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Monday, October 31, 2011

When UNICEF Tasked Media On Elimination of Mother to Child Transmission of HIV/Aids

Terkula Igidi

Jalingo — HIV/AIDS in sub-Saharan Africa and the Caribbean is said to have a female face. It is no wonder then that Nigeria is said to contribute about 30 per cent of the Mother-To-Child Transmission (MTCT) of HIV/AIDS burden to the world, having the highest number of pregnant women, about 200, 000 living with the epidemic and the United Nations International Children's Emergency Fund (UNICEF) believes reducing the burden lies squarely on the shoulders of the media.

"The media can clarify and disapprove misconceptions about HIV/AIDs and advocate policy actions to accelerate the prevention and elimination of MTCT and pediatric AIDS," Samuel Kaalu, UNICEF Communications Officer, D-Field Office, Bauchi, told journalists recently in Yola.

"Less than 50, 000 pregnant women are receiving anti-retroviral drugs to reduce the risk of MTCT," Dr Asusuji O. Osuji, UNICEF Assistant Representative in the D-Field Office, Bauchi, told journalists who met in Yola, Adamawa State for a one day sensitization workshop on how to eliminate MTCT.

He added that "prevalence in women reflects that in infants because of vertical transmission through pregnancy, labour, delivery and breastfeeding."

He indicated that prevalence rate for girls and women is higher than boys and men at all times except at age 15-19 when boys tend to be more adventurous and are exposed to higher risk of being infected with the virus.

He however said a HIV free survival for infants is possible with intervention. "Available technologies can reduce MTCT rate to less than five per cent among breastfeeding populations and to less than two per cent among non breastfeeding populations," Dr Osuji said.

Pediatric HIV infection is said to be a disappearing epidemic in higher income countries but in Nigeria, the gap between ante-natal care and HIV testing and counseling in pregnant women is still said to be wide, with Dr Osuji saying without dramatic progress in Nigeria, global goals are unlikely to be met.

According to Dr. Osuji, about 76 per cent opportunity has been lost in combating pediatric HIV, explaining that the "epidemic is relatively invisible" and may be taken for granted as it cannot be seen physically.

He also decried weak service delivery system and advocated the need to ginger them up, adding that the response to HIV/AIDS being "central and disease-specialist driven hampers non-medical approach and urged the media to intervene so that the bottlenecks can be removed in the fight against pediatric HIV.

He tasked the media to harp on behavioral change--abstinence and safe sex--and the deployment of biomedical strategies like safe blood products, safe needles, prevention of vertical transmission and male circumcision.

"Structural approaches also need to be taken. Social, economic, political, environmental and legal factors directly affecting HIV risks and vulnerability must be addressed," he said, adding that prevention of new infections and avoidance of unintended pregnancies, especially for women living with HIV/AIDS, was a sure way of eliminating MTCT.

Mr Kaalu, on his part, lamented that Nigeria has high income, strong cultural institutions and a large pool of private sector actors but are poorly engaged, resulting in low investment for children, limited social protection for the needy, limited human and institutional capacity for development and high regional disparities.

He reiterated that the goal of the workshop was to remind the media that they have to set agenda for the elimination of MTCT and pediatric HIV, and improve maternal and infant mortality rate and ensure the survival of children in the context of improved access to healthcare.

"Our target is to reduce Mother to Child Transmission (MTCT) to less than five per cent by 2015 and pediatric HIV by 90 per cent by 2015," saying UNICEF considers the media as partners and stakeholders because it is mostly the first source of information to the public. It has wide outreach and it can set agenda, especially on promoting universal access to treatment.

Earlier, the wife of the Adamawa State Governor, Hajiya Halima Nyako, who is also the chairperson, State Action Committee on AIDS (SACA), had said the media is a power group that can contribute immensely to the fight against HIV/AIDS.

She said HIV/AIDS prevalence rate in Adamawa State from 2008 to 2010 dropped from 6.8 per cent to 3.8 per cent because of awareness created by the media.

"The media must impact knowledge through advocacy, especially that abstinence and premarital testing are better approaches to reducing MTCT. I believe the media will leave here better equipped to fight the disease," she said.

The one day workshop which drew participants from notable media houses in the 10 DFO states of Adamawa, Bauchi, Borno, Gombe, Nasarawa, Kano, Plateau, Yobe, Jigawa and Taraba, had commitments of supporting efforts of governments and donor agencies in closing the gaps in the fight to eliminate MTCT.

http://allafrica.com/stories/201110241689.html

FG Partners Agency on Job Creation, Health Care



Efforts by the Federal Ministry of Women Affairs and Social Development to fast-track the Federal Government’s Transformation Agenda on women empowerment for the development of the nation, has received a boost.


This is as plans are underway to maximise the potentials of a medicinal plant, Moringa, to create jobs and step down maternal and child mortality in the country.


The Ministry is to partner a government agency, National Medicinal Plants Development Company (NMPDC) in mobilising and sensitising over 72 per cent of women in the country, predominantly the rural farmers to cultivate and process the plant and other 8,000 species of medicinal plants to provide health, nutrition and economic empowerment for them.


The recent development was contained in a press release, signed by press secretary of the ministry, Mr. Saghir Mohammed, and made available to THISDAY in Abuja.


According to the release, the Minister of Women Affairs and Social Development, Hajiya Zainab Maina, said Nigeria was a country blessed with abundant human and natural resources which are yet to be fully tapped.


She also commended the Federal Government for creating the National Medicinal Plants Development Company, which she noted, would ensure that the benefits of herbs in the country were fully exploited.


