A coalition of 15 NGO’s are pushing to introduce a Maternal Support Grant (MSG) in South Africa, which it argues could help put an end to child stunting and save South Africa’s public health system up to R13.8 billion annually.

The Department of Social Development has been exploring the evidence and economic benefits of the grant since 2012, and the case for its adoption grew in urgency earlier this year, when President Cyril Ramaphosa launched the mission to end stunting in his State of the Nation Address.

Ramaphosa singled out support for pregnant women and building on the Child Support Grant.

The MSG Advocacy Coalition says this grant does precisely that, and they are now pushing to fund it while the budget window is open.

This includes ensuring they have access to sufficient nutritious food, especially protein, to support healthy pregnancies.

Government departments have until Friday, 26 June, to stake their claims on the next three years of spending, including whether to fund a Maternal Support Grant for pregnant women living in poverty.

The Coalition, which includes researchers, argue that for every R1 invested, modelling shows society gets back around R30, mostly through preventing premature deaths and cutting healthcare costs.

At roughly R2 billion a year, the grant could save the public health system up to R13.8 billion annually.

Research shows that about 13% of South African babies are born underweight, the single strongest predictor of childhood stunting, yet an unemployed or informally employed woman gets no income support during pregnancy at all.

That means women stretching food, skipping meals and delaying antenatal care at the exact moment their baby’s development is being decided.

The Coalition says introducing this proposed grant would fill a long-standing gap in South Africa’s social protection system by providing income support to women during pregnancy, a period when good nutrition, health and maternal wellbeing impact an unborn baby’s growth and development.

A chief specialist scientist at the South African Medical Research Council, Wanga Zembe, says systematic reviews show that when pregnant women receive income support, they are
more likely to eat better, attend antenatal clinic visits, and give birth to healthier babies.

“This reduces low birth weight, improves early childhood development, and maternal mental health and saves lives. If we are serious about ending stunting, we must start where it begins — during pregnancy.”

Project Lead of Embrace, Julie Mentor, says the Maternal Support Grant addresses a specific maternity protection gap faced by women who are unemployed, informally employed or otherwise excluded from the Unemployment Insurance Fund maternity benefit and formal employment protections.

“For many women, this means trying to carry a pregnancy without any reliable income — stretching food, skipping meals or delaying essential care. Without targeted support, many vulnerable mothers are left to navigate pregnancy without the resources they need to protect their own health and that of their babies.”

Nutrition Lead for the Hold My Hand Accelerator, Liezel Engelbrecht, says the MSG’s primary purpose is not general income support but the protection of maternal and child health during a critical developmental window.

“The MSG offers a practical, evidence-based intervention that is not only affordable but also cost-saving, and it can be advanced while the social development department’s wider basic income support policy framework continues to be debated and costed.”

The Coalition says the MSG is a temporary intervention focused on pregnancy and the immediate postnatal period, which means it is fiscally manageable and reduces concerns around long-term dependency.

“The window to shape the next three years of spending is now open. Securing funding for
the MSG is an important step in strengthening South Africa’s social protection system
and improving outcomes for mothers and children,” Engelbrecht concludes.