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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 researchers help find opportunities to create knowledge
2016-09-15

Description: Mobile libraries  Tags: Mobile libraries

The initiative hopes that the mobile libraries
will continue to contribute towards literature
awareness and access to books at rural
schools in the Free State.
Photo: Supplied

Did you know that only 3 392 primary schools in South Africa have libraries? In the Free State the statistics are shocking. Only 277 primary schools have libraries, while 1 087 carry on without them. One of nine provinces in South Africa, the Free State is regarded as a rural province. The South African Primary Education Support Initiative (SAPESI), in partnership with other sponsors, has committed to expanding access to books by donating mobile libraries to service schools across South Africa. In the Free State, the project is embraced by the Free State Department of Education, which employs the mobile operators and library assistants to service these libraries, driving many kilometres of gravel road to visit remote farm schools and other under-resourced schools. SAPESI has set a goal to supply 75 mobile libraries to provide 2 000 schools with access to books by the year 2020.

Discovering the value of the mobile libraries
Although the mobile libraries in the Free State have been functioning since 2007, no formal research had been conducted on their work. Towards the end of 2014, the Free State Department of Education and the Flemish Association for Development Cooperation and Technical Assistance (VVOB) commissioned the UFS to carry out a participatory action research project. Dr Lynette Jacobs, Head of the School of Education Studies at the University of the Free State’s Faculty of Education and her team engaged with role-players at district and provincial level in a Participatory Action Research project.

The research project aimed to describe the work that mobile libraries do, and appraise its influence on learners and schools, towards improving their functionality. In addition, this project aimed to build research capacity within the district teacher development centres.

Highlights of the mobile library project
The way the Free State Department of Education embraced and supported the initiative by Mr Tad Hasunuma and SAPESI, was inspiring. Each of the five education districts has two fully equipped library buses that periodically visit schools. The stock on the buses is regularly replaced by books that SAPESI receives from the international community. Specific books are also loaded for teachers to use as resources. One of the outcomes of the research project was that guidelines were developed for teachers on how to use books in addition to curriculum material in the classroom. At district level, the teams reflected on the work that they were doing and implemented improvement plans to provide an even better service. Findings of the project were presented at the XIV Annual International Conference of the Bulgarian Comparative Education Society that focused on education provision earlier this year. It was lauded by representatives of the international education community as an example of good practice to provide education to marginalised children.

Reading helps enrich children’s lives
The research project concluded by stating that the aim of the mobile libraries was to provide learners and teachers at rural and farm schools with reading books, and they were doing as best they could. While the mobile libraries cannot make up for possible challenges related to teaching and learning or in infrastructure, the learners and the teachers are regularly provided with good resources to encourage reading and stimulate literacy development.

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