Addressing staff of NMPDC who paid a courtesy visit to her office, Maina, pledged her Ministry’s support to the organisation for their mutual benefit, and for health and economic empowerment of women, adding that her ministry was a major stakeholder in the industry, in view of its mandate which cuts across women, children, the elderly and persons with disabilities


The Managing Director of NMPDC, Hajiya Zainab Shariff, said the organisation plans to harness the potentials of local medicinal plants for health, nutritional and socio-economic benefit of Nigerians and the people of other countries. It also seeks to improve the health indices of the country through the integration of herbal medicine into the maternal healthcare delivery system.


The NMPDC boss informed the minister that, the global market for medicinal and herbal plant in 2007 was 87 billion dollars, and that India has over 8,000 manufacturing outfits for medicinal and herbal plants.


Shariff lamented that Nigeria was not actively involved in commercialisation of medicinal plants, with less than 5 per cent being tapped.


She stated that, “in line with the Transformational Agenda of the Federal Government, cultivation in small, medium and commercial scale will lead to wealth creation and employment generation”.


She stressed that harnessing the nutritional value of identified medicinal plants would reduce maternal and child mortality, Malaria and HIV burden, and was also a true way of facilitating the attainment of MDG goals and Vision 2020.

http://www.thisdaylive.com/articles/fg-partners-agency-on-job-creation-health-care/100999/

Nigeria: Kwara First Lady Offers Free Healthcare Service

Mustafa Abubakar
Ilorin — The LEAH Charity Foundation, a pet project of the Kwara State First Lady, Mrs. Omolewa Ahmed is offering free drugs, eye glasses and cataract operation for patients in Baruten Local Government Area of the state.

Mrs Ahmed, who disclosed this Wednesday in Ilesha-Baruba area of the council area while flagging off her mobile clinic programmes, said her Foundation was in partnership with the state Ministry of Health as well as several local and foreign organizations to provide free qualitative healthcare services to the people, stressing that the project was aimed at reducing the number cataract patients "to less than 10 percent of the 2011 base year figure by 2015".

She added that her programme, Omolewa Safe Motherhood Initiative, earlier launched in September at Alapa Cottage Hospital in Asa Local Government Area of the state, was aimed at tackling maternal and child mortality across the state.

Speaking on behalf of the Emir of Ilesha-Baruba, Alhaji Usman Bio Abubakar, a community leader Adam Yakubu, commended the first lady's initiative.

The Commissioner for Health, Kayode Abdul Issa, described the first lady's mobile clinic initiative as crucial to the realization of the Millennium Development Goals (MDGs) in the state's health sector.

http://allafrica.com/stories/201110210594.html

Nigeria: Stakeholders Hail Debut of Malaria Vaccine

Ruby Leo
Minister of state for Health Prof. Muhammed Ali Pate has described the debut of the world's first experimental malaria vaccine produced by pharmaceutical giants GlaxoSmithKkine as a positive development for health.

Prof Pate told Daily Trust that the vaccine which has been undergoing research for many years has shown remarkable promise and would help reduce the burden of maternal and infant mortality.

"It is a great leap forward in preventing the diseases that kill our children, mothers and adults," he added.

According to him, though the vaccine would not be in the market until 2015 and the vaccine is still undergoing clinical trial, there is hope that a malaria vaccine would be produced in no time.

Pate added that the country is already improving its vaccine distribution channels to ensure that the recent vaccines being introduced by the National Primary Health Care Development Agency (NPHCDA) get to the children that need it.

He pointed out once that is done, when the malaria vaccine is finally in the market, Nigeria will have the structures and systems in place to facilitate its effective distribution.

The President of the Nigerian Medical Association (NMA), Dr Idria Omede also described the vaccine as a good omen for the fight against malaria.

"Going by the magnitude, severity and associated with morbidity and mortality caused by malaria. This will be a relief for endemic and non- endemic areas that may have imported malaria.

Another medical practitioner, Dr Aminu Magashi Garba, said "from what I have heard the trial continues till 2014 and the children used in the clinical were protected by only 47% from malaria and it cannot be in the market until it has a 90% potency, so we still have a have long way to go."

http://allafrica.com/stories/201110210128.html

Health, Gender and Education MDGs: Outcomes on Policy Audits

Nigeria’s National flag


A one-day stakeholders’ validation workshop of Audit Reports on Policies on Gender, Health and Education was organised by the Civil Society Legislative Advocacy Centre (CISLAC) and the TY Danjuma Foundation in Abuja. Abimbola Akosile, who attended the meeting, examines the outcomes and recommendations

The Civil Society Legislative Advocacy Centre (CISLAC), in partnership with TY Danjuma Foundation, held a one-day stakeholders’ validation workshop of Audit reports on policies on Gender, Health and Education in Nigeria.

The meeting focused on the specific aims of working towards the actualisation of the outlined Millennium Development Goals (MDGs) between now and 2015.

The stakeholders were drawn from the ministries, lawmakers, civil society organisations and the media. In attendance were Chairman House committee on women affairs, Hon. Christina Alaaza; Office of the Special Adviser to the President on Gender, represented by Mrs. Davidson Ekpo.

The Federal Ministry of Health was represented by Dr. Chima Elenwune; Federal Ministry of Education, represented by Dr. Olu Ayewoh; National Human rights Commission, represented by Fatimah Shamaki; and other CSOs and ministries representatives.
The top resource person was the Dean, Faculty of Law, Ahmadu Bello University, Zaria, Kaduna State, Prof. Tawfiq Ladan

Three Audit Reports

The Audit reports for the three critical human development sectors (gender, education and health) considered during the validation workshop were undertaken by Prof. Ladan, who took all participants through an enriching and exhaustive analysis of the three sectors.
The reports sought to review the rationale, objectives and contents of the National Policy and implementation framework on education, health and gender; and to determine the relevance of the policy and legal frameworks in the attainment of the millennium development goals (especially MDG 2, 3, 4 and 6) and targets in Nigeria;

They also tried to make recommendations on how to address identified challenges in the implementation of the health, gender and education policy framework.

