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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

International speakers discuss diversity

2014-02-11

Dr Charles Alexander from UCLA
Photo: O'Ryan Heideman

International and local experts recently gathered on the Bloemfontein Campus to deliberate over the topic of diversity.

Student participation and mobility dramatically increased in higher education worldwide. Cultural, political, economic and social factors on a national and global scale, have brought the reality of diversity into the operational spaces of Higher Education Institutions. These challenges are not exclusive to South Africa, though. In the Netherlands and USA, universities are also challenged by the demands of an increasingly diverse student population.

Prof Jonathan Jansen, Vice-Chancellor and Rector of the UFS, acted as one of the keynote speakers during a two-day colloquium hosted by the Institute for Reconciliation and Social Justice. In an impelling address, Prof Jansen argued that change cannot be affected on a university campus if the surrounding community does not change as well. He also noted the spread of a culture of silence surrounding issues of misbehaviour. He urged that we need to find courage again to speak out. From the level of government, media and churches to the private spaces of our homes, we have to co-create an environment of care.

This message closely tied in with that of Prof Shirley Tate’s from the University of Leeds. In her keynote, she asserted that mere tolerance of someone different from you can lead to even more alienation. The path to true reconciliation is grounded in the intimacy of friendship. Friendship and empathy lead to trust and transcend racism.

Another keynote speaker from abroad, Dr Charles Alexander from the University of California, delineated a model for inclusive excellence. He explained that the major problem of true transformation is not due to a lack of ideas, but in the implementation thereof. “Realities of implementation short circuit the change process,” he said. He explained how campus environments can adapt in order to support and enhance lasting inclusivity.

We have to become complicit in the process of transformation, Prof Dr Ghorashi, Professor of Diversity and Integration at the Vrije Universiteit Amsterdam, conveyed. Linking up with the issue of silence, she demonstrated the power of speaking out, using examples from her extensive research among victims of violence. It is imperative, she maintains, that for transformation to materialise, we need to create safe spaces in which we can share our vulnerabilities.

Footnote: Due to unfortunate circumstances, both Prof Dr Ghorashi and Prof Shirley Tate could not personally attend the colloquium as planned. Their respective keynotes were read to the audience on their behalf.

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