which means that consulting costs or reliance on NGOs/NPOs can be avoided. (b) It is also feasible that existing internal capacity can be utilised to administer all training. There are public officials who regularly visit these facilities to conduct inspections and meet with the relevant staff members. These trips could be combined with training activities, or other internal resources could absorb this task within their current mandates. 8.8 Strategic Objective 5: Influence people across the life-cycle to make informed food and nutrition decisions through an integrated communications strategy 8.8.1 SO5-A: Develop and implement an integrated FNS advocacy and communication strategy The tasks required to achieve this objective are presented in table 52 below. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 148 Table 52: SO5-A: Develop and implement an integrated FNS advocacy and communication strategy Strategic intervention Specific activities Outputs Tasks Develop and implement an integrated advocacy and communication FNS strategy Develop and implement an integrated advocacy and communication plan led by the Deputy President of RSA Integrated advocacy and communication FNS strategy Development of a communication strategy 8.8.1.1 Costing results In order to ensure the BCC resonates with all who will be responsible for its implementation, a series of consultative meetings will need to be arranged to facilitate the strategy’s drafting process between relevant national, provincial and local representatives. The point of these meetings will be to ensure agreement between national and provincial representatives on the strategy. Two consultative meetings are intended to take place, the first being two to three full days while the second will take place over two full days. Table 53: Cost estimates for SO5-A: Develop an integrated FNS advocacy and communication strategy R Millions 2018/19 2019/20 2020/21 2021/22 2022/23 Total Total Consultative Meetings Cost R0.20 R0.00 R0.00 R0.00 R0.00 R0.20 Source: Costing outputs from FNS Costing Model N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 149 R Millions 2018/19 2019/20 2020/21 2021/22 2022/23 Total radio advert costs R3.71 R3.94 R4.17 R4.42 R4.69 Total pre-recorded radio interview costs R3.44 R3.65 R3.87 R4.10 R4.35 Total television advert costs R30.06 R31.87 R33.78 R35.80 R37.95 Total press advert costs R2.12 R2.25 R2.38 R2.52 R2.67 Total long-distance taxi advert costs R0.76 R1.58 R2.49 R3.51 R4.64 Total banner costs R0.01 R0.01 R0.01 R0.01 R0.01 Total gazebo costs R0.00 R0.00 R0.00 R0.00 R0.00 Total billboard costs R23.89 R36.96 R51.52 R67.69 R85.62 Total management fee costs R16.05 R20.06 R24.55 R29.51 R34.98 TOTAL COST R80.04 R100.32 R122.77 R147.56 R174.91 Once the communication and advocacy strategy has been developed, the actual advertising materials will need to be produced. Although substantial work still has to go into the BCC strategy, based on experience from previous communication strategies, there are certain platforms that are expected to be utilised. Research shows that the greater variety of communication mediums used in media campaigns, the more effective the results.40 The preliminary communications strategy has been developed with a lower income target market in mind, as these are the people that are most vulnerable to malnutrition and in most need of food security assistance. Hence, the strategy envisions the usage of a wide range of communication platforms that are easily accessible and highly visible to the intended beneficiaries, including television and newspaper adverts. These will be displayed not only on commercial platforms but also community platforms that cover a wide geographical and socio- economic audience. Table 54 below presents the cost estimates for the currently envisioned BCC and advocacy strategy. Table 54: Cost Estimates for SO5-A: Implement an integrated FNS advocacy and communication strategy Source: Costing outputs from FNS Costing Model N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 150 8.8.1.2 Key considerations (a) Research has shown that effective marketing and communication campaigns are “simple, straightforward and framed in such a way that campaign planners successfully redefine the issue for the target audience”. (b) Furthermore, it is very important that marketing materials are customised to their specific target audiences, particularly in South Africa with a myriad of different cultures and ethnicities living alongside one another. (c) Marketing materials should not just emphasise the nutritional messages, but also direct people towards the services offered by government in this regard and highlight steps people can take to improve their nutrition. It has been found that marketing campaigns are more likely to result in behavioural changes when they are combined with points of easy, actionable behaviour that people can then implementx. (d) There is evidence that billboards are not as effective as other forms of media due to their high costs, limited ability to target niche markets, and the brief time period during which people interact with them. It might be beneficial for the plan to focus more on electronic billboards than standard print billboards, as these are easier to customise, are able to keep catching the public eye with new designs, and tend to be more affordable. (e) Television adverts, despite their costs, are an effective means of communication and are thus justified. (f) It is of utmost importance, because of lack of evidence of the effectiveness of marketing campaigns upon behavioural changes, that the plan incorporates points of review to assess the impact of the communication strategy. This will assist in determining the correct communication mix, length and breadth, as research shows that the impact of advocacy programmes is not sustainable after they end and this needs to be mitigated. 8.8.2 SO5-B: Implement nutrition education at ECD centres and schools The tasks required to achieve this objective are presented in table 55 below. Table 55: SO5-B: Implement nutrition education at ECD centres and schools Strategic intervention Specific activities Outputs Tasks Develop and implement an integrated FNS advocacy and communication strategy Implement nutrition education at ECD centres and schools Caregivers in registered ECDs are knowledgeable on nutrition Development of ECD training materials 8.8.2.1 Costing results As mentioned, healthcare workers and government officials will need various promotional and educational materials to promote the messages and lessons of the NFNS Plan. These include items such as banners, posters, flipcharts and educational books and games. Displayed in Table 56, the development of flipcharts and educational information booklets are the two biggest costs of strategic objective 5-B. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 151 Table 56: SO5-B cost estimates R Millions 2018/19 2019/20 2020/21 2021/22 2022/23 Total Educational poster costs R0.59 R1.10 R0.01 R1.79 R0.02 R3.51 Educational leaflet costs R0.96 R1.53 R1.62 R1.72 R1.82 R7.65 Educational information booklet costs R2.44 R3.86 R4.10 R4.33 R4.61 R19.34 Total flipchart costs R7.32 R - R9.92 R - R14.65 R31.89 Total management fee costs R2.83 R1.62 R3.92 R1.96 R5.27 R15.60 TOTAL COSTS R14.14 R8.11 R19.57 R9.80 R26.37 R77.99 Source: Costing outputs from FNS Costing Model 8.8.2.2 Key considerations (a) Strategic Objective 5-B is relatively affordable and its major cost drivers can be well justified. For example, although the production of flipcharts constitutes one of the largest expenses, these are necessary teaching aids. Community health workers and ECD practitioners often operate in rural areas where verbally explaining and visually demonstrating key concepts are more effective teaching methods than written communication. (b) It is a concern that sending leaflets home with children might constitute a waste of resources as there is no guarantee that the leaflets will actually reach the parents and, if they do, the chances of parents properly engaging with the material to change their behaviour are limited. 8.9 Strategic Objective Six: Developing a monitoring and evaluation system for FNS, including an integrated risk-management system for monitoring FNS-related risks 8.9.1 SO6-A: Establish the NFNS Plan M&E Unit The stablishment of a team dedicated to the monitoring and evaluation of the NFNS Plan is essential for not only the performance of the tasks required to achieve Strategic Objective 6, but also for the success of the NFNS Plan in general. Therefore, before any activities set out under Strategic Objective 6 are performed, the NFNS Plan’s M&E unit has to be established. The NFNS Plan proposes the establishment of an M&E Unit located within the DPME and collaborating with Stats SA and the M&E directorates of other line ministries. Table 57 below presents the cost estimates associated with adding one administrator at DPSA level 8, two technical researchers at level 11, and one technical expert at level 13 to the DPME’s M&E Unit. These costs include the salaries and the setting-up of a formal office space. It is recommended that these officials are recruited as soon as possible and the model therefore assumes they will be employed by the beginning of the 2018/19 financial year. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 152 Table 57: SO6-A cost estimates R Millions 2018/19 2019/20 2020/21 2021/22 2022/23 Total A - Establish the NFNS Plan M&E Unit R3.13 R3.25 R3.50 R3.77 R4.06 R17.71 Staff salary packages (R'm) R3.02 R3.25 R3.50 R3.77 R4.06 R17.60 Cost of furniture and equipment R0.10 R0.00 R0.00 R0.00 R0.00 R0.10 Source: Costing outputs from FNS Costing Model 8.9.2 SO6-B: Incorporate a consistent set of core indicators in National Surveys 8.9.3 The tasks required to achieve this objective are presented in table 58 below. Table 58: SO6-B: Incorporate a consistent set of indicators in National Surveys Strategic intervention Specific activities Outputs Tasks Establish a core set of indicators for monitoring FNS interventions and risks. Identify and integrate a core set of FNS indicators in national surveys for continuous surveillance of FNS. Expanded set of core indicators incorporated in national surveys, to include: • % of households experiencing hunger • of individuals Experiencing hunger. 1) Identify databases with indicators relevant to food security and consolidate relevant indicators on central database as they become available. 2) Review measurement methodology of all indicators to ensure consistency across databases, regions and time. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 153 Strategic intervention Specific activities Outputs Tasks 3) Identify FNS related indicators for which data should be collected but currently are not. 4) Propose and negotiate new indicators to be integrated into relevant existing surveys. A cost estimate for the above activities is provided in Table 59 below. While there is some flexibility regarding the selection of an internal or external consultant to review the datasets, the same is not true in respect to facilitating a workshop to present on the results of the review. The cost estimate of this stands at roughly R200 000 over a 2-day period. Annexure 5 provides an overview of the parameters assumed in terms of attendance, catering and transport requirements. Table 59: SO6-B cost estimates R Millions 2018/19 2019/20 2020/21 2021/22 2022/23 Total B - Incorporate a consistent set of core indicators in National Surveys R1.20 R0.00 R0.00 R0.00 R0.00 R1.20 Consultant R1.00 R0.00 R0.00 R0.00 R0.00 R1.00 Workshops R0.20 R0.00 R0.00 R0.00 R0.00 R0.20 Source: Costing outputs from FNS Costing Model N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 154 8.9.4 SO6-C: Conduct implementation evaluations of the FNS 2017- 2022 completed The tasks required to achieve this objective are presented the table 60 below. Table 60: SO6-C: Conduct implementation evaluations of the NFNS Plan Strategic intervention Specific activities Outputs Tasks Conduct evaluations of the FNS 2018 2023 Increased food production by household producers Conduct an implementation evaluation of the FNS 2018-2023 Conduct an implementation evaluation of the FNS 2018-2023 Source: (The Government of the Republic of South Africa, 2017) The cost associated with the midline evaluation in 2020/21 and endline evaluation in 2022/23 are presented in table 61 below. Table 61: SO6-C cost estimates R Millions 2018/19 2019/20 2020/21 2021/22 2022/23 Total C - Conduct implementation evaluations of the NFNS Plan R0.00 R0.00 R0.77 R0.00 R1.10 R1.86 Midline Implementation Evaluation R0.00 R0.00 R0.77 R0.00 R0.00 R0.77 Endline Implementation Evaluation R0.00 R0.00 R0.00 R0.00 R1.10 R1.10 Source: Costing outputs from FNS Costing Model N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 155 Strategic intervention Specific activities Outputs Tasks Establish a FNS risk register for the country, by profiling FNS risks to which the country is vulnerable and how they should be addressed as part of the FNS disaster preparedness and management mechanism Analyse potential FNS hazards and risks and their impacts, including climate change, drought, price increases / fluctuations, pests, food safety / biotechnology, risks for nutrition, food industry cartels etc. Analysis and rating of hazards and their impacts Profile the risks to which the country is vulnerable, and how they should be addressed as part of the FNS disaster preparedness and management mechanism Develop mechanisms to