Executive Director, Civil Society Legislative Advocacy Centre (CISLAC), Auwal Ibrahim Musa (Rafsanjani), who welcomed participants to the forum, underlined the critical importance of meeting the vital MDGs on or before the 2015 deadline year for global realisation.

According to him, the MDGs are crucial to Nigeria’s development process and every effort must be put in by all relevant stakeholders to ensure their realisation for the growth and success of the country.

Prof. Ladan prepared and enlightened participants on three audit reports on the ‘National Gender Policy and Implementation Framework: - Meeting the Challenges of Attaining the MDGs and Targets in Nigeria. He also highlighted his research findings on the education and health sectors.

Policy on Gender

The audit report on gender policy reviewed the rationale, objectives and contents of the National Gender Policy and Implementation Framework.

It also sought to determine the policy relevance in the attainment of MDGs (especially MDG3) and targets in Nigeria; and to make recommendations on how to address any identified challenge(s) or gap(s) in the Gender policy/implementation framework.

The audit report on gender noted that Nigeria recognises that democracy and good governance requires that men and women have unrestricted access to spaces of power where they can realise their political value where their individual demands and preferences can be manifested and satisfied.

It added that reducing gender disparities can lead to improved macroeconomic performance. “The recognition that gender disparities are harmful and that government budgets are not gender neutral implies a need to incorporate gender considerations into the budgeting process”.

It noted that with the on-going reform measures in most of the sectors of the Nigerian economy tailored towards mainstreaming gender in law, policy, government, politics and economy, there was need for government to redouble her efforts by ensuring that adequate budgetary allocations are made and released in timely manner for gender oriented intervention programmes/activities.

In addition, the report stated that sustained political will was required to progressively mainstream gender in budgeting, governance, health, constitutionalism, access to economic resources as well as social services.

Attaining the Health Targets

The audit report on health sought to review the rationale, objectives and contents of the National Health Policy Frameworks; to determine the relevance of the policy frameworks in the attainment of MDGs (especially MDGs 4 - 6) and targets in Nigeria; and to make recommendations on how to address any identified challenge(s) in the implementation of the health policy frameworks.

In Abuja (Nigeria) in April 2001, African Heads of States and governments pledged to allocate at least 15 per cent of their annual budget to improvement in the health sector.

The report noted that the current structure of funding for the HIV/AIDS sub-sector was defective. “A situation where 87.3 per cent of the financing for HIV/AIDS comes from external sources is certainly not sustainable. It just shows that government is retreating from its obligations.

“If the health-related MDGs are to be achieved by 2015, there needs to be increased allocation of resources to the health sector by the Federal, State and Local Governments, and more importantly, a better coordination of efforts among these tiers of government.

This, it added, can be done by improving the quality of life of citizens, especially women, through a significant reduction of maternal and neonatal morbidity and mortality, unwanted pregnancy and sexually transmitted infections, and through the elimination of harmful practices and sexual violence.

Vital Recommendations

Prof. Ladan recommended that the decay in the health sector should be checked through the instrumentality of legislation and appropriate policy guidelines that are effectively implemented, monitored and evaluated.

He also urged the National Assembly to take steps to pass the proposed Health Sector Reform Bill (that has been before the National Assembly for more than four years) into law.

According to the audit report, the delay in passing the bill was mainly responsible for the on-going confusion in the nation’s health care delivery system; such that the rights and duties of health care providers, health workers, health establishments, and user are properly delineated.

To improve the policy environment, a vigorous preventive awareness campaign should be mounted like never before. This should be so enriched with cases and statistics to compel a positive change in the behaviour of the target populations and the message should be disseminated consistently and sustainably to the remotest corner of the country”, the report recommended.

Meeting Education Challenges

A detailed audit report by Prof. Ladan sought to review the rationale, objectives and contents of the National Policy and Legal Frameworks on Education; to determine the relevance of the policy and legal frameworks in the attainment of MDGs (especially MDG 2) and targets in Nigeria.

The report also made recommendations on how to address any challenge(s) or identified gap(s) in the policy and legal frameworks.
The audit report noted that there are more than 20 million children attending over 60,000 public basic education schools. North-South and rural-urban differentials are evident. In the urban sector, almost 4 out of every 5 children of primary school age are in school as against less than 3 out of every 5 in the rural areas.

The MDG target on primary education is to achieve 100 per cent net primary school enrolment and 100 per cent female-male parity by year 2015. The target also sates that school completion rate for all children, boys and girls alike should reach 100 per cent by 2015.
The report noted that Federal government and most likely state and local government budgetary allocation to education have not been substantial (given the needs of this sector) and stable.

The report also stressed the need for governments and private sector initiative in providing skills development for products of Quranic schools: - especially, in tailoring, shoe and soap-making etc.

Various Observations

Participants observed policy inconsistency and lack of continuity as ills affecting development in the country, and also observed the seeming lack of political will to invest in health, gender and education by the government.

They observed that the legislators are not properly mainstreamed in the struggle to achieve the MDGs.
Worried about the inefficiency and the high rate of corruption prevalent among the 774 LGAs in the 36 states of the federation; including the FCT, the participants identified lack of transparency and accountability as part of the ills behind the ineffectiveness of local governance in the country; which can affect the actualisation of the MDGs target in 2015.

Poor support and lack of encouragement for female who politicians was also identified as hindrance that could hamper the target of gender equity in the country.

