In Kenya, many women would rather deliver their babies at home, with no assistance, no drugs, and no medical equipment, than step foot inside a public or private hospital.
These same women would decide not to seek reproductive health care services, thereby increasing their risk of complications during childbirth and creating a higher maternal mortality and child death rate in the country.
The reason for this attitude among women is not ignorance, lack of information, or traditional values—it is the range of gross human rights violation occurring in Kenyan hospitals and clinics.
Over the years women have reported multiple cases of abuse during delivery, including being called ‘stupid’ by nurses; being cut with scissors to make delivery easier for nurses; being left alone to deliver; being forced to lay on soiled sheets during delivery; not receiving food or water during and after childbirth; having to wait an excessive amount of time for stitching vaginal tears; and being stitched with little or no anesthesia.
One woman working in a delivery ward in Kisumu, Kenya, reported that nurses often cut patients’ vaginas on purpose with scissors so that they could then make money for stitching the women back again. She also remembered nurses using abusive language and violence with patients, telling them to ‘spead your legs the way you did when you got pregnant.’
“You see women being mistreated and not being given their rights and you sympathize, [but] there is nothing you can do,” she later said.
According to Claris Oganga of the Federation of Women’s Lawyers, who spoke to delegates yesterday at the 3rd Africa Conference on Sexual Health and Rights in Abuja, the reasons for the poor state of health care in Kenya is complex and multi-faceted. Since 2006 Oganga has interviewed a number of women, health care providers, licensing and regulatory bodies, and leaders of medical associations for a joint project of the Federation of Women’s Lawyers and Centre for Reproductive Health. she found that poor access to hospitals, understaffing/lack of institutional support, demoralized health care staff, lack of supplies, unhygienic conditions, and lack of proper record keeping contributed significantly to the bottlenecks in the Kenyan health system.
The Kenyan government also holds part of the blame, with no strong commitment to issues relating to women and reproductive health, especially when considering future health budgets and care programs. There is no Minister of Health in Kenya, and no freedom of information act (though one is being drafted) to allow women to research their rights and seek redress when neglected or abused by nurses and doctors at health care centers.
Oganga recommended that government and non-profit sectors promote and develop policies and legislation that protect the rights of women seeking RH care and ensure sufficient regulation in both public and private facilities, as well as to ratify the Protocol on the Rights of Women in Africa, which explicitly recognizes the right to reproductive health care as key component of women’s fundamental human rights. She also recommended that nurses be trained on gender and human rights issues while still in college to understand the rights of their patients and to realize the impact of their care on expectant mothers.
* By Amanda Hale
Tuesday, 5 February 2008
Youths urged to be assertive in their views on sexuality and accountability
As the 3rd Africa Sexuality Health and Rights Conference kicked off at the International Conference Centre Abuja, Mrs. Nike Esiet, one of the Plenary speakers and the Executive Director at Action Health Incorporated AHI, Lagos reiterated the need for governments to give a listening ear to youth perspectives on sexuality, poverty and accountability. Their correct perceptions and interpretations, according to her, would go a long way in determining the level of their participation in nation building.
Speaking at the end of the Pre-conference Youth summit, which held yesterday at the Taraba Hall of the Centre, Esiet said that the youths in Africa should be aware and conversant of the different instruments available to address the afore-mentioned issues. She maintained that though Nigeria and other African countries are signatories to a number of declarations that concern youths, sexuality, poverty and accountability, their domestication would still not yield the expected results/situation until the youths become knowledgeable of the different instruments available to put them to practise.
Esiet added that the conference would have quite a number of lawyers in attendance, so quality consideration will be given to the issues of the practicability of the local, national, and international instruments for actualising the various declarations.
She finally urged the international youth delegates and those attending from Nigeria to be vocal and to participate actively so as to ensure that they are heard and their opinions are counted.
* By Nnenna Ike
Speaking at the end of the Pre-conference Youth summit, which held yesterday at the Taraba Hall of the Centre, Esiet said that the youths in Africa should be aware and conversant of the different instruments available to address the afore-mentioned issues. She maintained that though Nigeria and other African countries are signatories to a number of declarations that concern youths, sexuality, poverty and accountability, their domestication would still not yield the expected results/situation until the youths become knowledgeable of the different instruments available to put them to practise.
Esiet added that the conference would have quite a number of lawyers in attendance, so quality consideration will be given to the issues of the practicability of the local, national, and international instruments for actualising the various declarations.
She finally urged the international youth delegates and those attending from Nigeria to be vocal and to participate actively so as to ensure that they are heard and their opinions are counted.
* By Nnenna Ike
Sexuality health and rights promotion: Men’s active involvement urged
Men have been left behind in the move to emancipate and empower women according to Nonofo Molefhi, an MP for population and development in Botswana, who is due to address delegates to the third Sexual Health and Rights Conference in Abuja today.
“I have come to the realisation that while we were focusing on empowering women, we forgot to take the men with us,” said Molefhi at a press conference at the NACA offices in Abuja on Sunday. “Today’s women are not the mothers of yesterday. They are professionals, they take responsibility for themselves and their families – and men feel threatened because some power has been taken away from them.”
MP Molefhi, who is the chair of a special committee on HIV in Botswana, explained that within Botswana men often react violently to the newfound confidence and assertiveness in women, saying it often leads to heinous crimes. Hinting that as far as men are concerned, it is acceptable for the man to terminate a relationship, but not for women to take the first step to end the relationship. This often results in violence, and even murders. Men are generally away from home more than women, and often tend to have more than one partner, but they fail to realise that their wife will feel violated and betrayed, he said.
Molefhi is calling for campaigns not only to embrace women’s rights, but also for campaigns to assist men to come to terms with contemporary society and the goal of gender equality. To achieve this he laid the responsibility at the door of government, saying they should prioritise resources to improve gender equality and also focus on sexual health issues.
The MP said that most of the money spent on sexual health and related activities were in fact donor money. “It is time that the resource came out of our own national budgets,” he said. Molefhi added that following the Abuja declaration, governments are now required to report on how the requisite 15% of health budget is spent.
* By Sharon Davis
“I have come to the realisation that while we were focusing on empowering women, we forgot to take the men with us,” said Molefhi at a press conference at the NACA offices in Abuja on Sunday. “Today’s women are not the mothers of yesterday. They are professionals, they take responsibility for themselves and their families – and men feel threatened because some power has been taken away from them.”
