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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

But do you forgive yourself, Eugene de Kock? asks Candice Mama

2015-03-16

From the left are: Prof Pumla Gobodo-Madikizela, Candice Mama and Prof André Keet, Director of the UFS Institute for Reconciliation and Social Justice.
Photo: O'Ryan Heideman

Candice Mama: Audio

Candice Mama and her family met with her father’s assassin. Eugene de Kock. Prime Evil. Commander of the apartheid government’s covert Vlakplaas police unit. And what followed from this meeting was one of our country’s most poignant gestures of reconciliation. One by one, each family member expressed their forgiveness of De Kock, and soon afterwards, he was granted parole.

Candice recently visited the Bloemfontein Campus to talk about ‘An Unexpected Encounter with Eugene de Kock: A Journey of Transformation’. The event was a collaborative effort between the Institute for Reconciliation and Social Justice and Trauma, Forgiveness, and Reconciliation Studies.

“What makes it possible to cross the boundary from loss and pain to bond with the person who hurt you?” Prof Pumla Gobodo-Madikizela, asked Candice. “I had to educate myself about the when, where, and how, to get a context for Eugene de Kock,” she answered. With the encouragement of her mother, Candice became an avid reader from an early age. She devoured information, so that she could build a picture of this man within a specific historical and political context. What also contributed to this moment of reconciliation for her was De Kock humbling himself and taking full responsibility for his actions.

This meeting was not without inner conflict for Candice, though. “Why am I crying for hím?” she asked herself as she listened to him speak. “Why am I laughing?” she chastised herself as De Kock preened shyly for a group photograph with the family. “Is there something wrong with me to connect with him?” She questioned her values and beliefs. But instead of a monster, Candice saw the true essence of a repentant human being.

But how do you know he didn’t fake it, many people asked. Because it was “one of the most sincere and honest encounters I’ve experienced,” she said. During their meeting, Candice saw a man “crushed by the world”. Everything he believed as a young man, he realised, was a lie.

“Do you forgive yourself?” Candice asked the one question De Kock feared most. And in that moment, he was humanised for her. “When you’ve done the things I’ve done,” De Kock replied, “how do you forgive yourself?”
It remains an open question. But this act of forgiveness gives an entire country hope.

For more information or enquiries contact news@ufs.ac.za.

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