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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

Lessons of The Spear

2012-08-16

Discussing weighty issues at the UFS were from left: Prof. Jonathan Jansen; Vice-Chancellor and Rector; Nic Dawes, Editor-in-Chief, Mail & Guardian; Max du Preez: Investigative journalist and political columnist; Ferial Haffajee: Editor, City Press; and Justice Malala: Political commentator and newspaper columnist.
Photo: Johan Roux
14 August 2012

Podcast (MP3)

What were South Africans left with after The Spear? More importantly, what did we learn from The Spear?

These were the issues discussed at a seminar, Beyond the Spear, on the controversial Brett Murray painting at the Bloemfontein Campus of the University of the Free State (UFS) on Monday 13 August 2012.

The university hosted this seminar, Beyond the Spear, in conjunction with acclaimed journalists, to look deeper into the lessons that South Africans learnt from this painting and the reaction from the public and politicians following soon after it went on display at the Goodman Gallery in Johannesburg.

The four panellists, Mr Justice Malala (political analyst, journalist and host of the news show, The Justice Factor), Mr Nic Dawes (editor in chief of Mail & Guardian), Mr Max du Preez (investigative journalist and political columnist) and Ms Ferial Haffajee (editor of City Press), all presented their views and experiences on the public’s perceptions of this artwork.

In his opening remarks, Prof. Jonathan Jansen, Vice-Chancellor and Rector, said the purpose of the seminar was to help us make sense of what happened. Prof. Jansen also chaired this seminar.

“This being South Africa, there will be more ‘Spears’. More public crises will unfold that divide the nation and that will stir the emotions. We need to understand what happened so that we are better prepared to deal with the coming ‘Spears’.”

Issues on leadership, South Africa’s hurtful past and the freedom of expression were some of the topics raised by the panellists.

“This has taught us that South Africans – especially the older generation – still need to vent their anger… White South Africa must be patient and allow black citizens to shout at them,” said Mr Du Preez. He warned that this anger should serve a constructive purpose. In reaction to a question if Brett Murray did not disrespect Pres. Jacob Zuma’s dignity with his controversial painting, he said that this painting was “…rude and disrespectful.”

“It was meant to be. It was not honouring him.” He said that politicians will do anything, including messing with the country’s stability, to further their own interests. “From now on we need to be far more alert, far more cynical about our politicians.”

Mr Dawes shared his experience and said that the debates around The Spear were very painful considering where the nation has come from. He said the painting opened up painful pasts and difficult spaces. “It is up to the media to open up these difficult spaces.” He said the painting also brought up questions of how South Africans deal and live with pain. “South Africa must live with its past. The debate should now be how to preserve space for the country’s ghosts and how its citizens could get the resilience to deal with it.”

Ms Haffajee, who was caught in the crossfire between freedom of expression and human dignity and who refused to remove a picture of the painting from the City Press website, said that the media was viciously played by politicians.

“This had shown that achieving freedom took many lives, but it took very little to kill it.” She said The Spear is art that it is part of a rich cultural heritage of protest art.

Mr Malala said with the debates around The Spear painting, something died in South Africa. “The debate was taken away from us. We let politicians get to us.”

After the panellists delivered their presentations, Prof. Jansen led a discussion session between the audience and the panellists.

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