Comprehensive Care for Vulnerable Children in South Africa

Community Care

Western Cape

In 2024, the Western Cape had South Africa’s highest formal preschool attendance among children aged 0–4—yet only 42.1% attended a preschool or early learning program.

Little Steps

Western Cape

More than 40% of households surveyed in a Department of Basic Education and United Nations Children’s Fund study had no books at home for children.

Little Stars

Western Cape

81% of South African Grade 4 learners could not read for meaning in the 2021 Progress in International Reading Literacy Study assessment.

Helping Hands

KwaZulu-Natal

In KwaZulu-Natal, only 26.3% of children aged 0–4 attended a formal preschool or early learning program in 2024.

Joyful Beginnings

Gauteng

In Gauteng, just 41.1% of children aged 0–4 attended a formal preschool or early learning program in 2024.

Growing Hearts 

KwaZulu-Natal

In KwaZulu-Natal, 70.5% of children aged 0–4 stayed at home with a parent, guardian, or other adult rather than attending a formal preschool or early learning program in 2024.

Bright Start

KwaZulu-Natal

An estimated 29% of South Africa’s four-year-olds—about 350,000 children—are not enrolled in an early learning program.

Little Learners

KwaZulu-Natal

Among four-year-olds who are enrolled in early learning programs, only 42% are developmentally on track for early learning.

Sunshine Steps

Eastern Cape

30% of enrolled four-year-olds are already “falling far behind” in early learning before they even reach Grade 1.

Rising Stars

Eastern Cape

Another 28% of enrolled four-year-olds are “falling behind” in early learning—before formal schooling begins.

Bright Futures 

Western Cape

Children in higher-fee early learning programs are twice as likely to be developmentally on track as children in the poorest programs.

Growing Together

Gauteng

A new Starfish-supported preschool will expand early learning and developmental support for children in Gauteng.

At age four, 48% of girls are developmentally on track compared with only 37% of boys.

Bright Path

Western Cape

A new Starfish-supported school will provide young children with early learning, classroom support, and developmental opportunities in the Western Cape.                                    

68% of South Africa’s four-year-olds live in households with income below R1,634 per person per month.

Little Explorers

Limpopo

A new Karongwe-supported preschool will provide young children with early learning, play, and developmental support.

Nationally, only 35% of children aged 0–4 attended a formal preschool or early learning program in 2024.

Sunshine Corner

Limpopo

A new Karongwe-supported preschool will give children a safe place to learn, play, and build school-readiness skills.

Only 1% of Grade 4 learners demonstrated the advanced reading skills needed to integrate ideas and evidence across a text in the Progress in International Reading Literacy Study 2021.

Happy Hearts

Limpopo

A new Karongwe-supported preschool will strengthen early education and daily care for young children in the community.

South Africa’s Grade 4 Progress in International Reading Literacy Study reading score was 288—far below the Progress in International Reading Literacy Study international center point of 500.

Volunteer Experience

Limpopo

The volunteer experience will connect supporters with hands-on service, community engagement, and the work supporting children.

Even by Grade 6, 56% of South African learners still failed to reach the lowest Progress in International Reading Literacy Study reading benchmark.

Community Care

Western Cape

Starfish staff report that for some children at supported schools, the meal served at school may be the only substantial meal they eat that day.

Little Steps

Western Cape

23% of South African children live in severe child food poverty.

Little Stars

Western Cape

Only 21% of children under five in South Africa receive a minimum acceptable diet.

Helping Hands

KwaZulu-Natal

29% of young children in South Africa are stunted—a sign of chronic undernutrition.

Joyful Beginnings

Gauteng

5% of young children are affected by wasting, meaning they are dangerously thin for their height.

Growing Hearts

KwaZulu-Natal

Exclusive breastfeeding in South Africa was only 32% in the 2016 national health survey.

Bright Start

KwaZulu-Natal

A quarter of South African babies were reported as not breastfed at all in national nutrition data.

Little Learners

KwaZulu-Natal

The proportion of South African children under five living with overweight rose from 13% in 2016 to 23% in 2021–23.

Sunshine Steps

Eastern Cape

The United Nations Children’s Fund reports that in parts of the Eastern Cape, food insecurity is compounded by a lack of safe water and sanitation.

Rising Stars

Eastern Cape

In 2022/23, about 15,000 South African children were hospitalised with severe acute malnutrition.

Bright Futures

Western Cape

Around 1,000 South African children a year were estimated to die from preventable acute malnutrition in 2022/23.

Growing Together

Gauteng

A new nutrition program will provide reliable meals and nutritious food.

Four-year-olds who are stunted were found to be, on average, 5–6 months behind their peers developmentally.

Bright Path

Western Cape

A new nutrition program will provide dependable meals and food support to children attending Idayimani in the Western Cape.

61% of South African children under five were reported to suffer from anaemia in national nutrition data.

Little Explorers

Limpopo

A new nutrition program will provide dependable meals and food support alongside Maadishego (Karongwe Preschool 1).

In Limpopo, 25% of children under five were living with overweight in 2021–23.

Sunshine Corner

Limpopo

A new nutrition program will provide dependable meals and food support alongside Maakoma (Karongwe Preschool 2).

KwaZulu-Natal had the country’s highest provincial rate of under-five overweight in 2021–23 at 30%.

