1000 days from conception – a vital investment for the future

By Sarjo Camara-Singateh

It is often believed that the development of a child takes place when the child has passed the stage of a toddler. But nutritionists would argue that such belief is held out of ignorance.

They will argue that caring for the future child starts right from conception, when the female and male cells unite and the development of the foetus in the womb of the mother to be.

Mr Pa Modou Phall, the Executive Director of NaNA (National Nutrition Agency), a strong advocate of eating the right food to maintain a healthy body, told Foroyaa in an exclusive interview that the foetus in the womb of a mother needs protection from both parents not only to ensure the survival of that foetus but that life after delivery is ensured.

In selling his 1,000 days programme, the nutritionist explained that the 1000 days includes the nine months of pregnancy of the mother and the first two years of the child. He emphasised that nutrition plays an important role throughout these 1,000 days making it imperative to increase action and investment in nutrition particularly during the critical 1,000 days to drive progress to eliminate all forms of malnutrition, obesity and micro-nutrients deficiency.

The mother is central to his programme. “What this means is even before the mother is pregnant, she must be healthy, well nourished, and must be at the age of maturity for reproduction,” he explained.

Mr. Phall noted with dismay that nutrition is not at its best in the country and that most of the data that they use as the nutritional indicator of the general population is for children from 6 months old. He said they do “the measurement of these children on stunting, wasting and underweight” and made the startling revelation that under the SMART survey stunting stands at 22.9% in the country. These are children who are too short for their age. He made clear that stunting has some other implications in terms of intellectual development, productivity and later health problems that might emanate when they turn adults.

As for wasting, Mr Phall said that’s acute malnutrition, meaning children who are too light for their height (their height did not correspond with their weight). This, he said, stands at 10.9%. This means that those children are either suffering from acute food shortages or they were sick because these two go hand in hand,” Mr. Phall said.

For children underweight, (their age and weight do not correspond) the survey puts the figure at 16%.

He Phall, went a step further. He said, “there are also micronutrients deficiency among our children, others are having vitamin A deficiency, iron deficiency (leading to anaemia) and iodine deficiency.”

He made a point worth noting: “The combination of micronutrients deficiency and being deficit in weight and height have serious implications as far as learning is concerned and as far as productivity is concerned and this has general impact on socio- economy development of the country.”

Talking about good nutrition is one thing, but a well fed child or mother may fall ill and this may undermine his or her health. Hence immunization from conception is part of the equation for the 1000 days. Mr. Dawda Sowe of the Expanded Programme on Immunisation (EPI) stressed the importance of immunization since conception as it is the time when some antigens are used to prevent the pregnancy from abortion or being delivered as a still birth, it also protects the child from developing other disease conditions that can hampers his or her education, like polio.” He added that if a child did not receive the necessary immunisations on time this can cause death or everlasting disability on him or her, because disease conditions have no boundaries. “In the Gambia, we have 12 vaccine preventable disease, … for us we achieved 95% statistically is one out of 20, is very good compared to the other countries,” he boasted.

Protecting the pregnant mother against malaria is also an important part of this 1000 days equation and the advice of Mrs. Olimatou Colley, Senior Malaria officer, is noteworthy. Her advice is for pregnant mothers to come early at the antenatal clinics as early as 3 months, because it is only through antenatal services that some conditions can be detected and the taking of  the four doses of SP (Fansider) immunisation and the anti-tetanus vaccine for a safe pregnancy ensured. “You can only get this through a regular visit at the antenatal clinics,” she said.

She rationalised the danger of not heeding to her advice: “Most of the time when women are pregnant they are prone to infections because the physiological changes that take place during pregnancy tend to reduce their immune system, thereby exposing them to diseases like malaria and when they have malaria it becomes severe.

“Secondly the pregnant women can also have malaria parasite in the placenta they don’t have any sign of malaria, this parasite stays at the placenta and compete with the unborn child, for nutrients, oxygen thereby causing low birth weight.”

Just in case you think that the issues discussed above have nothing to do with child rights you will be disappointed because experts believe that immunisation and nutrition is a right that should be given to every child to be able to contribute effectively in the socio-economic development of the country. Child rights advocates argue that denying the child this right may mean terminating the child’s life at a tender age. Even health experts point out that states are obliged to provide health services and care for pregnant and lactating mothers to receive affordable and accessible health care services for us to have more surviving infants. If a child is protected from opportunistic diseases through immunisation this will help the child to grow a healthy and sound mind.

Mr. Njundu Drammeh the National Coordinator of Child Protection Alliance (CPA) stated that immunisation and nutrition are basically rights of children, they ensure that the child has that right to life, which is important and right to health, right to development, when the child gets all the necessary vaccination and gets nutritious food, and is taken care of the child develops, we  can see that healthy development of a child and the educational development of a child, they are very closely linked.

He says the State is the primary bearer for all these and the parents are the secondary duty bearers and have an obligation to ensure that the children grow up in such an environment.  He cited the Children’s Act, 2005, to back his assertions on each occasion.

I cannot conclude without discussing the economic implications. It is evident from the interview with Mr Pa Modou Phall that he fully recognises this but feels that it is a necessary responsibility that the state must execute though it needs the political will to do so. He said, “… nutrition is not a cheap intervention …… but they also need to invest in nutrition, because quite often most of the investment that is been done in nutrition is from donors but how long can we depend on donors to drive one of the most important sub-sectors like improving the nutritional status of the population?”

“We must go beyond just producing, but producing and adding value to the value chain, to make sure that even the rice we produce we can make multiple products of rice,” he remarked.

The 1000 days project, requiring nutrition and protection of child from conception without letup is indeed a laudable project because it is preparing a sound foundation for a future Gambia. Can a government pressed with immediate political gain have the capability to pursue such programme or do we need one that is committed to the future of The Gambia and not to immediate political gain?

 

Note: 1000 days is an advocacy programme, from conception and two years after birth.

Both the mother and the child should be taking nutritious and balance diet.