Wednesday, 30 January 2008

The milk of human goodness for mother and child

The human milk brings out the goodness in all

There are two major reasons why breastfeeding is important for the mother as well as for the child. One is the nutritional aspect while the other is the psychological aspect. While the nutritional aspect is no doubt very important, that which some think can be substituted, the psychological bonding which develops between the child and the mother is unparalleled and does not have any alternative.

Research has proved that breastfed babies have a healthier start in life because human milk contains a balance that closely matches infant requirements for brain development, growth and a healthy immune system. Since an infant’s immune system is not fully developed until the age of two, the human milk provides a distinct advantage over infant formula. Besides there is an emotional tie between the mother and her baby which begins during pregnancy and increases at birth -this attachment enables parents to make sacrifices for their infant.

Breastfeeding releases a hormone in a woman’s body that causes her uterus to return to its normal size and shape more quickly. Other advantages of breastfeeding for the mother include a reduction of the risk of premenopausal and postmenopausal breast cancer and ovarian cancer.

From a budget standpoint, breastfeeding can save a family a lot of money. This is because it saves the mother from buying infant formula for her baby. With the baby’s immunity boosted from taking its mother’s milk, there is less risk of infection, thus there is a reduction in the frequency of visits to the doctor.

Despite the benefits, not every mother is able to breastfeed. A mother’s health may prevent her from breastfeeding her baby. For example if a woman tests positive to HIV or has the T- cell Leukemia virus type 1, it is advised that the baby should not be breastfed because of the risk of transmission to the child.

Other conditions such as exposure to environmental chemicals, hepatitis C, breast surgery and implants, and metabolic disorder such as galactosemia (a condition in which the infant cannot metabolize lactose) make some mother not breast feed their babies. The use of drugs such as ergotamine, cyclosporine, anti-depressant, anti-anxiety by mothers are not beneficial to babies so mothers should always ask their physicians before continuing or taking new medications while nursing. Tobacco and alcohol use are not recommended because they are present in breast milk and with long exposure would easily affect the nursing baby.

Nearly all women can breastfeed, but many especially first time mothers - do run into problems. It is important to ask for help. Effective feeding can take a number of weeks to establish properly. The most important thing to know about breastfeeding is how to position the baby during a feed. If the baby is in the right position then everything else will follow. Once established most women then find feeding easy and enjoyable.

Breastfeeding however, requires a substantial commitment from a mother. While some mothers feel tied down by the constant demands of a nursing newborn, breastfeeding is not the end of a woman’s independence. Mothers can use pumps to express their milk and leave it for someone else to feed the baby while they go about their usual work activity. Others feel embarrassed or concerned about breastfeeding especially in public places.

Benefits of breastfeeding immediately after birth include protection against infections for the baby, less risk of jaundice and low blood sugar, improved milk production, and less blood loss in the mother
Skin-to-skin contact between mother and baby after birth is important because this has significant effects on infant health. Skin-to-skin means naked body to naked body with no clothes in between.

Other advantages of this first hour initiation is that baby learns feeding skills quicker, it prevents low blood sugar levels in the infant and the mild laxative effect of the colostrum helps in the passage of the meconium - the first blackish stool.

A mother’s body helps to keep the baby warm more effectively than blankets or an incubator. Babies who are kept skin-to-skin with their mothers are more likely to latch on and breastfeed well. Research has shown that the baby is less stressed, is calmer and has steadier breathing and heart rates when they have immediate contact with the mother

* By Adanma Ike

Tuesday, 29 January 2008

IMNCH: Turai Yar 'Adua commits to saving women and children

Picture of the First Lady Haija Turai Umar Musa Yar'Adua with the Minister of Health, Prof. Adenike Grange

That Nigeria has continued to record high Maternal, Newborn and child death rates is no longer news, that the Federal government has developed an Integrated Maternal, Newborn and Child Health (IMNCH) Strategy to strengthen the health system, scale up interventions and maximize impact towards achieving the Millennium Development Goals 4 and 5 is also not news.

What is news however is that in recognition of this fact, the first lady of the Federal Republic of Nigeria, Hajia Turai Umar Musa Yar’Adua, recently was made the National Goodwill Ambassador for Maternal, Newborn and Child Health (MNCH) in Nigeria. This means she will ensure that MNCH issues will remain on the front burner of the Nigerian national agenda and that come 2015, MDGs 4 and 5 would have been achieved, at least to a larger extent.

With over 100 witnesses ranging members of the National Assembly, Wives of Executive State Governors, Federal Ministers and representatives from both the organised private sector and the developmental agencies in Nigeria, at the investiture, the first lady pledged her total commitment to ensuring that the present alarming rates of maternal and child death are reduced and Nigeria is removed from the MNCH critical list. She looks forward to a time Nigeria would be placed side by side with developed counties on issues of Maternal, Newborn and Child Health.