In spite of the hope the new national health policy project towards reforming and ensuring improved health care delivery in the country between now and 2015, participants identified disagreement among the stakeholders in Health sector on some parts of the contents of the policy as another debilitating effect on the policy’s aims and the actualisation of the MDGs within the set targeted period.

They observed low budgetary allocation to health, gender and education ministries as part of the problems affecting the output of such sector(s) to national development and attainment of MDG goals.

Participants identified consistent lack of performance of LGAs as an offshoot of state government control and excessive influence on the funds and the activities of the local government areas.

They also observed that the last content of chapter two of the 1999 Constitution undermines the right on citizens to free and compulsory education.

Crucial Recommendations

The interactive Audit validation workshop after critical analysis into all the identified ills afflicting the actualisation of the MDGs between now and 2015 recommended various steps.

Participants recommended that policy makers and legislators be consist in making quality policies that are consist with the framework of gender, health and education to ensure attainment of the MDGs.

They called on the legislators and policy-makers to make stronger policies that would lead to the achievement of the MDGs, and urged lawmakers to play their legislative oversight role and appropriate resources into health, gender and education that would lead to the attainment of the MDGs.

The forum recommended that CSOs work closely with the LGAs in all the 36 states of the federation; including the Federal Capital Territory, Abuja for monitoring and evaluation of the funds meant for MDGs.

Participants also urged stakeholders in the health sector to harmonise their differences on the contents of the new national health policy in the interest of the sector and the actualisation of the MDGs.

Speakers at the workshop implored the CSOs to create awareness among the people and ensure that government is accountable and transparent to the people; while the Special Adviser to the President on MDGs was urged to partner the CSOs, Ministries and the media on the road to achieve MDG goals within the stipulated time.

CSOs were tasked to begin advocacy with the legislators in order to remove the clause in Chapter Two of the 1999 Constitution, which empowers office holder(s) to and not to give compulsory primary education, in order to make education accessible to all.

Participants recommended that periodic publications on the performance of the LGAs on primary health care delivery be adopted to ensure improvement in service delivery on health, while CSOs were urged to develop initiative for funding.

They thanked CISLAC for carrying out the Audit policy and organising the workshop. CISLAC’s intervention has provided CSOs with ‘their own’ document. They further observed that CSOs, ministries, media and government at all levels have the responsibility and duty to ensure the actualisation of the MDGs within the stipulated time.

http://www.thisdaylive.com/articles/health-gender-and-education-mdgs-outcomes-on-policy-audits/100912/

Group Wants Law On Exclusive Breast Feeding

By: Adebayo Ademola

Members of the National Assembly have been urged to legislate on the issue of exclusive breastfeeding of infants by Nigerian women to reduce infant mortality rate in the country.

A non-governmental organization, African International Baby-care Initiative, AFRIBABY, made the call at a press conference in Gwagwalada, Abuja.

Founder and President of AFRIBABY, Dr. Oscar Odiboh, the group has already presented an Exclusive Breastfeeding Bill to the National Assembly seeking for legislation mandating a 6-month exclusive breast feeding period for women in Nigeria, as well as make employers of labour grant 6 months maternity leave to such women.

He said Nigeria is at the risk of not achieving the 2015 MDG goals as regards infant mortality if urgent measures are not taken to encourage mothers to give maximum attention to their newborn babies for the first six months after birth.

Dr Odiboh said unless the practice of exclusive breastfeeding among mothers is encouraged, Nigeria risks losing more babies to infant related ailments.

According to Dr Odiboh, "Part of the bill advocates a 5% tax rebate for the organization. This is an incentive that will benefit both the nursing mother as well as the organization where she works. The tax rebate will be used to pay half of the salary of the nursing mother while on the 6 months leave, as well as to establish a crèche close to the organization, so she would have easy access to her baby during official break periods."

He also disclosed that the NGO is planning to hold its 2nd African International Baby-care exhibition in November.

The expo which is expected to be declared open by the first lady Dame Patience Jonathan will hold from the 15th to 17th of November 2011, at the premises of the University of Abuja Teaching Hospital, Gwagwalada, Abuja

http://allafrica.com/stories/201110200383.html

FG Needs N4trn to Attain MDGs

By Patrick Ugeh


Senior Special Assistant to the President on MDGs (SSAP-MDGS), Dr. Precious Kalambar Gbeneol, has said that N1 trillion would be required annually for the next four years to be able to achieve the overall objectives of the Millennium Development Goals (MDGs).

The goals, such as preventing maternal and infant deaths arising from access to good and affordable healthcare by the poor, prevention of HIV/AIDS transmission and education have a terminal date of 2015. These and five other goals like provision of safe water are supposed to be met by the deadline set about 10 years ago.

Gbeneol spoke while fielding questions from journalists at the presentation of a communiqué at the end of the four days retreat for actors and shareholders. It had the theme, ‘Refocusing MDGs for Sustainable National Transformation’.

Although it had been widely taken as an impossible task as Nigeria is way behind schedule, the newly appointed chief executive of the agency, Gbeneol, a medical practitioner, was optimistic.

“If everybody reprioritises their budget from individuals to local and state governments to align with the goals of the MDGs and put in more funds in addition to what they are putting in from the debt relief and if all stakeholders, action players and the man on the street is sensitised and embraces the MDGs as a focus in its attainment, I am optimistic we can achieve it,” she said.

Gbeneol assured the stakeholders that with the cooperation of everybody, and proper prioritisation, the attainment of the MDGs by the terminal year of 2015 would be possible.

The retreat was undertaken to review the implementation of the programme so as to identify the challenges, possibilities and prospects for the future.

Chairman, House Committee on MDGs, Hon. Alhassan Addo Doguwa, assured that since the Nigerian government was borne out of the will of the people, the legislature would always ensure that legislation and their implementation would impact positively on those they are representing.

