THE VITAL FIRST 1,000 DAYS

Numerous studies have shown that interventions in the first 1,000 days after conception have a major impact on the health and life-chances of the child.

In the Eastern Cape, where 24% of pregnant mothers are HIV positive, that impact is all the more critical. Half of all child deaths in South Africa occur within the first month of life. These children are exposed to HIV in utero and are at even greater risk of infection, low birth weight and infant mortality.

Studies of peer-to-peer Community Health Worker programmes like One to One’s Enable project in South Africa, have shown that mothers on such a programme are more likely to attend the recommended four antenatal care visits, to exclusively breastfeed at 3 months, and be less likely to consult traditional healers at 3 months.

In the rural Eastern Cape, our Enable project targets the most vulnerable, expectant mothers and children aged up to 6, with proactive healthcare and door-to-door visits. Through our intensive training, we empower local women, equipping them with the skills and knowledge to deliver health checks, support and referrals to hospitals when needed. Thousands of mothers-to-be, babies and children have already benefited from Enable and, after more than 1,250 births, the stand-out achievement has been an almost zero rate of mother-to-child HIV transmission.

During the first 1,000 days, the foundations for optimum health, rapid brain growth and child development are laid. Our Bright Start initiative takes the baton on from Enable, giving parents the tools to provide a nurturing, stimulating environment for their child.

Bright Start, grounded in the world-leading research of Professor Lorraine Sherr, is bringing early childhood development support to hundreds of vulnerable children affected by HIV.

 Community members are trained to deliver toy-based play sessions, applying the concept of cognitive rehearsal. Simple, repetitive tasks such as sorting shapes and doing puzzles can aid the development of visual, sensory and motor skills. Parents and caregivers are given these graded toys over multiple essions, trained in their use and how to enhance the engagement and attunement with their child.

An unexpected additional and valuable output of this initiative has come from the safe space it affords to parents and caregivers. It has enabled them to have the confidence to seek support on issues of domestic violence and child abuse.

We work closely with academic partners on both programmes to ensure that we are using validated approaches effectively.

As with all our work, the methodology involves scaling such initiatives to the point where they can be handed over to and sustained by the local government.

PROJECTS