At the event, the Minister of Health Professor Adenike Grange in her paper ‘Maternal, Newborn and Child Health: where are we now?’ made urgent calls to action to the first lady to solicit her support in drawing national attention to the consequences of not keeping the promise to meet the health related Millennium Development Goals. To the National Assembly, Grange’s call was to expedite action on passing the national health bill and other bills that impact on the lives of vulnerable groups, including women and children. The Minister of Health urged the wives of State Governors to advocate, and mobilize resources for the implementation of laws that promote the well-being of women and children in their states.

The civil society was not left out as Prof. Grange called on non-governmental organisations (NGOs) and Women Organizations for effective advocacy and community mobilization for the implementation of the interventions at different levels of the society as well as to support monitoring and evaluation of these interventions. The organized Private Sector were urged to adopt communities and health facilities and get involved in the management of these facilities, besides providing incentives including accommodation, water, electricity and motivation for staff.

In closing, Prof. Grange shared with the audience her new concept to bridge some of the major gaps identified in MNCH. This idea is to bring Maternity Waiting Homes on board. The Homes are intended for women with major obstetric complications requiring specialist care such as caesarean section (CS), blood transfusion, treatment of infections, use of specialised drugs for pregnancy induced hypertension. The Homes will also be used by women whose homes are in remote and/or inaccessible areas where health facilities are either not available or inaccessible. In the first phase of the project, a Home will be located in 6 yet to be identified pilot Local Government Areas within the six geopolitical zones.

The accumulation of credible evidence of the high level of maternal mortality, the dismal state of maternal health care in Nigeria coupled with the WHO ranking of Nigeria’s healthcare system performance as one of the worst in the world in 2002 have served to awaken healthcare and other political officials to action.
With the IMNCH strategy in place, people’s expectations is that partnerships will be forged across all walks of life to eliminate the three major delays and ensure: there is adequate information about pregnancy and labour complication signals available for mothers and their partners, adequate access to health facilities including proper citing of facilities, good quality road and communication network and an informed community to ensure adequate community support. Finally, that highly skilled attendants and quality equipment and supplies are provided at the health facilities.

The MDGs and health systems worldwide are watching to see that the first National goodwill ambassador can utilize IMNCH as a tool to make pregnancy safer and cut maternal and newborn morbidity and mortality by half by the year 2014- ten years from now!.

* By Constance Ndubuisi-Enyali

Wednesday, 23 January 2008

Micronutrients deficiency: Stunting Nigeria’s ‘intellect, strength, and vitality’

Over a decade ago, the World Bank publicly announced that vitamin deficiencies deprive one billion people worldwide of their intellect, strength, and vitality. Of this population, pregnant women and children are often and unfortunately the most affected.

During pregnancy and lactation, the micronutrient level for certain micronutrients like iron can substantially affect the outcome of a woman’s pregnancy. After birth, the amount of micronutrients in a woman’s body will impact her ability to provide quality breast milk to her child, which directly impacts a child’s potential for learning and its resistance to infections.

In Nigeria, low micronutrient levels among pregnant women is a leading contributor to infant low birth weight; not only stunting a child’s ability to thrive in childhood and adulthood, but also leading to increased risks for adult chronic diseases.

A major pitch to end this health crisis in Nigeria is the implementation of three low-cost micronutrient programs including food fortification, supplementation and education.

Food fortification by nature is the process of adding vitamins and minerals to a staple food eaten by a majority of the population. During the food processing stage, vitamins and minerals beneficial to child development are added to the staple foods and distributed to the population.

Recent studies in Southern and Western Africa show that adding vitamin A to sugar and vegetable oil can lower the risk and severity of maternal mortality, anaemia, and long-term affects of HIV/AIDS. Just a teaspoon of oil or sugar enriched with vitamin A taken twice a day can boost a child’s immune system and deliver about one-third of their daily needs for vitamin A—potentially saving their lives.

The second step, food supplementation, supplies vulnerable groups, primarily young women and children, with tablets, capsules and syrups enriched with vitamins and minerals. Though an effective method of supplying nutrients, supplementation presents a big challenge of finding a reliable delivery system to reach the most vulnerable and poorest populations.

The third step is educating Nigerians to make small changes in their diets and eating habits to protect themselves—and their children—against vitamin deficiencies. For this task, the Ministry of Health holds a responsibility for educating people about the benefits of food fortification through media campaigns, public health messages, and nutrition education programmes through primary and secondary schools. Private organizations and companies are also responsible for educating the public about the immense benefits of fortification in their advertising and marketing campaigns.

A challenge of this step is that better diets often require better income, and promoting healthier eating is not always easy. Many people prefer to stick to the cheaper foods they are familiar with and resist new additions to their meals. But, according to Carol Bellamy of UNICEF, “It is no longer a question of treating severe deficiency in individuals. It is a question of reaching out to whole populations to protect them against the devastating consequences of even moderate forms of vitamin and mineral deficiency.” For this to happen, an enormous commitment from the government, media, private organizations, schools, and the general public is needed to not only enrich foods with essential vitamins but to change the mindsets of the Nigerian public to embrace the benefits that such food fortification programs could provide.

