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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

Forgive and forget? Or remember and retaliate?

2015-10-08

Cover of the novel Kamphoer

Fact and fiction came together at the Bloemfontein Campus recently to discuss the traumatic repercussions of the South African War. The event forms part of a three-year project – headed by Prof Pumla Gobodo-Madikizela (University of the Free State Trauma, Forgiveness, and Reconciliation Studies) – which investigates transgenerational trauma in the aftermath of the South African War.

The discussion explored the theme, ‘Working through the Past: Reflections on the novel Kamphoer’.

Together, Emeritus Prof Chris van der Merwe (University of Cape Town) and the author of the novel, Dr Francois Smith (University of the Free State, Department Afrikaans and Dutch, German and French), engaged in a thought-provoking, insightful conversation, tracing themes of trauma and issues of forgiveness presented in Kamphoer. Prof Van der Merwe and Dr Smith demonstrated how both fiction and historical fact can inform our present, and guide us into the future.

Emeritus Prof Chris van der Merwe and Dr Francois Smith
discuss the novel Kamphoer and how the book relates to
current issues of transgenerational trauma.

“On a societal level,” Prof Van der Merwe said, “we need to work through trauma by putting it into words, and putting it into a narrative.” When it comes to historical trauma, should we forgive and forget, though? Or rather remember and retaliate? Neither, proposed Prof Van der Merwe. “What I want to plead for is the difficult challenge: remember and forgive.” But Prof Van der Merwe also pointed out that, although forgiveness blesses both the giver and receiver, it is an ongoing process.

Dr Smith agreed wholeheartedly. “One of the discoveries of my book is that forgiving is a continuous process. It’s not something that gets completed at a particular stage in your life. By the same token, you can’t say that you are ever able to leave the past behind.” These issues of trauma, forgiveness, the past versus the present, remembering and forgetting are all integral questions confronting the main character of the novel, Susan Nel .

They are also questions we, as a nation, are currently confronted with, too.

“At this moment in our society,” Prof Van der Merwe said, “we have enough killers. We have a greater need now for caring nurturers.”

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