Friday marks the first deadline for government departments to secure funding for priorities over the next three years, which the Minister of Finance outlines in his Medium-Term Budget Policy Statement later this year. This is a window of opportunity to finance strategies in the mission to end stunting such as a Maternal Support Grant (MSG) for pregnant women living in poverty.
Pregnancy is a biologically sensitive time when women are more vulnerable to job losses, increased financial instability and food insecurity.
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.
Although the MSG is not yet approved government policy, the Department of Social Development has been exploring the evidence and economic benefits of the grant since 2012.
The department’s case for the grant’s adoption grew in urgency this year when the mission to end stunting was announced in February. At the time, President Cyril Ramaphosa acknowledged the need for targeted support for pregnant women. This includes ensuring they have access to sufficient nutritious food, especially protein, to support healthy pregnancies. The president also pointed to the importance of building on existing social protection systems, like the Child Support Grant.
The MSG does exactly this. It targets a biologically sensitive period that shapes a child’s health and development and impacts future outcomes, and it’s cost-effective, time-bound and implementable through the same system as the Child Support Grant.
- Targets a biologically sensitive period
The MSG is positioned as a backwards extension of the Child Support Grant, with eligibility from the first antenatal booking.
“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, maternal mental health and saves lives,” says Wanga Zembe, a chief specialist scientist at the South African Medical Research Council.
“If we are serious about ending stunting, we must start where it begins — during pregnancy,” Zembe explains.
Approximately 13% of babies are born with a low birth weight in South Africa, placing them at increased risk of stillbirth, neonatal death, poor growth and developmental delays. Low birth weight is also one of the strongest predictors of childhood stunting.
“The MSG 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,” says Julie Mentor, Project Lead of Embrace.
“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,” Mentor adds.
- The MSG is cost-effective
At an estimated R2 billion per year, the grant would strengthen the impact of existing investments in early childhood development and health programmes. By supporting healthier pregnancies and reducing the number of babies born with a low birth weight, the MSG could also deliver significant savings — up to R13.8 billion annually in public health costs.
In fact, recent modelling suggests that for every R1 invested in the MSG, society gains approximately R30 in benefits, primarily through preventing premature deaths and reducing healthcare costs.
“The MSG’s primary purpose is not general income support but the protection of maternal and child health during a critical developmental window — pregnancy,” says Liezel Engelbrecht, Nutrition Lead for the Hold My Hand Accelerator.
This means the MSG is different to, and not in competition with, the broader income support policy that the Department of Social Development hopes to finalise in 2027.
“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,” Engelbrecht explains.
- The MSG is time-bound
The MSG is a temporary intervention focused on pregnancy and the immediate postnatal period, targeting support when it can have the greatest impact on maternal and child health. Its limited duration makes it fiscally manageable and reduces concerns around long-term dependency.
- The MSG is operationally feasible
The MSG can be delivered through existing health and social protection mechanisms, with pregnancy verification occurring through routine antenatal care. The grant’s clearly defined beneficiary group and limited duration make it administratively feasible, auditable and scalable without requiring substantial new infrastructure.
“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.
About the MSG Advocacy Coalition: The MSG Advocacy Coalition is a growing collective of NGOs and researchers with members including Embrace, Children’s Institute, the Equality Collective, DG Murray Trust (DGMT), Ilifa Labantwana, Grow Great, Hold My Hand, SAMRC/Centre for Health Economics & Decision Science – PRICELESS SA, HEALA, Amandla.mobi, Health Systems Research Unit at SAMRC, Perinatal Mental Health Project, Union Against Hunger, Legal Resources Centre, and the Institute for Economic Justice.
