‘Your baby’s life depends on those first 1000 days’: community health workers’ perspectives of the first 1000 days of life

ABSTRACT

Community health workers possess valuable insight into the experiences of South Africa’s children and caregivers. However, their knowledge is often overlooked in efforts to understand local realities, inform interventions, and develop relevant policies. This study aimed to explore community health workers’ perspectives of the first 1000 days of life, the critical period of development between conception and two years of age. Semi-structured interviews were conducted with 15 community health workers working with mothers and infants in Khayelitsha, Cape Town. A thematic analysis suggests that the community health workers view the first 1000 days as fundamental and foundational for children’s development. Furthermore, the community health workers identified key needs for mothers/caregivers and infants within the first 1000 days. The findings provide contextual grounding for the importance of the first 1000 days within South African communities.

KEYWORDS:

• Community health worker
• home visitor
• early childhood development
• first 1000 days of life
• Khayelitsha
• South Africa

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 34 years old, 4 years working as a CHW, 3 children, isiXhosa translator present.

2 37 years old, 2 years working as a CHW, no children, isiXhosa translator present.

3 34 years old, 2 years working as a CHW, 2 children, isiXhosa translator present.

4 44 years old, 1 year working as a CHW, 6 children, isiXhosa translator not present.

5 43 years old, 2 years working as a CHW, 1 child, isiXhosa translator not present.

6 47 years old, 4 years working as a CHW, 3 children, isiXhosa translator present.

7 32 years old, 5 years working as a CHW, 1 child, isiXhosa translator not present.

8 37 years old, 2 years working as a CHW, no children, isiXhosa translator not present.

9 36 years old, 3 years working as a CHW, 3 children, isiXhosa translator not present.

10 42 years old, 4 years working as a CHW, 4 children, isiXhosa translator not present.

Additional information

Notes on contributors

Ella Bust

Ella Bust is a Psychology Research intern at the Early Learning Resource Unit in South Africa. She researches subjects related to early childhood, including development, education, parenting, and intervention programmes. She recently completed her Master's in Research Psychology at the University of the Western Cape, where her focus was mother-infant bonding, the first 1000 days of life, and community health workers. She is passionate about improving the lives of young children and their caregivers.

Athena Pedro

Dr Athena Pedro is also a Research Psychologist and an Academic in the Department of Psychology at the University of the Western Cape. She was appointed as a Lecturer in August 2012. For the past seven years she has taken a special interest in working with children presenting with special needs, specifically children with learning difficulties and developmental delay. She is particularly involved with the development of remedial programmes as well as presenting psycho-educational workshops for parents of special needs children as well as preschool educators working with preschool children. Much of her focus has been on providing support for parents and educators who are from impoverished communities. She also provides training workshops to capacitate facilitators to work with primary school learners so that these facilitators can be an additional support that offers more direct guidance and facilitate learning within a classroom context or within a home schooling environment. Dr Pedro is also involved with various research projects within the field of Early Childhood Development and Education. She has also established both international and national (local) collaboration partnerships with colleagues in the ECD sector. She has published numerous manuscripts in peer accredited journals and 1 book chapter. She has graduated 27 postgraduate students and currently supervises 14 postgraduate students. She regularly attends academic conferences where she is often invited to present her research findings. She was also awarded the ‘Best Presentation Award' in Italy (2018). Dr Pedro has also been awarded with several scholarships and grants such as the National Research Foundation Prestigious Award (1999-2000/2001-2003/2008-2009), the VLIR scholarship (2008-2009) as well as Thuthuka Funding 2017-2019 and 2020-2022. She graduated with a B.A. (Psychology) and Honours degree in Psychology with a Cum-laude qualification. Dr Pedro’s passion and interest lies within the upliftment of communities by capacitating community stakeholders like parents, caregivers and teachers who are primary socialization agents. She believes that this approach not only create direct positive impact at grassroots level but also ensures sustainable change within communities as community members/ stakeholders take ownership themselves. Thus empowering community members to be the change they want to see. Dr Pedro also strives to instil within students a sense of personal desire and commitment to embrace their indigenous knowledge/heritage, gain understanding of a context of vulnerable communities and how they overcome daily adversities. She ardently motivate developing scholars to become deliberate social agents who strive for social justice and community upliftment.