The first thousand days within the Western Cape whole of society approach: Lessons for the collaborative governance of intersectoral action for health

Abstract

This report is a case study of the Western Cape’s Whole of Society Approach (WoSA) through the lens of the First Thousand Days (FTD) of childhood initiative, focusing in particular on its implementation in Saldanha Bay and to a limited extent the Drakenstein municipal areas/sub-districts. The case study reports on data collected by Ida Okeyo as part of her PhD, which has examined the emergence and implementation of FTD in the Province as a whole over the last 3-4 years. Experiences in Saldanha Bay and Drakenstein stand in contrast to elsewhere in the Province, where, despite original intentions, the FTD strategy has failed to take root as a cohesive intersectoral response to this critical moment in the lifecourse. This case study examines how WoSA (and the Better Spaces initiative before that), created an enabling context for intersectoral action within which FTD found a natural home. We spell out the elements of this enabling environment using a framework of ‘collaborative governance’, concluding that these elements are the necessary pre-conditions for advancing any intersectoral initiative more widely in the Western Cape Province and elsewhere. In this way, we aim to document and affirm lessons learnt through WoSA, and provide the case for its further development and institutionalisation in the Province.