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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

Judge Albie Sachs and Candice Mama discuss traumas of the past and forgiveness in the present

2015-08-05

Judge Albie Sachs embraces Candice Mama for her courage in confronting Eugene de Kock, who killed her father.

Two generations. Two stories of triumph. Two South Africans who have displayed immense courage.

Public Dialogue on Trauma, Memory, and Representations of the Past

Judge Albie Sachs and Candice Mama exchanged their experiences of past trauma and subsequent transformation in a public conversation. The event was co-hosted by Prof Pumla Gobodo-Madikizela and The Institute for Justice and Reconciliation (IJR) in Cape Town on Thursday 30 July 2015.

The event was the first instalment in a series entitled Public Dialogue on Trauma, Memory, and Representations of the Past. The theme of the discussion was ‘Intergenerational Dialogue on Trauma and Healing’.

"The aim of these public dialogue events we are co-hosting with IJR is to place the issues of trauma and memory, and the strategies that individuals and communities use to heal, in the public sphere," Prof Gobodo-Madikizela, Senior Research Professor in Trauma, Forgiveness, and Reconciliation Studies at the University of the Free State (UFS) said.

Judge Albie Sachs and Candice Mama in conversation

Former Constitutional Court Judge, Albie Sachs, talked about his participation in South Africa’s liberation struggle, the loss of his right arm in an assassination attempt, and meeting the man responsible – Henri van der Westhuizen. Despite years of exile and extended periods of solitary confinement, Judge Sachs maintains that “we need to acknowledge our history, not be trapped by it.” Judge Sachs also remarked, though, that “we’re seeing too much lamentation, not enough activation.” In a heartrending gesture, Judge Sachs embraced Candice Mama in a hug for her courage in confronting Eugene de Kock, who killed her father.

How poignant then, when Mama said, “I wanted to embrace the brokenness within him,” when she spoke about her meeting with De Kock. By the time I met with Eugene, I could meet him as a human being, not as a villain.” Mama believes that forgiving someone translates into an investment in the person you are forgiving and in your own sanity. She also emphasised the importance of dialogue to move our country forward: “When we share our stories with each other authentically, walls break down.”

This is a stance that Prof Gobodo-Madikizela supports strongly: “When we listen to one another, something unexpected emerges; we encounter the human in each other,” she said. “When we listen with open hearts to each other, we see and experience each other’s humanity.”

Building a bridge between research and society

Referring to the research aspect of the event, Prof Gobodo-Madikizela said that, "in establishing the series of public dialogue events, our vision is to create a bridge between scholarly research and the community at large, on the one hand, and a visual conscience of society, on the other." The UFS is collaborating with the IJR on this research project, which is funded by the Andrew W. Mellon Foundation. The endeavour is led by Prof Gobodo-Madikizela, who also serves as Board Member of the IJR.

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