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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

Up to 60% of students do not have enough to eat

2013-11-15

15 November 2013

A report of the University of the Free State has revealed the shocking statistics that almost two-thirds of the students at the university don’t have enough money to buy food, and suffer from hunger during terms.

The study, conducted internally by the university’s Department of Nutrition and Dietetics, was a response to a growing international concern that students worldwide were not getting enough to eat. While studies were conducted in the USA and Australia, no similar research has been done in South Africa.

“There have been many studies on the impact of poor nutrition on school kids,” says Dr Louise van den Berg, Senior Lecturer in the Department of Nutrition and Dietetics, “but almost no research on university students. South Africa is, overall, a food-insecure country, and the university wanted to establish how widespread this problem is among our students.”

The reasons given by students invariably referred to a lack of money, as many students were also supporting families. Some students admitted they lacked the knowledge to feed themselves properly, some admitted to borrowing money to buy food, and some even admitted to stealing food to survive.

“This research has confirmed something we have suspected for a long time,” Dr van den Berg states.

A number of students disclosed that they were reluctant to resort to the university feeding scheme, as they were ashamed to admit they did not have money to buy food.

This study is the first of its kind in South Africa, and underlines the fact that tertiary students are particularly vulnerable when it comes to food security. Often a student has to juggle their studies with their role as breadwinner.

A tiny ray of hope to students who find themselves as food insecure, is the No Student Hungry Programme that offers a food bursary to qualifying students.

This programme, initially established by Prof Jonathan Jansen, UFS Vice-Chancellor and Rector, and now managed by Grace Jansen and Karen Buys, offers a small allowance of about R30 per day to hungry students with an average academic achievement of 60% and above. This criterion discourages entitlement thinking and builds a strong sense of responsibility on the part of those who benefit from the food bursary.

Melanie, a second-year Geography and Environmental Management student, as well as a single mother, is a beneficiary of the NSH Programme. “This bursary helps me to get a balanced meal every day. It is one less worry for me. I dream of completing my studies so that I can be independent and provide my son with the life he deserves.”

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