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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

Leader of Bafokeng nation delivers a guest lecture at UFS

2011-05-05

Kgosi Leruo Molotlegi, leader of the Royal Bafokeng, Proff. Teuns Verschoor, Vice-Rector: Institutional Affairs, Jonathan Jansen, Vice-Chancellor and Rector of our university, and Hendri Kroukamp, Dean of our Faculty Economic and Management Sciences (acting).
Photo: Stephen Collett

Kgosi Leruo Molotlegi, leader of the Royal Bafokeng nation, asked the pertinent questions: Who decides our fate as South Africans? Who owns our future? in the JN Boshoff Memorial Lecture at our university.

He said: “It’s striking that today, with all the additional freedoms and protections available to us, we have lost much of the pioneering spirit of our ancestors. In this era of democracy and capitalist growth (systems based on choice, accountability, and competition), we nevertheless invest government with extraordinary responsibility for our welfare, livelihoods, and even our happiness. We seem to feel that government should not only reconcile and regulate us, but also house us, school us, heal us, employ us, even feed us.

“And what government can’t do, the private sector will. Create more jobs, invest in social development and the environment, bring technical innovations to our society, make us part of the global village. But in forfeiting so much authority over our lives and our society to the public and private sectors, I believe we have given away something essential to our progress as people and a nation: the fundamental responsibility we bear for shaping our future according to aims, objectives, and standards determined by us.”

He shared the turnaround of the education system in the 45 schools in the 23 communities of the Bafokeng nation and the effect of greater community, NGOs, the church and other concerned parties’ engagement in the curricula and activities with the audience. School attendance improved from 80% to 90% in two years and the top learners in the matric maths in Northwest were from the Bafokeng nation.

Kgosi Leruo Molotlegi stressed the need for people to help to make South Africa a better place: “As a country, we speak often of the need for leadership, the loss of principles, a decline in values. But too few of us are willing to accept the risk, the expense, the liability, and sometimes even the blame, that accompanies attempting to make things better. We are trying to address pressing issues we face as a community, in partnership with government, and with the tools and resources available to us as a traditionally governed community. It goes without saying that we can and should play a role in deciding our fate as members of this great country, and in the Royal Bafokeng Nation, as small as it is, we are determined to own our own future.”

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