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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

Service learning teaching strategy essential for the infusion of graduate attributes

2017-01-02

Dr Pulane Pitso, Director: Institutional Performance
Monitoring within Performance Monitoring and Evaluation
Branch in the Department of the Premier, Free State
Provincial Government (FSPG).
Photo: Rulanzen Martin

“Public service delivery is not only about ‘government’s sector end products’, but is also fundamentally related to the ways in which the citizens can be best served at the point of client interface, as the primary beneficiaries.”

It is against this backdrop that Dr Pulane Pitso’s study explored the role of Higher Education Institutions (HEIs) in infusing the curriculum with graduate attributes for improved service delivery. The study is entitled: Community service learning as a transformative tool for infusing the university curriculum with graduate attributes for improved service delivery.

Citizens the central focus in public-service delivery
Although with the advent of democracy, the South African public service introduced the Batho Pele “people first” initiative which is one of the key transformation-oriented initiatives to ensure that citizens are the central focus in public service delivery. An extant literature indicates that more work by the government still needs to be done in terms of the institutionalisation and implementation thereof.

Notwithstanding that public service is primarily responsible for addressing challenges related to poor service delivery, Dr Pitso moved from a premise that a multifaceted and collaborative approach, underpinned by a concerted effort by all relevant sectors, is more likely to contribute significantly towards improving service delivery. Specific focus was given to sectors primarily mandated to lay foundations through training and development such as HEIs, since the nature and quality of public service largely depends on the nature, quality and relevance of the system of education.

CSL a transformative teaching strategy
The basis for her thesis, emanated from the contention that public service delivery is a dynamic process which cultivates into a citizen-government relationship.

“It is this relationship that makes the implementation of the Batho Pele initiative crucial in ensuring that the social fabric and moral character of government is not compromised, thus the sustainability and facilitation of the emerged relationship,” Dr Pitso says.

The study focuses on the notion of community service learning (CSL) as an increasingly recognised transformative teaching strategy. It transcends lecture halls and utilises communities as educational spaces to provide practical exposure to real-life experiences to students on both learning and serving the communities.

Instilling graduate attributes in students
Dr Pitso’s thesis, which was predominately qualitative in nature, comprised two main stages. The first stage of the study focused on determining the current state of the public service in terms of the implementation of the Batho Pele principles. Whereas with the second stage, the focus was on determining the extent to which the graduate attributes are instilled in students by means of an exit-level CSL module at the UFS.

Dr Pitso’s thesis, which was awarded to her on 30 June 2016, is the product of five years of hard work, commitment and perseverance. She said it would not have been realised if it had not been for the leadership and mentorship of her promoter, Prof Mabel Erasmus, and co-promoter, Prof Victor Teise.

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