According to him, the MDG was a programme that was all over the country, borne out of the opinion of members of the National Assembly.

Doguwa said in relation to “our own legislation, execution and implementation of government policies”, the National Assembly and the executive were always mindful of the interest of the downtrodden masses.

http://www.thisdaylive.com/articles/fg-needs-n4trn-to-attain-mdgs/100925/

Nigeria: Shifting Goals Versus Human Rights

Nigeria, like many developing nations is caught in the web of popular slogans. This time, it is the slogan of the Millennium Development Goals (MDGs). The MDGs are portrayed as holding the promise of eradicating extreme poverty, achieving universal primary education, promoting gender equality and empowering women and reducing child mortality. Other promises of the MDGs include improving maternal health, combating HIV and AIDS, malaria and other diseases, ensuring environmental sustainability and developing a global partnership for development. These promises are to be realized on or before the magic year, 2015.

But wait a minute, have we not travelled on this road before? As a young man in the university in the early 80's, I knew of previous slogans; health for all, housing for all, education for all, water and sanitation for all, etc, all by a previous magic year, which was the year 2000. The year 2000 was portrayed as a miracle year and all things were supposed to fall in line by that year; indeed impecunious bachelors were supposed to get wives and spinsters were automatically entitled to husbands of their dreams by the year 2000. And the year came to pass and nothing changed. But shortly before that magic year, world leaders quickly gathered to shift the goal post to 2015 thinking that the year will never come or at least to give them a breathing space to continue playing on the hopes and aspirations of the people. Nigerian governments enjoyed all this goal and goal shifting business because it suited and still suits their idea of governance.

About three years to the terminal date of 2015, what is Nigeria's score on the MDGs? The story is still the same as the country occupies unenviable positions with statistics that put it at par with war ravaged nations. Life expectancy from birth is put at 48.4 years and we account for 10% of worldwide maternal mortality; expenditure on public health is just a paltry 1.7% of the GDP; over ten million children are out of school and still roam the streets, etc. It is indeed a litany of woes.

Before we could digest the continuous shifting of the goal post and the poor performance, the Abacha administration produced Vision 2010 and the Obasanjo administration further shifted the goal post to 2020. In thinking of 2020, it appeared to the leadership that it was a far away time and would give them some elbow room to continue playing games. However, it dawning on every discerning and reasonable person that the 2020 dream is either a malaria induced dream or one based on insane delusions. So, where do we go from here?

Roll back to the year 1948 and the days of the development of the jurisprudence of human rights by the United Nations and its agencies. The Universal Declaration of Human Rights, a common standard of achievement for all humanity had proclaimed the right to an adequate standard of living including food, clothing, housing and health, education, social security, the right to work and the full development of the human personality, etc. Fast forward to 1966, the United Nations adopted and opened for signature, ratification and accession the International Covenant on Economic, Social and Cultural Rights. The Covenant expanded and expounded the rights in the Universal Declaration including the rights to adequate housing, enjoyment of the highest attainable standard of physical and mental health; education, food, social security, protection for the family and the continuous improvement of living conditions. Nigeria is a state party to the Covenant and as such is expected to take steps to the maximum of its available resources, with a view to achieving progressively, the full realization of these rights.

The foregoing brings to the fore the central poser for this discourse; which vehicle provides the best protection for the beneficiaries - rights or goals? It appears to me that the idea of goals was invented to water down the language of human rights in these days of government denying its obligations and seeking to transfer them to an imaginary market. Governments do not want citizens to know about their rights and to make claims for the realisation of those rights. A goal is just an aspiration, something you hope to achieve, a mere target. The rights proclaimed in the Covenant and reaffirmed in Chapter 2 of our Constitution and under various laws including the Child Rights Act, the Universal Basic Education Act, etc, on the other hand are inherent in the human person; they are entitlements and claims that should be made on government by citizens. They form the basis of the social contract between government and the people.

The fundamental problem is that the state is attempting to force the basic needs approach on issues of human rights in situations where the only feasible alternative is the human rights paradigm. This is the justification for the sudden international interest and rush to designate many economic and social rights as MDGs. For purposes of clarity, the basic needs approach and the human rights paradigm differs in a number of ways. A human rights approach introduces a normative basis, which binds the state implying that beneficiaries of development are active "subjects" and "claim holders" and stipulates the duties and obligations of those against whom such claims can be made. Such approach introduces the accountability dimension not present in the MDGs approach. Further, not all human needs are recognized as rights; rights are indivisible, equal rights necessitate the elimination of inequalities and all human rights embody individual freedom. The human rights approach moves away from human development indicators premised on or oriented towards goals, not towards rights. Goals are something you reach for while human rights are inalienable, intrinsic. In short, they are our birth rights.

I therefore believe that these so called MDGs should be treated as the human rights of the people and the entitlements of the beneficiaries should be properly defined and articulated. Government need not provide everything free of charge as that is impossible because of limited resources but it can pick up a limited package of interventions in education, health, housing, water, electricity, roads, etc and these will be deemed the minimum entitlements of citizens which translate to the minimum core obligations of government. The rights based approach will ensure that budgets will be prepared and implemented with a focus on meeting these minimum core obligations. For instance, if there is a right of access to free maternal and child health, the government will calculate the cost of implementation and make it a priority in budget formulation and implementation. The funding of such rights would come from the Consolidated Revenue Fund as first line charges. They will take precedence over padded votes to non performing offices and MDAs of government.

