Advocacy Coalition calls for urgent approval of Maternal Support Grant

The MSG Advocacy Coalition (a growing collective of NGOs and researchers) has called for a swift approval of a Maternal Support Grant (MSG).

This comes after the coalition says the Department of Social Development’s proposed Maternal Support Grant (MSG), a monthly cash transfer to pregnant women for nine months, would fill a critical gap in our country’s social protection system that addresses the specific needs and vulnerabilities of expectant mothers, according to the MSG Advocacy Coalition.

The coalition is a collective of NGOs and researchers calling on the government to commit to a clear timeline for approval and implementation of an MSG policy. The coalition says its case is set out in new policy proposals published by non-profits, Hold My Hand, Change Ideas, and Grow Great.

According to the coalition, the proposals argue that the MSG is both affordable and cost-effective, with a net cost of around R2 billion annually, just 0.1% of current government expenditure.

It says that despite its potential, the policy has faced delays. “The MSG has been in the making for more than a decade, but the policymaking process was dealt a significant blow last year when a Cabinet sub-committee sent the draft MSG policy back to the Department of Social Development for further consideration, placing it in limbo,” says Liezel Engelbrecht, nutrition lead for the Hold My Hand Accelerator, incubated by the DG Murray Trust (DGMT).

She adds that, given the strong evidence supporting the MSG and the urgent need to improve maternal and infant nutrition and health, it is unclear what is holding the policy back. In response, the coalition developed its own proposals to reinforce the case for implementation.

The coalition says research shows that income support during pregnancy improves the health and nutritional status of both mother and child, reduces maternal stress and symptoms of depression and anxiety, and lowers the incidence of babies born with low birth weight (under 2.5kg), a key predictor of childhood stunting, which is linked to poor brain development. Food-insecure pregnant women are especially vulnerable, with their babies being 2.5 to 3.5 times more likely to become stunted.

Engelbrecht points out that poor pregnant women currently only qualify for state income support once their baby is born and registered for the Child Support Grant (CSG). Although around 13 million children up to the age of 18 receive the CSG, nearly half of eligible infants do not access it in their first year of life, when it is most effective in preventing stunting. Already, more than a quarter of South African children under five are stunted, with long-term consequences for education, productivity, earnings, and economic growth.

The coalition argues that the MSG should begin in the second trimester and continue for three months after birth, ensuring income support during the critical early months of a child’s life. This would create a financial bridge until the CSG is activated. To ensure continuity, the MSG must be designed so that recipients transition automatically to the CSG once the birth is registered and reflected in government systems.

According to the coalition, introducing the MSG would not only improve birth outcomes but also save the state billions. A nine-month grant reaching 800,000 pregnant women annually would cost about R2 billion, yet could yield savings of R13.8 billion in averted public health costs if fewer babies are born with low birth weight or complications.

It says the grant would also protect infants excluded from the CSG and lay the groundwork for early access to child support. Evidence shows that social grants, including the CSG, are primarily spent on essential household needs such as food, education and basic goods. Furthermore, the MSG would advance equity by reaching women in informal work who are excluded from Unemployment Insurance Fund maternity benefits, helping to reduce inequality and promote gender equity.

Julie Mentor, project lead of Embrace, a movement for mothers, says the MSG is a realisable opportunity to support pregnant women with a financial lifeline and economic agency when they need it most.  "Why wouldn’t we want to be a country that does this?”

The coalition says it is urging the Department of Social Development to table the MSG policy before Cabinet without further delay.

“The MSG is a cost-effective strategy to improve birth outcomes and reduce childhood stunting by protecting women affected by poverty and food insecurity. What is missing is the political will and interdepartmental coordination to deliver this much-needed support to pregnant women," says Nicola Eley, deputy director of Grow Great.

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