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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

UFS on the right track with transformation - Fulbright scholars

2010-08-27

Pictured from the left, are: Dr Wilmore-Schaeffer, Rev. Dr Streets and Ms Leah Naidoo (Senior Administrator of the Institute).
Photo: Mangaliso Radebe

“I think the university is not only on the right track but can really become a model for how to negotiate certain difficult processes, such as transformation, within a short period of time. I think it can become a model, not just for other universities, but also for the world.”

This was said by Dr Rozetta Wilmore-Schaeffer, who together with Rev. Dr Frederick J. Streets, recently worked with the International Institute for Race, Reconciliation and Social Justice at the University of the Free State (UFS) as Fulbright specialists. They helped the institute come up with ideas in terms of making the changes that are necessary for the transformation of the university.

“There is a great deal that has already been done despite the sense of urgency and impatience, and I think there is a great deal more to be done,” said Dr Wilmore-Schaeffer.

“I think this sense of urgency comes from those who are involved in the process of looking at the destination, the place that they want to be at, and feeling that they are very far from it.”

During their visit here the two had numerous conversations with both staff members and students.

“I have been most impressed by the students who I think are ready to make changes in many different ways – I am talking about students of all racial groups and gender. The fact that they are referring to transformation as ‘their struggle’ shows that they are prepared to make changes,” said Dr Wilmore-Schaeffer.
She, however, cautioned that there were those who were still against transformation taking place at the university.

“I think there is still some resistance from some quarters on both sides of the fence and I would expect that at this point in time. I think what is really hopeful is that there are so many students who are ready to make the changes, who are making the changes, who are struggling with issues around making the changes; and I think that is really the hope for the university and the hope for the future,” she said.

“The resistance is complex,” added Rev. Dr Streets. “It is around a fear for the future, the loss of identity on the part of both black and white students, and the desire for cultural continuity amongst white students as well as amongst a variety of ethnic black students.

“The resistance is about learning that you are not the only kid on the block anymore and how you then overcome the feeling of realising that you are not the dominant person anymore and that your culture is not the dominant culture anymore.”

They have given a preliminary report of their findings to the Rector and Vice-Chancellor of the UFS, Prof. Jonathan Jansen, which will be followed by a more detailed report later on.

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