This case study focuses on the multiple factors which feed into under 5 malnutrition (including the social determinants of disease). It is set in the Eastern Cape province of South Africa in 2002. The UNICEF Conceptual Framework is used as a tool for analysis.

The case is structured as a short narrative case study followed by an introduction to the UNICEF Conceptual Framework. In addition, contextual information is supplied and could be supplemented, using links to further sources of information, plus some tables and photographs. Also included are links to journal articles outlining possible responses to this situation.

This case study resource has been developed at the School of Public Health (SOPH), University of the Western Cape (UWC) and used in our teaching. It is based on a research project undertaken over 12 years in the Eastern Cape Province of South Africa by Emeritus Prof David Sanders and Prof Thandi Puoane of the SOPH, UWC with Prof Ann Ashworth from the London School of Hygiene and Tropical Medicine.