MP Molefhi, who is the chair of a special committee on HIV in Botswana, explained that within Botswana men often react violently to the newfound confidence and assertiveness in women, saying it often leads to heinous crimes. Hinting that as far as men are concerned, it is acceptable for the man to terminate a relationship, but not for women to take the first step to end the relationship. This often results in violence, and even murders. Men are generally away from home more than women, and often tend to have more than one partner, but they fail to realise that their wife will feel violated and betrayed, he said.
Molefhi is calling for campaigns not only to embrace women’s rights, but also for campaigns to assist men to come to terms with contemporary society and the goal of gender equality. To achieve this he laid the responsibility at the door of government, saying they should prioritise resources to improve gender equality and also focus on sexual health issues.
The MP said that most of the money spent on sexual health and related activities were in fact donor money. “It is time that the resource came out of our own national budgets,” he said. Molefhi added that following the Abuja declaration, governments are now required to report on how the requisite 15% of health budget is spent.
* By Sharon Davis
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
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
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
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
Tuesday, 18 December 2007
Attacking malaria…tackling the common enemy
With malaria being responsible for up to 63% of attendance at health facilities, 30 percent and 25 percent of child and infant mortalities in Nigeria respectively and 11 percent of maternal mortality in Nigeria, the federal ministry of health is pulling all stops at ensuring that the different interventions under the country’s roll-back malaria initiative are properly implemented for maximum impact.
Recognising Malaria as a common enemy to humanity, especially to pregnant women and children, Dr Yemi Sofola, the Coordinator of the Nigeria Malaria Control Programme has called on all tiers of government, countries, partners and stakeholders to take affirmative action to address in a broad based manner the issue of malaria and to collectively make all efforts to eliminate malaria.
While speaking at the national review meeting for malaria programme managers at the picturesque Gateway Hotel in Ijebu-ode Nigeria recently, Sofola stated that the devastating effect of malaria has not only laid a heavy burden on the gaunt health system in Nigeria but has also diverted funding priorities creating huge gaps in our national development.
The Nigerian national malaria control programme is employing a workable and evidence-based framework for the elimination of malaria and this includes; improving prompt and appropriate management of malaria cases; promotion of multiple preventive measures such as the use of Insecticide Treated Nets; promotion of the use of Intermittent Preventive Treatment for pregnant women; development of workable partnership for Health System Development; improvement of monitoring and evaluation including tracking of project implementation and commodities and operational research to increase the evidence base for policy.
As she urged greater commitment of the programme personnel, Sofola commended the programme partners ‘who have stuck with us through thick and thin. We believe that our concerted efforts will definitely yield the successes we have been expecting since the Roll Back Malaria initiative.’
She shared with participants that the meeting was also to enable the programme to commence the process for the development of a new Business that would enable the programme to mobilize the required resources form within and outside Nigeria in order to massively scale up service delivery to have the desired impact.
Sofola opined that with the rising profile of malaria, the current bottlenecks being experienced at the state and local government levels will soon be overcome and the expected output and outcomes of interventions met to halve the burden of malaria by 2010 and a malaria-free Nigeria by 2015.
By Nnenna Ike
Recognising Malaria as a common enemy to humanity, especially to pregnant women and children, Dr Yemi Sofola, the Coordinator of the Nigeria Malaria Control Programme has called on all tiers of government, countries, partners and stakeholders to take affirmative action to address in a broad based manner the issue of malaria and to collectively make all efforts to eliminate malaria.
While speaking at the national review meeting for malaria programme managers at the picturesque Gateway Hotel in Ijebu-ode Nigeria recently, Sofola stated that the devastating effect of malaria has not only laid a heavy burden on the gaunt health system in Nigeria but has also diverted funding priorities creating huge gaps in our national development.
The Nigerian national malaria control programme is employing a workable and evidence-based framework for the elimination of malaria and this includes; improving prompt and appropriate management of malaria cases; promotion of multiple preventive measures such as the use of Insecticide Treated Nets; promotion of the use of Intermittent Preventive Treatment for pregnant women; development of workable partnership for Health System Development; improvement of monitoring and evaluation including tracking of project implementation and commodities and operational research to increase the evidence base for policy.
As she urged greater commitment of the programme personnel, Sofola commended the programme partners ‘who have stuck with us through thick and thin. We believe that our concerted efforts will definitely yield the successes we have been expecting since the Roll Back Malaria initiative.’
She shared with participants that the meeting was also to enable the programme to commence the process for the development of a new Business that would enable the programme to mobilize the required resources form within and outside Nigeria in order to massively scale up service delivery to have the desired impact.
Sofola opined that with the rising profile of malaria, the current bottlenecks being experienced at the state and local government levels will soon be overcome and the expected output and outcomes of interventions met to halve the burden of malaria by 2010 and a malaria-free Nigeria by 2015.
By Nnenna Ike
Goge Africa’s charity event raises awareness for orphans and children with special needs
While most fingers point at the Nigerian government and the health institutions they fund as being the culprits when it comes to the appalling number of women and children who die needless deaths in Nigeria, corporate organisations are pitching in to highlight the need to have better health policies that would ensure that children are born healthy because of the quality of care their mothers had access to during pregnancy and childbirth.
Improving MNCH takes more than government policies and roundtable discussions among policy makers. Though the different tiers of government have an obligation to ensuring the health of its residents, there is an immediate need for effective involvement of organizations at the community levels as a stepping stone for making a difference in the society.
To this end, the Lagos-based organization Goge Africa took the opportunity of the festive season to host a charity event for orphans and children with special needs. Knowing that many children in Lagos do not have the privilege of visiting parks or cultural shows because of their physical challenges, congenital disabilities, and lack of opportunities arising from coming from broken homes, the management of Goge Africa decided to invite them to enjoy a day of dancing and music.
Isaac Moses, the co-director of Goge Africa, while speaking with the Devcoms team stated that this year’s event was part of Goge’s ongoing community support projects meant to bring publicity to MNCH issues such as child development and maternal health.
His words, ’The government should continue to educate women on the need to access antenatal care in clinics so as to prevent child disabilities in the future, they should also endeavour to provide these clinics with the skilled medical staff and equipment.”
According to Moses, “They [the government] are most visible, so I usually mention them first. But organizations have their own responsibilities, too. I find if people aren’t asked to give, they won’t give. So it’s up to organizations like ours to push multinationals to give funds to children.”