By Amanda Hale

Contraception as a prelude to quality MNCH

Many women are familiar with the better-known barrier contraceptive methods namely: condoms, diaphragms and the cervical cap. With perfect use, combined with spermicide, the pregnancy rates are minimal, but with typical use, the pregnancy rates are much higher. One reason for the high failure rate of barrier methods is their inconvenience and sometimes messiness; these usually make people not to use them regularly. For example, the diaphragm and condom have been said to interfere with spontaneity, is messy and a little uncomfortable.

Different methods of contraception have their individual advantages and disadvantages. There’s no single ‘best’ method of contraception, so a woman has to decide which is most suitable for her. Whatever the situation, there should be a contraception option that works for every woman. For many people, barrier methods of contraception are best, because they not only prevent pregnancy, but also prevent HIV and other sexually transmitted diseases from being passed on during sex.

The hormonal methods are among the most effective contraceptive choices for women. There are two main types of hormonal contraceptive :the contraceptive pill, and the injectable hormonal contraceptive. If used properly, both are extremely effective in providing protection against pregnancy – but they provide no protection at all against sexually transmitted diseases.

The contraceptive pills, also known as the birth control pill is very effective if the pill is taken exactly according to the instructions. The chance of pregnancy occurring is practically nil as long as the pill is taken reularly and at practically the same period each day. A disadvantage of the pill is that it does not provide any protection against STDs. The combination of the birth pill and male condom is a good protection against both pregnancy and STDs.

The contribution of contraception to reductions in obstetric mortality and morbidity is universally acknowledged. One major pathway is by reducing the number of unwanted births. Each pregnancy and childbirth carry a health risk for the woman, and where obstetric services are poor, maternal mortality is still very high.

Contraception contributes to better maternal health beyond its potential to reduce the proportion of births that are unwanted. This depends on the extent to which births averted by contraception would otherwise pose as greater risk to the mother than wanted or intended births. The risks of childbirth are known to vary with the mother’s age and may also be linked to her parity (number of children she has had already) and to the interval since the previous birth. Contraception is likely to change the age pattern of childbearing, particularly by reducing fertility at older ages, and will certainly affect parity-specific fertility.

No particular contraceptive method is right for every woman. Personal beliefs, willingness to risk pregnancy and comfort levels with the various methods vary from woman to woman. But all women have a choice in planning their families according to what's right for them thereby assuring a better quality maternal, newborn and child health (MNCH).

Reported by: Adanma Ike

Saturday, 12 January 2008

Third Africa Conference on Sexual Health and Rights

No less than 500 delegates from over 25 countries will come together in Abuja, Nigeria for this year's 3rd Africa Conference on Sexual Health and Rights. The event from January 3-7 will be held at the prestigious Abuja International Conference Centre and features a keynote address from Elizabeth Mataka, the UN Secretary General's Special Envoy on HIV in Africa.

Convened by Action Health Incorporated (AHI) under the sponsorship of the African Federation for Sexual Health and Rights, the conference will examine the interrelationships between poverty and sexuality and how the issue of accountability affects sexual health and social well-being in Africa. Special attention will be granted to the issue of accountability including fiscal responsibility in sexual health and rights work, ensuring equality of access to sexual health information, participation of target populations in programming, rehabilitation of victims of rights abuses, and the empowerment of disenfranchised and vulnerable populations.

Dr. Uwem Esiet, Convener, African Federation for Sexual Health and Rights, said that the main goal of the conference is to catalyze understanding of sexuality, both within and outside the continent. His words: "It is a singular opportunity to reflect on where we are as far as sexuality is concerned and to assess our personal and organizational accountability to improving our understanding of sexuality."

Reducing maternal mortality is part of the focus of the conference, with presentations on maternal mortality which would enable participants who are interested in reducing maternal deaths to see what has worked in the past and apply these methods in their home countries and communities, while, at the same time, downsizing what has not worked.

"We should not necessarily have to die or suffer as we exercise our sexuality," commented Esiet. "We should stick up for the woman, for the positive sexuality practices that fulfill our lives to procreate safely."

Youth involvement is also at the core of the conference, with side events such as youth sexuality discussions and youth capacity events sponsored by IPPF, IPAS, IWHC, and AHI to promote dialogue between adults and youth on sensitive issues such as sexuality education, sexual violence and abuse, gender roles and traditional practies. Professor Babatunde Osotimehin, Director-General of the Nigeria National Agency for the Control of AIDS (NACA), will lead the range of panel discussions as Conference Patron.

The 3rd Africa Conference on Sexual Health and Rights is preceded by the 2nd Africa Conference on Sexual Health and Rights held in Nairobi, Kenya from June 19-21, 2006.

By Amanda Hale