address FNS risks and hazards by: 1. Establishing (design) a strategic grain reserve facility, 2. Instituting food price-support mechanism for the benefit of the poor, 3. Review Marketing of Agricultural Products Act, 1996 and other relevant legislation impacting on food security Mechanisms of addressing risks and hazards including grain reserve facility, price support mechanism, and legislation to enable State participation in the food system Enhance capacity for generating and using FNS and risk monitoring and evaluation information Identify groups vulnerable to various FNS risks and profile them Risk profiles for vulnerable groups completed 8.9.5 SO6-D: Analyse and rate hazards and risks associated with FNS, and their impacts The tasks required to achieve this objective are presented in table 62 below. Table 62: SO-6D: Analyse and rate hazards and risks associated with FNS, and their impacts N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 156 The estimated cost of these tasks includes a once-off cost of R2.51m in the year that risks to food and nutrition security are analysed originally. It is expected that in each subsequent year of the plan, this analysis along with the data already on the register will have to be updated at an average annual cost of R850 000. Once risks and hazards have been identified and the report has been prepared, there will be a need to develop specific measures and mechanisms to address these. Development of these mechanisms will fall outside the scope of this costing model, as their costs will ultimately be based on the findings of the risk and hazard analysis. Table 63: O6-D cost estimates R Millions 2018/19 2019/20 2020/21 2021/22 2022/23 Total D - Analyse and rate hazards and risks associated with FNS, and their impacts R2.51 R0.86 R0.92 R0.98 R0.63 R5.89 Analysing risks R2.51 R0.00 R0.00 R0.00 R0.00 R2.51 Updating risk and hazard analysis R0.00 R0.86 R0.92 R0.98 R0.63 R3.39 Source: Costing outputs from FNS Costing Model The work involved in performing the initial analysis in 2018/19 will be of an extremely technical nature requiring very specialised skill and competencies and a significant amount of time. Although we expect that the M&E unit will commission the research and ensure that it is comprehensive and of sufficient quality, its outsourcing is highly recommended. The annual updates, which contribute to the majority of the costs over the period could potentially be performed by the M&E unit. This will however have to be done in collaboration with various state agencies and entities such as Stats SA, ARC, SANBI, relevant Civil Society Organisations and the M&E functions within those line ministries involved in the NFNS Plan. The potential for insourcing this work will however depend on the degree of knowledge transfer that occurs during the initial analysis and the level of complexity of the work required. As it is not really possible at this stage to predict whether sufficient knowledge could be transferred or how complex this work might be, we deemed it necessary to include the costs of an external expert for all the work required. CONCLUSION The NFNS Plan 2018-2023 aims to “Implement a priority set of actions, and establish the necessary institutional architecture to lead, coordinate, budget and monitor the implementation of these actions, to deliver significant improvements in food and nutrition status by 2030”. It is widely recognised that food security and nutrition is a major challenge in South Africa disproportionately affecting poor N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 157 and vulnerable households and individuals. The overall objective of the NFNS Plan is therefore not only commendable but also a pressing priority for the country. Nevertheless, addressing a challenge of this scale will require significant resources. The aggregate cost estimates for the NFNS Plan are presented in Table 64 along with the estimates of the funding41 over the period. Table 64: Aggregate affordability (2018/19 – 2022/23) R Millions Total additional costs Total funding42 % additional funding requirement Strategic Objective 1 R18.76 R222.84 8.4% Strategic Objective 2 R66 256.15 R39 994.55 165.7% Strategic Objective 3 R11 234.91 R443 229.48 2.5% Strategic Objective 4 R7 024.92 R138 805.87 5.1% Strategic Objective 5 R703.79 R515.94 136.4% Strategic Objective 6 R23.70 R350.38 6.8% Total R85 262.23 R623 119.06 13.7% Source: Researcher’s calculations Funding is based on estimates of the funding of the budget programmes that are most likely to fund the activities as set out in the plan. 42 (National Treasury, 2017) N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 158 Overall, the NFNS Plan will require an average increase in funding of 13.7% over the 5-year period of the plan. Although significant funding will be required for Strategic Objectives 3 and 4, these are generally well-funded functions and the required increase in funding is somewhat marginal. Relative to the NFNS Plan’s total cost, the cost of implementing Strategic Objectives 1 and 6 is also low. It is also expected that the additional funding requirement will be low relative to the budget programmes that will fund the activities of these objectives. Strategic Objectives 1 and 6 will require very little compared to both the current funding and the NFNS Plan’s total cost. Although Strategic Objective 5 will necessitate substantial additional funding, as mentioned, for the advocacy and BCC strategy of Strategic Objective 5 to be effective there is a certain minimum threshold of resources that must be employed. Therefore, instead of attempting to narrow the scope of the strategy, additional funding could be unlocked through a collaborative funding approach in which all departments involved in the NFNS Plan contribute to the funding of the strategy. The largest drivers of the costs and additional funding requirement of the NFNS Plan are the activities and targets of Strategic Objective 2. Increasing funding by more than 2.5 times over the NFNS Plan’s period is highly unlikely. The targets set out in the plan are important, but given current constraints on Government’s budget, it is likely that the extent of additional funding could delay or hamstring implementation of the plan. As discussed, meaningfully addressing food security and nutrition in South Africa is an important but challenging undertaking. Due to the scale of the problem, the resource requirement is tremendous. 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Annexure 1: Programmes implemented by government departments to address food and nutrition security # Programme Description of programme Department of Agriculture, Forestry & Fisheries 1 AgriBEE Developed to support Black South Africans to actively participate in the agricultural sector as owners, managers, professionals, skilled employers in all business interfaces; and to encourage inclusive processes, a participatory culture and collective efforts towards growth and development of the South African economy 2 Agro-processing strategy To create an enabling environment for SME agro processors to fully and actively participate in the mainstream economy. 3 Animal and Veld Management Programme Improvement of the livelihoods of rural poor through coordinating the effective implementation of socio economic infrastructure. 4 Comprehensive Agriculture Support Programme (CASP) To provide effective agricultural support services, promoting and facilitating agricultural development, by targeting beneficiaries of land reform’s restitution and redistribution and other black producers who have acquired land through private means and are engaged in value-adding enterprises. 5 Fetsa Tlala The Initiative is aimed at implementing the food production pillar of the National Policy, maximisation of food cultivation, by putting a million hectares of land under production by the 2018/19 production season. 6 Integrated Food Security and Nutrition Programme Government approved the National Policy on Food and Nutrition Security and the Household Food and Nutrition Security Strategy in 2013 to continue responding to the hunger challenges of the country. 7 Irrigation scheme rehabilitation DAFF is currently preparing a plan for irrigation scheme rehabilitation. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 165 # Programme Description of programme 8 LandCare Programme Department to coordinate effectively all relevant departments or units across all spheres of government in a manner that fosters the intergovernmental approach to rural development. This was especially necessary, and continued to be, to avoid duplication of services as is the case in Animal and Veld Management Programme (DRDLR) and the Land Care Programme (DAFF). Focuses on land-resource management through the promotion of sustainable-use practices. 9 Masibambisane Rural Development Initiative (MRDI) Aims to develop rural communities through infrastructure development, skills development and transfer, as well as access to markets for small-scale farmers. 10 Micro-agricultural Financial Institutions of South Africa (Mafisa) Provides access to finance for farmers, especially beneficiaries of the land restitution, redistribution and land-tenure reform programmes. 11 Participative Forestry Projects The DAFF Directorate: Forestry Development (Participative Forestry) in conjunction with Danida is supporting the establishment of community projects through regional forestry staff. An estimated R2 million has already been spent from the Community Facilitation Fund to support the establishment of projects on the ground. Current projects include beekeeping, which is a partnership with the Agricultural Research Council, and the establishment of medicinal nurseries in partnership with various stakeholders. 12 Recapitalisation and Development Programme This contravenes the policy provision for Recapitalisation and Development. Further, the Report did not give evidence of the link between the grants and section 42C approvals, whether similar communities received support. 13 Recapitalisation and Development Programme In relation to adequate budget for new claims, the DRDLR has reprioritised R571 million over the 2015 Medium Term Expenditure Framework (MTEF) period from the existing baseline to fund new claims. With recapitalisation and development, an amount of R4.7 billion has been proposed. 14 Zero Hunger The Programme seeks optimal use of land and agrarian reform, ensuring land tenure for food security, enhancement of government’s food purchase programme and better production inputs. 15 Nguni Cattle project Involves loans of 30 pregnant Nguni heifers and one breeding bull to qualifying farmers. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 166 # Programme Description of programme Department of Basic Education 16 National School Nutrition Programme (NSNP) The programme is implemented within the larger framework of the National Integrated Food and Nutrition Security Policy. It is intended to enhance learning capacity and improve access to education. During the 2015/16 financial year the NSNP reached nearly 9 million learners in 21 000 schools. About 56 000 volunteer food handlers (VFHs) support the programme and earn a stipend, which is reviewed annually. The NSNP serves one cooked meal per day that consists of a protein dish, a starch and a fresh vegetable or fruit. Three pillars form the basis of the programme: • School feeding to provide nutritious meals • Establishment and maintenance of school food- gardens • Nutrition education, to encourage healthy eating habits and lifestyle choices. • The NSNP and Integrated School Health Programme (ISHP) further support a deworming programme in schools. 17 School Food- Gardens Programme School food-gardens are a second pillar of the NSNP. The initiative presents an opportunity to educators and learners for hands-on experience and give insights into small-scale agricultural initiatives. It also has the potential to develop positive attitudes and instil values towards active citizenry, skills for natural-resource management, and interest in careers related to agriculture and nutrition. The recommendation of a report on the NSNP Evaluation (DPME, 2016) is to reinvigorate the food-production component of the NSNP by dedicating funding and mobilising partnerships to expand the resource-base for implementing the programme. Department for Public Works 18 The Infrastructure Delivery Improvement Programme (IDIP) A capacity-building programme to address problems relating to the planning and management of public-sector infrastructure delivery. The goal of IDIP is to improve the efficiency and effectiveness of the delivery of public sector infrastructure through developing and institutionalising best-practice systems and tools. Annexure 1: Programmes implemented by government departments to address food and nutrition security - continued N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 167 # Programme Description of programme Department of Public Works 19 Road Maintenance Programme Will enhance service delivery capacity, thereby impacting positively on the population. 