The daylong charity event, held at Apapa Amusement Park in Lagos, drew a crowd of children, families, media, non-profit organizations, and government sectors, including the Federal Ministry of Health and UNICEF, who led a health and nutrition workshop for the children. Dance competitions, gift-giving, and cultural performances were among the festivities throughout the event, as well as a visit from the popular musicians the Mamuzee Twins.
By Amanda Hale
Improving MNCH takes more than government policies and roundtable discussions among policy makers. Though the different tiers of government have an obligation to ensuring the health of its residents, there is an immediate need for effective involvement of organizations at the community levels as a stepping stone for making a difference in the society.
To this end, the Lagos-based organization Goge Africa took the opportunity of the festive season to host a charity event for orphans and children with special needs. Knowing that many children in Lagos do not have the privilege of visiting parks or cultural shows because of their physical challenges, congenital disabilities, and lack of opportunities arising from coming from broken homes, the management of Goge Africa decided to invite them to enjoy a day of dancing and music.
Isaac Moses, the co-director of Goge Africa, while speaking with the Devcoms team stated that this year’s event was part of Goge’s ongoing community support projects meant to bring publicity to MNCH issues such as child development and maternal health.
His words, ’The government should continue to educate women on the need to access antenatal care in clinics so as to prevent child disabilities in the future, they should also endeavour to provide these clinics with the skilled medical staff and equipment.”
According to Moses, “They [the government] are most visible, so I usually mention them first. But organizations have their own responsibilities, too. I find if people aren’t asked to give, they won’t give. So it’s up to organizations like ours to push multinationals to give funds to children.”
The daylong charity event, held at Apapa Amusement Park in Lagos, drew a crowd of children, families, media, non-profit organizations, and government sectors, including the Federal Ministry of Health and UNICEF, who led a health and nutrition workshop for the children. Dance competitions, gift-giving, and cultural performances were among the festivities throughout the event, as well as a visit from the popular musicians the Mamuzee Twins.
By Amanda Hale
Tuesday, 11 December 2007
Empowering Youths to Drive Nations Forward
The growing need for youth involvement in development issues was at the forefront of Nigeria’s agenda last week as Action Health Incorporated (AHI) Nigeria, alongside an array of non-governmental organisations in Lagos met with Donald Floyd, President and CEO of the National 4-H Council, a U.S.-based non-profit organization, in Lagos to discuss partnerships for innovative youth development projects in Nigeria.
The National 4-H Council is the partner of 4-H, one of the United States’ largest youth development programs, which works with the mission to advance youth development movement; building a world in which youth and adults learn, grow, and work together as catalysts for positive change. According to Floyd, youth empowerment can only take place when adults step up and give young people the skills and opportunities to grow personally and professionally.
Youth involvement in decision-making is an important fuel to the social and economic strength of every nation, and should thus be encouraged in every developmental organization. “We need to give young people governance positions,” said Floyd. “Youths should have the power to sit on the board of directors or to make funding decisions within their organization, and also to make important decisions about the development of their communities and country.”
Floyd described his own experience working with four young people on the board of directors for the National 4-H Council. “It was an often painful experience,” he said with a laugh, “but the best strategy was for youths and adults to learn to mentor each other-- sometimes young people knew things we didn’t, and sometimes we knew things that they didn’t.
“It’s all about mutual learning to work together as catalysts for change.”
The meeting took place at a brunch reception hosted by AHI and drew a variety of non-profit organizations from Lagos to discuss the importance of youth empowerment in Nigeria, and how creative partnerships between local, national and international organizations can boost the level of youth projects and youth involvement in Nigeria’s future.
*By Amanda Hale
The National 4-H Council is the partner of 4-H, one of the United States’ largest youth development programs, which works with the mission to advance youth development movement; building a world in which youth and adults learn, grow, and work together as catalysts for positive change. According to Floyd, youth empowerment can only take place when adults step up and give young people the skills and opportunities to grow personally and professionally.
Youth involvement in decision-making is an important fuel to the social and economic strength of every nation, and should thus be encouraged in every developmental organization. “We need to give young people governance positions,” said Floyd. “Youths should have the power to sit on the board of directors or to make funding decisions within their organization, and also to make important decisions about the development of their communities and country.”
Floyd described his own experience working with four young people on the board of directors for the National 4-H Council. “It was an often painful experience,” he said with a laugh, “but the best strategy was for youths and adults to learn to mentor each other-- sometimes young people knew things we didn’t, and sometimes we knew things that they didn’t.
“It’s all about mutual learning to work together as catalysts for change.”
The meeting took place at a brunch reception hosted by AHI and drew a variety of non-profit organizations from Lagos to discuss the importance of youth empowerment in Nigeria, and how creative partnerships between local, national and international organizations can boost the level of youth projects and youth involvement in Nigeria’s future.
*By Amanda Hale
Thursday, 6 December 2007
Creative social marketing can stem unintended pregnancies in Africa
In Nigeria, the rise of unintended pregnancies and sexually transmitted diseases demands a revolutionary approach to social marketing in order to promote positive behaviour among youth. The following story of successful youth social marketing programs in Cameroon, Rwanda, and Madagascar could be applied to Nigeria’s social framework as well. With such a wide range of print, radio, and broadcast journalists pulling together to highlight sensitive and controversial issues regarding reproductive health and safe sex—such as cross-generational sex (sex between older men and younger women)—Nigeria could see a substantial reduction in harmful sexual and reproductive practices.
**
The social learning theory, which categorizes human behaviour in terms of the dynamic interaction between personal factors (knowledge, expectations, and attitudes), behavioural factors (skills and self-efficacy), and environmental factors (social norms, access to information, products and services, and ability to influence others), has been identified as capable of shaping young people’s perception of safe sexual behaviour.
This is based on a study by Population Services International (PSI), which was conducted across Cameroon, Madagascar, and Rwanda. PSI’s theory is based on the belief that individuals learn not only through their own experiences, but also by observing the actions of others and the consequences of those actions. The program concluded that after two years of media interaction with youth on reproductive issues in Cameroon, Rwanda, and Madagascar, that repeated exposure to multiple communication channels is necessary to change youth’s sexual behaviour.
Population Services International (PSI), a US-based non-profit group, implemented youth-oriented programs to prevent unplanned pregnancies and STDs, including HIV/AIDS, among youth between the ages of 15-24 years.
