Preventing Stunting — Lessons From a Western Cape Maternal Health Pilot

Why It Matters

The program proves that integrated cash‑plus‑care interventions can curb child stunting and break intergenerational poverty, offering a replicable model for low‑resource health systems.

Key Takeaways

• 1,000+ vulnerable mothers enrolled across three Western Cape districts.
• Monthly vouchers (~$28) cover protein‑rich foods, 80% redemption rate.
• Community health workers bridge clinics and homes, boosting breastfeeding and weight gain.
• Enrollment processes and fragmented data systems slowed rollout, prompting workflow fixes.
• Phase 2 will streamline pregnancy enrollment and prioritize beneficiary dignity.

Pulse Analysis

Stunting remains one of South Africa’s most hidden health crises, with nearly one in six children under five in the Western Cape failing to reach their growth potential. The condition erodes cognitive ability, reduces educational attainment and inflates future healthcare costs, perpetuating a cycle of poverty. As food prices surge and household incomes stagnate, early‑life nutrition has become a decisive factor in a child’s trajectory, prompting policymakers to look beyond traditional health services toward holistic, preventive solutions.

The Khulisa Care pilot tackles this challenge by marrying cash assistance with hands‑on care. Beneficiaries receive monthly vouchers—approximately $28—restricted to protein‑rich staples such as eggs, milk, beans and pilchards, while community health workers deliver home visits, breastfeeding guidance, nutrition counseling and mental‑health support. Early results are encouraging: more than 1,000 mothers have been enrolled, voucher redemption exceeds 80%, and mothers report lower food‑related stress and better infant weight gain. However, the rollout exposed operational friction points, including time‑intensive enrollment and fragmented data platforms, prompting rapid adjustments like a multi‑swipe redemption system.

The pilot’s lessons are already informing Khulisa Care 2.0, which will prioritize early pregnancy enrollment, streamline data integration and reinforce the dignity of recipients. If scaled, this integrated cash‑plus‑care model could reshape maternal‑child health policy across low‑ and middle‑income contexts, demonstrating that targeted financial support combined with community‑based care can deliver measurable reductions in stunting. Such evidence strengthens the case for governments to invest in innovative, adaptable programs that address the root causes of nutrition insecurity rather than merely treating its symptoms.