20 The Expanded Public Works Programme Provides poverty and income relief through temporary work for the unemployed, carrying out socially-useful activities. Department of Small Business Development 21 Cooperative Incentive Scheme Provides financial support to qualifying companies in various sectors of the economy. Department of Transport 22 Integrated urban space and public transport programme Coordinates planning and implementation of public transport, human settlement, economic and social infrastructure, and location decisions into sustainable urban settlements connected by densified transport corridors. Department of Water Affairs and Sanitation 23 Working for Water Spearheads the fight against invasive alien plants. This programme works in partnership with local communities, to whom it provides jobs. Department of Health 24 Calcium supplementation, Iron folate supplementation (or multiple micronutrients) Distribution of supplements at ante-natal clinics in primary healthcare clinics (PHCs) and hospitals. 25 Child Healthcare Problem Identification Programme An audit of child deaths in participating hospitals found that about 63% of under 5s who died were malnourished, with the majority of them infected with HIV. 26 Deworming (situational*) Child Health Weeks, Routine PHC services and outreach 27 Exclusive Breastfeeding promotion* Community nutrition programmes delivered through PHCs and hospitals 28 Fortification of staples* Market-based strategy N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 168 # Programme Description of programme 29 Integrated Nutrition Programme Provided a broad framework for the reorientation of nutrition services in South Africa since 1994. Significant gains were made in this period, particularly in the development of specific policies and the implementation of micronutrient strategies. 30 Multiple micronutrient supplements and targeted supplementary feeding to undernourished individuals Community nutrition programmes, clinics, PHCs and hospitals. 31 Salt iodisation Market-based strategy 32 Therapeutic zinc supplementation Diarrhoea treatment – PHCs, hospitals 33 Vitamin A supplementation Hospital services, child health weeks, Routine PHC services and outreach. Department of Rural Development and Land Reform 34 Agri-Parks Roll out of Agri-Parks in all 44 districts across the country. This is a Rural Development Programme that will serve as a catalyst for the revitalisation of the rural economy. 35 Animal and Veld Management Programme The Department must develop mechanisms to enhance its capacity to coordinate effectively all relevant departments or units across all spheres of government in a manner that fosters the intergovernmental approach to rural development. This continues to be necessary to avoid duplication of services as is the case in Animal and Veld Management Programme and the DAFF Land Care Programme. 36 Comprehensive Rural Development Programme (CRDP) Tackles issues such as underdevelopment, hunger, poverty, joblessness, lack of basic services and other social ills which have become synonymous with rural areas and redistribution of 30% of the country’s agricultural land. 37 Land Reform for Agricultural Development Identify strategically-located land acquired, provide farm development support to smallholder farmers and establish a functional system and institutional arrangements. 38 Proactive Land Acquisition Strategy (PLAS) Aims to support local government to develop area-based planning and improve coordination among the institutions responsible for land reform. Annexure 1: Programmes implemented by government departments to address food and nutrition security - continued N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 169 # Programme Description of programme 39 Recapitalisation and development programme To increase production and food security, graduate emerging farmers into commercial farmers, create job opportunities within the agriculture sector and establish rural development monitors. 40 Restitution Programme Responsible for the settlement of land restitution claims under the Restitution of Land Rights Act, No. 22 of 1994, as amended, and the provision of settlement support to beneficiaries. Department of Social Development 41 Comprehensive ECD Programme The ECD Policy was approved by Cabinet in February 2015 and subsequently gazetted for public comment. The Comprehensive ECD Programme will be finalised after approval of the ECD Policy. 42 Early Childhood Development Programmes These programmes include some aspects of basic services provision, citizenship (birth registration), social security, health care for women and children, early child care and education, and preparation for formal schooling. 43 Food Banks Each food bank acts on behalf of social services agencies, by procuring food which is mainly donated by the food and grocery industries, government agencies, individuals and other organisations. 44 Food parcels DSD provides funding to home-based community-based care (HBCBC) organisations to enable them to provide food parcels, among other services, to people living with HIV 45 Food vouchers Part of the Social Relief from Distress Programme provided for the procurement of food from specific retailers. 46 Government Food Purchasing Programme Establishment of food value-chains for improved rural economies. This outcome of the Food-Purchasing Programme focuses on promotion of rural food value chain development in order to ensure better market access for both subsistence and smallholder producers. 47 Social grants Provides monetary assistance to those most in need. 48 Social relief of distress programmes Social relief of distress is temporary provision of assistance intended for persons in such dire material need that they are unable to meet their families’ most basic needs. 49 Soup Kitchens / Drop-in centres DSD makes funding available to soup kitchens and drop in-centres to run food-provision points across the province 50 War on Poverty The most deprived households identified in the poorest wards would be visited periodically during this campaign by a team of professionals and community workers to identify their specific needs, accelerate their access to government services, and provide safety nets. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 170 Annexure 1: Programmes implemented by government departments to address food and nutrition security - continued # Programme Description of programme Department of Trade and Industry 51 Aquaculture Development and Enhancement Programme (ADEP) An incentive programme available to South African registered entities engaged in primary, secondary and ancillary aquaculture activities in both marine and freshwater, classified under SIC 132 (fish hatcheries and fish farms) and SIC 301 and 3012 (production, processing and preserving of aquaculture fish). 52 Black Business Supplier Development Programme (BBSDP) A cost-sharing grant offered to small black-owned enterprises to assist them to improve their competitiveness and sustainability. 53 Local Economic Development The DTI initiated the Incubation Support Programme (ISP) to develop incubators and create successful enterprises with the potential to revitalise communities and strengthen local and national economies. 54 Technology Demonstration Centres (TDCs) TDCs focus on demonstrating, exhibiting and providing training in the use of available technologies – especially with regards to value-addition processes. Human Rights Commission 55 PAIPS The programme seeks to promote and facilitate interaction between the SAHRC, civil society and Parliament on human rights issues; to engage with the legislative drafting and oversight function of Parliament; and to monitor and raise awareness about South Africa’s international and regional treaty obligations. Presidency 56 Community Works Programme Employs community members to serve as food preparers and/or brings in other service providers or agencies to organise food distribution and feeding on behalf of ECD centres and service providers, such as those operating food distribution centres. Department of Public Works 57 Expanded Public Works Programme (EPWP) The EPWP supports National Development Plan Outcome 4: “Decent employment through inclusive economic growth”. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 171 Annexure 2: Global policy environment for Food Security and Nutrition Title Brief description Year UN General Assembly (UNGA): Sustainable Development Goals (SDGs) Member states discussed and adopted 17 goals. Goal 2 aims to: “End hunger, achieve food security and improve nutrition and promote sustainable agriculture”. Relevant targets: 2.1 By 2030, end hunger and ensure access by all people, in particular the poor and people in vulnerable situations, including infants, to safe, nutritious and sufficient food all year round. 2.2 By 2030, end all forms of malnutrition, including achieving, by 2025, the internationally agreed targets on stunting and wasting in children under 5 years of age; and address the nutritional needs of adolescent girls, pregnant and lactating women and older persons. 2015 Draft High-Level Strategy of the Scaling Up Nutrition (SUN) Movement (2016 2020) The group reaffirmed the ambition of the SUN Movement as an inclusive, multi-stakeholder, multi-sectoral movement open to all countries committed to achieving nutrition justice and an end to malnutrition in all its forms. 2015 WHA66.10: Follow up to the Political Declaration of the High-level Meeting of the UN General Assembly on the Prevention and Control of Non Communicable Diseases Endorsed the WHO Global Action Plan for the prevention and control of NCDs 2013-2020; adopted the comprehensive Global Monitoring Framework for the prevention and control of NCDs, including the set of 25 indicators capable of application across regional and country settings to monitor trends and assess progress; and adopted nine voluntary global targets for achievement by 2025 for the prevention and control of NCDs. Relevant indicator: halt the rise in diabetes and obesity. 2013 WHA65.6: Comprehensive Implementation Plan on Maternal, Infant and Young Child Nutrition Endorsed the comprehensive implementation plan on maternal, infant and young child nutrition and urges member states to put the plan into practice, as appropriate. Includes six global targets to be achieved by 2025 and five corresponding actions. Targets: • 40% reduction in the number of children under 5 who are stunted • 50% reduction of anaemia in women of reproductive age • 30% reduction in low birthweight • No increase in childhood overweight • Increase the rate of exclusive breastfeeding in the first 6 months to at least 50% • Reduce and maintain childhood wasting to less than 5%. 2012 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 172 Title Brief description Year UNGA Resolution 67/174 Reaffirmed the importance of the right to food as part of the right to an adequate standard of living. Member states recommitted the international world to focus on the realisation of the right to food. 2012 Copenhagen Consensus: hunger and malnutrition Reiterated the scaling-up of cost-effective interventions such as breastfeeding as the best investment in reducing childhood undernutrition. 2012 Revised SUN Road Map The 2012 Road Map complements the SUN Movement Strategy 2012-2015. It provides a greater level of detail on how the movement’s stakeholders will work together to ensure greatest impact of their collective actions on nutrition outcomes in SUN countries. The 2012 Road Map is a revision of the 2012 version, and continues to evolve as strategies and approaches are refined. Until recently, South Africa had not signed the SUN Road Map. 2012 WHA63.23: Infant and Young Child Nutrition. Urged member states to increase political commitment to preventing and reducing malnutrition in all its forms, to expedite implementation of the global strategy on infant and young child feeding, and to expand interventions. 2010 SUN Road Map Developed as a key contribution to realising the MDGs, the Road Map proposed a multi- stakeholder global effort to Scale Up Nutrition. Until recently, South Africa had not signed the SUN Roadmap. 2010 SUN Framework for Action to Scale-Up Nutrition Based on a collaborative effort of a wide range of developing country partners, community service organisations, UN, multilateral and bilateral agencies. 2010 Framework for Scaling Up Nutrition Developed in 2010 to put nutrition back on the international agenda. 2010 127th Session of the FAO Council: Voluntary Guidelines to Support the Progressive Realization to Adequate Food in the Context of National Food Security Provide practical guidance to states in their implementation of the progressive realization of the right to adequate food in the context of national food security, to achieve the goals of the World Food Summit Plan of Action. 2004 UNGA: Millennium Development Goals (MDGs) Member states adopted 8 goals. Relevant goals: • Eradicating extreme poverty and hunger • Ensuring environmental sustainability 2001 Annexure 2: Global policy environment for Food Security and Nutrition N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 173 Title Brief description Year World Food Summit Defined food security as existing “when all people at all times have access to sufficient, safe, nutritious food to maintain a healthy and active life”. 1996 International Covenant on Economic, Social and Cultural Rights (ICESCR): Article 11. Member states recognised the right to food as part of the right of everyone to an adequate standard of living for himself and his family. • 11.1 refers to the right to food: “Including adequate food, clothing and housing, and to the continuous improvement of living conditions”. • 11.2 refers to the fundamental right of everyone to be free from hunger: “The fundamental right of everyone to be free from hunger” 1976 Universal Declaration of Human Rights: Article 25 “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing, medical care and social services…” 1948 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 174 Annexure 3: Africa regional policy environment for food and nutrition security Title Brief description Year Malabo Declaration on Accelerated Agricultural Growth and Transformation for Shared Prosperity and Improved Livelihoods Expressed concerns relating to, among others, child under nutrition, child stunting, child underweight and hunger, and recommitted to reaching the goal of effecting nutritional security for inclusive economic growth and sustainable development. 