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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

The book on ‘Reitz’ still not closed

2016-08-12

Prof André Keet, Director: Institute for Reconciliation and
Social Justice (IRSJ) with the authors of Transformation
and Legitimation in Post-apartheid Universities: Reading
Discourses from ‘Reitz’, JC van der Merwe and
Dionne van Reenen.

A new IRSJ book tackles issues of transformation.

Transformation and Legitimation in Post-apartheid Universities: Reading Discourses from ‘Reitz’ is the first in a series on critical studies in higher education transformation from the Institute for Reconciliation and Social Justice (IRSJ). In his introduction to this series, Prof André Keet, Director: Institute for Reconciliation and Social Justice (IRSJ), highlights why a scholarly work of this nature was necessary: “Acts of resistance against structurally-anchored forms of exclusion within universities in both South Africa and elsewhere suggest that, despite our best efforts, the social structure of the academy … has remained more or less intact over the past several decades.” The book was recently launched during the fifth anniversary reflections of the IRSJ.

Transformation and Legitimation in Post-apartheid Universities: Reading Discourses from ‘Reitz’ explores and expands on the landmark “Reitz” incident. The authors, JC van der Merwe, Deputy-Director at the Institute for Reconciliation and Social Justice (IRSJ) and Dionne van Reenen, researcher and PhD candidate at the IRSJ, offer insights on how this incident and the events surrounding it represent a recurring pattern that continues to underpin many processes in post-apartheid South Africa.

Prof Jonathan Jansen, Chair of the Advisory Board of the IRSJ, and Vice-Chancellor and Rector of the UFS, says of the authors: “The courage of their convictions is reflected in this book. They have played, and will continue to play, an amazing role in shaping the discourse around transformation.”

Jamie Turkington, former editor of the IRAWA Post during the time of the ‘Reitz’ incident and facilitator during the five-year anniversary function, says: “This book will be beneficial for every student and every person involved in the University of the Free State since 1980 till now to read and absorb the valuable points therein. If you thought Reitz was over, it shouldn’t be; it is as relevant today as ever.”

"If you thought Reitz was over..."

Turkington adds that the book will serve as a “worthwhile conversation starter at UFS”, raising such questions as:
• How much legitimacy was the UFS able to acquire internally, within the university community, as well as in society at large?
• How do we chart a way forward from here?
• How do we keep the progress going?

As the book itself says: “Reitz serves as a reminder to higher education practitioners that our humanity is fragile in terms of who we are and what we can achieve. Transformation and legitimation, and the way higher education institutions handle these going forward, promises to be seminal in the foreseeable future of the sector.”

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