First 1000 Days

the critical WinDoW to ensure that chilDren survive anD thrive

May 2017

SouTH AfRICA

WHY? south africa’s under-five

The first 1000 days of life - between a woman’s pregnancy and her child’s second birthday - mortality rate has dropped by
50% since 2002, yet still stands
is a unique period of opportunity when the foundations for optimum health and development
at 42 per 1000 live births
across the lifespan are established. The right nutrition and care during the 1000 day window
influences not only whether the child will survive, but also his or her ability to grow, learn and
rise out of poverty. As such, it contributes to society’s long-term health, stability and prosperity. Diarrhoea is one of the five
leading causes of death of
young children
Children in South Africa continue to die from preventable causes of death including pneumonia,
HIV, TB and diarrhoea - all of which are influenced by poor health seeking behaviour, health
care, infectious diseases, nutrition and hygiene of the pregnant mother and child during the children who are exclusively
breastfed are 14 times more
first 1000 days. About half of all children dying in South Africa are HIV positive, 34 per cent
likely to survive the first six
have severe malnutrition, and 30 per cent are underweight. Neonatal deaths account for nearly months of life than
40 per cent of overall deaths of children under the age of 5. While access to prevention of non-breastfed children
mother to child transmission of HIV (PMTCT) services is nearly universal, retention in care,
poor infant feeding practices, as well as challenges with immunization coverage continue to nearly 40% of children do
jeopardize the health and development of babies and young children. not receive all basic
vaccinations
Approximately one third of children under the age of 3 are stunted, a reflection of chronic
malnutrition. The effects of stunting last a lifetime, leading to impaired brain development,
lower IQ, weakened immune systems and greater risk of diseases later in life. Children who handwashing with soap alone
were stunted frequently have lower productivity, and earn up to 20 per cent lower than average prevents up to 50 per cent of
childhood diarrhoea
wages as adults. Stunting can reduce a country’s GDP by as much as three per cent. Rising
childhood obesity in South Africa is another reflection of poor nutrition and poor infant feeding
practices that also leads to disease and ill health later in life.
33 per cent of children aged
1-3 years are stunted
What? PRoMoTING GooD NuTRITIoN, HeAlTH AND SANITATIoN (low height for age)
DuRING THe fIRST 1000 DAyS of lIfe
evidence demonstrates that it is far more effective to support brain development in the first
place by preventing nutritional deficits, than to depend on replacement therapy once a deficit 20 per cent of stunting begins
in the womb
has occurred. This requires improved nutrition for adolescent girls and young women before,
during and after pregnancy; timely uptake of PMTCT services by HIV positive pregnant women
and their babies; screening for TB and retention in care; exclusive breastfeeding during the first
six months of the infant’s life; provision of nutritious, safe and appropriate food to complement approximately 13 per cent of
breastmilk as the baby grows; availability of safe water; improved hygiene and sanitation children under 5 years are
overweight
practices; and regular monitoring to track growth and development.

Breastfeeding, in particular, is of critical importance. As a baby’s first vaccine, it is the first approximately 30 per cent of
and best protection they have against illness, disease and death. Promotion, support and children from birth to age 4
protection of exclusive breastfeeding until six months - including for HIV positive mothers lived in households that ran
out of money to buy food
who are on treatment and virally suppressed - are high impact public health interventions
 First 1000 Days - THe CRITICAl WINDoW To eNSuRe THAT CHIlDReN SuRVIVe AND THRIVe

that are well known to optimise child survival, and must be supported Who? GoVeRNMeNT, DeVeloPMeNT PARTNeRS
by regular growth monitoring, complete immunizations and adequate AND CIVIl SoCIeTy
complementary feeding. Preventing diarrhoeal and respiratory
uNICef works closely with the Departments of Health, Social
illnesses through handwashing with soap, and ensuring mental
Development and Basic education to ensure a comprehensive focus
stimulation through play and affection are also fundamental for optimal
on the first 1000 days for mothers and their children. Development
child development up to age 2 and beyond.
partners, private sector, academia, civil society, and the media are
hoW? A CoMPReHeNSIVe PACkAGe of SeRVICeS also engaged to support the scale up of programmes; raise awareness
foR MoTHeRS, BABIeS, fAMIlIeS AND CAReGIVeRS among families, clinics and schools; and strengthen the linkages within
communities.
By adopting a comprehensive and multisectoral approach, uNICef
helps Government and partners to address all the aspects that hinder
What next? ADDReSSING GAPS AND eNSuRING
mothers and babies from receiving adequate care and nutrition during
No oNe IS lefT BeHIND
the critical 1000 day period. This includes:
o educating families and providing support to mothers for exclusive South Africa has made great progress towards ensuring better health
breastfeeding and survival of mothers and babies across the country. However,
due to geographic disparities, inequities and inefficiencies in the
o Scaling up infant and young child feeding programmes
functioning of the health system, certain localities and communities
o Raising awareness on the importance of growth monitoring remain disadvantaged or underserved. Through research and use of
o expanding immunization coverage and uptake latest monitoring technologies, uNICef is supporting Government to
o Training communities on the importance of handwashing with identify where and why there are gaps in knowledge, demand, access
soap to prevent illness and service delivery. This information is being used to target action
and ensure the right interventions reach the right people, thus making
o ensuring eligible households receive their child support grants
best use of available resources. By building knowledge and capacity
and have sufficient money to buy food
among all stakeholders and promoting quality service delivery for
o Novel use of mobile health technology (such as Mom Connect) to those who are most in need, uNICef is helping Government to ensure
deliver direct communication to parents and caregivers on their no mothers and children are left behind.
mobile phones, which educates them on the the needs of their
babies, and supports them to get the health care they need

ProMising Practices to iMProve results

along the First 1000 Days:
strengthening health systems by identifying bottlenecks,
prioritizing actions and building capacities at primary care and
community levels - the 3 Feet Approach in select districts has shown
dramatic reductions in under-five child deaths and improvements in
coverage and access to care.

improving linkages with early childhood Development centres

in communities with primary care clinics - including building
capacities of eCD practitioners for growth monitoring, improved
hygiene practices, early identification of problems in children and
referrals to care.

Building capacities of front line community health workers to

support mothers and families for exclusive breastfeeding, improved
hygiene practices, early stimulation and completing immunizations.

improving knowledge and demand for services with mHealth

innovations like the Digital Road to Health Booklet, that provides
tailored information to the mother/caregiver on all aspects of child
health and development.
 First 1000 Days - THe CRITICAl WINDoW To eNSuRe THAT CHIlDReN SuRVIVe AND THRIVe

hoW can you helP?

a coMPelling investMent:
To ensure all children are afforded the best start in life requires action
to strengthen the health system; improve coverage and quality of Children who get the right nutrition during the first
services; and increase community-level awareness and demand for 1000 days:
care. By supporting comprehensive programmes that focus on the
first 1000 days of life, companies have the opportunity to demonstrate o Are 10 times more likely to overcome the most life threatening
private sector leadership and make a concrete investment that will child diseases
change the development outcomes for millions of children. In doing so, o Complete 4.6 more grades at school
you directly support the objectives of the National Development Plan o Go on to earn 21% more in wages as adults
as well as the Sustainable Development Goals in South Africa. o Are more likely as adults to have healthier families

contact us
to explore concrete and tailored partnership opportunities, please contact:

Sandra Bisin Carine Munting

Chief, Communications and Partnerships Manager
Partnerships email: cmunting@unicef.org
email: sbisin@unicef.org