2014 Brazzaville Declaration on Non Communicable Diseases The “Brazzaville Declaration” committed member states to develop integrated national action plans and strengthen institutional capacities for NCD prevention and control. 2011 Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa: Article 15 Member states should “Ensure that women have the right to nutritious and adequate food,” and implement specific steps to fulfil these obligations. 2003 Comprehensive Africa Agriculture Development Programme (CAADP) CAADP provides for strong state commitment and investment in agricultural development. The CAADP initiative is structured around the following four pillars (“areas of primary action”): • Land and Water Management • Rural infrastructure and trade-related capacities for markets • Increasing food supply and reducing hunger • Agricultural research technology dissemination and adoption 2003 New Partnership for Africa’s Development (NEPAD) NEPAD manages a number of programmes and projects in six theme areas. The relevant theme: • Agriculture & Food Security 2002 African Charter on the Rights and Welfare of the Child (ACRWC): Article 14 Obliges member states to: • 14(2)(c) Ensure the provision of adequate nutrition and safe drinking water • 14(2)(d) Combat disease and malnutrition within the framework of primary healthcare 1999 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 175 Annexure 4: Existing policy environment for food and nutrition security in South Africa Title Brief description Year National strategic plan for the prevention and control of obesity 2015-2020 1. Due to the high levels of obesity in the country, a strategic plan was created to reduce this increasing burden. The strategy focuses on 6 six broad goals. These are: 2. Create an institutional framework to support inter sectoral engagement 3. Create an enabling environment that supports availability and accessibility to healthy food choices in various settings 4. Increase the percentage of the population engaging in physical activity (PA) 5. Support obesity prevention in early childhood (in utero – -12 years) 6. Communicate with, educate and mobilise communities 7. Establish a surveillance system and strengthen monitoring, evaluation and research 2015 South African National Policy on Food, Nutrition and Security Approved by cabinet in 2014. It identifies five pillars to achieve food security: • Availability of improved nutritional safety nets; • Improved nutrition education • Alignment of investment in agriculture towards local economic development • Improved market participation of the emerging agricultural sector • Risk management 2014 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 176 Title Brief description Year Medium Term Strategic Framework Priority 2014-2019 (MTSF) Strategic Objective 2 is rural development, land and agrarian reform and food security. In addition, it indicates that: • Food security is part of a long and healthy life for all South Africans (par. 6.2) • The rural economy (agriculture) is to create one million new jobs by 2030 as part of vibrant, equitable, sustainable rural communities contributing towards food security for all (par. 6.7) • The protection and enhancement of environmental assets and natural resources are required in order to manage threats relating to, amongst others, food security (par.6.10) • A strong emphasis should be placed on the school nutrition programme (par. 6.13). • Relevant outcomes: • Outcome 7 is formulated as: “Vibrant, equitable, sustainable rural communities contributing to food security for all” • Outcome 13 deals with: “A comprehensive, responsive and sustainable social protection system”. 2014-2019 Roadmap for Nutrition in South Africa 2013 2017 The roadmap lists a number of priority interventions, including: • Exclusive breastfeeding; • Healthy eating for optimal weight during pregnancy and breastfeeding; • Nutritional education; • Therapeutic zinc, A, iron folate and calcium supplements; and • Micronutrient supplements for undernourished people, particularly those with HIV and TB 2013 National Strategic Plan for the Prevention and Control of NCDs 2013 2017 Strategic plan developed to combat NCDs, both risk factors and diseases are addressed. Relevant target: Reduce the percentage of people who are obese and/or overweight by 10% by 2020 2013 Annexure 4: Existing policy environment for food and nutrition security in South Africa N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 177 Title Brief description Year Infant and Young Child Feeding Policy These guidelines, which replace those issued by the government in 2007, cover six main topics including: • Early initiation of breastfeeding in health facilities; • Continued breastfeeding for at least two years; • Infant feeding for mothers living with HIV; • Use of commercial formula; • The introduction of complimentary foods from six months; and • Feeding infants and young children in difficult circumstances. 2013 Strategic Plan for Maternal, Neonatal, Child and Women’s Health (MNCWH) and Nutrition in South Africa This plan is aligned to and supports the process of Primary Health Care (PHC) re-engineering. The three strands of the PHC – expanded school health services, ward-based outreach teams, and district clinical specialist teams – will play a key role in delivering community based MNCWH services to communities and households, and will facilitate access to services at PHC- and hospital levels. Relevant goal: eradicate extreme hunger and poverty; 2012 National Development Plan (NDP) 2012-2030 One of the key focus areas of the NDP is agriculture. It aims at eliminating income poverty by 2030 and indicates a strong commitment to household food and nutrition security. It is of the view that the ability to access food determines household food security. 2012 Integrated School Health Policy The Integrated School Health Programme aims to provide a more comprehensive package of services, which addresses not only barriers to learning, but also other conditions which contribute to morbidity and mortality amongst learners during both childhood and adulthood. The programme also includes a new, more prominent emphasis on the provision of health services in schools, which previously only conducted health screenings and referrals. 2012 Regulations (R991/2012): international code on marketing of breast milk substitutes Following guidelines from UNICEF and the Tshwane declaration South Africa introduced regulations to enforce the international code on marketing of breast milk substitutes. 2012 The Tshwane Declaration Besides promoting, protecting and supporting breastfeeding generally, the declaration specifically adopts breastfeeding as the default feeding method for HIV-exposed infants and promotes human milk banks to support breastfeeding and breast milk feeding. 2011 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 178 Title Brief description Year National Health Act 61 • s 2(c)(iii) The protection of, respect for, promotion of and fulfilment of the section 28(1)(1(c) constitutional right of children to basic nutrition • s 21(2)(b) The duty of the Director-General of the Department of Health to, in accordance with the National Health Policy, “issue, and promote adherence to, norms and standards on health matters, including (i) nutritional intervention” 2003 Food Fortification Legislation The fortification of all maize meal and wheat flour in South Africa became mandatory. 2003 Integrated Nutrition Programme Strategic Plan Upon consultation with experts, a strategic plan was required for the INP. This plan set out targets and objectives following expert consultation. The targets were revised annually. 2001 Integrated Sustainable Rural Development Strategy (ISRDS) Addresses rural development in a broader framework of intersectoral cooperation to improve health and social development. One of its key activities is the development of income-generating projects. The Nutrition Directorate is one of many directorates providing technical support such as nutrition knowledge and food management expertise and skill. 2001 Guidelines for the in patient management of acute, severe Protein Energy Malnutrition (PEM) Based on the WHO Ten Steps. The guidelines include primary and secondary interventions, products for nutritional rehabilitation, entry and exit criteria for food supplementation and the management and treatment of under-nutrition. The WHO Ten Steps, together with the Guidelines on Nutrition Interventions and the Integrated Management of Childhood Illnesses, have been implemented and expanded to all health facilities in the nine provinces. 2000 Integrated Nutrition Programme (INP) The INP encourages and supports programmes that are integrated, sustainable and community-driven as opposed to the fragmented and mostly food-based approaches of predecessors. The INP focuses on seven focus areas/strategies, namely: 1. Contribution to household food security 2. Disease-specific nutrition support, treatment and counselling 3. Growth monitoring and promotion 4. Nutrition promotion, education and advocacy 5. Promotion, protection and support of breastfeeding 6. Micronutrient malnutrition control and 7. Food service management. 1998 Annexure 4: Existing policy environment for food and nutrition security in South Africa N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 179 Title Brief description Year Constitution of South Africa: Section 27 The right to health care, food, water and social security is enshrined in section 27, which also obliges the State to take reasonable legislative and other steps, within the context of its available resources, to progressively give content to each of these rights: (1) (b) Everyone has the right to have access to sufficient food and water. (2) The state must take reasonable legislative and other measures, within its available resources, to achieve the progressive realisation of these rights. 1996 Division of Revenue Act (DoRA) The National School Nutrition Programme’s Conditional Grant Framework (CGF) is an Annexure of the Division of Revenue Act (DoRA)43, which is published annually and outlines minimum requirements with respect to: • complying with recommended food specifications and an approved menu of meals providing starch, protein and fresh vegetables/fruit • varying servings of fresh fruit/vegetables daily between green and yellow/red, and varying of protein-rich foods such as sugar beans, soya mince • mandatory serving of pilchards at least once a week • Ultra-High Temperature (UHT) pasteurised milk or maas should be served once a week. Milk should be approved in line with dairy standards set by Milk South Africa. Published annually N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 180 ANNEXURE 5: Parameters for the costing of the National Food and Nutrition Security (FNS) Council Establish the National Food and Nutrition Security (FNS) Council Table 2: Cost components to establish a national multi-sectoral food and nutrition security council R millions 2018/19 2019/20 2020/21 2021/22 2022/23 National FNS Council meetings Number of FNS Council meetings per year 1 1 1 1 1 Number of days per FNS Council meeting 1 1 1 1 1 Number of delegates at FNS Council meetings 24 24 24 24 24 Number of sector experts at FNS Council meetings 6 6 6 6 6 Seating allowance (honorarium) for sector expert R6 000 R6 420 R6 869 R7 350 R7 864 Number of attendees requiring flights 5 5 5 5 5 Cost of return flight per attendee R3 860 R4 033 R4 215 R4 404 R4 603 Number of attendees travelling by car 3 3 3 3 3 Cost of accommodation per distance attendee per night R1 500 R1 691 R1 796 R1 908 R2 026 Cost of venue hire Internal Internal Internal Internal Internal Catering cost per day per head R200 R200 R200 R200 R200 National FNS Council consultative forums Number of FNS consultative forums per year 1 1 1 1 1 Number of days per FNS consultative forums 2 2 2 2 2 Number of delegates at FNS consultative forums 70 70 70 70 70 Number of sector experts at FNS consultative forums 6 6 6 6 6 Seating allowance (honorarium) for sector experts’ R6 000 R6 420 R6 869 R7 350 R7 864 Number of attendees requiring flights 30 30 30 30 30 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 181 R millions 2018/19 2019/20 2020/21 2021/22 2022/23 Cost of return flight per attendee R3 860 R4 033 R4 215 R4 404 R4 603 Number of attendees travelling by car 18 18 18 18 18 Cost of accommodation per distance attendee per night R1 500 R1 691 R1 796 R1 908 R2 026 Cost of venue hire Internal Internal Internal Internal Internal Catering cost per day per head R200 R200 R200 R200 R200 National FNS Council international conference preparatory meetings Number of preparatory meetings per year 2 2 2 2 2 Number of days per preparatory meeting 1 1 1 1 1 Number of delegates at preparatory meetings 8 8 8 8 8 Number of sector experts 2 2 2 2 2 Seating allowance (honorarium) for sector expert R6 000 R6 420 R6 869 R7 350 R7 864 Cost of venue hire Internal Internal