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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

“You cannot find Ubuntu in a culture of dominance” – Dr Mamphela Ramphele during second Leah Tutu Gender Symposium

2015-02-28

From the left are: Samantha van Schalkwyk, Zanele Mbeki, Prof Pumla Gobodo-Madikizela and Dr Mamphela Ramphele.
Photo: Johan Roux

Video message from Mrs Leah Tutu

Session 1: Keynote address by Dr Mamphela Ramphele
Ndiyindoda! Yes, you are a man

Session 2: Professor Robert Morrell from the University of Cape Town
South African Gender Studies: Setting the context

Session 3: How can we engage young men to act against violence against women?
Panel discussion by Lisa Vetten (Wits Institute for Social and Economic Research), Despina Learmonth (Psychology Department, University of Cape Town) and Wessel van den Berg (Sonke Gender Justice)

Session 4: Professor Pumla Gobodo-Madikizela
Self-defence as a strategy for women’s resistance: Reflections on the work of Susan Brison

Engaging men to act against gender-based violence in the Southern African context.

This was the theme of the second International Leah Tutu Symposium, hosted by the Gender Initiative of Trauma, Forgiveness and Reconciliation Studies of the University of the Free State (UFS) on Tuesday 24 February 2015.

What does it mean to be man? How can men become active in the fight against gender-based violence? And when does one say: enough is enough? Questions like these set the tone as highly-respected individuals such as Dr Mamphela Ramphele, Prof Rob Morrell, Lisa Vetten and Andy Kawa took to the stage in the Odeion on the Bloemfontein Campus.

Leah Tutu
Unfortunately, Mrs Leah Tutu could not attend this year’s event, but she still managed to send sparks of wit and insight into the auditorium. In her video message, Mrs Tutu referred to the fact that our country has “consigned discriminatory legislation to the rubbish bin of the past”, but we continue to inhabit a divided society.

“We have a constitution and bill of rights that should have sounded the death knell for patriarchy. But women are unsafe across the land,” Mrs Tutu said. “Our freedom cost too much to be left out in the rain,” she urged.

Ndiyindoda! Yes, you are a man
In Dr Ramphele’s keynote address, “Ndiyindoda! Yes, you are a man”, she scrutinised the dominant masculinity model that has supported an alpha-male mentality for millennia. A mentality that celebrates dominance, power and control – where the winner takes it all. How then, can we expect our young boys to embrace the value system of a human rights culture?

“Gender equality is at the heart of our constitutional democratic values. Yet, our society continues to privilege and celebrate the alpha male as a masculinity model,” Dr Ramphele said. This dissonance can only produce conflict and violence.

We encourage our young men to be gentle, communicative, caring people who show their emotions. And when they do, what do we as women do? Do we encourage them?

“Or do we join those who call them wimps, moffies, sissies? How do we respond when they are ridiculed?” Dr Ramphele asked. Are we, as mothers, fathers and grandparents willing to socialise our children to acknowledge a diversity of masculinities as equally valid in our society?

The new man and the new woman of the 21st century need to be liberated from the conflict-ridden dominant masculinity model. They need to be able to shape their identity in line with a value system of human rights as enshrined in our constitution.

Perhaps Dr Ramphele’s message could be summed up by one sentence: You cannot find Ubuntu in a culture of dominance.

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