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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

From wheat protein to perfect pizza

2017-09-26

Barend Wentzel received his PhD at the Department
of Plant Sciences during the university’s
winter graduation ceremony.
He is pictured here with Prof Maryke Labuschagne,
professor in Plant Breeding at the UFS.
Photo: Charl Devenish

Barend Wentzel, an alumnus of the University of the Free State’s Department of Plant Sciences, is passionate about plant breeding.

He literally eats and lives wheat proteins. In 1989 he initiated a breeding programme on arum lilies. “This breeding programme is at an advanced stage,” he said. Besides reading, playing the piano and accordion, Barend, due to the nature of his research at the Agricultural Research Council, also experiments with different types of ciabatta recipes made from sour dough. “I usually make my own pizza on Saturday evenings,” he said.

He is working at the Agricultural Research Council – Small Grain (ARC-SG) at the Wheat Quality Laboratory where he established a Cereal Chemistry Laboratory.

Complexity of flour quality
He explains that the focus of his research is on wheat protein composition. “The research conducted for my PhD study explains the complexity of flour quality to a certain extent, and it further emphasises the influence of the environment and genetic composition on selected baking characteristics.

“Wheat protein can be divided into different types of protein fractions. These protein fractions contribute differently to dough properties and baking quality and the expression is affected by different components in the environment, including locality, rainfall and temperature.

“Protein content alone does, however, not explain the variation in baking quality parameters, such as mixing time, dough strength and extensibility, and loaf volume.

“Several methods can be applied to quantify the different protein fractions. I am using high-performance liquid-chromatography (HPLC). The procedure entails the separation of a wheat protein extract through a column with chromatographic packing material. The injected sample is pumped through the column (known as the stationary phase) with a solvent (known as the mobile phase). The specific procedure, size-exclusion high-performance liquid-chromatography (SE-HPLC), is also used by the university’s Department of Plant Breeding, as well as in several international Cereal Chemistry Laboratories,” said Barend.

Dough strength and to loaf volume
“One of the highlights from the study was the positive contribution of the albumin and globulin protein fractions to dough strength and to loaf volume. The findings were wheat cultivar specific and the growing environment influenced the expression. The contribution of these protein fractions was much larger than previously reported for South African wheat cultivars,” said Barend.
“Previous reports indicated that these protein fractions had a non-specific contribution to the gluten network during dough formation. The findings from this PhD justify further research on albumins and globulin proteins.”

The Cereal Chemistry Laboratory at ARC-SG is involved in postgraduate student training under Barend’s guidance. He serves as co-promoter for several MSc and PhD students. He is also a collaborator on an international project with the International Maize and Wheat Improvement Centre (CIMMYT) in Mexico. Barend is furthermore working on improving wheat quality for processing and health purposes as a member of the expert working group of the International Wheat Initiative.

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