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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

Prof Antjie Krog speaks on verbalising revulsion and the collusion of men

2015-06-26

From the left are Prof Lucius Botes, UFS: Dean of the Faculty of the Humanities; Prof Helene Strauss, UFS: Department of English; Prof Pumla Gobodo-Madikizela, UFS: Trauma, Forgiveness and Reconciliation Studies; Prof Antjie Krog, UCT: Department Afrikaans and Dutch; Dr Buhle Zuma, UCT: Department of Psychology. Both Prof Strauss and Dr Zuma are partners in the Mellon Foundation research project.

“This is one of the bitterest moments I have ever endured. I would rather see my daughter carried away as a corpse than see her raped like this.”

This is one of 32 testimonies that were locked away quietly in 1902. These documents, part of the NC Havenga collection, contain the testimonies of Afrikaner women describing their experiences of sexual assault and rape at the hands of British soldiers during the South African War.

This cluster of affidavits formed the foundation of a public lecture that Prof Antjie Krog delivered at the University of the Free State’s (UFS) Bloemfontein Campus on Tuesday 23 June 2015. The lecture, entitled ‘They Couldn’t Achieve their Goal with Me: Narrating Rape during the South African War’, was the third instalment in the Vice-Chancellor’s Lecture Series on Trauma, Memory, and Representations of the Past. The series is hosted by Prof Pumla Gobodo-Madikizela, Senior Research Professor in Trauma, Forgiveness, and Reconciliation Studies at the UFS, as part of a five-year research project funded by the Andrew W. Mellon Foundation.

Verbalising revulsion

The testimonies were taken down during the last two months of the war, and “some of the women still had marks and bruises on their bodies as evidence,” Prof Krog said. The victims’ words, on the other hand, struggled to express the story their bodies told.

What are the nouns for that which one sees? What words are permissible in front of men? How does one process revulsion verbally? These are the barriers the victims – raised with Victorian reserve – faced while trying to express their trauma, Prof Krog explained.

The collusion of men

When the war ended, there was a massive drive to reconcile the Boers and the British. “Within this process of letting bygones be bygones,” Prof Krog said, “affidavits of severe violations by white men had no place. Through the collusion of men, prioritising reconciliation between two white male hierarchies, these affidavits were shelved, and, finally, had to suffer an embargo.”

“It is only when South Africa accepted a constitution based on equality and safety from violence,” Prof Krog said, “that the various levels of deeply-rooted brutality, violence, and devastation of men against the vulnerable in society seemed to burst like an evil boil into the open, leaving South African aghast in its toxic suppurations. As if, for many decades, we did not know it was there and multiplied.”

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