Written By: Olivia Ste. Marie
The first 1000 days are crucial to human development. Let’s explore how the First 1000 Days Initiative was pivotal in improving health outcomes for infants and mothers in Uganda, the United States, Guatemala, and India.
“As a result of a lack of attention to the first 1000 days, newborn deaths accounted for 44 perecent of the total mortality among children under five in 2012” (2). The first 1000 days refers to the time from when an infant is conceived until its second year of life. This time period sets the stage for fulfilling individual potential: the brain develops rapidly, the immune system is bolstered, and the foundation of physical growth is laid (1). Let’s dive into the ways that the First 1000 Days initiative has impacted communities in Uganda, Guatemala, the United States, and India.
The Movement That Made it Happen - Scaling Up Nutrition
The Scaling Up Nutrition (SUN) movement created an initiative which focused on the first 1000 days in order to anchor a new ethic of cooperation amongst the humanitarian community. Unlike other public health programs that work solely to reduce one problem, like malnourishment for instance, Scaling Up Nutrition places issues of education, health, water, agriculture, infrastructure and the environment in conjunction with one another. They recognized that the first 1000 days is a time of tremendous potential and vulnerability. Specifically, malnourishment during this time of growth can impact brain development and increase the risk for chronic illnesses later in life (1). They compared the results of this initiative between various countries. These effects are outlined below.
Uganda
In Uganda, SUN improved both nutrition and agriculture through a program called HarvestPlus. Hunger seasons, which are stretches of time when individuals starve due to weather patterns that limit crop growth, have immense implications on fetal growth and development. Therefore, by creating crops that are more resistant to weather, diseases and other external factors, mothers and infants were able to attain proper nutrients from these modified crops (1).
This program was deemed successful by the end of the initiative. It was observed that none of the children taking part of the First 1000 Days initiative were stunted thanks to the orange sweet potatoes and high-iron bean crops. SUN is working to expand the usage of these crops to different districts (1).
Guatemala
In Guatemala before SUN’S intervention, there were enormous stunting problems in children due to the high prevalence of parasites and worms. This stunting problem was caused by bad eating habits, sanitation issues, and contaminated water. There was also a huge wage gap in the country caused by the Guatemalan Civil War (1).
SUN’s goal was to decrease stunting rates by implementing a program called Primeros Pasos, which provides reliable healthcare for women and children. This program not only provided healthcare, which focused on improving nutrition, but it also worked to explore the impacts of parasites in child development. Additionally, a nutrition recuperation project was established in order to provide treatment and recovery for underweight children from twenty-five families. Although this successful program had been promised to be expanded by new government leadership, they have not yet taken action (1).
The United States
In the United States, specifically in Chicago before SUN’s intervention, there was no infrastructure in place to support mothers in poverty. Food deserts were common, resulting in obesity and malnutrition. There was also lots of violence prevalent in Chicago that limited mothers from being able to exercise or walk to food stores without fear (1). SUN worked to introduce WIC stores which are supplemental nutrition programs for women, infants and children (3). These establishments worked to provide nutritious options for low-income people, which ended up being extremely helpful for mothers in the first 1000 days.
Due to the success of the WIC stores established by SUN, the Chicago legislature is establishing Healthy Chicago 2.0 which will help to eliminate inequities in the city by first tackling “opportunity deserts,” which are places in which basic opportunities for survival are difficult to find (1).
India
In India, undernutrition, poverty, poor sanitation, and improper education are common. The country has made technological and agricultural progress, but unfortunately the majority of the population remains poor. Females are viewed as an economic loss, resulting in increased rates of stunting in females. The discrimination of women has led to the establishment of the Y Chromosome Initaitve by SUN which educates parents about how genetics works and empowers women to advocate for themselves in the home setting (1).
Unfortunately, stunting due to malnutrition and bad sanitation is still prevalent in India. The National Food Security Act, which was promised by the Indian government to help ensure that all people get access to basic nutritional needs, is off to a slow start (4). Additionally, the Integrated Child Development Services, which provides nutritional meals, preschool education and primary healthcare, was cut (5). Until the Indian government acknowledges how crucial the first 1000 days are to human development, impoverished Indian populations will continue to suffer.
References:
1 . Thurow R. The First 1000 Days. PublicAffairs; 2017.
2. World Health Organization. Children: Reducing Mortality. Who.int. Published September 19, 2018. https://www.who.int/news-room/fact-sheets/detail/children-reducing-mortality
3. WIC and Retail Grocery Stores | Food and Nutrition Service. www.fns.usda.gov. Accessed October 15, 2022. https://www.fns.usda.gov/wic/wic-retail-store-fact-sheet#:~:text=WIC%20is%20the%20Special%20Supplemental
4. NFSA. Nfsa.gov.in. Published 2013. https://nfsa.gov.in/portal/NFSA-Act
5. SACHDEV Y, DASGUPTA J. INTEGRATED CHILD DEVELOPMENT SERVICES (ICDS) SCHEME. Medical Journal Armed Forces India. 2001;57(2):139-143. doi:10.1016/s0377-1237(01)80135-0
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