The rights based approach also envisages duties for the people. If governments begin to deliver on these rights, the willingness of citizens to pay taxes and support government will improve. Accountability will improve and government will have a higher moral ground to demand fiscal and other support from the citizens. This raises the final challenge for the federal and state governments, to come forward with entitlements and claims of citizens and the implementation mechanisms for new funds they intend to free from the proposal to remove fuel subsidy. Insisting on committing over 70 per cent of the budget to recurrent expenditure after the hardship imposed on citizens by the subsidy withdrawal will attract a national outrage.

Onyekpere is the Lead Director, Centre for Social Justice

Email: censoj@gmail.com

http://allafrica.com/stories/201110190741.html

African Parliaments Endorse a Resolution to Boost Maternal and Infant Health

Written by Naftali Mwaura

The legislative arm of the African Union, the Pan Africa Parliament (PAP) Wednesday urged governments to devote greater financing towards health of women and children.

In the resolution passed during the 5th session of the 2nd Pan African Parliament held on 3rd-14th October in Johanesburg, South Africa, members reiterated that matern al, newborn and infant health is critical to overall human and social development in Africa.

Health experts acknowledge that political commitment is a key catalyst towards realization of millennium development goals 4 and 5 on infant and maternal health in Sub-Sahara Africa.

African Parliaments are therefore well placed to mobilize political action and funds required to implement programs on maternal and infant health.

Rotimi Sankore,the Secretary, Africa Public Health Parliamentary Network hailed the latest endorsement and remarked “we welcome this landmark resolution by pan African parliament, which is a significant step towards African Parliamentary action to help end the tragic annual loss of an estimated 4.2 million lives of African Women and Children.”

Sankore added “the resolution strongly complements the African Union Commission-led Campaign for Accelerated Reduction of Maternal, Newborn and Child Mortality in Africa (CARMMA), launched in 31 Countries over the last two years”.

Carole Presern, the Director, Partnership for Maternal, Newborn&Child Health (PMNCH) echoed similar sentiments and stressed that “this PAP resolution demonstrates the vital and positive contribution that parliaments globally can make to saving and improving the lives of women and children, and in particular the commitment of African parliamentarians to their constituents.”

The latest resolution urge speakers of parliaments in the continent to lobby governments to increase budgetary allocation to programs related to women and childrens`health.

Likewise, the speakers are tasked with ensuring that policies are developed and implemented to embolden progress on maternal and infant health.

The resolution calls for high level parliamentary support to accelerate the implementation of a plan on policy and budget support towards health of mothers and their infants that was agreed by chairs of Finance and Budget committees of national parliaments in October 2010.

It was presented to speakers of African parliaments during their second annual conference held on 17th to 18th October, 2011.

Five senior members from each of the 54 African Union member states have pledged to work alongside speakers and relevant committees of national parliaments to implement the PAP resolution on maternal, newborn and child health.

African Union heads of States and governments as well pledged to reinvigorate efforts aimed at improving health of women and children during a high level summit held in Kampala, Uganda in July 2010.

According to a statement, the latest parliamentary resolution combines an integrated implementation of African maternal, newborn and child frameworks with the United Nations Secretary General’s Global Strategy for Women and Children, launched in 2010 to accelerate progress towards achieving the MDGs.

A partnership involving the Africa Public Health Parliamentary Network, the United Nations Population Fund (UNFPA), and the global Partnership on Maternal Newborn and Child Health (PMNCH), has worked closely with the Pan African Parliament in the lead up to this resolution.

The United Nations contend that 7.6 million children under the age of five and an estimated 350,000 women die each year from pregnancy related causes, most of which are preventable.

Ban Ki-Moon, the UN Secretary General has underscored the need for accelerated action to combat threats to women and children’s health.

He said “we must there fore do more for the newborn who succumbs to infection for want of a simple injection, and for the young boy who will never reach his full potential because of malnutrition”.

Culled from: African Science News

http://www.africasciencenews.org/en/index.php/health/63-health/191-african-parliaments-endorse-a-resolution-to-boost-maternal-and-infant-health-

Nigeria: Women Ministry to Create More Jobs With Moringa Plant

Ojoma Akor

Plans are underway by the Ministry of Women Affairs and Social Development in partnership with a government agency, National Medicinal Plants Development Company (NMPDC) to maximize the potentials of a medicinal plant, Moringa, in creating jobs and stepping down maternal and child mortality in the country.

A statement from the ministry signed by the Assistant Director Press and Publications, Mr. Saghir el-Mohammed, said the ministry will partner the agency to mobilize and sensitize the over 72 percent of women in the country, especially rural farmers amongst them, to cultivate and process the plant and other 8,000 species of medicinal plants, to provide health, nutrition and economic empowerment for them.

Speaking when a delegation of the NMPDC paid her a visit, Minister of Women Affairs and Social Development, Hajiya Zainab Maina said Nigeria is a country blessed with abundant human and natural resources which are yet to be fully tapped.

She commended the Federal Government for creating the National Medicinal Plants Development Company, which she noted, would ensure that the benefits of herbs in the country are fully exploited.

The Managing Director of NMPDC, Hajiya Zainab Shariff, said the organization plans to harness the potentials of Nigerian medicinal plants for health, nutritional and socio-economic benefit of Nigerians and the people of other countries.

"It also seeks to improve the health indices of the country through the integration of herbal medicine into the maternal healthcare delivery system," she said.

http://allafrica.com/stories/201110180448.html

Nigeria: 'Every State Should Have a VVF Centre'

interview

USAID ACQUIRE-Fistula Care Project has done much to advance effective service delivery on Vesicovaginal fistula (VVF) in Nigeria. The Project Manager, Efem Iyeme Efem, advocates at least one VVF centre in every state in Nigeria to maximize VVF care around the country in this interview with Onimisi Alao.

Why did you choose Ogoja and Ilorin as project sites: Is VVF more prevalent in these two towns or did you pick them as referral centres for the South - South and North Central sub-regions respectively?

