Fetal Alcohol Spectrum Disorders (FASD) are not only a health issue. They are shaped by the systems, policies and environments that influence people’s lives long before pregnancy begins.
Through Rethink Your Drink and Hold My Hand, DGMT is working to shift the conversation from individual blame to systems change. This means addressing the upstream drivers of alcohol harm while strengthening the conditions that help children thrive.
Overview
Fetal Alcohol Spectrum Disorders (FASD) is an umbrella term used to describe a range of lifelong physical, behavioural, cognitive, and developmental challenges that can occur when a baby is exposed to alcohol during pregnancy. Effects can include difficulties with learning, memory, attention, emotional regulation, growth, and social functioning. The severity and presentation can vary widely from person to person.
South Africa has some of the highest reported rates of FASD in the world. For too long, prevention has focused mainly on awareness and individual behaviour change. While education remains important, it is not enough on its own.
FASD risk is shaped by a wider environment of alcohol affordability, availability, marketing, poverty, food insecurity, stress, and limited support for pregnant women and caregivers. These factors interact with South Africa’s inequality trap, where children are born into conditions that limit their potential before they have had a fair chance to begin.
A systems approach asks a different question: How do we design environments that make FASD less likely?
This means aligning alcohol policy, maternal support, child nutrition, social protection, health services, and community action around one shared goal: improving outcomes for children.
Why This Matters Now
South Africa is at an important policy moment. The National Strategy to Accelerate Action for Children calls on all of society to prioritise children and work together to improve their wellbeing.
At the same time, there is growing national recognition that alcohol harm affects children directly and indirectly, including through prenatal exposure, violence, household instability, poor nutrition, and stunted growth.
This creates an opportunity to move from awareness to implementation, and from fragmented programmes to coordinated prevention.
About Hold My Hand
Hold My Hand is a national campaign of action for children and teens in support of the National Strategy to Accelerate Action for Children. It brings together civil society, government, communities and partners to accelerate progress for children.
The campaign is built on a simple idea: when society aligns behind children, change can happen faster and at greater scale.
Preventing FASD is not only about changing individual behaviour. It is about changing the systems that shape behaviour, risk and opportunity.
By designing prevention around children, South Africa can reduce alcohol harm, strengthen families, and help more children reach their full potential.
