Bukhali is a Zulu word meaning smart/powerful, signifying the great potential benefit of optimizing women’s health for herself and her future offspring.
Our HeLTI- South Africa proposal has been approved by CIHR


The health, societal and economic burden of non-communicable diseases (NCDs) is significant, increasing, and propagated by early life environments (undernutrition/stress) and later life adiposity, decreasing physical activity, increasing sedentary behaviour, poor dietary diversity, and intergenerational factors. The NCD burden falls heavily on low- and middle-income countries and this pattern is predicted to intensify dramatically in the near future. South Africa’s (SA) evolving burden of disease is complex due to:

– persisting malnutrition (infant stunting of 20%)
– the highest prevalence of overweight and obesity (OWO) in Sub-Saharan Africa, particularly among women
– rising rates of non-communicable diseases such as of type 2 diabetes (T2D)

Global initiatives to mitigate adversity during the first 2000 days have resulted in significant improvements in maternal and child survival. However, the longer-term impact of interventions delivered preconception/prenatally/early childhood on child growth and social/cognitive development has been less clear. Therefore, there is a need to begin laying the foundation for healthy trajectories by optimizing women’s health prior to and during pregnancy and reinforcing optimal health in the infant to offset obesity and cardio metabolic risk and improve cognitive development.

How it works?
To address this need we have assembled a multidisciplinary team of experts from 7 Institutions across South Africa and 6 Institutions across Canada who will focus on a longitudinal analysis of how early-life exposures in the preconception period and during pregnancy, infancy and childhood impact life-long trajectories of health and development of children in South Africa.

Our study population will be drawn from Soweto, SA, a historically disadvantaged urban area of the City of Johannesburg, where the SA team members have significant existing research infrastructure and demonstrated experience in recruitment for pregnancy and child cohort studies.

We hypothesize that an integrated intervention starting pre-conceptionally in women and at appropriate points across the lifecourse (pregnancy, infancy and childhood) will improve cardiovascular and metabolic health, reduce childhood adiposity and improve child development outcomes. Ultimately this will reduce the risk of NCDs.

Core Teams

  • Canada
    Stephen Lye
    Philip Awadalla
    Diego Bassani
    Zulfiqar Bhutta
    Laurent Briollais
    Bill Cameron
    Cindy-Lee Dennis
    Barbara Fallon
    Jill Hamilton
    Janet Jamieson
    Jenny Jenkins
    Stephen Matthews
    Daniel Roth
    Steve Scherer
    Daniel Sellen
    Deborah Sloboda
    Moshe Szyf
    Suzanne Tough
  • South Africa
    Shane Norris
    Tobias Chirwa
    Lumbwe Chola
    Clive Gray
    Heather Jaspan
    Kathleen Kahn
    Andre Kengne
    Salome Kruger
    Estelle Lambert
    Naomi Leviit
    Lisa Micklesfield
    Thandi Puoane
    Michele Ramsay
    Linda Richter
    Marius Smuts
    Stephen Tollman
    Mark Tomlinson

BUKHALI Working Groups (WG)
The WGs will be formed from the pool of co-investigators and their respective networks to ensure success and integrity of the project in areas of:

– Cohort operations
– Child Growth and Metabolism
– Cognitive, Behavioural and Social Development
– Analytics
– Genomics
– Ethics/privacy
– Capacity development
– Data management (DM)
– Communications and knowledge exchange

Related Publications

Coming Soon