Fistula is found everywhere in Nigeria. It is not only a problem of the north. Our activities in Ebonyi State have clearly shown this. The challenge for Nigeria is to ensure that every state has at least one fistula center to attend to the women who have VVF. The General Hospital Ogoja is uniquely positioned to serve the five local government areas in Northern Cross River where Fistula is very prevalent. It is close to their communities and clients can easily access the facility. For Ilorin, there is also a great need there. The Hospital at Sobi is also well placed to serve communities.

We understand that there are plans for the takeover of the Katsina center by the federal government. How far has this plan gone?

It is still a work in progress. Things do not just happen that quickly. On our part, we will do as much as we can in terms of advocacy to help the process but it depends on the speed at which the two governments - state and federal operate.

What is the rationale behind the takeover of the center by the federal government?

The federal government is moving towards setting up regional centers of excellence that will bring more specialized hands to attend to very complex fistulae. These centers will be training centers and will work to ensure that those that are challenging in the regions are referred to the center for further attention. We on our part, see this as the way to go, rather than have a National Center of Excellence in Abuja

Would it not have been better for the federal government to build its own centers from the scratch while allowing the present centers to run side by side?

That would not reflect prudent use of funds. Taking over the centers and upgrading them adequately will be the best approach. In Nigeria, we are always fond of new constructions but we forget that those facilities need to be maintained. If the Federal Government constructs its own centers, where will the staff come from? You will find that all the staff from the state facility will apply to join Federal and in so doing, the state facility will become abandoned and gradually dilapidate into oblivion, like many structures in Nigeria. So yes, we support the takeover and the funds that should have been used for more construction can be used to improve the facility.

What has been your role in Federal Government's involvement in VVF projects with resultant takeover of the Ebonyi centre?

The US Government, through USAID has played, and continues to play major role in the support of the Ebonyi Center. Along with other partners, support repairs of women with fistula, raising the awareness of the services of the center, thus increasing uptake, worked with the staff of the facility and government of the state on the idea to have the government take over the center to relieve the state of the burden of attending to clients from other states and also that of paying for staff from their meager purse. We also worked at the Federal level and the National Council of health Level to prepare the grounds for this and advocate for it to happen. So while we may not have been out there carrying placards to ask the government to take it over, in the idea and the subsequent groundwork, we played great role.

Are you comfortable with the situation at the Ebonyi center since the takeover by the federal government?

We believe that things are going well, so far, though from our perspective, the pace should be faster. However, knowing how the Federal Government works, I will give them kudos for moving this fast and this far, in the process.

From your experience, would you say that the incidence of VVF in Nigeria has reduced, or has remained constant since you started your VVF project in the country?

It would be hasty to say so, given that we do not have the benchmarks to prove that. With time, through the National Obstetric Fistula Working Group, we should be able to determine what the actual incidence is, and from there, determine if an impact has been made. Suffice to say however that our project, along with others have clearly raised the profile of the condition and made people more aware of it. We have succeeded in showing that this is also a condition that women in the south suffer and so gradually, others factors that cause Maternal Morbidity, when attended to adequately, will reduce, leading to even more reduction in the incidence of fistula.

Funding has remained a major constraint in the fight for the reduction of VVF in the country, with zero allocation by most states and the federal government for VVF services. How can this situation be reversed?

There has been some positive action in this regard, thanks to our direct discussion with some of these states. Bauchi Government is taking the lead on this. They have so far allocated N120 Million to addressing fistula activities in the state. This is a good start. Other states may not have included direct budget line for fistula, but have increased their allocation for Maternal Health. While we applaud them also, we would like to ask that they follow the lead in Bauchi State to not only earmark funds for Fistula, but actually "EYEMARK" it for use in fistula intervention.

Stakeholders have suggested the mainstreaming of VVF services in maternal and primary healthcare programmes, do you think this will help draw attention to VVF as a major factor and in so doing attract more funding to it?

The USAID/Fistula Care project has actually been the project that started championing this in Nigeria from the first day it was launched in Sokoto on February 5, 2007. We believe that mainstreaming fistula repairs as part of the routine health care delivery system will be the way to go, and have those regional centers of excellence to attend to fistula clients with complex conditions. So yes, we advocate for it. We have even developed a framework which we call "Levels of Care Framework" that, if introduced by the states and the Federal Government, will lead to mainstreaming fistula as part of the routine health care delivery system. We have also introduced "Integration" as a short cut process, where fistula is integrated into Family planning such that women who come to seek for services are educated about fistula and how to prevent it. We are in the process of talking to other intervention area managers on the need to expand this integration approach. This will gradually move us away form vertical programming to an integrated one, which will save cost and maximize staff usage.

Has government at all levels demonstrated the requisite political will to fight VVF in Nigeria?
Well, you know, as they say, "Talk is Cheap". We have had governments that have said the right things but short on action. However, we also have had governments that have taken the bull by the horn and come through with their plans. Bauchi is one of those states that have really shown that they can put their money where their mouth is. Ebonyi of course was another state that took it to the next level, leading to the takeover of the facility by the government. So, Ebonyi is really the state to emulate on this. The immediate past administration in Zamfara State did a great job supporting fistula and the women of the state benefited a lot. The first Trained the Trainer of fistula Surgeons that we supported was from Zamfara, thanks to the support of the then government. We are currently in discussion with the new government to see how we can improve upon the foundations laid by the former administration for the good of the women of the state. Sokoto state on the other hand has been working quietly to improve the services at the facility. They have increased the number of wards and given the facility a facelift. Of course you know that Katsina is where it all started and they are moving towards a well deserved Federal Government takeover. Overall, we would like to see governments who cannot afford to take on fistula as a main project, support their women to seek repairs in other states. If we can repair several women with fistula from Lagos State - the center of Excellence - then, every state in Nigeria and indeed every government should know that they have to do something about fistula in their states.

http://allafrica.com/stories/201110180394.html

OB/GYN's solar suitcase saves lives in poor nations


In March 2008, Dr. Laura Stachel arrived in the obstetrics ward of a state hospital in Zaria, Nigeria, determined to find out why so many women were dying in childbirth.