Past social marketing programs in Africa endeavoured to stem the tide of unintended pregnancies and STDs by using donated products such as condoms, and then selling them—attractively advertised under a brand name—in small shops and outlets to low-income shoppers. This encouraged people with low incomes, particularly youth, to buy condoms without fear of social backlash from shopkeepers or friends.
PSI workers took this conventional approach, but added a new twist—based on PSI’s behaviour change framework, which incorporates elements of the most commonly used behaviour change theories, such as the social learning theory, the health belief model, and the theory of reasoned action, PSI used the media to communicate intensively with youth and encourage them to use condoms or abstain from sex. In Cameroon, PSI launched a multi-media program with peer educators, journalists, comic strip artists, radio personalities, and scriptwriters to develop messages in the media, which highlighted experiences of youth who challenged social norms to protect their health. Television and radio advertisements aired repeatedly for four to six weeks and encouraged positive sexual behaviours, such as young women buying condoms to protect themselves from pregnancies and STDs. Additionally the program employed street vendors to sell monthly youth newspapers, called 100 % Jeune Le Journal, to youth around Cameroon. The newsletter included articles about reproductive health, letters from readers and responses from peer educators, sports, music, comic strips, and tear-out colour posters.
By Amanda Hale
**
The social learning theory, which categorizes human behaviour in terms of the dynamic interaction between personal factors (knowledge, expectations, and attitudes), behavioural factors (skills and self-efficacy), and environmental factors (social norms, access to information, products and services, and ability to influence others), has been identified as capable of shaping young people’s perception of safe sexual behaviour.
This is based on a study by Population Services International (PSI), which was conducted across Cameroon, Madagascar, and Rwanda. PSI’s theory is based on the belief that individuals learn not only through their own experiences, but also by observing the actions of others and the consequences of those actions. The program concluded that after two years of media interaction with youth on reproductive issues in Cameroon, Rwanda, and Madagascar, that repeated exposure to multiple communication channels is necessary to change youth’s sexual behaviour.
Population Services International (PSI), a US-based non-profit group, implemented youth-oriented programs to prevent unplanned pregnancies and STDs, including HIV/AIDS, among youth between the ages of 15-24 years.
Past social marketing programs in Africa endeavoured to stem the tide of unintended pregnancies and STDs by using donated products such as condoms, and then selling them—attractively advertised under a brand name—in small shops and outlets to low-income shoppers. This encouraged people with low incomes, particularly youth, to buy condoms without fear of social backlash from shopkeepers or friends.
PSI workers took this conventional approach, but added a new twist—based on PSI’s behaviour change framework, which incorporates elements of the most commonly used behaviour change theories, such as the social learning theory, the health belief model, and the theory of reasoned action, PSI used the media to communicate intensively with youth and encourage them to use condoms or abstain from sex. In Cameroon, PSI launched a multi-media program with peer educators, journalists, comic strip artists, radio personalities, and scriptwriters to develop messages in the media, which highlighted experiences of youth who challenged social norms to protect their health. Television and radio advertisements aired repeatedly for four to six weeks and encouraged positive sexual behaviours, such as young women buying condoms to protect themselves from pregnancies and STDs. Additionally the program employed street vendors to sell monthly youth newspapers, called 100 % Jeune Le Journal, to youth around Cameroon. The newsletter included articles about reproductive health, letters from readers and responses from peer educators, sports, music, comic strips, and tear-out colour posters.
By Amanda Hale
Monday, 3 December 2007
Immunization of children: the greatest achievement of all…
Immunization: gifting disease immunity to children of all social statusTHURSDAY, NOVEMBER 29, 2007
Experts have reiterated the fact that up to 3 million deaths are prevented yearly and 750, 000 children saved from disability if vaccination services are improved and maintained. The immunization of all children remains one of the greatest achievements of all humanitarian goals.
This assertion was made at the high level 1-day Conference session titled ‘immunization in Nigeria during the just concluded 34th edition of the international Medical Exhibition and Conference held at the Ocean View Hotel, Victoria Island Lagos.
Prof Chris Obionu of the college of medicine, University of Nigeria, Enugu Campus Nigeria, gave the presentation for the day titled the ‘Value of vaccine’. According to him, vaccine-preventable diseases/ infections constitute a major cause of morbidity and mortality worldwide, especially in developing countries like Nigeria. These diseases include: measles, yellow fever, smallpox, poliomyelitis, neonatal tetanus, tuberculosis, hepatitis B, and cerebrospinal meningitis. According to him, with future vaccine development, the number of preventable diseases will increase with future.
Though eradication of these diseases is possible through vaccination, there are concerns that vaccine coverage is falling. While a surprisingly large number of people are reluctant to accept vaccinations even when they are given free of charge, some governments view vaccines as a capital intensive venture instead of an investment and thus are reluctant to allocate funds to vaccination programmes. Thus there is no sustainable financial backing for the different vaccination programmes. He also lamented the ignorance of the value of vaccines which leads to squandering of immunization resources.
Outlining the values of vaccine for the individual, Prof Obionu said ‘Three million deaths are prevented yearly and 750,000 children are saved from disabilities. For the community, next to clean drinking water, vaccines are the most effective intervention in reducing and preventing the incidence of infectious diseases. While for the economy of the nation, its benefits are a decrease in: hospitalization, loss of productivity, and need for expensive treatment, permanent disabilities and disease outbreak.’
Prof Obionu maintained that government and individuals need to recognize the value of vaccines and disease prevention. The Government should recognize that a healthy population attracts investments and increase in productivity. He stressed that adequate investment in resources (human, material and financial resources) is needed for effective immunization. Applying the lessons learned from smallpox eradication in the use of other vaccines to fight diseases will enhance the value of vaccination.
He stressed that vaccines must be made available to all people no matter where they are in the world. Vaccines should be as highly valued as pure drinking water. With a motto such as “No vaccination, no achievement of the health-related MDGs”, the government will work harder towards achieving these goals. ‘Living in a world free of polio, and maybe measles, is not a dream. It can actually be realized’, he concluded.
By Adanma Ike.
Friday, 30 November 2007
Fight Against HIV/AIDS Carried To Imams
Fight Against HIV/AIDS Carried To Imams
In the continuous and combined efforts at ensuring better public health in Nigeria, the ongoing workshop organized by the Muslims Against Aids (MAIDS) in conjunction with the Public Affairs Section of the United States Consulate General is a major landmark in the fight against HIV/AIDS pandemic in the Nigeria.
‘Protecting the Ummah: Role of the Imam’ is the theme of the 3-day HIV/AIDS workshop.
