May 23, 2014 |

Gugu Xaba: making the most of a child’s first 1,000 days

The first 1,000 days of life determine a child’s health and development, says Gugu Xaba. She leads our Window of Opportunity project to make sure kids get the best start.
Close-up of a newborn wrapped in a red blanket.
The first 1,000 days of life determine a child’s health and development, says Gugu Xaba. She leads our Window of Opportunity project to make sure kids get the best start. Photo: PATH.

Early in Gugu Xaba’s career, when she was still a community health nurse, she realized the difference she could make in the lives of her fellow South Africans. It was the early 1990s, and HIV was devastating people’s lives. Treatment was not yet available, and a solution seemed impossible.

Portrait of Gugu Xaba.
Gugu Xaba. Photo: PATH/Patrick McKern.

“I remember well the amount of counseling we had to do with people who were infected,” says Gugu, who now works with PATH’s program in South Africa. “The need to give hope when there was nothing.”

She knew she had succeeded when she saw a change in people’s eyes. “They came in with eyes that were despairing, but their eyes were calm when they left. They could see the reason to go on in life.”

A baby named Bokang

Eventually, the impossible became possible. Thanks to the efforts of the South African government and many organizations, including PATH, South Africans today are receiving treatment and living longer.

Gugu’s career took a turn, too. She earned a master’s degree in public health and worked at institutions including South Africa’s Department of Health, the Elizabeth Glaser Pediatric AIDS Foundation, and the US Centers for Disease Control. In 2012, she came to PATH to lead our Window of Opportunity project, which focuses on improving the health of children under the age of two.

These children often face dire health risks. South Africa has one of the highest rates of newborn mortality in the world—43,000 infants die every year. More than half of them are HIV-positive or exposed to HIV.

And 3.7 million children have been orphaned, including a little boy called Baby Bokang.

Watch this video to learn more about PATH’s Window of Opportunity project in South Africa.

Opening windows of opportunity

Both of Bokang’s parents were HIV-positive. Within a month of his birth, Bokang was abandoned by his mother, and his father died of HIV-related infections. He, too, is HIV-positive.

To help children like Bokang, the Window of Opportunity project is strengthening care over the course of the first 1,000 days of life—from a woman’s pregnancy to her child’s second birthday.

“This period is the window of opportunity because what happens during this time determines a child’s health and development,” says Gugu. “It shapes a child’s entire life.”

Services across the continuum of care

PATH designed the Window of Opportunity project to innovate across the continuum of care—making sure women get regular prenatal care, infants are born safely, and babies get the best health, nutrition, and early childhood development services.

A PATH-trained team of community health workers is providing Bokang with services to close the gap in care he missed during his first months of life. They regularly visit his home to make sure he is immunized, his growth is monitored, and he is free of new infections.

Woman speaks while standing at a lectern. Her image is projected on a screen in the background.
Gugu Xaba spoke about her work in South Africa at PATH’s recent Breakfast for Global Health. Photo: PATH/Christopher Nelson.

Already an impact

The project is in its early stages, but it is already having an impact, says Gugu. Women are coming to the clinic earlier in their pregnancies and more are breastfeeding their infants. Fewer babies are HIV-positive, and fewer mothers are dying from complications in pregnancy and childbirth. In one district, PATH helped reduce the number of maternal deaths by 65 percent in just one year.

“I’m happy to say that Bokang is doing very well,” says Gugu. “My goal is to see the same for children across South Africa—and to not miss any more opportunities to protect children from getting HIV.”

No more missed opportunities

Gugu knows just how tragic missed opportunities can be. Her brother, Richard, died from AIDS in 2001, not long before treatment became available in South Africa.

“I have so often thought, ‘If only treatment had come in time. If only he’d lived a little longer,’” She says. “I don’t want to have to say ‘if only’ about South Africa’s children. I want to say to them: ‘You can grow up strong and healthy, and we’re here to make sure you have that chance.’”

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