Internal Internal Internal Catering cost per day per head R200 R200 R200 R200 R200 International cooperation and knowledge exchange Number of conferences per year 1 1 1 1 1 Number of days per conference 5 5 5 5 5 Number of delegates attending the conference 4 4 4 4 4 Cost of return flight per attendee R25 000 R26 125 R27 300 R28 529 R29 812 Cost of accommodation per attendee R1 659 R1 775 R1 899 R2 032 R2 174 Daily allowance per attendee R1 540 R1 648 R1 763 R1 886 R2 018 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 182 SO1-B: Establish the Provincial and local Food and Nutrition Security (FNS) Councils Table 64: Cost components to establish the Provincial and local Food and Nutrition Security Councils ANNEXURE 5: Parameters for the costing of the National Food and Nutrition Security (FNS) Council - continued R millions 2018/19 2019/20 2020/21 2021/22 2022/23 National FNS Council meetings Number of FNS Council meetings per year 2 2 2 2 2 Number of days per FNS Council meeting 1 1 1 1 1 Number of delegates at FNS Council meetings 24 24 24 24 24 Number of sector experts at FNS Council meetings 4 4 4 4 4 Seating allowance (honorarium) for sector experts R6 000 R6 420 R6 869 R7 350 R7 864 Cost of venue hire Internal Internal Internal Internal Internal Catering cost per day per head R200 R200 R200 R200 R200 Provincial FNS Council consultative forums Number of FNS consultative forums per year 1 1 1 1 1 Number of days per FNS consultative forums 1 1 1 1 1 Number of delegates at FNS consultative forums 100 100 100 100 100 Number of sector experts at FNS consultative forums 4 4 4 4 4 Seating allowance (honorarium) for sector experts R6 000 R6 420 R6 869 R7 350 R7 864 Number of attendees travelling by car 50 50 50 50 50 Cost of venue hire Internal Internal Internal Internal Internal Catering cost per day per head R200 R200 R200 R200 R200 District FNS Council meetings Number of meetings per year 2 2 2 2 2 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 183 R millions 2018/19 2019/20 2020/21 2021/22 2022/23 Number of days per meeting 1 1 1 1 1 Number of sector experts 4 4 4 4 4 Seating allowance (honorarium) for sector experts R6 000 R6 420 R6 869 R7 350 R7 864 Cost of venue hire Internal Internal Internal Internal Internal Number of attendees travelling by car 4 4 4 4 4 R millions 2018/19 2019/20 2020/21 2021/22 2022/23 Total production, including current production 1 462 124 2 000 000 2 714 418 3 684 031 5 000 000 Number of tonnes produced in addition to current production 393 220 931 096 1 645 514 2 615 127 3 931 096 Total tonnes produced receiving support (3-year support cycle) 393 220 931 096 1 645 514 2 221 907 2 606 780 R millions 2018/19 2019/20 2020/21 2021/22 2022/23 Total production including current production 1 198 862 3 000 000 3 779 763 4 762 203 6 000 000 Number of tonnes produced in addition to current production 719 772 2 520 910 3 300 673 4 283 113 5 520 910 Total tonnes produced receiving support (3-year support cycle) 719 772 2 520 910 3 300 673 3 563 341 2 280 228 SO2-A: Increase food produced by smallholder producers Table 65: Annual production of fruit and vegetables (in tonnes) Table 66: Annual production of maize and beans (in tonnes) N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 184 ANNEXURE 5: Parameters for the costing of the National Food and Nutrition Security (FNS) Council - continued Table 67: Annual additional production by smallholder producers supported (in tonnes), by type of commodity C o m m o d it y P ro d u ct io n c o st p er t o n n e P er ce n ta g e o f ad d it io n al p ro d u ct io n p er c o m m o d it y 20 18 /1 9 20 19 /2 0 20 20 /2 1 20 21 /2 2 20 22 /2 3 S tr a w b e rr ie s R 13 8 8 8 .7 5 0 .0 % C it ru s R 4 11 .9 9 8 .9 % 3 4 9 5 3 8 2 7 6 4 14 6 2 6 8 19 7 5 0 3 2 3 1 7 14 C a b b a g e R 1 4 4 0 .8 5 8 .9 % 3 4 9 5 3 8 2 7 6 4 14 6 2 6 8 19 7 5 0 3 2 3 1 7 14 C a rr o ts R 1 6 3 3 .5 3 8 .9 % 3 4 9 5 3 8 2 7 6 4 14 6 2 6 8 19 7 5 0 3 2 3 1 7 14 To m a to e s R 4 0 9 5 .4 6 2 .0 % 7 8 6 4 18 6 2 2 3 2 9 10 4 4 4 3 8 5 2 1 3 6 B u tt e rn u t R 2 0 5 2 .5 4 8 .9 % 3 4 9 5 3 8 2 7 6 4 14 6 2 6 8 19 7 5 0 3 2 3 1 7 14 O n io n s R 2 1 0 4 .8 4 8 .9 % 3 4 9 5 3 8 2 7 6 4 14 6 2 6 8 19 7 5 0 3 2 3 1 7 14 S p in a c h R 2 2 6 8 .8 6 8 .9 % 3 4 9 5 3 8 2 7 6 4 14 6 2 6 8 19 7 5 0 3 2 3 1 7 14 B e e tr o o t R 2 4 7 1.1 8 8 .9 % 3 4 9 5 3 8 2 7 6 4 14 6 2 6 8 19 7 5 0 3 2 3 1 7 14 S w e e t p o ta to e s R 2 5 6 4 .4 6 8 .9 % 3 4 9 5 3 8 2 7 6 4 14 6 2 6 8 19 7 5 0 3 2 3 1 7 14 P o ta to e s R 2 9 2 6 .5 2 8 .9 % 3 4 9 5 3 8 2 7 6 4 14 6 2 6 8 19 7 5 0 3 2 3 1 7 14 B ri n ja l R 3 7 5 8 .3 4 2 .0 % 7 8 6 4 18 6 2 2 3 2 9 10 4 4 4 3 8 5 2 1 3 6 L e tt u ce R 3 9 3 7. 3 3 2 .0 % 7 8 6 4 18 6 2 2 3 2 9 10 4 4 4 3 8 5 2 1 3 6 C a u lifl o w e r R 4 2 4 8 .8 8 2 .0 % 7 8 6 4 18 6 2 2 3 2 9 10 4 4 4 3 8 5 2 1 3 6 A m a d u m b e R 5 0 9 2 .6 5 2 .0 % 7 8 6 4 18 6 2 2 3 2 9 10 4 4 4 3 8 5 2 1 3 6 G re e n b e a n s R 5 4 0 3 .5 9 2 .0 % 7 8 6 4 18 6 2 2 3 2 9 10 4 4 4 3 8 5 2 1 3 6 G re e n p e a s R 5 7 4 8 .7 8 2 .0 % 7 8 6 4 18 6 2 2 3 2 9 10 4 4 4 3 8 5 2 1 3 6 B ro cc o li R 8 0 4 0 .9 6 2 .0 % 7 8 6 4 18 6 2 2 3 2 9 10 4 4 4 3 8 5 2 1 3 6 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 185 C o m m o d it y P ro d u ct io n c o st p er t o n n e P er ce n ta g e o f ad d it io n al p ro d u ct io n p er c o m m o d it y 20 18 /1 9 20 19 /2 0 20 20 /2 1 20 21 /2 2 20 22 /2 3 M a iz e R 1 6 8 5 .4 0 5 0 .0 % 3 5 9 8 8 6 1 2 6 0 4 5 5 1 6 5 0 3 3 7 1 7 8 1 6 7 1 1 14 0 1 14 B e a n s R 2 9 2 1. 3 6 5 0 .0 % 3 5 9 8 8 6 1 2 6 0 4 5 5 1 6 5 0 3 3 7 1 7 8 1 6 7 1 1 14 0 1 14 20 18 /1 9 20 19 /2 0 20 20 /2 1 20 21 /2 2 20 22 /2 3 N u m b e r o f h e c ta re s a c q u ir e d 9 0 0 0 0 9 5 0 0 0 15 9 3 12 15 9 3 12 15 9 3 12 % o f h e c ta re s a llo c a te d t o s m a llh o ld e r p ro d u ce rs 5 0 % 5 0 % 5 0 % 5 0 % 5 0 % N u m b e r o f h e c ta re s a llo c a te d t o s m a llh o ld e r p ro d u ce rs 4 5 0 0 0 4 7 5 0 0 7 9 6 5 6 7 9 6 5 6 7 9 6 5 6 A ve ra g e c o st p e r h e c ta re R 7 8 3 7. 8 0 R 7 8 3 7. 8 0 R 7 8 3 7. 8 0 R 7 8 3 7. 8 0 R 7 8 3 7. 8 0 % a lr e a d y b u d g e te d f o r b y g o ve rn m e n t 10 0 % 10 0 % 0 % 0 % 0 % Ta b le 6 8 : A n n u a l a d d it io n a l p ro d u ct io n b y s m a llh o ld e r p ro d u ce rs s u p p o rt e d ( in t o n n e s) , b y t y p e o f co m m o d it y Ta b le 6 9 : P a ra m e te r a ss u m p ti o n s fo r la n d a cq u ir e d f o r sm a llh o ld e r p ro d u ce rs N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 186 SO2-B Increase production of aquaculture by smallholder producers Neither Tilapia nor Catfish are currently produced at meaningful levels in South Africa. Consultations with the aquaculture sub programme in DAFF revealed that a meaningful target for Catfish and Tilapia production for 2022 is 5 000 tonnes. According to the DAFF Aquaculture Yearbook, in 2014, approximately 1 700 tonnes of Tilapia was imported. It has therefore been assumed that this would be a reasonable target for local production. This would therefore imply Catfish production of 3 300 tonnes in 2022/23 to reach the 5 000 tonnes target. It is assumed that production increases gradually for the first two years and then more rapidly in the last three as production. Feed costs and the FFC are assumed to remain constant and are based on research done for the IDC on the potential for the production, processing and export of Tilapia for the Southern African market44. ANNEXURE 5: Parameters for the costing of the National Food and Nutrition Security (FNS) Council - continued Table 70: Parameter values assumed in the estimation of the costs of increasing aquaculture production R millions (excl. unit costs) 2018/19 2019/20 2020/21 2021/22 2022/23 Tilapia production Annual tonnes of Tilapia produced 350 700 941 1 265 1 700 Cost of feed per kg R17.86 R18.93 R20.07 R21.27 R22.55 Feed conversion ratio (FFC) 1.5 1.5 1.5 1.5 1.5 Cost of feed as a % of total production costs 60% 60% 60% 60% 60% Cost per tonne of production R44 650.00 R47 325.00 R50 175.00 R53 175.00 R56 375.00 Catfish production Annual tonnes of Catfish produced 750 1 500 1 951 2 537 3 300 Cost of feed per kg R17.86 R18.93 R20.07 R21.27 R22.55 Feed conversion ratio 1.5 1.5 1.5 1.5 1.5 Cost of feed as a % of total production costs 60% 60% 60% 60% 60% Cost per tonne of production R44 650.00 R47 325.00 R50 175.00 R53 175.00 R56 375.00 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 187 R millions (excl. unit costs) 2018/19 2019/20 2020/21 2021/22 2022/23 Total number of households 16 923 308 16 923 308 16 923 308 16 923 308 16 923 308 Number of households involved in subsistence agriculture 2 217 106 2 313 229 2 413 519 2 518 157 2 627 331 Number of households with vegetable gardens 856 362 918 346 931 467 944 775 958 274 Percentage of households involved in subsistence agriculture 13.1% 13.7% 14.3% 14.9% 15.5% Increase the number of households involved in agriculture Provision of training Percentage of agricultural households requiring subsistence farming training 100% 100% 100% 100% 100% How many farmers per information day 100 100 100 100 100 How many information days per year 4 4 4 4 4 Cost per farmer per information day if lunch is provided R112.36 R119.10 R126.25 R133.82 R141.85 Vegetable gardens Provision of equipment and infrastructure Number of new households involved 57 800 61 984 13 121 13 308 13 499 Cost of provision per new household per annum R5 350.25 R5 671.26 R6 011.54 R6 372.23 R6 754.56 Provision of production consumables - - - Cumulative number of new households involved in agriculture 57 800 119 784 132 905 146 214 159 712 Annual cost per farmer p.a. R173.03 R183.42 R194.42 R206.09 R218.45 SO2-C: Increase food produced by subsistence (household) producers Parameter assumptions Table 71: Annual cost model parameter values for the increase in the number of subsistence producers N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 188 ANNEXURE 5: Parameters for the costing of the National Food and Nutrition Security (FNS) Council - continued R millions (excl. unit costs) 2018/19 2019/20 2020/21 2021/22 2022/23 Other subsistence farming Provision of equipment and infrastructure - - - Number of new households involved 34 328 34 139 87 169 91 330 95 676 Cost of provision per new household per annum R8 216.80 R8 709.81 R9 232.40 R9 786.34 R10 373.53 Provision of production consumables Cumulative number of new households involved in agriculture 34 328 68 467 155 635 246 965 342 641 Annual cost per farmer p.a. R1 538.72 R1 631.04 R1 728.90 R1 832.64 R1 942.60 Provision of land Number of hectares acquired 90 000 95 000 159 312 159 312 159 312 % of hectares allocated to subsistence producers 10% 10% 10% 10% 10% Average cost per hectare R7 031.13 R7 031.13 R7 031.13 R7 031.13 R7 031.13 % already budgeted for 100% 100% 0% 0% 0% N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 189 Production input packages Table 3: Standard production input package for vegetable farming Gardens ITEM DESCRIPTION ITEM QUANTITY UNIT COST TOTAL COST Consumables Seed pack 1 R39.82 R39.82 Fertiliser and LAN (5kg) 1 R123.42 R123.42 Total annual consumables - - R163.24 Equipment and infrastructure Treated poles (2.4mX15cm) 21 R94.26 R1 508.16 wire mash 45M R155.29 R6 988.05 Unails 1packet (500g) R110.00 R110.00 pedestrian gate 1 R660 R660 Watering can 1 R56.87 R56.87 Harvesting crate 1 R73.88 R73.88 Rake 1 R113.30 R113.30 Fork 1 R113.30 R113.30 Hand hoe and handle 1 R98.86 R98.86 Water tank 2500l 1 R3 850 R3 850 Contingency 10% R15 697.89 R1 569.79 Total equipment and infrastructure costs Source: (KZN Department of Agriculture and Land Reform, 2017) N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 190 Production input packages Table 3: Standard production input package for vegetable farming Indigenous chickens (Approximation used for all “other” farming INPUT QUANTITY/ PROJECT UNIT COST TOTAL COST (IN R) (IN R) Consumables Vaccines (250ml) 2 R90 R180 Deworming (150ml) 2 R80 R160 Crushed yellow maize 6 R400 R2400 Total annual consumables - - R2740 Equipment and infrastructure Indigenous Hens 9 R170 R1530 Indigenous Cockerel 1 R250 R250 Corrugated Iron (sheets of 2mx2m) 8 R89 R712 Chicken wire (13mm whole size and 2mm thickness) x8meters 1 R250 R250 Treated Poles (2.4mx15cm) 10 R100 R1000 U-nails 1 R100 R100 Water Tank 2000lt 1 R4 000 R4000 Total equipment and infrastructure costs - - R10 456.00 urce: (KZN Department of Agriculture and Land Reform, 2017) N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 191 SO2-D: Establish and strengthen producer development institutions Costs estimated by the Department of Agriculture, Forestry and Fisheries Table 73: Cost of establishing and strengthening producer development institutions R M ill io n s 20 17 /1 8 20 18 /1 9 20 19 /2 0 20 20 /2 1 20 21 /2 2 20 22 /2 3 To ta l S O 2 E : E st a b lis h a n d s tr e n g th e n p ro d u ce r d e ve lo p m e n t in st it u ti o n s R 8 2 3 .6 9 R 1 0 16 .5 2 R 1 0 7 2 .7 7 R 1 15 0 .6 5 R 1 19 2 .4 0 R 1 17 1. 12 R 6 4 2 7. 15 A cc re d it a ti o n a n d r e g is tr a ti o n o f C o lle g e s R 2 .3 6 R 5 .2 1 R 5 .5 5 R 5 .8 5 R 5 .6 8 R 6 .0 2 R 3 0 .6 6 A d m in is tr a ti o n s u p p o rt R 4 2 .4 0 R 4 4 .7 3 R 4 7. 4 2 R 5 0 .3 1 R 5 3 .3 7 R 5 6 .6 1 R 2 9 4 .8 3 C o m p e n sa ti o n o f E m p lo y e e s R 3 5 6 .5 1 R 3 9 4 .4 2 R 4 2 0 .9 6 R 4 4 9 .0 4 R 4 7 9 .0 6 R 5 0 8 .7 3 R 2 6 0 8 .7 4 C u rr ic u lu m r e v ie w w it h e m p h a si s o n v a lu e a d d it io n R 15 .19 R 18 .4 0 R 19 .5 9 R 2 1. 0 4 R 2 2 .9 7 R 2 1. 