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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

Research into surrogate milk important to wildlife conservation

2017-05-08

Prof Gary Osthoff from the UFS Department of
Microbial, Biochemical and Food Biotechnology,
will soon work on a milk formula for elephants.
Photo: Supplied

Research is being done at the University of the Free State (UFS) to analyse and synthetically imitate the unique milk of various wildlife species. This research is not only of scientific value, but also serves the conservation of South Africa’s wildlife species. At the forefront of this research is Prof Garry Osthoff from the Department of Microbial, Biochemical and Food Biotechnology.

Orphaned rhino calf pulled through with surrogate milk
“There is still a lot of research to be done. Naturally the research is of scientific importance, but with surrogate milk having the same composition as the mother’s milk of a specific species, orphaned calves or cubs of that species could be pulled through during a difficult time of weaning. Bearing in mind that exotic animals fetch thousands and even millions of rands at auctions, it goes without saying a game farmer will do everything possible to provide only the best nourishment to such an orphaned animal. In such a case, synthetically-manufactured milk would be the right choice,” says Prof Osthoff.

The fruits of his research were recently demonstrated in Germany when a rhino calf was left orphaned in the Leipzig Zoo. Prof Osthoff’s article: “Milk composition of a free-ranging white rhinoceros during late lactation” was used as a directive for applying surrogate milk for horse foals (which is already commercially available), since the composition of horse and rhino milk largely corresponds. The surrogate milk was used with great success and the rhino calf is flourishing. He mentions that such an orphan is often given the wrong nourishment with the best intentions, resulting in the starvation of the animal despite the amount of cow’s milk it devours.

With surrogate milk having the same
composition as the mother’s milk of a
specific species, orphaned calves or
cubs of that species could be pulled
through during the difficult time
of weaning.

Milk formula for baby elephants in the pipeline
With baby elephants left orphaned due to the increase in elephant poaching for their ivory, several attempts have been made to create a milk formula in order to feed these elephants. To date, many elephants have died in captivity from side effects such as diarrhoea as a result of the surrogate formula which they were fed.

Prof Osthoff recently received a consignment of frozen milk which he, together with researchers from Zimbabwe, will use to work on a milk formula for elephants. They are studying the milk in a full lactation period of two years. During lactation, the composition of the milk changes to such an extent that a single surrogate formula will not be sufficient. Four different formulas should probably be designed.

Prof Osthoff says that of the different species he has researched, elephants are the most interesting and deviate most from the known species.

Although his research to develop surrogate milk is adding much value to the wildlife industry, and although he finds this part of his work very exciting, his research focus is on food science and nutrition. “What is currently authentic in milk research is the study of the fat globules with content, the structure and composition of the casein micelle, and the prebiotic sugars. The knowledge which is gained helps to improve the processing, development of new food products, and development of food products for health purposes,” says Prof Osthoff.

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