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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

Lecture focuses on how Marikana widows embody the transformative power of art

2015-08-11

Makopane Thelejane

"When I got the news of my husband is dead, I put my hands above my head, as you see me in this picture. I could not bear the ache in my heart." - Makopane Thelejane

A woman looks down on a canvas covered in thick layers of red, dark shadows falling across her face. A brief moment that captures the silently-devastating aftermath of the Marikana massacre that bled into the lives of 34 widows.

It is this silent trauma that was at the centre of the last instalment of the Vice-Chancellor’s Lecture Series for 2015. “These stories of the Marikana widows are important. It is these stories of silence that live behind the spectacular scenes of the violence,” Prof Pumla Gobodo-Madikizela, Senior Research Professor in Trauma, Forgiveness, and Reconciliation Studies at the University of the Free State (UFS) said at the event.

Panel
The lecture, which took place on Monday 27 July 2015 on the Bloemfontein Campus, took the form of a panel discussing the theme of “Speaking wounds: voices of Marikana widows through art and narrative”. The panel consisted of members from the Khulumani Support Group, including Dr Marjorie Jobson (National Director) and Judy Seidman (Sociologist and Graphic Artist), as well as Nomfundo Walaza, former CEO of the Desmond Tutu Peace Centre.

Betty Lomasontlo Gadlela

"Then this dark time came, a dark cloud over me. It made me to have an aching heart, which took me to hospital, from losing my loved one, my husband, in such a terrible manner. " - Betty Lomasontlo Gadlela

Trauma made visible
In a project initiated by Khulumani, the Marikana widows were encouraged to share their trauma through painting body maps – in which the widows depicted their own bodies immersed in their trauma – and narrating their personal stories. Throughout the workshops, the focus always remained on the women. As Siedman put it, “the power of this process is rooted in the participants. The statements of what the participants experienced is what’s important.”

Initially silenced and isolated, this group of women has now moved “into a space where they have become connected to each, and stand up for each other in the most powerful ways,” Dr Jobson said. “Our work is conceptualised in terms of giving visibility and voice to the people who know what it takes to change this country; to change this struggle.”

The transformative power of art and narrative
During her response, Walaza pointed out “how art and narrative can transform traumatic memory and become integrated in the survivors’ life story.” This gives individuals the opportunity, she said, “to step into a space of mutual listening and dialoguing in which people bond together.”

Co-hosted by Prof Gobodo-Madikizela and the UFS Institute for Reconciliation and Social Justice, the lecture series forms part of a five-year research project funded by the Andrew W. Mellon Foundation.

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