2 4 R 11 8 .4 2 L e a d e rs h ip d e ve lo p m e n t a n d c h a n g e m a n a g e m e n t R 3 3 .6 8 R 4 6 .2 3 R 5 1. 2 5 R 5 5 .7 2 R 5 9 .7 8 R 6 4 .8 6 R 3 11 .5 3 L ib ra ry e x p e n se s R 6 .4 9 R 6 .8 5 R 7. 2 6 R 7. 7 0 R 8 .17 R 8 .6 7 R 4 5 .15 O p e ra ti o n a l e x p e n se s R 2 3 1.1 5 R 2 4 4 .2 2 R 2 5 8 .9 2 R 2 74 .6 0 R 2 9 1. 2 2 R 2 9 8 .7 3 R 1 5 9 8 .8 5 Im p ro ve m e n t o f in fr a st ru c tu re a n d e q u ip m e n t R 13 5 .9 1 R 2 5 6 .4 6 R 2 6 1. 8 1 R 2 8 6 .3 9 R 2 7 2 .14 R 2 0 6 .2 6 R 1 4 18 .9 8 S o u rc e : C o lle g e s R e v it a lis a ti o n P la n N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 192 SO2-E: Create an enabling policy environment Costs estimated by the Department of Agriculture, Forestry and Fisheries Table 74: Cost of creating and enabling policy environment R M ill io n s 20 17 /1 8 20 18 /1 9 20 19 /2 0 20 20 /2 1 20 21 /2 2 20 22 /2 3 To ta l S O 2 G : C re a te e n a b lin g p o lic y e n v ir o n m e n t R 4 8 .2 7 R 12 .1 6 R 1. 8 3 R 1. 9 4 R 1. 8 5 R 1. 9 6 R 6 8 .0 2 A p p o in t d ra ft in g t e a m l e d b y r e g is tr a rs o f re le v a n t d e p a rt m e n ts R 0 .0 0 R 0 .0 0 R 0 .0 0 R 0 .0 0 R 0 .0 0 R 0 .0 0 R 0 .0 0 A p p ro ve S o u th A fr ic a n P ro d u ce r S u p p o rt P o lic y R 4 .2 6 R 0 .0 0 R 0 .0 0 R 0 .0 0 R 0 .0 0 R 0 .0 0 R 4 .2 6 C o n d u c t R e g u la to ry D ia g n o st ic I m p a c t A n a ly si s b y a p p o in ti n g a n e x te rn a l se rv ic e p ro v id e r (f o r a n d a ll o th e r re le v a n t A c ts ) R 11 .7 2 R 0 .0 0 R 0 .0 0 R 0 .0 0 R 0 .0 0 R 0 .0 0 R 11 .7 2 C o n d u c t R e g u la to ry D ia g n o st ic Im p a c t A n a ly si s b y a p p o in ti n g a n e x te rn a l se rv ic e p ro v id e r (f o r p ri o ri ti se d A c ts ) R 8 .8 4 R 0 .0 0 R 0 .0 0 R 0 .0 0 R 0 .0 0 R 0 .0 0 R 8 .8 4 D e ve lo p c o n ce p t d o c u m e n t b y d ra ft in g t e a m o f re g is tr a rs i n c lu d in g l e g a l se rv ic e s (i n h o u se ) R 7. 4 8 R 1. 5 7 R 1. 6 7 R 1. 7 7 R 1. 6 6 R 1. 7 6 R 15 .9 1 D e ve lo p s in g le o n lin e a p p lic a ti o n f o r p a rt ic ip a n ts a c ro ss R 11 .4 9 R 10 .5 9 R 0 .17 R 0 .18 R 0 .19 R 0 .2 0 R 2 2 .8 2 D e ve lo p m e n t o f S o u th A fr ic a n A g ri c u lt u ra l P ro d u ce r S u p p o rt B ill R 4 .4 8 R 0 .0 0 R 0 .0 0 R 0 .0 0 R 0 .0 0 R 0 .0 0 R 4 .4 8 Im p le m e n t re co m m e n d a ti o n s a cc o rd in g t o Im p a c t A n a ly si s* R 0 .0 0 R 0 .0 0 R 0 .0 0 R 0 .0 0 R 0 .0 0 R 0 .0 0 R 0 .0 0 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 193 R M ill io n s 20 17 /1 8 20 18 /1 9 20 19 /2 0 20 20 /2 1 20 21 /2 2 20 22 /2 3 To ta l S O 2 H : D e ve lo p a n d u p sc a le in st ru m e n ts t o s u p p o rt p ro d u ct io n a n d a cc e ss t o m a rk e ts f o r sm a llh o ld e r p ro d u ce rs R 5 .8 9 R 9 .2 0 R 14 .6 9 R 17 .1 6 R 2 0 .2 4 R 0 .0 0 R 6 7. 17 R e e n g in e e ri n g A g ri c u lt u ra l D e ve lo p m e n t F in a n ce R 1. 3 8 R 0 .5 6 R 0 .5 6 R 0 .5 6 R 0 .5 6 R 0 .0 0 R 3 .6 1 U n lo c k in g F in a n ce f o r G ra in s th ro u g h P P P G ra in s R 4 .5 1 R 8 .6 4 R 14 .13 R 16 .6 0 R 19 .6 9 R 0 .0 0 R 6 3 .5 6 SO2-F: Develop and up-scale instruments to support production and access to markets for smallholder producers Costs estimated during Operation Phakisa Table 75: Cost of the development of instruments that support production and improve access to markets for smallholder producers S o u rc e : A g ri c O p e ra ti o n P h a k is a N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 194 SO3-A: Promote early registration of children born in public health facilities within the prescribed 30-day period Table 76: Cost components to promote early registration of children born in public health facilities within the prescribed 30-day period R millions 2018/19 2019/20 2020/21 2021/22 2022/23 Development of birth registration system - Capex Cost of server hardware R34 220 732 - - - Cost of disaster recovery hardware R33 449 148 - - - R14 321 R14 321 - - 127 127 - - R42 789 R42 789 - - 236 236 - - R1 711 037 - - - R1 672 457 - - - R295 000 - - - R468 000 - - - Development of birth registration system - Opex Cost of server R150 000 R150 000 R150 000 R150 000 R150 000 Cost of active ID verification R600 000 R600 000 R600 000 R600 000 R600 000 Storage cost per record R0.69 R0.69 R0.69 R0.69 R0.69 Number of records stored 836 713 1 747 713 2 735 190 3 801 380 4 948 576 Bio-component costs R377 R377 R377 R377 R377 Number of bio component licenses required 96 96 96 96 96 On-site resource cost R7 500 000 R7 500 000 R7 500 000 R7 500 000 R7 500 000 Support and maintenance cost R180 000 R180 000 R180 000 R180 000 R180 000 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 195 R millions 2018/19 2019/20 2020/21 2021/22 2022/23 Child Support Grant Number of additional recipients 59 691 121 316 184 923 250 558 318 271 Value of grant R4 797 R5 046 R5 309 R5 585 R5 875 R millions 2018/19 2019/20 2020/21 2021/22 2022/23 Development of ISPIS - Capex Cost of server hardware R34 220 732 - R38 450 415 - R43 202 886 Cost of disaster recovery hardware R33 449 148 - R37 583 462 - -R42 228 778 Cost to develop server hardware R1 711 037 - R1 922 521 - R2 160 144 Cost to develop disaster recovery hardware R1 672 457 - R1 879 173 - R2 111 439 Development of ISPIS - Opex Cost of server R150 000 R150 000 R150 000 R150 000 R150 000 Cost of active ID verification R600 000 R600 000 R600 000 R600 000 R600 000 Storage cost per record R0.69 R0.69 R0.69 R0.69 R0.69 Number of records stored 20 000 000 28 000 000 35 000 000 40 000 000 45 000 000 On-site resource cost R7 500 000 R7 500 000 R7 500 000 R7 500 000 R7 500 000 Support and maintenance cost R180 000 R180 000 R180 000 R180 000 R180 000 SO3-B: Achieve a universal child support grant registration for eligible children Table 77: Cost components to achieve a universal child grant registration for eligible children SO3-C: Develop an integrated social protection information system (ISPIS) to improve access to social assistance programmes Table 78: Cost components to develop an integrated social protection information system N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 196 SO3-D: Improve provision of nutritious meals through an expanded network of feeding and food distribution centres Table 794: Cost components to improve provision of nutritious meals through an expanded network of feeding and food distribution centres R millions 2018/19 2019/20 2020/21 2021/22 2022/23 NSNP – Primary schools Number of new kitchen staff 82 165 247 330 413 Annual salary of kitchen staff Volunteer Volunteer Volunteer Volunteer Volunteer Average meal cost per day R2.95 R3.15 R3.35 R3.57 R3.81 Additional meals per day 20 628 41 326 62 094 82 931 103 840 Feeding days per year 194 194 194 194 194 NSNP – Secondary schools Number of new kitchen staff 91 181 273 364 456 Annual salary of kitchen staff Volunteer Volunteer Volunteer Volunteer Volunteer Average meal cost per day R4.03 R4.30 R4.59 R4.90 R5.23 Additional meals per day 12 217 24 475 36 775 49 116 61 498 Feeding days per year 194 194 194 194 194 Community Nutrition and Development Centres New CNDCs required 45 45 15 15 15 Cost to set up a CNDC R32 280 R33 959 R35 725 R37 582 R39 537 Meal cost at CNDCs R2.20 R2.34 R2.49 R2.65 R2.82 Meals per day at CNDCs 10 042 22 500 25 900 29 480 33 250 Feeding days per year at CNDCs 365 365 365 365 365 Social relief of distress New beneficiaries added 24 837 59 945 77 311 97 189 119 945 Annual cost per beneficiary R7 886 R8 297 R8 728 R9 182 R9 659 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 197 R millions 2018/19 2019/20 2020/21 2021/22 2022/23 Development of training material Resource days for development of material 160 - - - Resource cost for development of material Internal - - - Development and printing of material R95 502 R101 232 R194 449 R206 116 R218 483 Community Nutrition Development Centre training Number of new CNDCs 45 45 15 15 15 Health promoters per CNDC 1 1 1 1 1 Cost to administer training to health promoter Internal Internal Internal Internal Internal Food handlers per CNDC 3 3 3 3 3 Cost to administer training to food handler Internal Internal Internal Internal Internal Early Childhood Development Centre training ECDCs to be newly registered 3 091 3 091 5 667 5 667 5 667 Caregivers per ECDC 4 4 4 4 4 Cost to administer training to caregiver Internal Internal Internal Internal Internal School kitchens training Number of new school kitchens 0 0 0 0 0 Food handlers per school kitchen - - - Cost to administer training to food handler Internal Internal Internal Internal Internal SO4-A: Improve nutrition training for health promoters and food handlers in community nutrition centres (ECDs, Schools, and CNDCs) and improve the ability of ECDs to address nutrition issues Table 80: Cost components to improve training on nutrition and focus of community health workers and food handlers in community nutrition centres N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 198 R millions 2018/19 2019/20 2020/21 2021/22 2022/23 Community Nutrition Development Centre audit Number of CNDCs to be audited 45 45 15 15 15 Cost to inspect a CNDC R1 839 R1 967 R2 105 R2 253 R2 410 Early Childhood Development Centre audit Number of ECDCs to be audited 3 091 3 091 5 667 5 667 5 667 Cost to inspect an ECDC R1 839 R1 967 R2 105 R2 253 R2 410 SO4-A: Improve nutrition training for health promoters and food handlers in community nutrition centres (ECDs, Schools, and CNDCs) and improve the ability of ECDs to address nutrition issues Table 80: Cost components to improve training on nutrition and focus of community health workers and food handlers in community nutrition centres SO4-B: Increase coverage and availability of multiple micronutrient supplements (MMNS) (folic acid, iron, calcium, vitamin A), deworming tablets, and fortified porridge across the life course for undernourished infants and children, WRA, and people living with HIV and TB Table 81: Cost components to increase coverage and availability of MMNS, deworming tablets, and fortified porridge across the life course for undernourished infants and children, pregnant and lactating women, and people living with HIV and TB R millions 2018/19 2019/20 2020/21 2021/22 2022/23 Vitamin A supplementation Unit (dose) cost of Vitamin A R0.70 R0.75 R0.79 R0.84 R0.90 Children (12-59 months) requiring Vitamin A 824 964 1 483 197 1 703 819 1 931 200 2 233 173 Doses of Vitamin A per child (12-59 months) 2 2 2 2 2 Deworming Unit (dose) cost of deworming R2.63 R2.80 R2.98 R3.17 R3.37 Children (12-59 months) requiring deworming 780 109 1 402 552 1 611 178 1 826 196 2 111 751 Doses of deworming per child (12-59 months) 2 2 2 2 2 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 199 R millions 2018/19 2019/20 2020/21 2021/22 2022/23 Children (7-14 years) requiring deworming - 5 123 613 5 541 746 5 962 789 Doses of deworming per child (7-14 years) 2 2 2 2 2 Multiple micronutrient supplementation Unit (dose) cost of MMNS R0.30 R0.32 R0.34 R0.36 R0.38 Pregnant and lactating women requiring MMNS 91 100 185 152 282 227 382 399 485 742 Doses of MMNS per pregnant and lactating woman 90 90 90 90 90 People living with HIV/TB requiring MMNS 762 653 1 568 319 2 418 819 3 316 040 4 261 940 Doses of MMNS per person living with HIV/TB 90 90 90 90 90 Children <5 with MAM/SAM requiring MMNS 18 220 33 944 43 902 54 173 68 004 Doses of MMNS per child <5 with MAM/ SAM 90 90 90 90 90 Iron supplementation Unit (dose) cost of iron R0.20 R0.21 R0.22 R0.24 R0.25 Pregnant and lactating women requiring iron 91 100 185 152 282 227 382 399 485 742 Doses of iron per pregnant and lactating woman 7 290 7 290 7 290 7 290 7 290 People living with HIV/TB requiring iron 762 653 1 568 319 2 418 819 3 316 040 4 261 940 Doses of iron per person living with HIV/TB 480 480 480 480 480 Children <5 with MAM/SAM requiring iron 18 220 33 944 43 902 54 173 68 004 Doses of iron per child <5 with MAM/ SAM 480 480 480 480 480 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 200 R millions 2018/19 2019/20 2020/21 2021/22 2022/23 Calcium supplementation Unit (dose) cost of calcium R0.28 R0.29 R0.31 R0.33 R0.35 Pregnant and lactating women requiring calcium 91 100 185 152 282 227 382 399 485 742 Doses of calcium per pregnant and lactating woman 270 270 270 270 270 People living with HIV/TB requiring calcium 762 653 1 568 319 2 418 819 3 316 040 4 261 940 Doses of calcium per person living with HIV/TB 90 90 90 90 90 Children <5 with MAM/SAM requiring calcium 18 220 33 944 43 902 54 173 68 004 Doses of calcium per child <5 with MAM/ SAM 90 90 90 90 90 Folic acid supplementation Unit (dose) cost of folic acid R0.73 R0.78 R0.83 R0.88 R0.94 Pregnant and lactating women requiring folic acid 91 100 185 152 282 227 382 399 485 742 Doses of folic acid per pregnant and lactating woman 540 540 540 540 540 Fortified porridge Unit (serving) cost of porridge R2.42 R2.57 R2.74 R2.92 R3.10 Pregnant and lactating women requiring porridge 91 100 185 152 282 227 382 399 485 742 Servings of porridge per pregnant and lactating woman 30 30 30 30 30 SO4-A: Improve nutrition training for health promoters and food handlers in community nutrition centres (ECDs, Schools, and CNDCs) and improve the ability of ECDs to address nutrition issues Table 80: Cost components to improve training on nutrition and focus of community health workers and food handlers in community nutrition centres N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 201 R millions 2018/19 2019/20 2020/21 2021/22 2022/23 People living with HIV/TB requiring porridge 762 