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First 1 000 Days initiative promotes mother and child healthcare

01 November 2024 | Story André Damons | Photo Supplied

Dr Nomakhuwa Tabane is the Head of the Department of Paediatrics and Child Health at the University of the Free State.

The first 1 000 days of a baby’s life, from conception to the age of two, constitute a critical period during which children’s brains form as many as 1 000 neural connections every second – a pace that will not be repeated in their lifetime.

These connections are the building blocks of every child’s future, which makes the role of a campaign like the First 1 000 Days vitally important. It highlights the importance of stimulation and learning from the earliest possible moments, good nutrition for expectant mothers, prevention of malnutrition of children, and early diagnosis of chronic, life-threatening illnesses and developmental disorders.

This is according to Dr Nomakhuwa Tabane, Head of the Department of Paediatrics and Child Health at the University of the Free State (UFS). The campaign was promoted by Dr Tabane’s department in partnership with the Mother and Child Academic Hospital (MACAH) Foundation. The annual campaign kicks off on 1 November each year.

“There are certain factors that can interfere with this process and result in irreversible damage to children’s brain development, poor growth, and compromised immunity. Those conditions include prematurity, ischaemic brain damage, and infections. These are also the top contributors to the neonatal mortality.

“In the one-month to 49-month-old period, the causes of mortality and morbidity that affect brain development and growth include respiratory illnesses like pneumonia, diarrhoeal diseases, and malnutrition,” says Dr Tabane.

Aims of the campaign

The First 1 000 Days initiative promotes excellent mother, infant, and child healthcare by supporting community-based programmes that drive the message of the importance of the first 1 000 days of life to teenagers, young adults, healthcare workers, and the public. This initiative aims to bring about interventions that can address the Under-5 Mortality Rates (U5MR), including Neonatal Mortality Rates (NMR), Infant Mortality Rates (IMR), and Perinatal Mortality Rates (PMR).

“The campaign also aims to improve the growth and development of children in their first 1 000 days of life from conception until they are two years old. It also aims to improve expectant mothers’ health and prevent and decrease maternal mortality in the Free State, as well as to prevent unwanted pregnancies, focusing on decreasing teenage pregnancies.”

According to Dr Tabane, the 2020 South African UN Inter-agency Group for Child Mortality Estimation (UNIGME) estimate for U5MR was 32 deaths per 1 000 live births, NMR of 11 per 1 000 live births, and infant mortality rate (IMR) of 26 per 1 000 live births as compared to the Medical Research Council (MRC) estimate of U5MR of 28 per 1 000 live births, NMR of 12 per 1 000 live births and IMR of 21 per 1 000 live births (15).

South Africa behind other BRICS countries

Based on the 2020 UNIGME report, says Dr Tabane, South Africa has achieved the Sustainable Development Goals (SDG) goals of NMR and the U5MR. South Africa’s indicators were much better than the UNIGME and the MRC 2020 estimates, but it still falls behind other BRICS countries.

“In contrast to other BRICS countries (Brazil, Russia, India, China, and South Africa), UNIGME reports that in the same reporting period of 2020, China’s U5MR was seven per 1 000 live births, Brazil's 15 per 1 000 live births, and Russia's five per 1 000 live births (16). In 2020, the South African national in-hospital neonatal mortality rate (NMR) based on DHIS data was 12,0 per 1 000 live births; the infant mortality rate (IMR) was 15.1 per 1 000 live births, and the under-5 mortality (U5 MR) rate was 16.9 per 1 000 live births, with differences amongst provinces,” says Dr Tabane.

The first 1 000 days campaign’s interventions include education to prevent illnesses and deaths and promote good health, growth, and development. While many training programmes on child survival strategies have been rolled out (e.g., MSSN, HBB, ETAT, AANC, ESMOE, and IMCI), in-service training still has significant gaps.

Other interventions include preventing unwanted and unplanned pregnancies, providing healthcare support for therapeutic and interventional care, strengthening the implementation of the existing strategies developed by the Department of Health to reduce Maternal and Child Mortalities, and monitoring and evaluating the interventions.

News Archive

Game farming a lens to analyse challenges facing democratic SA – Dr Kamuti

2017-05-30

Dr Tariro Kamuti, Postdoctoral Fellow at the Centre
for Africa Studies at the University of the Free State.
Photo: Rulanzen Martin

One of the challenges facing South Africa’s developing game farming policy is the fractured state in the governance of the private game farming sector, says Dr Tariro Kamuti.

Dr Kamuti, a Postdoctoral Research Fellow at the Centre for Africa Studies (CAS) at the University of the Free State (UFS), was presenting a seminar on Wednesday 17 May 2017 under the topic, Private Wildlife Governance in a Context of Radical Uncertainty: Challenges of South Africa’s Developing Game Farming Policy, which takes material from his PhD. He received his PhD from both the Vrije University in Amsterdam and the UFS in 2016.

His presentation explored how the private game industry positions itself in accordance with existing agricultural and environmental regulations. It also investigated the state’s response to the challenge of competing needs over land and wildlife resources which is posed by the gaming sector. “The transformation of the institutional processes mediating governance of the private game farming sector has been a long and enduring arrangement emerging organically over time,” Dr Kamuti said.

Game farming links wildlife and agricultural sectors
“I decided on this topic to highlight that game farming links the wildlife sector (associated with conservation and tourism) and the agricultural sector. Both make use of land whose resources need to be sustainably utilised to meet a broad spectrum of needs for the diverse South African population.

“The continuous skewed ownership of land post-1994 justifies questioning of the role of the state in confronting challenges of social justice and transformation within the economy.”

“Game farming can thus be viewed as a lens through which to study the broad challenges facing a democratic South Africa, and to interrogate the regulatory and policy framework in the agricultural and wildlife sectors at their interface,” Dr Kamuti said.

Challenges facing game farming policies
The state alone does not apply itself to the regulation of private gaming as a sector. “There is no clear direction on the position of private game farming at the interface of environmental and agricultural regulations, hence game farmers take advantage of loopholes in these institutional arrangements to forge ahead,” Dr Kamuti said.

He further went on to say that the state lacked a coherent plan for the South African countryside, “as shown by the outstanding land restitution and labour tenant claims on privately owned land earmarked for wildlife production”.

The South African government was confronted with a context in which the status quo of the prosperity of the middle classes under neoliberal policies was pitted against the urgent need to improve the material well-being of the majority poor. Unless such issues were addressed, this necessarily undermined democracy as a participatory social force, Dr Kamuti said.

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