The poverty-stricken country on the coast of West Africa accounts for 2 percent of the world's population but 10 percent of maternal deaths, according to the World Health Organization. Stachel, an obstetrician-gynecologist then pursuing a doctorate of public health at UC Berkeley, expected to provide clinical advice on ways to improve procedures.

But she learned something far more basic was going wrong: The hospitals and health clinics simply didn't have electricity for large and unpredictable parts of the day.

Stachel saw midwives delivering babies by kerosene lantern. She observed a cesarean section during which the lights went out, forcing the surgeons to finish using her flashlight. She watched as a woman who arrived with a uterine rupture and barely a pulse was told to find a clinic with power.

"I was seeing the sickest patients I'd ever seen in rooms not as well equipped as an American garage," she said. "I would be there at night and think, 'I'm just here to watch these women die.' "

Without reliable electricity and standard tools, "(hospital workers) couldn't do the job they were trained to do," she said.

So instead of giving medical advice, she decided to get them more reliable power. As it happened, she knew whom to ask. Her husband, Hal Aronson, has spent more than a decade teaching about renewable energy systems throughout California.

When Stachel returned from Nigeria, they set to work designing a solar system for the hospital. The project would eventually lead them to form WE CARE Solar (wecaresolar.org), a Berkeley nonprofit that's now delivered 80 compact solar systems to health clinics around the world, including Burma, Liberia and Haiti. Dozens more will soon be en route to Uganda, Nigeria and India.

On Thursday, the organization will be recognized as one of 15 laureates at the Tech Awards in San Jose, an annual event celebrating individuals and organizations around the globe that leverage technology to benefit humanity.

Stachel never intended for any of this to happen.

She spent 14 years as an obstetrician-gynecologist, building up a Berkeley practice that she loved, helping thousands of women deliver healthy babies. But a degenerative back condition made it harder and harder to do the job, eventually forcing her to give up all deliveries and surgical procedures in 2002.

"I had this injury where I couldn't do what I was trained to do," she said, echoing the words she used for those doctors in Nigeria. "I was robbed of that."

She decided to study public health, which was what brought her to Nigeria as a consultant. The Zaria solar project eventually became the subject of her dissertation. But even that was supposed to be a one-off - until things took an unexpected turn.

Solar suitcase
Using a grant from the Blum Center for Developing Economies and funds from UC Berkeley, Stachel and Aronson went to work on a more than $20,000 project to provide a blood bank, communications system and nearly 1-kilowatt solar system at the hospital. It would be enough to keep the lights, suction machines and other critical infrastructure humming when the power flickered out.

To test their design, Aronson and Stachel created a miniature prototype that fit into a suitcase, in part to minimize customs issues. That small system, however, had a big, immediate impact at the hospital.

The local doctors pleaded with Stachel to leave the suitcase while the full system was under development. Smaller health clinics in outlying regions that got word of the hospital's solar system would later petition for one as well.

The couple realized they'd inadvertently struck upon what could be a scalable solution for health clinics throughout Nigeria and other impoverished regions. The prototype "solar suitcase" contained less than $1,000 of gear. How could they say no?

In the year after the large solar system was installed in the Zaria hospital, the maternal mortality rate dropped by about 70 percent.

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2011/10/15/BUFR1LHQVQ.DTL&type=tech

Maternal child mortality in Nigeria improves to 487 per 100,000

Minister of Health, Prof. Onyebuchi Chukwu, has said that the last demographic survey project conducted in 2008 shows an improvement of maternal child mortality ratio of 487 per 100.000 in Nigeria.


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Chukwu stated this in Abuja during the presentation of award for excellence in midwifery to Mrs. Catherine Oluwatoyin Ojo, organised by the federal ministry of health in collaboration with Nursing and midwifery council of Nigeria in recognition of her outstanding performance in maternal and child health care.

The minister commended the university of Benin teaching hospital for conducting the first test cell transplant but insisted on improvement of maternal mortality from 80% to 100% and urged the Ahmadu Bello University teaching hospital to imbibe their counterpart in Benin. He commended Mrs Ojo for her excellence and competence in saving Nigerian Lives and urged her to keep the flag flying.

Responding, the awardee, Mrs Catherine Oluwatoyin Ojo said that child survival is a priority in her life and dedicate the award to her father and husband for their support. Mrs Ojo works as a midwife at the Ahmadu Bello University Teaching Hospital (ABUTH). She was nominated for this award by the nursing and midwifery council of Nigeria and supported by the west African college of Nursing as an accomplishment noted by the ABUTH and international organisation in her remarkable contribution towards improving the quality of care in maternal,infant and new born care in Nigeria.
Mrs Ojo is currently involved in (PEPFAR) research on care of the HIV expose infants, she is trainer for BFHI, prevention mother to child transmission of HIV/AIDS, infant feeding option of HIV positive mothers,community based newborn care, and community integrated management of child illness.
http://www.nigeriancompass.com/index.php?option=com_content&view=article&id=6533:maternal-child-mortality-in-nigeria-improves-to-487-per-100000-&catid=328:commune&Itemid=624

Vaccination: Easy way out of cervical cancer

Widespread of vaccination has the potential to reduce cervical cancer deaths around the world by as much as two-thirds. