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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

From peasant to president; from Samora Machel to Cahora Bassa

2015-03-25

Prof Barbara Isaacman and Prof Allen Isaacman
Photo: Renè-Jean van der Berg

When the plane crashed in Mbuzini, the entire country was submerged in a profound grieving.

This is how Prof Allen Isaacman, Regents Professor of History at the University of Minnesota, described the effect President Samora Machel’s death in 1986 had on Mozambique. In a public lecture, Prof Isaacman spoke about the man, Samora Machel, and the influences that shaped Machel’s life. The event, recently hosted by the UFS International Studies Group on the Bloemfontein Campus, was part of the Stanley Trapido Seminar Programme.

Samora Machel: from peasant to president
Born in 1933 into a peasant family, Machel was allowed to advance only to the third grade in school. “And yet,” Prof Isaacman said, “he became a very prominent local peasant intellectual and ultimately one of the most significant critics of Portuguese colonialism and colonial capitalism.” Machel had a great sense of human agency and firmly believed that one is not a mere victim of circumstances. “You were born into a world, but you can change it,” Prof Isaacman explained Machel’s conviction.

From herding cattle in Chokwe, to working as male nurse, Machel went on to become the leader of the Liberation Front of Mozambique (Frelimo) and ultimately the president of his country. To this day, not only does he “capture the imagination of the Mozambican people and South Africans, but is considered one the great leaders of that moment in African history,” Prof Isaacman concluded his lecture.

Displacement, and the Delusion of Development: Cahora Bassa and Its Legacies in Mozambique, 1965–2007
Later in the day, Profs Allen and Barbara Isaacman discussed their book: ‘Displacement, and the Delusion of Development: Cahora Bassa and Its Legacies in Mozambique, 1965–2007’ at the Archives for Contemporary Affairs. As authors of the book, they investigate the history and legacies of one of Africa's largest dams, Cahora Bassa, which was built in Mozambique by the Portuguese in the late 1960s and early 1970s.

The dam was constructed under conditions of war and inaugurated after independence by a government led by Frelimo. The dam has since operated continuously, although, for many years, much of its electricity was not exported or used because armed rebels had destroyed many high voltage power line pillars. Since the end of the armed conflict in 1992, power lines have been rebuilt, and Cahora Bassa has provided electricity again, primarily to South Africa, though increasingly to the national Mozambican grid as well.

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