*4.4. Contributions to Communities and Professionals Working in the Field of Early Child Development*

This study makes a contribution by increasing our understanding of the various factors that could potentially have affected the first 1000 days of absent learners in the Foundation Phase. These insights could provide Government, NGOs, communities, and professionals working in the field of Early Childhood Development (ECD) with recommendations that could be considered during their planning of future programs and interventions. These recommendations include—(1) educate the broader communities on the importance of the first 1000 days through continual social media campaigns, by making use of platforms like the radio, television, newspapers, and Facebook; (2) incorporate the guidelines set out by the World Health Organization on the identification and management of substance abuse during every antenatal visit, to screen the past and present substance use/abuse of mothers; (3) provide support groups for pregnant mothers and mothers with children up to two years, in order to offer emotional support, education, and practical guidance regarding nurturing care, attachment, and stimulation of children in this time-period; (4) offer workshops and interactive events to biological fathers and extended family members to establish meaningful support to mothers during pregnancy and after their child's birth; (5) add a module that focuses on the first 1000 days to the tertiary training curriculum of social workers, healthcare workers, ECD practitioners and educators; and (6) include first 1000 days initiatives in national and international policies, to compel and guide countries regarding the implementation of these interventions during this critical time-period.

#### **5. Conclusions**

Research on a South African and international level highlights the many factors that could influence the first 1000 days of life—between pregnancy and the second birthday of children. Whilst research emphasizes that adequate nutrition and care during this unique time-period determine whether children will thrive and reach their full potential, it is evident that this is not always true for all children. Based on the findings of this study, it was concluded that a substantial number of factors, such as the health and nutrition of both the mothers and their children, substance use/abuse during pregnancy, toxic stress, support to the mothers and their children, attachment, attentive care, stimulation and play could have played a role during the first 1000 days of the absent learners in this study. Most of these factors relate to the Western Cape Government's First 1000 Days campaign launched in South Africa, entitled 'Right Start Bright Future'. It was confirmed by literature that the factors relating to the First 1000 Days campaign could potentially have affected the development of children during their first 1000 days, with a lifelong impact on, amongst others, their schooling.

In addition, it is imperative that support is offered to both mothers and their children during this critical time. It is, therefore, essential that NGOs, practitioners, and even the private sector are educated on the importance of the first 1000 days of life, in order to motivate them to collaborate with government departments to strengthen the support of mothers and children. Greater collaboration and multi-sector partnerships are, therefore, needed to improve services focusing on the first 1000 days of life, enabling all children to thrive and transform.

**Author Contributions:** Conceptualization, C.v.Z. and C.v.W.; Formal analysis, C.v.Z. and C.v.W.; Investigation, C.v.Z.; Methodology, C.v.Z. and C.v.W.; Project administration, C.v.W.; Supervision, C.v.W.; Visualization, C.v.Z.; Writing—original draft, C.v.Z.; Writing—review & editing, C.v.Z. and C.v.W. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research received no external funding.

**Institutional Review Board Statement:** The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the registered Health Research Ethics Committee of North-West University (NWU-000008-19-A1 approved on 17 April 2019).

**Informed Consent Statement:** Informed consent was obtained from all subjects involved in the study.

**Data Availability Statement:** The data presented in this study are available on request from the corresponding author. The data are not publicly available due to privacy.

**Acknowledgments:** The authors acknowledge the professional services delivered by Mari Grobler (language editor) who has her own academic language practice, and Neville Robertson, who is a research assistant at the North-West University (Potchefstroom Campus), for his assistance with regards to reference and technical aspects. Finally, we would like to thank the biological mothers who participated in this research who helped us to understand the various factors that played a role during the first 1000 days of their children.

**Conflicts of Interest:** Although one author had a personal interest in absent learners, as a result of her work context, various aspects were incorporated into the study to combat any form of bias that could have inappropriately influenced the interpretation of the research results.
