Table 3 Frames, levels and problem definitions

Individual

Biomedical

1. FTD as a maternal and child health mortality problem:

“Safeguarding and preserving the lives of mothers during childbirth, is one of the globally accepted essential functions of a health care system. The maternal mortality ratio is therefore viewed as one of the key markers of the effectiveness of health care systems globally. Western Cape Government Health is therefore committed to reducing maternity mortality, in line with this imperative.” (First 1000 Days Rapid Situational Analysis Situational Analysis, p. 82, 2016)

“Improve maternal, perinatal and child mortality by addressing avoidable causes of deaths” (Intervention Framework in Situational Analysis, p. 85, 2016)

Family

Nurturing care

2. FTD as an early childhood development problem:

“Overwhelming scientific evidence attests to the tremendous importance of the early years for human development and to the need for investing resources to support and promote optimal child development from conception. Lack of opportunities and interventions, or poor quality interventions, during early childhood can significantly disadvantage young children and diminish their potential for success” (NIECD, p. 8, 2015)

“Provision of universal developmentally appropriate early learning opportunities for young children from birth …. Review and strengthening of a comprehensive national food and nutrition strategy … Support for pregnant women, new mothers/fathers and children under 2 years of age” (NIECD, p. 64, 2015)

Community/societal

Socioeconomic

3.FTD indicating the need to address social determinants of health:

“The Western Cape Government acknowledges that we have a society that still carries the burdens of inequity....The Western Cape Government is therefore committed to promote wellness in communities in order to ensure safety, health and inclusivity across all communities within the province.” (Provincial Strategic Plan, p. 36, 2014)

“A whole-of-society approach to improving people’s lives – an approach built on partnerships with citizens, civil society, business, and other spheres of government” (HealthCare 2030, p. 65, 2014)