The Unicef report found that 1.4 million children live in homes that rely on often dirty streams for drinking water, 1.5 million have no flushing lavatories and 1.7 million live in shacks, with no proper bedding, cooking or washing facilities.
Four in 10 live in homes where no one is employed and, in cases of dire poverty, the figure rises to seven in 10.
Contrary to the rest of Africa, where pneumonia and diarrhoea are the biggest child killers, South African children are most likely to die from HIV/Aids. More than five million are currently infected with HIV, and 40 per cent die from the pandemic annually.
Aida Girma, Unicef's South African representative, said that two thirds of child deaths were preventable with simple improvements in primary care for children.
Rhoda Kadalie, executive director of Impumelelo Social Innovations Centre which seeks out novel ways to tackle poverty, said the problem could be traced back to 1994, when the post-apartheid, ANC government focused on "the economy, black economic empowerment and the consolidation of power" rather than education and health care.These subjects are not sexy and those ministries are given to the weaker ministers who have little political power," she said. "As a result, we are awash with policies but there's no political will or competence at a local level to implement them. The facts speak for themselves: if we don't invest in our children now, we might as well give up on our future."