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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

UFS study finds initiation does not build character

2015-06-24

Photo: Canva.com

Initiation at schools and school hostels does not build character or loyalty. On the contrary, it is a violation of human dignity and the rights of children.

This is the opinion of researchers from the University of the Free State’s Faculty of Education after an exploratory study of initiation practices in schools.

Although the use of initiation in schools and school hostels is forbidden by the Regulations to Prohibit Initiation Practices in Schools, the study found that this practice is still widely evident in schools. The study also found that, in some cases, teachers and/or principals take part.

In the study, led by Dr Kevin Teise from the Faculty of Education, it was found that physical deeds and even violence and emotional degradation were inflicted under the guise of ‘initiation’.

The study was discussed recently during a panel discussion between the Faculty of Education, the Faculty of Law, and the Institute for Reconciliation and Social Justice.

The ‘initiation activities’ that take place during school hours ranged from carrying senior learners’ bags or doing other favours for them, handing over their food or food money, doing senior learners’ homework, and looking down when they speak to senior learners.

In school hostels, it was found that learners were expected to do humiliating things, and were also subjected to physical demands and even violence. Learners pointed out that they were smeared and beaten, their heads pushed into toilets, they had to bath or shower in cold water, they had to eat strange things, and they were prevented from sleeping.

Dr Teise says initiation practices are a general phenomenon in the schools and school hostels that took part in the investigation. Newcomers were subjected to silly and innocent practices, but also to physically and emotionally degrading, and even dangerous ones, before and after school, and during breaks and sports- and cultural gatherings.

“The study’s findings give every indication that the constitutional principles on which the policy document, Regulations to Prohibit Initiation Practices in Schools, is modelled, are not being put into practice and respected at these schools. Policy documents and school rules are pointless if learners, old pupils, parents, teachers, and the broad community consider initiation an acceptable behaviour that is, ostensibly, an inseparable part of school or hostel tradition and of the maturation and/or team-building processes.”

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