Speaking at the opening, Ms Mary Lou Johnson Pizarro, Public Diplomacy Officer at the US Consulate reiterated the important role of religious leaders in the effort to reduce HIV infection and the resultant effects of the social stigma. According to her, since HIV/AIDS does not discriminate against everyone based on their race, colour, ethnic tribe or religion, there is a need to ensure that the efforts at its reduction to come from various sectors of the society. She stressed that the Imams will serve as a catalyst for change because of their influential positions in their various communities.
Pizarro said, the US Government will continue to support the fight against the spread of HIV/AIDS in Nigeria and also expect that the workshop will serve as an eye-opener for the participants who have ample opportunities of relating and practicing the things they would learn in the course of the workshop.
Capt. M.B. Ahmad, one of the workshop participants said that the role of religious leaders in the fight against HIV/AIDS cannot be over emphasized because of the influence they have over their followers. He lamented the fact that there has always being workshops on HIV/AIDS organized for various groups of people but there has not being any for religious leaders especially the Imams. While lauding the organizers of the workshop, he was optimistic that programme will serve its objectives and expectation and urged for a more regular workshops.
The training for the Imams, which will be the first of its kind in Lagos, Nigeria, has participants from the various local government areas of Lagos. The workshop which is part of activities to mark the 2007 World AIDS Day is expected to end on the 29th of November 2007.
By Akinpelumi Akinlolu
In the continuous and combined efforts at ensuring better public health in Nigeria, the ongoing workshop organized by the Muslims Against Aids (MAIDS) in conjunction with the Public Affairs Section of the United States Consulate General is a major landmark in the fight against HIV/AIDS pandemic in the Nigeria.
‘Protecting the Ummah: Role of the Imam’ is the theme of the 3-day HIV/AIDS workshop.
Speaking at the opening, Ms Mary Lou Johnson Pizarro, Public Diplomacy Officer at the US Consulate reiterated the important role of religious leaders in the effort to reduce HIV infection and the resultant effects of the social stigma. According to her, since HIV/AIDS does not discriminate against everyone based on their race, colour, ethnic tribe or religion, there is a need to ensure that the efforts at its reduction to come from various sectors of the society. She stressed that the Imams will serve as a catalyst for change because of their influential positions in their various communities.
Pizarro said, the US Government will continue to support the fight against the spread of HIV/AIDS in Nigeria and also expect that the workshop will serve as an eye-opener for the participants who have ample opportunities of relating and practicing the things they would learn in the course of the workshop.
Capt. M.B. Ahmad, one of the workshop participants said that the role of religious leaders in the fight against HIV/AIDS cannot be over emphasized because of the influence they have over their followers. He lamented the fact that there has always being workshops on HIV/AIDS organized for various groups of people but there has not being any for religious leaders especially the Imams. While lauding the organizers of the workshop, he was optimistic that programme will serve its objectives and expectation and urged for a more regular workshops.
The training for the Imams, which will be the first of its kind in Lagos, Nigeria, has participants from the various local government areas of Lagos. The workshop which is part of activities to mark the 2007 World AIDS Day is expected to end on the 29th of November 2007.
By Akinpelumi Akinlolu
Monday, 19 November 2007
Training of non-obstetrician healthcare workers can stem haemorrhage
Dr. Sadauki and Prof. Otolorin during a session at the SOGON conference. FRIDAY Nov 16, 2007
BENIN NIGERIA ----- The Effective competency-based training of non-obstetrician healthcare workers can lead to the successful management and prevention of Post partum haemorrhage (PPH) which has been acknowledged to be the leading cause of death among women globally and particularly in Nigeria. In the same vein, the use of anatomic models has been found to be invaluable for clinical skills development in the absence of PPH client load.
This result of the study conducted by Access to Clinical and Community Maternal, neonatal and Women’s Health Services (ACCESS, Nigeria) with the support of USAID was disseminated at the ongoing 41st scientific conference and AGM of the Society of Obstetrics and Gynaecology of Nigeria (SOGON) by Professor Emmanuel Dipo Otolorin, Chief of Party of ACCESS, Nigeria in a presentation titled ‘Competency Based Training for the Prevention and Management of Postpartum Haemorrhage’.
According to Professor Otolorin, since PPH can be drastically reduced with the Active Management of the Third Stage of Labour (AMTSL) and other medical skills, there is a critical need to ensure that birth attendants develop skills for managing this stage and other skills such as Manual removal of placenta; Repair of episiotomy and vaginal/perineal lacerations; Repair of cervical lacerations; Compression of abdominal aorta and the Bimanual compression of uterus.
The study which showed that there was marked improvement in the competence levels of the study participants was conducted in Zamfara and Kano States in Northern Nigeria. The maternal mortality rate in northern Nigeria is estimated at 1000 per 100, 000 live births and this can be attributed to the fact that many deliveries are done with no skilled attendant present and where they are present, may lack the skills required to manage the haemorrhage. The simulated scenarios which required different cadre of health personnel such as the laboratory scientist, anesthesian, working together brought to fore the need to develop and encourage the effective collaboration/team spirit among different medical personnel.
In the study, both skilled and semi-skilled health workers were trained using Anatomic models which included childbirth simulator, Fetal model, Placenta model with velcro attachment to abdominal wall, Cloth placenta with membranes and Foam blocks. While equipment such as Delivery kit, Episiotomy repair kit and print teaching materials were used and the study participants made to use Personal protective equipment, Decontamination equipment and Sharps disposal boxes.
However, the study showed that there was a need to step down the language of the training package for Community Health Extension Workers (CHEWs) besides training more midwives and CHEWs who are closest to these women in the community. Otolorin pointed that other skills that needs to be included in the curriculum include Suturing and knot tying (simple, vertical and longitudinal mattress stitches), conducting bedside clotting test, Use of hydrostatic balloon, and the use of antishock garment.
Otolorin concluded that competence-trainings should be a regular feature in Nigerian health facilities and for personnel in different fields relevant to maternal and neonatal health. This will ensure the properly management of emergency pregnancy complications but attention should be paid to the training of the community extension workers who are the people closest to the women in resource poor settings.
*Reported by Nnenna Ike
Haemorrhage-stopping device unveiled at SOGON conference
FRIDAY November 16, 2007 BENIN, NIGERIA ----- A novel method of treating haemorrhagic shock in women during or after childbirth has been unveiled and is being advocated for use by obstetricians and gynaecologists of Nigeria. The revelation of the Non-Pneumatic Anti Shock Garment (NASG) was made at the ongoing 41st Scientific Conference of the Society of Obstetrics and Gynaecology of Nigeria (SPGON) taking place in Benin Nigeria.
