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01 November 2024 | Story André Damons | Photo Supplied
Dr Nomakhuwa Tabane
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

An education system based on hope is what South Africa needs – Dr Beryl Botman
2016-05-26

Description: Hope revised Tags: Hope revised

Dr Beryl Botman, a postdoctoral research
fellow at the IRSJ, with Dr Willy Nel research associate
at the IRSJ and lecturer at the UFS
Faculty of Education.

HOPE is tangible and concrete construct that should be rooted in the learning and training of teachers,” said Dr Beryl Botman, a postdoctoral research fellow at the Institute for Reconciliation and Social Justice (IRSJ).

She presented her research paper Educators, praxis, and hope: A philosophical analysis of post-apartheid teacher education policy, based on the theoretical ideologies of Paulo Freire’s Pedagogy of the Oppressed. She explores ways in which oppression has been justified, and how it has been overcome through a mutual process between the oppressor and the oppressed, drawing on Paolo Freire’s theories and practices. The presentation was held at the University of the Free State’s (UFS) Faculty of Education, on the Bloemfontein campus on 13 May 2016.

From oppression to hope

Hope should be an educational construct for teacher education in South Africa. Dr Botman asserts that epistemology and ontology should be inseparable, as they are pivotal to an education system that is transformational.

The recent country-wide student protests and demonstrations are an indicant that education institutions need to seek understanding of mechanisms that fuel social conflict. Dr Botman claims that vast social inequalities make the process of democratisation difficult thus hindering transformation. She states that a critical consciousness is important for all South Africans, but more so for educators; it can be used as a tool to understanding the mechanisms of social conflict.

“Self-reflection and self-critique is vital for educators, we need to understand that we do not have all the answers because we ever-evolving beings, working on understanding ourselves and the people around us,” said Dr Botman.

The notion of hope
“I am a farmer. I have no hope for a future that is different from today. This quotation comes from Paulo Freire’s work," said Dr Botman. She said that the South African context and environment is similar. She said that people cannot live for today; one should live for tomorrow if hope is to manifest itself.

South African education environment needs to adopt a progressive consciousness that is future orientated, “You need to be hopeful, if you are radical. You need to be able to envision a new society and a new world,” said Dr Botman.

“You cannot only denounce the present, you need to also announce your hopes for a new society. South Africa needs education systems built on understanding. Although change is difficult, it is necessary for transformation,” Dr Botman added.

What makes hope educational?
“Hope is a vision for a tomorrow that is different, and vital for a transformative education system. To get out of a state of despair, people need to educate their hope. Lately, the issue of white privilege has been brought to the fore. You need to educate your hope, so that you understand the reality of others but, more importantly, of yourself,” said Dr Botman.

Dr Botma added that teacher education needs to adopt a Freirean pedagogy with a strong philosophy based on hope. The agency of teachers can either be hopeful or without hope. It is vital that education promotes hope.

“Teachers need to rely on their existential experience, the experiences of others, and the experiences of the children or students they teach. An understanding of all these experience reinforces the idea that people are life-long learners, always learning and adapting to society’s needs,” said Dr Botman.

Teachers as agents of hope

Dr Botman stated that current South African education policy is directed towards transformation but it does not stipulate means to achieve this objective. Further, she argues that educators need to put greater emphasis on self-knowledge, self-reflection, and self-education. Connecting with teachers, parents, students and the community engages with their self-knowledge and reflection.

Reorientation of teacher education
Dr Botman concluded by mentioning that rethinking ontological and epistemological aspects of education is important, and should be a pivotal point of teacher education. A renewed vision of hope-orientated philosophy and pedagogy needs to be adopted by the education institutions. A praxis, which is an informed action, when a balance between theory and practice is achieved. There is a need for an inclusive exploration of education philosophies and education systems not only European and Western but also African and Eastern as well.

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