Mapping child health and development policies and implementation challenges in South Africa: A scoping review

Abstract

Background: South Africa faces significant health challenges due to a combination of infectious diseases, non-communicable diseases, malnutrition and underdevelopment among children. While policies aimed at improving child health and development have sought to address these issues by focusing on improving healthcare access, nutrition, education and equitable service delivery, gaps in implementation persist.
Aim: To map available literature and policy documents regarding child health and development in South Africa over the last 15 years.
Setting: The review was conducted in South Africa.
Method: The scoping review was conducted using the Joanna Briggs Institute methodology and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. We searched using academic databases (MEDLINE, Google Scholar, African Journals Online [AJOL]), government reports (South African Department of Health, National Planning Commission) and grey literature from 2008 to 2023. All authors were involved in the study selection and data extraction, and over 90% agreement was reached to include relevant articles. Records were screened using predefined inclusion criteria. Data were charted and synthesised thematically to map policy domains and identify implementation patterns and evidence gaps.
Results: Policy attention was highly concentrated in food provision; maternal and child health; child growth and development; economic well-being; and access to resources, though these themes showed uneven articulation and poor-to-moderate implementation. The policy landscape also reflected poor prioritisation and weak articulation in practice for caregiver mental health and child psychosocial well-being. Major barriers include inequitable resource allocation and service delivery across provinces, limited intersectoral collaboration and incomplete monitoring data.
Conclusion: South Africa has developed comprehensive child health and development policies; however, gaps in implementation continue to hinder progress.
Contribution: The findings can help address gaps in the implementation of child health and development policies in South Africa through policy integration, equitable resource distribution and improved data monitoring to meet child health and development goals.