Professor Oladosu A. Ojengbede, Director Centre for Population & Reproductive Health, College of Medicine, University of Ibadan Oyo State Nigeria made this known in his presentation titled ‘Management of haemorrhagic shock’.
According to Ojengbede, obstetric haemorrhage is blood loss or bleeding during pregnancy; labour and within 42 days of termination of pregnancy. When there is excessive blood loss, women go into a state of shock which is progressively more dangerous if actions are taken on time to revive the patient. The major method of managing haemorrhagic shock’ is through resuscitation, which involves oxygenation, restoration of circulation, drug therapy, further evaluation and remedy of the basic problem that led to the shock.
The NASG is constructed like a pair of open-seamed trousers with one half made of velcro material so that it can be worn by women of varying sizes. It is worn from the abdomen to the legs and works by applying external counter pressure to the lower body, such that the blood is forced back towards the head and chest when the women is in a prone position. This way, the NASG can be used for Postpartum hemorrhage, Post cesarean hemorrhage, Ectopic Pregnancy, Trauma with injury/hemorrhage below the diaphragm while stabilizing the woman for further evaluation, transporting or preparing for definitive surgical treatment.
The NASG can be applied by anybody –doctors, nurses, CHEW, health attendants, ambulance drivers etc - who has been trained and with proper monitoring for adverse effects, can be safely and comfortably used for 24 - 48 hours. The NASG is so effective, it may arrest bleeding and avoid surgical intervention and even decrease the need for blood transfusions.
Prof Ojengbede however warned that the use of anti shock garment does not avert the necessity for evaluation to identify cause of shock, management of fluid and blood replacement, and appropriate therapy.
Prof. Ojengbede and colleague testing NASG at SOGON conference.
*Reported by Nnenna Ike
Professor Oladosu A. Ojengbede, Director Centre for Population & Reproductive Health, College of Medicine, University of Ibadan Oyo State Nigeria made this known in his presentation titled ‘Management of haemorrhagic shock’.
According to Ojengbede, obstetric haemorrhage is blood loss or bleeding during pregnancy; labour and within 42 days of termination of pregnancy. When there is excessive blood loss, women go into a state of shock which is progressively more dangerous if actions are taken on time to revive the patient. The major method of managing haemorrhagic shock’ is through resuscitation, which involves oxygenation, restoration of circulation, drug therapy, further evaluation and remedy of the basic problem that led to the shock.
The NASG is constructed like a pair of open-seamed trousers with one half made of velcro material so that it can be worn by women of varying sizes. It is worn from the abdomen to the legs and works by applying external counter pressure to the lower body, such that the blood is forced back towards the head and chest when the women is in a prone position. This way, the NASG can be used for Postpartum hemorrhage, Post cesarean hemorrhage, Ectopic Pregnancy, Trauma with injury/hemorrhage below the diaphragm while stabilizing the woman for further evaluation, transporting or preparing for definitive surgical treatment.
The NASG can be applied by anybody –doctors, nurses, CHEW, health attendants, ambulance drivers etc - who has been trained and with proper monitoring for adverse effects, can be safely and comfortably used for 24 - 48 hours. The NASG is so effective, it may arrest bleeding and avoid surgical intervention and even decrease the need for blood transfusions.
Prof Ojengbede however warned that the use of anti shock garment does not avert the necessity for evaluation to identify cause of shock, management of fluid and blood replacement, and appropriate therapy.
Prof. Ojengbede and colleague testing NASG at SOGON conference.
*Reported by Nnenna Ike
Friday, 16 November 2007
Govt makes pronouncement on post-partum haemorrhage drug
FRIDAY Nov 16, 2007
BENIN NIGERIA ------As Post-Partum Haemorrhage (PPH) continues to be the leading cause of maternal deaths in Nigeria accounting for 25% of maternal mortality, the search for a drug that can be administered to women especially in rural and resource poor setting got a boost with the federal ministry of health making a pronouncement on the drug Misoprostol. This is because the burden of maternal mortality rests on the grass root population and since this drug requires little/no expertise; its use should be promoted in order to reduce PPH which hitherto is the commonest cause of maternal mortality.
Dr Moji Odeku Director at the Reproductive Health Unit of the Ministry of Health made this pronouncement on behalf of the government at the 41st Conference of the Of Gynaecology and Obstetrics Of Nigeria (SOGON) taking place in the ancient city of Benin, Nigeria from the 14th to 17th November 2007.
She told participants that the present maternal mortality situation were basically due to the three delays namely: seeking care; accessing care and reaching healthcare. This was besides the fact that most pregnant women are anaemic and thus cannot tolerate blood loss, the lack of blood bank in most health facilities, and the socio-cultural and religious bias against blood transfusion. These trends according to her led to the study on the dug ‘Misoprostol’, a 3rd line uterotonic which is stable at room temperature, has a long shelf life and can be used at primary level were 70% of Nigerians dwell.
Dr Odeku said that the federal Ministry has since reviewed the clinical guideline and is recommending that ‘Misoprostol’ be introduced at health facility levels where it ca be administered by skilled birth attendants including doctors, nurses and midwives, and can also be administered by trained health care providers who are MLSS trained Community Health Extension Workers (CHEWS). She stressed that every effort would be made to ensure that the drug is readily available in the country and at generic dosages at affordable prices.
However, her presentation maintained that though ‘Misoprostol’ should be used for the prevention of PPH, uterotonics should be used in the following order Oxytocin, Erometrin and Misoprostol. She concluded that the information memo will be presented at the National Council on Health later in the year while a National dissemination meeting by the Minister of health would convene in December 2007. Thereafter, the ministry would commence a State training and sensitisation on the use of ‘Misoprostol’ in the 36 state of Nigeria including the FCT. This would be to enlighten the personnel who might be administering ‘Misoprostol’ in future against mis-use.
Dr Odeku urged medical personnel to embark on data gathering as an form of operation research to assess side effects, compare the cadre of the drug administrators and other relevant information as this would him in the formulation of the right policy on the drug use in Nigeria.