Happy Hearts

Limpopo

A new nutrition program will provide dependable meals and food support alongside Maamela (Karongwe Preschool 3).

Children living in severe food poverty are up to 50% more likely to suffer life-threatening malnutrition.

Safe Haven Drop-In Site 1

Limpopo

A new community drop-in site will provide food, care, and practical support to children in the surrounding community.

South Africa is one of just 20 countries that together account for 65% of all children living in severe child food poverty globally.

Open Arms Drop-In Site 2

Limpopo

A second community drop-in site will extend reliable food and care to more children in the surrounding community.

The United Nations Children’s Fund reports that cheap, nutrient-poor ultra-processed foods are increasingly displacing healthier foods in young children’s diets.

Fresh Food Partnership

Limpopo

This community partner has two central kitchens and two farms to feed 2,400 children in 10 preschools and 2 primary schools.

Among South African children aged 5–19, the prevalence of overweight rose from 9% in 2000 to 21% in 2022.

Jim Johnson Wagon

Mobile Healthcare

Provides screenings, preventative care, treatment, health education, referrals, and follow-up support.

About 3.9 million South African children have had to walk more than 30 minutes to reach the health facility. In some very remote areas, children have to walk hours just to see a doctor. 

Zisize Wellness Wagon 1

Mobile Healthcare

Delivers mobile healthcare directly into communities with screenings, preventative care, referrals, and follow-up support.

KwaZulu-Natal’s human immunodeficiency virus prevalence was 16.0% in 2022—the second highest provincial rate in South Africa.

Zisize Wellness Wagon 2

Mobile Healthcare

Brings primary and preventative healthcare directly into underserved communities.

KwaZulu-Natal had an estimated 1.98 million people living with human immunodeficiency virus (HIV) in 2022.

Wellness Wagon

Mobile Healthcare

Helps children and families receive essential healthcare closer to home.   

Air pollution was linked to approximately 3,365 deaths of children under five in South Africa in 2021.

Healthy Beginnings Program

Maternal Health

Provides maternal healthcare and support during pregnancy and the early stages of a child's life.                                   

KwaZulu-Natal recorded 26,515 pregnancies among girls aged 10–19 in just nine months; 1,254 were girls aged 10–14.

Sasol Oral Health Program

Dental Care

Provides oral-health education, dental screenings, preventative care, oral-hygiene supplies, and referrals when further treatment is needed.        

The World Health Organization estimates that 41% of South African children aged 1–9 have untreated decay in their baby teeth.

Sanitary Items for Girls

Menstrual Health & Dignity

Provides sanitary pads to school-aged girls who may not otherwise have reliable access to menstrual-hygiene supplies. By making these essentials available through Starfish-supported programs, girls can manage their periods with greater dignity and confidence, reducing a practical barrier that can disrupt classroom participation, daily routines, and consistent school attendance.

A 2026 Parliamentary colloquium heard that 83% of girl learners lack consistent access to menstrual hygiene products and one in four misses school each month because of it.

Partnership with

Save the Children 

Child Safeguarding

Through a six-month partnership with Save the Children South Africa, Starfish is strengthening child safeguarding systems across its staff and partner network through audits, policy and reporting improvements, screening, and safeguarding training. The partnership is designed to embed consistent safeguarding practices and support Starfish toward Bronze Child Safeguarding Accreditation.

42% of South African children have experienced some form of maltreatment by an adult who was supposed to care for them.

Cardiopulmonary Resuscitation Training for Teachers

Emergency Preparedness

Each Starfish-supported school will have at least one teacher or staff member certified in cardiopulmonary resuscitation, so someone on site is prepared to respond during a medical emergency. The training gives educators practical lifesaving skills, greater confidence in an emergency, and clear steps to take while professional medical assistance is being reached.     

South Africa records more than 1,500 drowning deaths a year—nearly one-third involve children under 14.

Children's Grief Counseling

Grief & Bereavement Support

Provides grief counseling and emotional support to children grieving the loss of a parent or primary caregiver.

A Parliamentary study in rural KwaZulu-Natal found that parents migrating for work can leave children with grandparents—or, in some cases, without adult supervision.

School Fee Grant Program

Education Assistance

Provides targeted school-fee support so children facing financial hardship can remain connected to their education.

The United Nations Children’s Fund reports that 22% of learners leave school for financial reasons.

Sharks Foundation School Shoes Program

School Shoes

Our ongoing partnership with the Sharks Foundation will provide school shoes to children who need them so they can attend school with greater comfort and dignity.

The United Nations Children’s Fund reports that 48% of pupils drop out before completing matric (12th grade).

Sewing & Livelihood Program

Western Cape

Starfish donated two sewing machines, helping unemployed single mothers build sewing skills and access resources to make school uniforms for children.

In Western Cape farming communities, 42% of farmworkers are temporary or casual workers, leaving many families dependent on seasonal income.

Safe Haven Drop-In Site 1

Limpopo

A new drop-in site will provide children with food, care, and a dependable place to receive practical support.

Limpopo recorded 14,615 child-headed households led by 14–18-year-olds in 2024.

Open Arms Drop-In Site 2

Limpopo

A second drop-in site will extend food, care, and practical support to more children in the surrounding community.

Statistics South Africa child-protection data show that 58 children are sexually abused in South Africa every day.