653 1 568 319 2 418 819 3 316 040 4 261 940 Servings of porridge per person living with HIV/TB 30 30 30 30 30 Children <5 with MAM/SAM requiring porridge 18 220 33 944 43 902 54 173 68 004 Servings of porridge per child <5 with MAM/SAM 30 30 30 30 30 R millions 2018/19 2019/20 2020/21 2021/22 2022/23 Development of breastfeeding counselling training material Resource days for development of material 80 - - - Resource cost for development of material Internal - - - Development and printing of material R29 122 R32 524 R11 703 R12 995 R14 425 Development of KMC training material Resource days for development of material 80 - - - Resource cost for development of material Internal - - - Development and printing of material R28 646 R31 993 R11 511 R12 783 R14 190 Breastfeeding counselling training Number of healthcare workers requiring training 1 678 1 768 600 629 658 Cost to administer training to healthcare worker Internal Internal Internal Internal Internal SO4-C: Improve access and coverage of breastfeeding, complimentary feeding counselling, and the provision of KMC Table 82: Cost components to improve access and coverage of breastfeeding, complimentary feeding counselling, and the provision of KMC N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 202 SO4-C: Improve access and coverage of breastfeeding, complimentary feeding counselling, and the provision of KMC Table 82: Cost components to improve access and coverage of breastfeeding, complimentary feeding counselling, and the provision of KMC R millions 2018/19 2019/20 2020/21 2021/22 2022/23 KMC training Number of healthcare workers requiring training 420 442 150 157 165 Cost to administer training to healthcare worker Internal Internal Internal Internal Internal Breastfeeding counselling provision Number of new healthcare workers - - - Annual salary of healthcare worker R278 578 R298 078 R318 944 R341 270 R365 159 Take-home material required 53 985 68 575 73 867 79 312 86 354 Unit cost of take home material R3.44 R3.65 R3.87 R4.10 R4.35 KMC services provision Number of new healthcare workers - - - Annual salary of healthcare worker R278 578 R298 078 R318 944 R341 270 R365 159 Number of low birth weight babies 123 532 125 533 127 567 129 633 131 733 Unit cost of KMC binder R148.96 R158.49 R168.64 R179.43 R190.91 Unit cost of take home material R3.44 R3.65 R3.87 R4.10 R4.35 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 203 SO4-D: Improve the access and coverage of growth monitoring and promotion services via facility audits Table 83: Cost components to improve the access and coverage of growth monitoring and promotion services via facility audits R millions 2018/19 2019/20 2020/21 2021/22 2022/23 Growth, monitoring and promotion facility audits Cost to audit a GMP facility R14 535 R15 552 R16 641 R17 806 R19 052 Number of GMP facilities requiring audits - - - Growth, monitoring and promotion facility equipment GMP facilities requiring new equipment 893 893 218 218 218 Unit cost of a MUAC tape R12.77 R13.59 R14.45 R15.38 R16.36 MUAC tapes required per GMP facility 30 30 30 30 30 Unit cost of an infant scale R1 047 R1 114 R1 185 R1 261 R1 342 Infant scales required per GMP facility 3 3 3 3 3 Unit cost of a length board R 1 183 R1 259 R1 339 R1 425 R1 516 Length boards required per GMP facility 3 3 3 3 3 Unit cost of a stadiometer R98.49 R104.80 R111.51 R118.64 R126.63 Stadiometers required per GMP facility 3 3 3 3 3 Unit cost of a BMI wheel R26.97 R28.70 R30.54 R32.49 R34.57 BMI wheels required per GMP facility 4 4 4 4 4 Growth, monitoring and promotion services Number of new healthcare workers - - - Annual salary of healthcare worker R195 806 R209 512 R224 178 R239 870 R256 661 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 204 SO4-E: Ensure effective and timely remedial actions are taken to prevent and manage acute malnutrition Table 84: Cost components to ensure effective and timely remedial actions are taken to prevent and manage acute malnutrition R millions 2018/19 2019/20 2020/21 2021/22 2022/23 Development of IMAM training material Resource days to develop material 60 - - - Resource cost to develop material Internal - - - Development and printing of material R60 825 R69 932 R24 443 R27 143 R30 130 IMAM training Number of healthcare workers requiring training 893 893 218 218 218 Cost to administer training to healthcare worker Internal Internal Internal Internal Internal IMAM services Number of new healthcare workers - - - Annual salary of healthcare worker R221 523 R237 030 R253 622 R271 375 R290 372 Schools GMP screening Number of primary schools requiring screening 907 1 814 2 721 3 175 3 628 Cost to administer GMP screening to primary school Internal Internal Internal Internal Internal Number of secondary schools requiring screening 516 1 032 1 548 2 064 2 580 Cost to administer GMP screening to secondary school Internal Internal Internal Internal Internal N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 205 R millions 2018/19 2019/20 2020/21 2021/22 2022/23 Development of e-learning material Resource days to develop material 180 - - - Resource cost to develop material Internal - - - Development and printing of material R76 525 R85 467 R30 752 R34 149 R37 907 Screening, assessment, counselling and support training Number of healthcare workers requiring training 73 421 77 358 26 259 27 509 28 808 Cost to administer training to healthcare worker Internal Internal Internal Internal Internal R millions (excl. unit costs) National 2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 Consultative Meetings Number of Consultative Meetings 0 1 0 0 0 0 Duration of consultative meeting 0 2 0 0 0 0 Number of delegates from each province 0 5 0 0 0 0 SO4-F: Improve the quality and effectiveness of clinical screening and assessment, counselling, and support for NCDs, with focus on preventing under- and over-nutrition (obesity) and control at all ideal clinics Table 85: Cost components to improve the quality and effectiveness of clinical screening and assessment, counselling, and support for NCD, with focus on preventing under and over-nutrition (obesity) and control at all ideal clinics SO5-A: Develop and implement an integrated advocacy and communication plan led by the Deputy President of RSA Table 86: Consultative Meetings N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 206 SO5-A: Develop and implement an integrated advocacy and communication plan led by the Deputy President of RSA Table 86: Consultative Meetings R millions (excl. unit costs) National 2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 Number of provinces travelling 0 5 0 0 0 0 Number of delegates from national departments 0 10 0 0 0 0 Flights & Transport Western Cape Unit Cost of Return Flight Cost to Gauteng R3,500.00 R3,710.00 R3,932.60 R4,168.56 R4,418.67 R4,683.79 Average Gautrain & Bus Round Trip from Airport to Hatfield Station R360.00 R381.60 R404.50 R428.77 R454.49 R481.76 Eastern Cape Unit Cost of Return Flight Cost to Gauteng R3,500.00 R3,710.00 R3,932.60 R4,168.56 R4,418.67 R4,683.79 Average Gautrain & Bus Round Trip from Airport to Hatfield Station R360.00 R381.60 R404.50 R428.77 R454.49 R481.76 Free State Unit Cost of Return Flight Cost to Gauteng R3,500.00 R3,710.00 R3,932.60 R4,168.56 R4,418.67 R4,683.79 Average Gautrain & Bus Round Trip from Airport to Hatfield Station R360.00 R381.60 R404.50 R428.77 R454.49 R481.76 KwaZulu-Natal Unit Cost of Return Flight Cost to Gauteng R3,500.00 R3,710.00 R3,932.60 R4,168.56 R4,418.67 R4,683.79 Average Gautrain & Bus Round Trip from Airport to Hatfield Station R360.00 R381.60 R404.50 R428.77 R454.49 R481.76 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 207 R millions (excl. unit costs) National 2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 Northern Cape Unit Cost of Return Flight Cost to Gauteng R3,500.00 R3,710.00 R3,932.60 R4,168.56 R4,418.67 R4,683.79 Average Gautrain & Bus Round Trip from Airport to Hatfield Station R360.00 R381.60 R404.50 R428.77 R454.49 R481.76 Own Car Travel Limpopo Average round trip distance to Pretoria (km 648 648 648 648 648 648 Unit Cost per Kilometer R3.55 R3.76 R3.99 R4.23 R4.48 R4.75 Mpumalanga Average round trip distance to Pretoria (km 560 560 560 560 560 560 Unit Cost per Kilometer R3.55 R3.76 R3.99 R4.23 R4.48 R4.75 North West Average round trip distance to Pretoria (km 740 740 740 740 740 740 Unit Cost per Kilometer R3.55 R3.76 R3.99 R4.23 R4.48 R4.75 Accommodation Total number of nights per delegate 0 3 0 0 0 0 Cost per night R1,300.00 R1,378.00 R1,460.68 R1,548.32 R1,641.22 R1,739.69 Number of delegates requiring accommodation 5 5 5 5 5 5 Catering Number of Delegates 0 55 0 0 0 0 Number of teas per day per delegate 2 2 2 2 2 2 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 208 SO5-A: Develop and implement an integrated advocacy and communication plan led by the Deputy President of RSA Table 86: Consultative Meetings R millions (excl. unit costs) National 2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 Number of lunches per day per delegate 1 1 1 1 1 1 Number of dinners per day per delegate 1 1 1 1 1 1 Cost per tea R50.00 R53.00 R56.18 R59.55 R63.12 R66.91 Cost per lunch R100.00 R106.00 R112.36 R119.10 R126.25 R133.82 Cost per dinner R120.00 R127.20 R134.83 R142.92 R151.50 R160.59 Table 87: Radio Adverts R millions (excl. unit costs) National 2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 Advertisement design costs Number of designs 0 1 1 1 1 1 Number of hours per design 9 9 9 9 9 9 Cost per hour of design R650.00 R689.00 R730.34 R774.16 R820.61 R869.85 Pre-recorded radio interview production and media costs SABC Radio Pre-recorded interviews Cost per producing & airing an interview R26,628.10 R28,225.79 R29,919.33 R31,714.49 R33,617.36 R35,634.40 No. of Adverts per quarter 11 11 11 11 11 11 No. of quarters 11 11 11 11 11 11 Community Radio Pre-recorded interviews (60") N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 209 R millions (excl. unit costs) National 2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 Cost per producing and airing an interview R59,200.00 R62,752.00 R66,517.12 R70,508.15 R74,738.64 R79,222.95 No. of Adverts per quarter 5 5 5 5 5 5 No. of quarters 4 4 4 4 4 Community Radio Pre-recorded interviews (45") Cost per producing and airing an interview R44,400.00 R47,064.00 R49,887.84 R52,881.11 R56,053.98 R59,417.22 No. of Adverts per quarter 5 5 5 5 5 5 No. of quarters 4 4 4 4 4 R millions (excl. unit costs) National 2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 Television Advert Design Costs Number of designs 0 1 1 1 1 1 Number of hours per design 9 9 9 9 9 9 Cost per hour of design R650.00 R650.00 R650.00 R650.00 R650.00 R650.00 Television Advert Production Costs Unit cost per television advert R1,980,000 R2,098,800 R2,224,728 R2,358,211.6 R2,499,704.3 R2,649,687 Number of television adverts produced 0 1 1 1 1 1 Table 88: Television Adverts N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 210 R millions (excl. unit costs) National 2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 Television Advert Media Costs 60” SABC TV airing costs per spot R80,159.42 R84,968.99 R90,067.12 R95,471.15 R101,199.42 R107,271 45” SABC TV airing costs per spot R67,822.46 R71,891.81 R76,205.32 R80,777.64 R85,624.30 R90,762 No 60" Spots per month 10 10 10 10 10 10 No 45" Spots per month 10 10 10 10 10 10 No. of months 0 12 12 12 12 12 60” E-TV airing costs per spot R31,909.09 R33,823.64 R35,853.05 R38,004.24 R40,284.49 R42,702 45” E-TV airing costs per spot R23,931.82 R25,367.73 R26,889.79 R28,503.18 R30,213.37 R32,026 No 60" Spots per month 10 10 10 10 10 10 No 45" Spots per month 10 10 10 10 10 10 No. of months 0 12 12 12 12 12 60” ENCA airing costs per spot R12,875.00 R13,647.50 R14,466.35 R15,334.33 R16,254.39 R 17229.65 Table 88: Television Adverts - continued N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 211 R millions (excl. unit costs) National 2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 45” ENCA airing costs per spot R2,761.46 R2,927.15 R3,102.77 R3,288.94 R3,486.28 R 3695.45 No 60" Spots per month 10 10 10 10 10 10 No 45" Spots per month 10 10 10 10 10 10 No. of months 0 12 12 12 12 12 Television Cutdown Production Costs Number of Cutdowns 0 1 1 1 1 1 Cost of Cutdown R40,000.00 R42,400.00 R44,944.00 R47,640.64 R50,499.08 R53,529.02 R millions (excl. unit costs) National 2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 Press Advert Design Cost Number of designs 1 1 1 1 1 Number of hours per design 9 9 9 9 9 9 Cost per hour of design R650.00 R650.00 R650.00 R650.00 R650.00 R650.00 Daily Sun 39 x 7 printing costs per week R10,101.00 R10,707.06 R11,349.48 R12,030.45 R12,752.28 R13,517.42 Table 89: Press Adverts N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 212 Table 89: Press Adverts - continued R millions (excl. unit costs) National 2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 Number of adverts per month 4 4 4 4 4 Number of Months 3 12 12 12 12 12 Isolezwe 39 x 7 printing costs per month R3,551.28 R3,764.35 R3,990.21 R4,229.63 R4,483.40 R4,752.41 Number of adverts per month 4 4 4 4 4 Number of Months 3 12 12 12 12 12 Sowetan (Main body) 39 x 8 printing costs per month R10,374.00 R10,996.44 R11,656.23 R12,355.60 R13,096.94 R13,882.75 Number of adverts per month 4 4 4 4 4 Number of Months 3 12 12 12 12 12 Die Son printing costs per month R10,101.00 R10,707.06 R11,349.48 R12,030.45 R12,752.28 R13,517.42 Number of adverts per month 4 4 4 4 4 Number of Months 3 12 12 12 12 12 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 213 