*Reported by Nnenna Ike
For more updates please join 1. http://groups.yahoo.com/group/SciPHJournalismForum/ and 2. http://health.groups.yahoo.com/group/ReproductiveHealthforum/
##
BENIN NIGERIA ------As Post-Partum Haemorrhage (PPH) continues to be the leading cause of maternal deaths in Nigeria accounting for 25% of maternal mortality, the search for a drug that can be administered to women especially in rural and resource poor setting got a boost with the federal ministry of health making a pronouncement on the drug Misoprostol. This is because the burden of maternal mortality rests on the grass root population and since this drug requires little/no expertise; its use should be promoted in order to reduce PPH which hitherto is the commonest cause of maternal mortality.
Dr Moji Odeku Director at the Reproductive Health Unit of the Ministry of Health made this pronouncement on behalf of the government at the 41st Conference of the Of Gynaecology and Obstetrics Of Nigeria (SOGON) taking place in the ancient city of Benin, Nigeria from the 14th to 17th November 2007.
She told participants that the present maternal mortality situation were basically due to the three delays namely: seeking care; accessing care and reaching healthcare. This was besides the fact that most pregnant women are anaemic and thus cannot tolerate blood loss, the lack of blood bank in most health facilities, and the socio-cultural and religious bias against blood transfusion. These trends according to her led to the study on the dug ‘Misoprostol’, a 3rd line uterotonic which is stable at room temperature, has a long shelf life and can be used at primary level were 70% of Nigerians dwell.
Dr Odeku said that the federal Ministry has since reviewed the clinical guideline and is recommending that ‘Misoprostol’ be introduced at health facility levels where it ca be administered by skilled birth attendants including doctors, nurses and midwives, and can also be administered by trained health care providers who are MLSS trained Community Health Extension Workers (CHEWS). She stressed that every effort would be made to ensure that the drug is readily available in the country and at generic dosages at affordable prices.
However, her presentation maintained that though ‘Misoprostol’ should be used for the prevention of PPH, uterotonics should be used in the following order Oxytocin, Erometrin and Misoprostol. She concluded that the information memo will be presented at the National Council on Health later in the year while a National dissemination meeting by the Minister of health would convene in December 2007. Thereafter, the ministry would commence a State training and sensitisation on the use of ‘Misoprostol’ in the 36 state of Nigeria including the FCT. This would be to enlighten the personnel who might be administering ‘Misoprostol’ in future against mis-use.
Dr Odeku urged medical personnel to embark on data gathering as an form of operation research to assess side effects, compare the cadre of the drug administrators and other relevant information as this would him in the formulation of the right policy on the drug use in Nigeria.
*Reported by Nnenna Ike
For more updates please join 1. http://groups.yahoo.com/group/SciPHJournalismForum/ and 2. http://health.groups.yahoo.com/group/ReproductiveHealthforum/
##
IMNCH endorsed by Nigerian Obstetricians and Gynaecologists
Chief (Dr.) Abiola-Oshodi, 1st Vice President with Dr. (Sir) JOhn Okaro, President, SOGON. FRIDAY November 16, 2007 BENIN, NIGERIA ----- Nigerian Obstetricians and Gynaecologists have formally thrown their weight behind the Federal government’s new initiative to effectively ameliorate the dismal state of the maternal and child care delivery in Nigeria. The initiate known as the Integrated Maternal, Newborn and Child Health (IMNCH) Strategies is being spearheaded by the federal ministry of health involves the reorganization and reorientation of the health system to ensure the delivery of a set of essential interventions which will provide a continuum of care for women, neonates and children. The IMNCH strategy is a holistic approach; it replaces the competing calls for mother or child.
Dr (Sir) John Okaro, President of the Society of Obstetrics and Gynaecology of Nigeria (SOGON) made this assertion, Thursday at the opening of the 41st Scientific Conference and AGM of the Society in Benin Nigeria. Dr Okaro was reacting to a speech made by Dr Moji Odeku, Director, Reproductive Health Unit at the Federal Ministry of Health Abuja.
In her speech, Dr Odeku said, the IMNCH represents the articulation of bold and new thinking on how to fast-track comprehensive action to turn around maternal and child health in the country. It pulls together in a practical continuum, an evidence-based maternal, newborn and child health framework for achieving Millennium Development Goals. Since maternal and neonatal mortality are often the result of a badly managed pregnancy and home delivery without a skilled birth attendant, the thousands of needless deaths would be prevented by implementing the integrated maternal, newborn and child health interventions.
She maintained that the new initiative would only be effective when bodies of medical professionals such as SOGON buy in into it and thus reduce the numerous parallel-running programmes on maternal and child healthcare. According to Odeku, IMNCH is a multisectoral approach which can only work when the different sectors acknowledge their roles and start implementing the responsibilities accruing to the roles.
She maintained that a sustained investment and a systematic phased gradation of essential IMNCH interventions, integrated in a continuum of care is required — when these interventions are in place the lives of many more mothers, infants and children will be saved. While commending the Edo State government for the new directive of tree treatment for pregnant women and children under five years, Odeku urged every state government to make adequate investment plans for the human resource and health facility in the areas under their jurisdiction so that the roll-out of IMNCH would yield lasting impact.
Responding, Dr. Okaro, asserted that maternal death, stillbirths and newborn deaths are strongly linked to deliveries which take place outside of health facilities, without properly trained birth attendants in attendance, or in health centres which are not equipped or staffed to handle emergency obstetric or neonate crises. He hoped that with the roll-out and implementation of the IMNCH strategy, the problems of not having skilled attendants, health centres without necessary facilities to deal with obstetric emergency and all the other problems that the members of the Society face in the discharge of their duties.
It is hoped that integrating maternal, newborn and child healthcare services will provide an opportunity for the health sector to eliminate unhelpful dichotomies (i.e. mother vs child, short term vs long term, skilled care vs community approaches, and intrapartum vs continuum of care) that stifle funding and lead to confusion and ultimately cost lives.
The SOGON Conference is a 4-day event with the main theme being Intersectorial collaboration for improving maternal and Neo-natal Health, while the Subthemes are Prevention of Cervical Cancer, Post-partum Haemorrhage.
*Reported by Nnenna Ike
For more updates please join 1. http://groups.yahoo.com/group/SciPHJournalismForum/ and 2. http://health.groups.yahoo.com/group/ReproductiveHealthforum/
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Thursday, 15 November 2007
SOGON conference begins: Experts call for adherence to WHO recommendations
Prof. Emmanuel Dipo Otolorin, Chief of Party, ACCESS NigeriaTHURSDAY Nov 15, 2007
BENIN NIGERIA------Prof. Otolorin, Chief of Party, ACCESS Program Nigeria has made a call to Nigerian medical professionals in the field of Obstetrics and Gynaecology to update themselves with current recommendations for the prevention of Post-partum Haemorrhage. Since PPH is the leading cause of maternal mortality globally and especially in Nigeria.
