School of Public Health Report of Activities 2019–2020

Page 28

Whole of Society Approach: Addressing early childhood development and the First Thousand Days Initiative Intersectoral collaboration for health – where the health sector works with other sectors to address social determinants of health – has been advocated since the 1978 Alma Ata Declaration of Primary Health Care and, more recently, by the Sustainable Development Goals. Addressing social determinants of health is particularly crucial between conception and when a child is two years old, during which time development occurs in all domains – sensory, motor and cognitive. Conceived of as the First Thousand Days (FTD) and referred to as ‘nurturing care’, this period therefore presents a window of opportunity for early childhood interventions that ensure a conducive environment for adequate child development. An intersectoral approach to FTD is crucial as evidence shows that integrated health, nutrition and stimulation interventions promote positive outcomes that impact the whole life course. Launched in 2016 by the Province in the Western Cape, the FTD Initiative has been a focus of research at the School of Public Health (SOPH). This has included examining policy processes from 2016 to 2019 to better understand the real-life possibilities for, and constraints to, intersectoral action for health. As part of the broader FTD study, doctoral candidate Ida Okeyo and professors Helen Schneider and Uta Lehmann have analysed how the FTD Initiative emerged and was formulated within the Saldanha Bay Municipality - an area that was experimenting with approaches to joined-up government referred to as the ‘Whole of Society Approach’ or WoSA.

The Whole of Society Approach The WoSA was approved by the provincial Cabinet in April 2017 and was framed as a co-created and collaborative endeavour between provincial government sectors and local municipalities. The goals were linked to broader policies and frameworks at all levels - from the global Sustainable Development Goals, the country’s National Development Plan, the Provincial Strategic Plan and the Integrated Development Plans of local government. The WoSA was to be piloted in two rural sub-districts (Saldanha Bay and Drakenstein) and two urban subdistricts (Khayelitsha and Hanover Park/Manenburg). General WoSA plans for each region included the assignment of heads of provincial departments to lead each area and an entry process into each community that would be guided by the local municipalities.

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The Saldanha Bay WoSA process began at the end of the 2017 and was led by the head of the provincial Health Department along with local municipal players. One of the earliest activities was the establishment of strategic focus areas and accompanying local area teams. The FTD Initiative itself was launched in Saldanha Bay in early 2019.

Figure 1: Life course approach that shaped the WoSA network [DSD: Department of Social Development; DCAS: Department of Community and Safety; DOH: Department of Health; WCED:Western Cape Education Department]

Saldanha Bay Municipality During 2019 we conducted qualitative interviews with key informants involved in the Saldanha Bay WoSA team. We also observed five WoSA team meetings for different governance structures and analysed key WoSA documents. Although still in its infancy, early findings of the FTD Initiative have shown how the WoSA team adopted the life-course approach as a central framing idea, with FTD and early childhood development as key focus areas for co-ordinated action. The ‘Carol and Lindi’ story – of a mother and child living in an ideal state with the necessary tools, opportunities and appropriate services to cater for their needs over the life-course – provided a powerful common joint framework which was readily adopted by various stakeholders. They frequently repeated the story, symbolising a new collective mindset focused on communities and citizens rather than an inward looking, sectoral approach.


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Articles inside

Staff farewells

4min
pages 62-63

PUBLICATIONS

46min
pages 76-90

Staff of the School of Public Health

43min
pages 64-75

Annual David Sanders Lecture in Public Health and Social Justice

7min
pages 58-59

STAFFING Farewell to Comrade Professor David Sanders: SOPH founding director

4min
pages 60-61

LINKS, PARTNERS AND FUNDERS

4min
pages 55-56

Projects Collaborative projects with UWC’s Department of Dietetics

44min
pages 40-51

and Nutrition

10min
pages 52-54

Improving access to vaccines and medical products: Building capacity in supply chain management in East Africa Promoting food and nutrition literacy using multi-media

3min
page 37

education-entertainment

3min
pages 38-39

interventions’

5min
pages 35-36

Sixth Health Systems Research Global Symposium Promoting African adolescents’ full potential through ‘accelerator

5min
pages 32-34

Cape Town Together and the Community Action Networks (CANs

3min
pages 30-31

Whole of Society Approach: Addressing early childhood development and the First Thousand Days Initiative

4min
pages 28-29

Student academic achievements

11min
pages 12-16

DIRECTOR’S FOREWORD

5min
pages 4-5

Collaborations through SARChI

8min
pages 24-26

Graduated with a PhD in Public Health

10min
pages 17-20

RESEARCH AND PROJECT WORK

3min
page 23

Short courses and continuing education

3min
pages 21-22

Doctoral programme: Enriching African practice and scholarship

5min
pages 9-10

Countdown to 2030

2min
page 27
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