Firm foundation is necessary to develop healthy, well-rounded children

The South African Child Gauge 2024 carries a powerful message: prioritise early childhood development without delay, to build a healthy, well-rounded generation.

Titled “Enhancing early childhood development”, the annual publication’s 17th issue was launched on Wednesday, 21 August, at the University of Cape Town’s (UCT) Hasso Plattner School of Design Thinking Afrika (d-school Afrika).

The South African Child Gauge is published by UCT’s Children’s Institute (CI). Its partners are the United Nations Children’s Fund (UNICEF); the Lego Foundation; the Department of Science and Innovation–National Research Foundation (DSI–NRF) Centre of Excellence in Human Development; the Standard Bank Tutuwa Community Foundation; the Elma Foundation; the Raith Foundation; and the Constitutionalism Fund.

The d-school Afrika was packed to the rafters with dignitaries including South Africa’s first lady, Dr Tshepo Motsepe; children’s rights activists and academics; as well as members of the public and private sector, who gave their undivided attention as speakers delivered their reflections at the podium. This year, the publication is divided into three key focus areas: Children and Law Reform; Enhancing Early Childhood Development; and Children Count – the numbers.

Set a firm foundation

During her keynote address, Dr Motsepe said that it is imperative to invest early in children’s health, as well as in the health and welfare of their mothers. She likened the concept of setting a strong foundation for children to building a foundation for a house – for both, that step is necessary to avoid severe structural damage and collapse.

“To build a strong, peaceful and prosperous nation, we need to start investing early in the care of younger citizens.”

“To build a strong, peaceful and prosperous nation, we need to start investing early in the care of younger citizens – the same way a strong foundation is necessary when building a house,” Motsepe said.

So, what does it mean to invest in early childhood development? According to Motsepe, it all starts long before the child is conceived, through investing in safe, supported environments for the mother, access to health and nutrition programmes, information on the best time to have children, and ensuring that women are protected from gender-based violence. On conception, she said, it is crucial to provide mothers with early access to healthcare during the antenatal period to monitor their health and well-being, and that of their baby. In addition, she said, it is as important to provide fathers with the skills and tools they need to support their partners.

Initiate responsive care

After birth, she said, initiating breastfeeding within the first hour, skin-to-skin contact, and ensuring the baby hears the sound of the mother’s voice and heartbeat will help the baby to adapt gently to life outside the womb. Ultimately, she said, young children will thrive if parents and caregivers are sensitive and responsive to their needs.

“This is the information young mothers sorely need. Babies need caregivers for feeding, putting them to sleep, comforting them, keeping them safe from harm. They need caregivers who talk, sing and play with them, and take time to listen and encourage their efforts and build confidence,” she said.

“This responsive care provides a strong foundation for lifelong health and development for their first cry, smile, first words; and their first day of formal school, that sets the trajectory for their future success.”

A time of celebration, reflection

Addressing the audience, Professor Linda Richter of the DSI–NRF Centre of Excellence in Human Development, based at the University of the Witwatersrand, said the launch of The South African Child Gauge is a time for both celebration and reflection. The publication is a “tremendous achievement” that summarises what researchers have come to know. But its most important function, she said, is joining a community who are committed and invested in the well-being of children.

Professor Richter said the latest publication adds to the plethora of research already in the public domain, and reminded the audience that while South Africa is rich in data, the country falls short on implementation.

The launch of the publication and its findings provides an opportune moment to pay close attention to the spectrum of needs of young children. Health, nutrition, safety and security, early learning and responsive care are at the top of the list. Richter echoed Motsepe’s message on the importance of providing mothers with relevant support service programmes from conception and during the antenatal and postnatal period, and for these to extend beyond birth into the child’s primary school years.

“We need support for parents that goes beyond programmes to policies, services [and] community assistance. We need a funding model,” she said.

Set priorities

To adequately support mothers and young children during the first 1 000 days of life – a crucial stage for brain, body and immune system development – Richter said South Africa needs to set a few succinct, specific national priorities and commit to achieving them over the next couple of years.

But because these priorities remain unclear, she has developed her own, which, she added, are “close to my heart”:

• All women who give birth at state hospitals and are discharged within six hours should be guaranteed state-sponsored transport home.
• Every caregiver collecting the Child Support Grant should be given a picture book once a year, suited to their child, that includes a paragraph on the importance of book sharing to nurture relationships and to support the child’s cognitive and language development.
• Legislation must be developed to control the huge quantities of cheap and accessible snacks, like the bags of “orange corn pops”, that toddlers living in under-resourced communities nibble on all day.

“It could be a myriad of other such possibilities that are supported by science [and] political inclination. As a scientific policy and practice community, we have achieved a huge amount. But we still have a long way to go to help achieve real change for our children,” she said.

Early childhood development

When she reached the podium, CI director, Associate Professor Wiedaad Slemming, said that although it was not planned this way, her prepared presentation aligned perfectly with the speakers’ reflections.

Associate Professor Slemming stressed that early childhood development is not a place, a centre or an early-learning programme. It’s about a lot more than that, and refers to the process by which children grow, develop and thrive – physically, mentally, emotionally, spiritually, morally and socially. It all starts at conception and continues until the start of formal schooling.

Currently, Slemming said, [many] children in South Africa live in abject poverty; 55% of children who attend early-learning programmes are not developmentally on track, and malnutrition and child mortality are on the rise. Therefore, what’s needed now is an early and sustained investment to maximise lifelong health and development. This approach includes providing support for families and caregivers.

“We need to put our heads together to think through [and] make sure there’s a continuum of these sorts of interventions and supports available to young mothers and children.”

And for children in need of extra care, she said, it’s important to intervene early to support them. All forming part of the fix should be minimising harm to improve outcomes; strengthening referral health and psychosocial systems to provide a seamless support system that addresses complex challenges; and providing inclusive services that allow all children to participate and thrive. Increasingly, she said, researchers are also exploring what can be done pre-conception to ensure the well-being of the child.

“We need to put our heads together to think through [and] make sure there’s a continuum of these sorts of interventions and support available to young mothers and children. But it’s a whole-child, whole-of-society approach. And it takes an equity stance, meaning that we prioritise the needs of those families and children who need it most,” she said.

Others who contributed to the discussion during this event included Professor Lionel Green-Thompson, the dean of UCT’s Faculty of Health Sciences; Professor Jeff Murugan, UCT’s acting deputy vice-chancellor for Research and Internationalisation; Christine Muhigana, UNICEF South Africa; Professor Mark Tomlinson of the Institute for Life Course Health Research at Stellenbosch University; Janeli Kotzé, acting director, Early Childhood Development, Department of Basic Education; and Zanele Twala, CEO of the Standard Bank Tutuwa Community Foundation.