He made this call while presenting his paper titled Prevention of Post-Partum Haemorrhage the role of Uterotonics at the pre-conference workshop preceding the opening of the 41st Conference of the Society Of Gynaecology and Obstetrics Of Nigeria (SOGON) taking place in the ancient city of Benin from the 14th to 17th November 2007.
According to him, the various uterotonic agents used to prevent PPH include Oxytocin, Ergometrine and Prostaglandin analogues. However there is evidence to show the choice of Oxytocin as the first line of drug for the prevention of PPH over other uterotonics. He maintained that the large number of death experienced by Nigerian women would be reduced if proper attention is paid by medical personnel to the services rendered during a last stage of delivery. This, he said is known as Active management of third stage of labour (AMTSL)
Prof. Otolorin added the advantages of Oxytocin as being effective within 2 to 3 minutes after administration, minimal side effects, can be used on all women and that it is inexpensive. He cited its disadvantage as requiring cold chain handling and storage to maintain its potency. This he said can be remedied with the provision of solar cooling facility.
According to him, with Nigeria being in the tropics, we should be able to utilise the abundant sunlight we have with cost effective innovations. He recommended that Nigerian States should use the UNICEF prototype of solar coolant for vaccines for the storage of Oxytocin. He explained that one solar cooling facility can be procured and maintained by a number of health facilities in a State, such that there is always an availability of Oxytocin in health centres for use by women during delivery.
To ensure that the AMTSL is enhanced such that women do not die of PPH in Nigeria, there is need for an intersectoral approach to the services offered at that period. There should be an efficient collaboration among the different medical personnel, from the midwives, the laboratory scientist, doctors and even the people outside of the health facility. The government’s role would be in the provision of utilities such as electricity, water, and drugs supply at all times to health facilities.
Benin cultural troop at the opening ceremony of the SOGUN Conference.*Reported by Nnenna Ike
Failure of CEDAW, NIRH bills passage retrogressive
Dr. (Sir) John Okaro, President, Society of Gynaecology and Obstetrics of Nigeria (SOGON)Failure Of CEDAW, National Institute of Reproductive Health Bills Malicious And Retrogressive---SOGON
THURSDAY November 15, 2007 BENIN, NIGERIA ----The failure of the National Institute of Reproductive Health (NIRH) and the CEDAW Bills at the Nigerian legislative houses has been described as malicious and retrogressive in view of the fact that these bills would have started a marked reduction in the number of women who die in Nigeria due to pregnancy-related complications and their natural roles as women. Though Nigeria contributes only 2% of the world population, she contributes up to 10%of the deaths of women who die from pregnancy with an estimated 53,000 dying every year!
Prof (Sir) John Okaro, President of the Society of Obstetrics and Gynaecology of Nigeria (SOGON) made this assertion, Wednesday at the Pre-Conference Press briefing of the 41st Scientific conference and AGM of the Society. According to him, the failure of passage of the National Institute of Reproductive Health (NIRH) and the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), both women-friendly Bills would make the Nigerian statistics on maternal and neonatal deaths remain unacceptably high because of the misconception that the bills will promote abortion.
The Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) is the only human rights treaty which affirms the reproductive rights of women and targets culture and tradition as influential forces shaping gender roles and family relations, while the National Institute of Reproductive Health (NIRH) sought to promote the reproductive health of the vulnerable –all women. The Convention provides the basis for realizing equality between women and men through ensuring women's equal access to, and equal opportunities in, political and public life -- including the right to vote and to stand for election -- as well as education, health and employment. State parties agree to take appropriate measures against all forms of traffic in women and exploitation of women.
The 41st SOGON scientific conference kicked off yesterday Wednesday 14, 2007 in the ancient city of Benin in Nigeria, with the body calling on the media to wake up to its responsibility of educating the Nigerian masses with the view of reducing the three delays that lead to maternal mortality in Nigeria. His words, ‘the press is the bulwark of the future of the Nigerian women, and thus the future of Nigeria. Only the effective partnering of the Press with the medical professional associations would bring about the needed change amongst the populace and even among policy makers.’
Prof. Ladipo, Executive Director AFRH Ibadan, Oyo State, NigeriaProfessor Ladipo, Executive Director of Association for Reproductive and Family Health Ibadan, reiterated that only the proper understanding of the three delays by all would lead to a reduction in the deaths of Nigerian women during pregnancy. The Press should educate Nigerians about the delays at home, delay in getting to a health facility and the delay in accessing medical care at the facility. According to him, ‘Addressing these delays require that we provide appropriate education to our people, and we raise their level of confidence in the health system, then at the same time, make provision for community midwives who will reside at the communities to be available and skilled. A lot more still needs to be done from the point of view of improving the man power, improving the commodity supply, ensuring that electricity is regular, ensuring that water supply is regularly available, and ensuring that the morale of the health workers themselves is improved.’
Professor Emmanuel Dipo Otolorin, Country Director of ACCESS Nigeria called for more political commitment towards issues that concern women and children from the Nigerian polity. He called on the political leaders to take necessary steps that would ensure that posterity remembers them for good, by making statements and taking the actions to implement them. According to him, ‘Leadership should not be about oneself and the gains for one’s family, it should be about what I helped other people to achieve, what legacies I was able to put in place that would make people to remember me for good.’
The fact that about 53,000 women die annually in Nigeria is a grim realty that Nigeria policy makers have not firmly grasped in the past. These women die mainly from complications during pregnancy and delivery which include excessive bleeding after delivery, sepsis, pregnancy associated high blood pressure, anaemia, malaria and unsafe abortion. Most of these deaths are preventable if the society is better enlightened, social amenities in place and the health system given a boost of motivated personnel, drug supply and the right equipment to handle emergency obstetric complications.
The SOGON Conference is a 4-day event with the main theme being Intersectorial collaboration for improving maternal and Neo-natal Health, while the Subthemes are Prevention of Cervical Cancer, Post-partum Haemorhage.
*Reported by Nnenna Ike
EDITORS NOTE: For more daily reports please go to
http://devcomsmediadelivernow.blogspot.com/
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