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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

Miss Deaf SA inspires UFS teachers with her life story

2009-11-26

Pictured from the left, are: K. Botshelo, Vickey Fourie (Miss Deaf SA) and A. Morake.

Vicki Fourie, Miss Deaf SA 2009 and Miss Deaf HESC, recently visited the University of the Free State to motivate aspiring Foundation Phase teachers by sharing her life story with them.

When Vicki was two years old, her parents found out that she couldn’t speak. Two possible explanations were that she had had an ear infection or speech problems. They took her to a specialist and after a brain scan they found out that Vicki had 97% hearing loss in both ears.

Hearing aids were required and Vicki’s father, Pastor Gerhard Fourie from the Christian Revival Church (CRC) enrolled her in a kindergarten school for deaf children, Carel Du Toit in Cape Town.

However, even though Carel Du Toit’s slogan is ‘Where Deaf Children Learn to Speak’, it was because of her mother’s efforts that Vicki is able to communicate effectively with hearing people today.

Bonita Fourie would sit with her child every single day and teach her how to pronounce words phonetically and how to read lips. It is because of that that Vicki is not dependent on sign language at all.

When she was seven years old, her parents enrolled her in an English A.C.E. school. Even though Vicki’s home language is Afrikaans, her parents decided to go against the norm by placing her in an English school (most deaf/hard of hearing people cannot learn a second language). Today Vicki is fluent in both languages.

“I used to think that my hearing aids are just a normal thing you put on, like using glasses for reading,” she said. “I still think that way. People always come up to me and say, ‘It’s amazing how easily you adapt to hearing people. You have no stumbling blocks or holdbacks.’

“To me it’s interesting because my reaction is always this: ‘God gave me this situation, and I have made the best of it. I’ve overcome it, and therefore I can go forward in life’. We were born not to survive, but to thrive. I detest the attitude of, ‘I’m a victim, so the world owes me something’. The world owes nobody anything! We can be victorious over our own circumstances. It is possible. My name’s meaning is testifies to this: “Vicki” comes from the word “Victory”. I was meant to be victorious, and not a victim.”

Vicki, who is now 20, has achieved so much in life. She did ballet, hip-hop, modern dancing, drama (she even went to America for her dramatic monologue and poetry recitation), and she has published over 70 magazine articles, nationally and internationally. Her dreams are to write books one day, become a TV presenter, and motivate and inspire people all over South Africa through public speaking.

When one hears this story, one cannot help but be surprised by her success. It makes you realize that anything is possible when you see the potential in a child, and then do everything in your power to develop it and draw it out. When you believe in the child that you are educating, that child will sense it and blossom like a flower.

“Courage isn’t a gift, it is a decision,” Vicki said. “There will always be things that try to hold you back. The key to working with any child is to be patient, patient, and patient! Teachers play a huge role in equipping children for the future. It is a big responsibility, but it can be done.”

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