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01 November 2024 | Story André Damons | Photo Supplied
Dr Nomakhuwa Tabane
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

Water research aids decision making on national level
2015-05-25

Photo: Leonie Bolleurs

With water being a valuable and scarce resource in the central regions of South Africa, it is no wonder that the UFS has large interdisciplinary research projects focusing on the conservation of water, as well as the sustainable use of this essential element.

The hydropedology research of Prof Pieter le Roux from the Department of Soil, Crop and Climate Sciences and his team at the UFS focuses on Blue water. Blue water is of critical importance to global health as it is cleared by the soil and stored underground for slow release in marshes, rivers, and deep groundwater. The release of this water bridges the droughts between showers and rain seasons and can stretch over several months and even years. The principles established by Prof Le Roux, now finds application in ecohydrology, urban hydrology, forestry hydrology, and hydrological modelling.

The Department of Agricultural Economics is busy with three research projects for the Water Research Commission of South Africa, with an estimated total budget of R7 million. Prof Henry Jordaan from this department is conducting research on the water footprint of selected field and forage crops, and the food products derived from these crops. The aim is to assess the impact of producing the food products on the scarce freshwater resource to inform policy makers, water managers and water users towards the sustainable use of freshwater for food production.

With his research, Prof Bennie Grové, also from this department, focuses on economically optimising water and electricity use in irrigated agriculture. The first project aims to optimise the adoption of technology for irrigation practices and irrigation system should water allocations to farmers were to be decreased in a catchment because of insufficient freshwater supplies to meet the increasing demand due to the requirements of population growth, economic development and the environment.

In another project, Prof Grové aims to economically evaluate alternative electricity management strategies such as optimally designed irrigation systems and the adoption of new technology to mitigate the substantial increase in electricity costs that puts the profitability of irrigation farming under severe pressure.

Marinda Avenant and her team in the Centre for Environmental Management (CEM), has been involved in the biomonitoring of the Free State rivers, including the Caledon, Modder Riet and part of the Orange River, since 1999. Researchers from the CEM regularly measures the present state of the water quality, algae, riparian vegetation, macro-invertebrates and fish communities in these rivers in order to detect degradation in ecosystem integrity (health).

The CEM has recently completed a project where an interactive vulnerability map and screening-level monitoring protocol for assessing the potential environmental impact of unconventional gas mining by means of hydraulic fracturing was developed. These tools will aid decision making at national level by providing information on the environment’s vulnerability to unconventional gas mining.

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