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Child Survival
& Development

Child Survival, Development and Thriving

Programme Overview

The Child Survival, Development, and Thriving (CSDT) programme was introduced to the Nelson Mandela Children’s Fund (NMCF) in 2016. The main goal of this programme is the survival, development, and thriving of children under the age of five years, with a particular emphasis on the first 1000 days of life (including pregnancy). Child mortality and malnutrition have been identified as significant issues affecting children under the age of five in South Africa.

In response to this, the CSDT works through implementing partners (IPs) to employ the following three key elements:


  1. – strengthening of health systems;
  2. – family outreach; and
  3. – community outreach.

To strengthen health systems, community healthcare workers (CHWs) are trained to provide quality services to mothers and children. Additionally, CSDT works with clinic committees (CCs) to better provide quality services. For family outreach, CHWs conduct home visits to educate families about pre- and post-natal care, immunisation, nutrition, and early learning and stimulation.

CHWs also conduct community outreach initiatives to promote maternal and child health knowledge. These activities aim to strengthen the links between CHWs, clinics, and communities for sustainability. Furthermore, CSDT engages key stakeholders in maternal and child healthcare (MCHC) to increase access to health and nutrition for pregnant women, mothers, and children under 5. The CSDT collaborates with the three programmes of the Fund to ensure more holistic and integrated efforts to achieve its aims more effectively. In summary, CSDT is founded upon the belief that if families, children under 5, breastfeeding mothers, and fathers are supported by strengthened CHWS, clinics, CCs, and communities to access improved child and maternal healthcare and nutrition, then child malnutrition and mortality will be reduced.

Child Survival, Development and Thriving

Programme History

A graphical summary timeline of the CSDT programme for the years 2016 to 2022 is provided below. For further detail on the history of the programme, refer to the CSDT Critical Reflection and Review Document (2022).


Grant disbursed: R3 295 486.00

Inception of the CSDT programme

Learning about the first 1000 days (Save the Children)

Development of programme document

Call for proposal and contracting of IPs (5)


Grant disbursed: R3 295 486.00

Grant disbursed: R2 100 000.00

*Entry and activation of CSDT in Northern Cape, Eastern Cape, and Kwa-Zulu Natal provinces

*Partnerships formed with local health departments and stakeholders (e.g., DoH, PATH, etc.)

*Capacitated health systems via training and capacity-building 

*Orientation workshop for new IPs

*Initial phase of program: implementation on the ground

*Increased antenatal and postnatal care (ANC & PNC) through family outreach

*Partner exchange visit for learning purposes

*Worked with 5 clinics, 52 CC members, and 54 field workers (CHWs, FCMs, etc.)

*1100 families reached

Grant disbursed: R3 525 000.00

*Development of CSDT M&E system

*Programme expansion (to North West province and additional communities in EC and KZN – including additional IPs, field workers, clinics, ECD centres, training and capacitation)

*Progamme review with LETSEMA

*Learning and sharing session as part of the strategy implementation review

*Integration with SLP

*Reached around 7000 children with a 50% improvement in ANC early entry and adherence, 74% full immunisation, and 0% mother-to-child transmission

Grant disbursed: R3 525 000.00

* #VaxTheNation campaign

* Advocacy initiative on the impact of environmental pollution on children in mining communities

*Aligning IPs to M&E framework

*Documentation of working models on ground

*IP exchange visits

*Integration with SLP

*Increased immunisation adherence, increased exclusive breastfeeding in first 6 months (80%)

*2473 children under 5 reached through child health and 9378 children stimulated through play

Grant disbursed: R2 239 590.00

*Digitised M&E and data collection system

*Developed COVID-19 manuals and training for IPs, field workers, and Fund staff

*Adaptation to new ways of supporting pregnant women, mothers, and children during and after lockdown to mitigate impact of COVID (e.g., child malnutrition, food security, good hygiene practices)

*Documentation of Breastfeeding Buddies case study

*Improved adherence to ANC (1007), PNC (1341), and immunisations (5638)

Grant disbursed: R6 144 470.00

*Video documentation of the baby competition

*Launch of nutrition project in KZN

*Worked with 13 IPs, 19 clinics, and 177 field workers (CHWs, FCMs, etc.)

*4379 families and 3739 children reached

Child Survival, Development and Thriving

Programme Focus

NMCF recognises there are numerous challenges the country and its people are facing. The organisation has identified the following most pressing challenges that it would like to contribute towards addressing:


  • In collaboration with Sustainable Livelihoods Programme’s (SLP) Savings Mobilisation Programme
  • CSDT will promote healthy and balanced eating by supporting establishment of household food gardens, and educating families about the importance of nutrition to child survival, development, and thriving
  • Mothers will be capacitated on food processing skills for income generation
  • Surplus from the gardens will be sold to generate income for the household

Youth Unemployment

  • CSDT does not directly work to reduce youth unemployment
  • Mothers will be capacitated on food processing skills for income generation

Violence against Children

  • Conduct annual child safety campaigns for households and early childhood development (ECD) centres
  • Mothers will be capacitated on food processing skills for income generation

Child Mortality

  • Strengthen care systems to better respond to the needs of children under the age of 5 to ensure their survival and development Key strategies on next slide
Child Survival, Development and Thriving

Key Strategies

NMCF places children at the heart of their focus and recognises the fact that children are located within a family and a community which is fundamental to their health, safety, wellbeing, empowerment, and the provision and promotion of their holistic rights and responsibilities. Bronfenbrenner’s (1986) socio-ecological framework views child development as a complex system of interactions at multiple levels of the surrounding environment (from family, friends, schools, and communities) to broader-level values, economics, laws, and policies. Bronfenbrenner (1986) divided a person’s environment into different systems, including the micro-system, exo-system, and macro-system

Child Survival, Development and Thriving

Conceptual Frameworks

At NMCF, recognition is given to the life-stage approach, and this is reflected in its programmes. Each programme targets a specific stage of life. The CSDT programme specifically targets children under the age of 5 years as child mortality rates within this age group are high. It also has a specific focus on the first 1000 days of life (from conception up to the age of around 2), given the particular vulnerabilities within this age group. Children cannot and should not be considered in isolation, and their surroundings must be considered.

Child Survival, Development and Thriving

Implementing Partners

The identified partners will operate in the following priority districts. As illustrated in the map below, a total of 25 priority districts have been identified for the strategic period (2023-2027). A subset of 12 priority districts will be targeted in the first phase (2023) (green pins) and the remaining 13 priority districts will be targeted in the second phase (2025) (red pins). The priority districts specific to CSDT for the first strategic period are shown in orange text.