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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

Nat Nakasa the inspiration behind UFS academic’s PhD thesis

2017-01-09

Photo: Supplied

“I’m interested in alternative ways of approaching things, so I wanted to look at how journalism can be used in an unconventional way to contribute to a developing society.”

This is why Dr Willemien Marais, a lecturer in the Department of Communication Science at the University of the Free State (UFS), decided to title her thesis: Nat Nakasa as existential journalist, describing a form of journalism that places emphasis on the individual’s experiences.

“Existentialism is a philosophy that provides scope for an individual approach to life, and I like Nat Nakasa’s writing because of his excellent sense of humour despite his horrific circumstances as a black journalist during apartheid,” she says.

A practical approach to writing

Dr Marais analysed Nat Nakasa’s approach to journalism through articles he wrote in the early 1960s. She searched for relevant themes of existentialist philosophy in Nakasa’s work in order to prove that he could be read as an existential journalist.

She mentions that in terms of contemporary relevance, Nakasa’s approach to journalism suggests that existentialism could provide the journalist with a practical approach to writing, especially for those journalists working in developing societies.

“The relevance of this approach lies in the fact that any society is always between things – the old and the new – which might require the journalist to operate outside the boundaries of conventional journalism.”

This study was qualitative in nature because of the interpretation required. She mentions that it was basically one of many possible interpretations of Nakasa’s work; with this one using existentialism as a lens.

An intellectually stimulating thesis

Dr Marais quotes French existentialist Jean-Paul Sartre, who said that interpreting someone’s work, especially someone who was no longer alive, was open to “thousands of shimmering, iridescent, relevant meanings”, and her research represents one of these possible meanings of Nakasa’s work as a journalist.

When asked how long she had worked on her thesis, Dr Marais simply answered “too long!” She mentions that her thesis was initially more of an intellectual exercise. Whereas the actual act of writing took about four months, she spent many years thinking about the topic. “Now that all is said and done, I realise I had to grow into the topic. It took me a while to realise that true understanding does not come overnight!”

Dr Marais mentions that other than herself and the work of Nat Nakasa, there were no other roleplayers involved. “For many, many years it was just Nat Nakasa and I. It was frustrating and exhilarating all at the same time.”

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