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01 November 2024 | Story André Damons | Photo Supplied
Dr Nomakhuwa Tabane
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

"Service" needs to return to public service
2010-09-14

At the memorial lecture were, from the left, front: Chris Hendriks, Proff. Liezel Lues, Chris Thornhill and Lyndon du Plessis; middle: Prof. Hendri Kroukamp, Mss Alet Fouche, Lizette Pretorius; and back: Proff. Koos Bekker and Moses Sindane.
– Photo: Stephen Collett.

There is a serious need for the concept of “service” to be reintroduced to the public service. In addition to this, public servants need to behave ethically and honestly if the public service were to achieve its main aim of service delivery to South African citizens and thereby also restore the trust of citizens in the state.

This was the central theme of the JN Boshoff Commemorative Lecture hosted by the Department of Public Administration and Management at the University of the Free State UFS). The lecture by Prof. Chris Thornhill, emeritus professor of Public Administration and Management at the University of Pretoria, focused on “Administrative and Governmental Challenges: Lessons from the Past”. He drew pertinent parallels with the administrative and governmental practices during the times of Pres. JN Boshoff, second president of the Orange Free State in 1855, and the challenges faced in this regard by the current government and public service.

Prof. Thornhill highlighted important aspects such as globalisation, the environment, public service and democratic government in his presentation.
He said the borders between countries have all but vanished and governments therefore have to carefully consider the effects of globalisation on its domestic affairs. The strength of a country’s currency, for example, was not only determined by how that country viewed or perceived it, but also by the international community’s perception of that country’s political and economic stability. This, in turn, could have serious implications for that country’s investment and economic prospects.

Governments are compelled to attend to the utilisation of its natural resources as these resources are finite and therefore irreplaceable. Policy interventions have to be introduced to decrease or regulate the use of certain natural resources or alternative measures need to be introduced. The example of bio-fuel production in various countries was highlighted.

He said the South African public service is characterised by three debilitating factors, namely the prevalence of corruption, the interference of politicians in administrative functions and a lack of appropriate skills and therefore a lack of commitment on the part of officials. In the municipal sector, for example, 46% of municipal managers have less than one year’s experience and this mainly occurs because of the practice of deployment (the appointment of a person based on political affiliation). An amendment to the Local Government: Municipal Systems Act is currently under consideration, in terms of which municipal managers will be disallowed to hold party political positions simultaneously.

According to Prof. Thornhill this is a step in the right direction, but more needs to be done to neutralise the impact of these debilitating factors in order to restore the credibility of the public service.

On democratic government Prof. Thornhill said the fact that the majority of a country’s citizens elect a political party to power does not automatically make the government capable of governing effectively and efficiently. It is therefore important for the rulers to understand their governing role within a democratic context, but more importantly to act accordingly. It is also important not to centralise power unduly as this could be a serious threat to accountable government. The 17th amendment to the Constitution, 1996, currently under consideration, and in terms of which national and provincial government will be allowed to intervene in local government matters, was highlighted as a case in point.

Prof. Thornhill said it was essential for those involved to sincerely and honestly and ethically deal with the above matters for the public service to overcome current challenges.
 

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