NGOs say a Maternal Support Grant would cost the state about R2 billion annually, but the savings would be far greater

27 October 2025  

ISSUED BY THE MSG ADVOCACY COALITION: NGOs say a Maternal Support Grant would cost the state about R2 billion annually, but the savings would be far greater

In 2025, poor pregnant women remain excluded from South Africa’s R267 billion per year social grant system, despite overwhelming evidence showing that state provision of income support during pregnancy delivers strong public health, economic and social returns for the country.

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 government to commit to a clear timeline for approval and implementation of an MSG policy. The coalition’s case is set out in new policy proposals published by non-profits, Hold My Hand, Change Ideas and Grow Great.  

The policy proposals show that the MSG is affordable and cost-effective at a net cost of around R2 billion annually, which is just 0,1% of current government spending.  

“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).

“Considering strong evidence for the MSG and the urgent need to improve maternal and infant nutrition and health, it’s unclear what is holding the policy back. We’ve therefore put together our own policy proposals to demonstrate the strength of the case,” Engelbrecht explains.

Income support during pregnancy improves the health and nutritional status of mother and child, lowers maternal stress, symptoms of depression and anxiety, and reduces incidence of babies born with a low birth weight (less than 2.5kg), which is a strong predictor of childhood stunting, in turn linked to poor brain development in young children.

Food insecure pregnant women are at greater risk of delivering low birth weight babies. And those babies are 2.5 to 3.5 times more likely to become stunted.

“As things stand, poor pregnant women are only eligible for income support from the state after their baby is born and registered to receive the Child Support Grant (CSG),” says Engelbrecht.

Even though approximately 13 million children up to the age of 18 receive the CSG, nearly 50% of eligible children are not accessing it in their first year of life when it can have the greatest impact on preventing stunting. Already, more than a quarter of children under the age of five in South Africa are stunted. The effects extend beyond childhood, influencing school performance and workforce productivity, earnings and ultimately, economic growth.

“The exclusion rate of the CSG among infants strengthens our case for the MSG to begin in the second trimester of pregnancy and to continue three months after birth, ensuring there is income support in the home to buy food and basic necessities in the first months of a child’s life. This design provides a financial bridge until the CSG is activated,” Engelbrecht explains.

The MSG must be designed in such a way that recipients transition automatically to the CSG after a birth is registered and appears in government’s systems, ensuring continuity of support.  

Introducing the MSG would save the state billions of rands

1.   Affordable and cost-effective: A nine-month grant that reaches 800 000 pregnant women annually would cost about R2 billion. But it could generate savings of R13.8 billion from averted public health costs alone if fewer babies are born low birth weight or have complications from poor birth outcomes.

2.   Improves birth outcomes: Income support during pregnancy reduces low birth

weight and stunting.

3.   Protects infants excluded from the CSG: It sets the foundation for an easy transition to access child support early. There is substantial evidence that social grants, including the CSG, are mainly spent on essential household needs such as food, education and basic goods.  

4.   Advances equity: The MSG reaches women in informal work excluded from the Unemployment Insurance Fund maternity benefits, thereby helping to reduce inequality and promote gender equity.

“The MSG is a realisable opportunity to support pregnant women with a financial lifeline and economic agency when they need it most,” says Julie Mentor, Project Lead of Embrace, a movement for mothers.

“Why wouldn’t we want to be a country that does this?”

The coalition is calling on 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,” says Nicola Eley, Deputy Director of Grow Great.

“What is missing is the political will and interdepartmental coordination to deliver this much-needed support to pregnant women,” Eley concludes.