R millions (excl. unit costs) National 2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 The Times (Main body) 39 x 8 printing costs per month R7,410.00 R7,854.60 R8,325.88 R8,825.43 R9,354.95 R9,916.25 Number of adverts per month 4 4 4 4 4 Number of Months 3 12 12 12 12 12 R millions (excl. unit costs) National 2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 Taxi Branding Design Costs Number of designs 0 1 1 1 1 1 Number of hours per design 40 40 40 40 40 40 Cost per hour of design R 650.00 R 650.00 R 650.00 R 650.00 R 650.00 R 650.00 Taxi Wrapping production costs per taxi R 10,500.00 R 11,130.00 R 11,797.80 R 12,505.67 R 13,256.01 R 14,051.37 Taxi Wrapping media costs per taxi per month R 1,041.67 R 1,104.17 R 1,170.42 R 1,240.64 R 1,315.08 R 1,393.98 No of Taxis across 9 provinces 0 30 60 90 120 150 No. of months 3 12 12 12 12 12 Table 90: Wrapping Long Distance Taxis N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 214 Table 91: Banners R millions (excl. unit costs) National 2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 Pull Up Banner design costs Number of designs 0 0 0 0 0 0 Number of hours per design 1 1 1 1 1 1 Cost per hour of design R650.00 R650.00 R650.00 R650.00 R650.00 R650.00 Printing Number of pull up banners - - - - Production Costs of Pull Up Banners R1,375.00 R1,457.50 R1,544.95 R1,637.65 R1,735.91 R1,840.06 Media Banner design costs Number of designs 0 1 1 1 1 1 Number of hours per design 1 1 1 1 1 1 Cost per hour of design R650.00 R689.00 R730.34 R774.16 R820.61 R869.85 Printing Number of media banners 0 1 1 1 1 1 Production Costs of Media Banners R5,500.00 R5,830.00 R6,179.80 R6,550.59 R6,943.62 R7,360.24 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 215 R millions (excl. unit costs) National 2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 Gazebo design costs Number of designs 0 0 0 0 0 0 Number of hours per design 3 3 3 3 3 3 Cost per hour of design R650.00 R650.00 R650.00 R650.00 R650.00 R650.00 Printing Gazebos printed in full colour on the roof plus 3 sides 0 0 0 0 0 0 st of each gazebo R10,500.00 R11,130.00 R11,797.80 R12,505.67 R13,256.01 R14,051.37 Table 92: Gazebos N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 216 Table 93: Billboards R millions (excl. unit costs) National 2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 Print Billboards 0 3 1 1 1 1 Billboard Design Costs 2 2 2 2 2 2 Number of designs R650.00 R650.00 R650.00 R650.00 R650.00 R650.00 Number of hours per design 0 15 30 45 60 75 Cost per hour of design 3 12 12 12 12 12 No. of Billboards across 9 provinces per month R57,564.61 R61,018.49 R64,679.60 R68,560.37 R72,673.99 R77,034.43 No. of Months 0 3 3 3 3 3 Billboard Production and Media Costs per billboard per month 2 2 2 2 2 2 Electronic Billboards Electronic Billboard Design Costs Number of designs R650.00 R689.00 R730.34 R774.16 R820.61 R869.85 Number of hours per design 0 15 30 45 60 75 Cost per hour of design 3 12 12 12 12 12 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 217 R millions (excl. unit costs) National 2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 Display Costs Number of billboards (8 per metro) 64 64 64 64 64 Number of months 3 12 12 12 12 12 Number of spots per day 480 480 480 480 480 480 Length of spots 15 seconds 15 seconds 15 seconds 15 seconds 15 seconds 15 seconds Cost per spot R1.10 R1.17 R1.24 R1.31 R1.39 R1.47 R millions (excl. unit costs) National 2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 25% Management Fee R - R 16.05 R 20.06 R 24.55 R 29.51 R 34.98 Table 94: Management Fees N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 218 SO5-B: Implement nutrition education at ECD centres and schools Table 6: Educational Training Posters R millions (excl. unit costs) National 2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 Poster Design Costs Number of designs 3 4 - 4 Number of hours per design 2 2 2 2 2 2 Cost per hour of design R650.00 R650.00 R650.00 R650.00 R650.00 R650.00 Poster Printing Costs A1 posters printed in full colour one sides on 180gsm paper (R R3.60 R3.82 R4.04 R4.29 R4.54 R4.82 No. of posters 148,000 - 216,000 A2 posters printed in full colour one side, on 180gsm paper (R) R2.90 R3.07 R3.26 R3.45 R3.66 R3.88 No. of Posters 83,184 148,000 - 216,000 Translations of posters into 10 official languages (R) R1,200.00 R1,272.00 R1,348.32 R1,429.22 R1,514.97 R1,605.87 No. of languages 10 10 10 10 10 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 219 R millions (excl. unit costs) National 2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 Leaflet Design Costs Number of designs 1 1 1 1 1 Number of hours per design 2 2 2 2 2 Cost per hour of design R650.00 R650.00 R650.00 R650.00 R650.00 R650.00 Leaflet Printing Costs A4 leaflet printed in full colour both sides on 135gsm paper (R) R0.89 R0.94 R1.00 R1.06 R1.12 R1.19 No. of Leaflets 987,636 1,500,000 1,500,000 1,500,000 1,500,000 Translations of leaflets into other languages R2,640.00 R2,798.40 R2,966.30 R3,144.28 R3,332.94 R3,532.92 No. of languages 10 10 10 10 10 Table 95 : Educational Training Leaflets N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 220 Table 96: Educational Training Information Booklets R millions (excl. unit costs) National 2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 Info Booklets Design Costs Number of designs 4 - 4 - 4 Number of hours per design 6 6 6 6 6 Cost per hour of design R650.00 R650.00 R650.00 R650.00 R650.00 R650.00 Info booklet Printing Costs A4 booklets printed in full colour both sides on 135gsm paper (R) R2.24 R2.37 R2.52 R2.67 R2.83 R3.00 No. of Information Booklets 987,636 1,500,000 1,500,000 1,500,000 1,500,000 Translation of A1 / A2 posters into other languages (R) R7,200.00 R7,632.00 R8,089.92 R8,575.32 R9,089.83 R9,635.22 No. of languages 10 10 10 10 10 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 221 R millions (excl. unit costs) National 2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 Flip Charts Design Costs Number of designs 4 - 4 - 4 Number of hours per designed page 1 1 1 1 1 Cost per hour of design R650.00 R650.00 R650.00 R650.00 R650.00 R650.00 Flip Chart Printing Costs A3 double sided, printed in full colour on 200gsm per page (R) R0.96 R1.02 R1.08 R1.15 R1.22 R1.29 No. of pages - 40 40 40 40 40 No. of flip charts 177,912 - 215,000 - 215,000 Table 97: Educational Training Flipcharts N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 222 Table 98: Tablecloths R millions (excl. unit costs) National 2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 Tablecloth Design Costs Number of designs 0 0 0 0 0 0 Number of hours per design 1 0 0 1 1 1 Cost per hour of design R650.00 R650.00 R650.00 R650.00 R650.00 R650.00 Tablecloth Printing Costs Tablecloths, printed in full colour, one side only (R) R1,405.00 R1,489.30 R1,578.66 R1,673.38 R1,773.78 R1,880.21 No. of tablecloths 0 0 0 0 0 0 R millions (excl. unit costs) National 2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 25% Management Fee R - R 2.83 R 1.62 R 3.92 R 1.96 R 5.27 Table 99: Management Fees N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 223 SO6-A: Increase food produced by smallholder producers Parameter assumptions as respective salary packages. The table also provides all unit costs associated with furniture and equipment required for setting up the required office space. Table 100: Establishment of M&E Unit National 2018/19 2019/20 2020/21 2021/22 2022/23 R millions Baseline Baseline Baseline Baseline Baseline Staff salary packages Level 8 Number of employees 1 1 1 1 1 Total cost R334,499.03 R361,258.95 R390,159.66 R421,372.44 R455,082.23 Level 11 Number of employees 2 2 2 2 2 Total cost R1,563,183.62 R1,688,238.31 R1,823,297.37 R1,969,161.16 R2,126,694.06 Level 13 Number of employees 1 1 1 1 1 Total cost R1,125,135.59 R1,203,895.08 R1,288,167.74 R1,378,339.48 R1,474,823.24 Total cost of staff salary packages (R’m) R3.02 R3.25 R3.50 R3.77 R4.06 Furniture and equipment (Level 9 and below) Work stations R6,741.60 R0.00 R0.00 R0.00 R0.00 Office chair R5,561.82 R0.00 R0.00 R0.00 R0.00 Credenza R4,494.40 R0.00 R0.00 R0.00 R0.00 Letter tray R471.91 R0.00 R0.00 R0.00 R0.00 Dustbins R168.54 R0.00 R0.00 R0.00 R0.00 The table below provides an overview of the parameter assumptions in relation to the establishment of the M&E Unit. In particular it shows the number of staff members to be recruited over the term of the plan, as well N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 224 SO6-A: Increase food produced by smallholder producers Parameter assumptions - continued National 2018/19 2019/20 2020/21 2021/22 2022/23 R millions Baseline Baseline Baseline Baseline Baseline Desktop computer R6,741.60 R0.00 R0.00 R0.00 R0.00 Total cost of providing required furniture and equipment (Level 9 and below) R24,179.87 R0.00 R0.00 R0.00 R0.00 Furniture and equipment (Level 9 and below) Work station R20,224.80 R0.00 R0.00 R0.00 R0.00 Office chair R16,685.46 R0.00 R0.00 R0.00 R0.00 Credenza R13,483.20 R0.00 R0.00 R0.00 R0.00 Letter tray R1,415.74 R0.00 R0.00 R0.00 R0.00 Dustbins R505.62 R0.00 R0.00 R0.00 R0.00 Laptop R26,966.40 R0.00 R0.00 R0.00 R0.00 Total cost of providing required furniture and equipment (Level 11 - 13) R79,281.22 R0.00 R0.00 R0.00 R0.00 Total cost of furniture and equipment R0.10 R0.00 R0.00 R0.00 R0.00 Total cost of establishing M&E unit R3.13 R3.25 R3.50 R3.77 R4.06 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 225 SO6-B: Incorporate a consistent set of core indicators in national surveys Parameter assumptions The table below shows the assumptions concerning the consultant. The premise is that a Level 12 consultant will be contracted to undertake the abovementioned task (to the extent that the proposed option of utilising existing staff proves unfeasible due to over-capacitation). The consultant will be contracted for a period of 90 days to revise existing and identify gaps in national surveys. Table 101: Assumptions (Contractual work) National 2018/19 2019/20 2020/21 2021/22 2022/23 Consultant Level 12 Number of consultants 1 1 1 1 1 Daily rate R11,145.12 R11,925.28 R12,760.05 R13,653.25 R14,608.98 Number of working days 90 - - - Total cost (Rm) R1.00 R0.00 R0.00 R0.00 R0.00 As elaborated earlier, subsequent to completion of the above undertaking, a workshop will be facilitated to present the findings. The table below provides an overview of some of the unit costs associated with facilitating the workshop. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 226 Table 102: Assumptions (2-Day Workshop) Item Components Units & Costs 2018/19 Provincial seating allowances No. members per Province 5 No. of Provinces 9 No. of meetings 2 Flights Average return-flight cost from Cape Town to Gauteng R3,710.00 Average return-flight cost from Eastern Cape to Gauteng R3,710.00 Average return-flight cost from KZN to Gauteng R3,710.00 Average return-flight cost from Free State to Gauteng R3,710.00 Average return-flight cost from Northern Cape to Gauteng R3,710.00 Average Gautrain & Bus Round Trip from airport to Pretoria Station R381.60 Number of delegates per Province 5 Number of trips 2 Own car travel Average round-trip distance, Limpopo Pretoria (km) 648 Average round-trip distance, North West Pretoria (km) 740 Average round-trip distance, Mpumalanga Pretoria (km) 560 Cost per kilometer R3.76 Number of delegates per Province 5 Accommodation Total number of nights per delegate 5 Cost per night R1,590.00 Number of delegates per Province Number of Provinces outside Gauteng 8 N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 227 Catering Number of delegates 55 Number of teas per day 2 Number of lunches per day 1 Cost per tea R53.00 Cost per lunch R106.00 Delegates per Province Total number of delegates 60 WC 6 KZN 6 NC 6 EC 6 FS 6 GP 12 MP 6 NW 6 LP 6 Venue Hire Cost per day R37,100.00 SO6-C: Conduct implementation evaluations of the FNS 2017-2022 Parameter assumptions An outline of some of the main inputs and assumptions related to this task is presented in the table below. A Level 12 consultant will be contracted to carry out an implementation evaluation for a period of 120 days at the midline (2020/21) and endline (2022/23) points. N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 228 Table 103: Assumptions (implementation evaluation) National (R millions) 2018/19 2019/20 2020/21 2021/22 2022/23 Midline Implementation Evaluation Consultant (Level 12) Days contracted - 120 - Daily rate R0.00 R0.00 R6,380.02 R0.00 R0.00 Total cost R0.00 R0.00 R765,602.87 R0.00 R0.00 Endline Implementation Evaluation Consultant (Level 12) - - - Days contracted - - - 120 Daily rate R0.00 R0.00 R0.00 R7,304.49 Total cost R0.00 R0.00 R0.00 R0.00 R876,538.73 National (R millions) 2018/19 2019/20 2020/21 2021/22 2022/23 Analyse risks to SA food security Technical Advisory Committee - - - Professional days contracted 250 - - - Daily rate R10,030.61 R0.00 R0.00 R0.00 R0.00 Total cost of analysing risks (Rm) R2.51 R0.00 R0.00 R0.00 R0.00 SO6-D: Analyse and rate hazards and risks associated with FNS Table 104: Assumptions (risks and hazards analysis and update) N A T IO N A L F O O D A N D N U T R IT IO N S E C U R IT Y P L A N F O R S O U T H A F R IC A 2 0 1 8 2 0 2 3 229 National (R millions) 2018/19 2019/20 2020/21 2021/22 2022/23 Analyse risks to SA food security Update risks and hazard analysis Technical Advisory Committee Professional days contracted 40 40 40 40 Contract value (daily rate) R0.00 R21,432.53 R22,932.80 R24,538.10 R15,753.46 Notes Department of Planning, Monitoring & Evaluation www.dpme.gov.za