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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

Inaugural lecture: World on verge of agricultural revolution

2008-05-19

A changing economic climate and new technology will see to a number of interesting changes in the livestock industry in the next few years. This is according to Prof. Frikkie Neser of the Department of Animal and Wildlife and Grassland Sciences, who delivered his inaugural lecture at the UFS on the subject: “The quest for a superior animal”.

Prof. Neser focused on the future of animal breeding in the next few decades.

He said the world, but especially South Africa, stand on the verge of a revolution in the agriculture sector. The whole production scenario will probably change. The high fuel and food prices are the two biggest factors that will play a role.

“Increasing fuel prices opened the door for the production of bio-fuel. The fuel industry is in direct competition with humans and the livestock industry for the same resource that result in unbelievable high prices for maize, sunflower and soya. These prices can further increase with the worldwide shortage of food,” he said.

More profitable breeds could take the place of existing breeds because of the big increase in input costs, he said. “Selection for more effective, and not maximum production, will became more important.

“There are also indications of pressure on feed lots. If this industry downsizes, it could lead to a total turnaround in the beef industry. The feed lots prefer a later maturing animal that can put on a lot of weight before fat is laid down. If this industry declines, early maturing breeds and some of the synthetic breeds, as well as crossbreeding with early maturing breeds, will play a more prominent role in the meat industry.

“This will also lead to a decline in the total number of animals in order to prevent overgrazing. This can result in an increase in imports from neighbouring countries and especially Brazil, where production costs are much lower.

“One way to increase the profitability of meat production is to utilise niche markets. There is world-wide a shift to more natural products. The demand for grass-fed beef drastically increased. According to research it is healthier than meat from feed lots and usually free of hormones and antibiotics. If factors such as traceability are put in place, this could be a very profitable niche mark for the South African meat industry,” he said.

Prof. Neser also said: “In order for breeding societies to survive they need to increase the number of members and the animals that are being registered. This they do by replacing the word stud with recorded animals. Hereby they open the door for excellent commercial animals to become part of the seed-stock industry. Another benefit is that especially in the smaller breeds more information becomes available, resulting in more accurate breeding values.”

Prof. Frikkie Neser.

Download complete Inaugural lecture - Afrikaans (Pdf format)

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