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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

South Africa praised for dealing with its history
2012-07-12

“I listened to an incredible conversation on how South Africans can talk about the past. We failed to do that in the US. We cannot move on because we failed to name the ghosts in our past. I am honouring what South Africa is doing.”

These are the words of a staff delegate from a university in the USA in a case study at the Global Leadership Summit led by Prof. André Keet, Director of the International Institute for Studies in Race, Reconciliation and Social Justice at the University of the Free State (UFS).

Students and academics from universities in the USA, Belgium, the Netherlands and Japan are attending a Global Leadership Summit with the theme “Transcending Boundaries in Global Change Leadership” at the UFS.

In the case study, symbols on the Bloemfontein Campus such as the MT Steyn Statue, Justitia symbol of justice at the building of the Faculty of Law, the artwork Van hier tot daar, and the Women’s Memorial were presented to the audience and the question was asked if they had to be removed or if they had to remain.

Students overwhelmingly felt that symbols of the past had to remain. Here are some of the comments:

  • “Without our past we would not be here today. Without the past, we would not know why we are here or where we are going.”
  • “It is important for students that it remains on campus, as a reminder that history must not repeat itself.”
  • “There is room for new symbols. We must look back but must also look at the future.”
  • “We must resolve the problems of the past and move on.”
  • “We must remember that we cannot go back there again. We must not take away part of other people’s history.”
  • “Symbols must be contextualised.”
  •  “Don’t look in the rear mirror, but through the windscreen where you are going. The windscreen is far bigger.”

One student said the statute of MT Steyn filled him with anger.

Prof. Keet said the act of running away from the ghosts of the past was a way to keep those ghosts alive. The past cannot be dealt with, only visited. The ghosts connect people with the past and allow the past to be present in the now.
 

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