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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

UFS alumnus receives PhD in Statistics from the University of Oxford
2016-06-03

Description: DW Bester  Tags: DW Bester

In May of this year, DW Bester obtained
a DPhil in Statistics at the University of
Oxford.
Photo: Supplied

On 14 May this year, Dr DW Bester received a DPhil in Statistics from the University of Oxford. The entire ceremony, which was held in the Sheldonian Theatre in Oxford, was conducted in Latin, as has been the case for the past 800 years.

Dr Bester completed his undergraduate studies and his honours degree at the University of the Free State (UFS). “At first, I was only planning to study for a master’s degree, but was privileged to get an opportunity to do a PhD as well. I didn’t think twice!” he says.

Studies at the University of Oxford


Universities in England do not require a master’s degree for PhD studies. With the help of Prof Max Finkelstein from the UFS Department of Mathematical Statistics and Actuarial Science, Dr Bester registered for the DPhil programme in Statistics directly after his honours studies.

“The title of my thesis was: Joint survival models: A Bayesian investigation of longitudinal volatility. It dealt with a problem in the medical field to determine the cause of stroke risk: is it the absolute level of blood pressure, or the volatility thereof? The analysis of this question led to interesting models which needed advanced application techniques. I had to study these techniques and write programmes for their application.

Although Dr Bester is working currently as the technical head of a company that calculates insurance for power stations, satellites, rockets, and cyber risks, he would like to continue working with his Oxford supervisor in future to make the techniques they have developed more accessible for researchers outside of the field of statistics.
 
“Studying at Oxford requires hard work, perseverance, and a lot of luck. Luck plays a big role, since there are no guarantees that hard work will ensure you a spot in one of the top universities.

Regarding his studies at Oxford, Dr Bester thinks back on his exposure to the GNU/Linux operating system, and free software. “I have seen how valuable this is for analyses in practice. I also had the privilege of meeting the father of free software, Richard Stallman,” Dr Bester says.

2011 Rhodes Scholar

He was elected as Rhodes Scholar in 2011. According to Dr Bester, who has been interested in Mathematics since high school, the Rhodes scholarship was something of a fluke. He applied for the Rhodes scholarship on the recommendation of Prof Robert Schall of the Department of Mathematical Statistics and Actuarial Science.

Role of the UFS in his successes


In addition to the continued support from the team of passionate professors and lecturers at the UFS, the actuarial degree at the UFS is fraught with statistics. Emphasis is also placed on Bayesian statistics. This was crucial to his studies at Oxford. According to Dr Bester, this topic is emphasised strongly in the international statistics community.

Dr Bester regards the work done by two of his lecturers, Michael von Maltitz and Sean van der Merwe, among his highlights at the UFS. Since our first year, they have created an atmosphere of camaraderie among the students. “I think this contributed to the success of everybody. They also make an effort to present topics outside of the syllabus regularly,” says Bester.

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