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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

Hearing loss a silent public health crisis in South Africa

2017-03-27

Dr Magteld Smith engages on the topic of hearing loss
and how it coincides with the commemoration of
World Hearing awareness during the month of March.
Photo: Oteng Mpete

Communication is a principal challenge for people with hearing loss. It can be difficult to negotiate everyday interactions, whether in the workplace, on the street, in classrooms, courts, during consultations with health professionals, or even when contacting the police. The World Health Organisation’s (WHO) World Hearing Day is an annual advocacy event held each year on 3 March to raise awareness and promote ear and hearing care across the world. In many countries this awareness campaign usually starts on 3 March but many continue to create awareness for the full month of March.

Hearing loss is a global reality
According to Dr Magteld Smith, a researcher at the University of the Free State (UFS) School of Medicine’s Department of Otorhinolaryngology, unaddressed hearing loss poses a high cost for the economy globally and has a significant impact on the lives of those affected. Interventions to address hearing loss are available in South Africa but are not accessible or affordable for most citizens. This is partly because not only persons with hearing loss but also people with disabilities experience barriers in accessing services that many of us take for granted, including health, education, employment, and transport as well as information. These difficulties are exacerbated in less-advantaged communities.

“WHO estimates that there are more than 360 million persons with hearing loss globally. The statistics in South Africa are unreliable due to the different definitions used by Statistics South Africa and the absence of training of the officials who conduct and collect statistics concerning hearing loss in South Africa,” says Dr Smith.

According to Dr Smith, analysis from retrospective studies reflects that about 17 out of 1 000 infants are born daily in South Africa with severe to profound hearing loss. However, Dr Smith states that the number could be higher because of late diagnosis, high levels of undiagnosed and untreated hearing loss. This excludes young adults, adults and the elderly as well as children with acquired (become deaf after birth) hearing loss.

Crisis that needs urgent intervention
Dr Smith says hearing loss is an emergency which the South African government fails to prioritise. She says that research published confirms that the risk compounding the projected increase in hearing loss that comes with an ageing population. This is a looming and silent public-health crisis.
She believes that the government should take urgent action to align research-spending with the current and projected size and impact of hearing loss. It should also collaborate across related conditions, such as vision, neurodegenerative diseases and neurological conditions. Furthermore, the government needs, and is obligated, to deliver more accessible and integrated services and develop quality standards that take account of the whole pathway – linking public health, clinical and social needs.

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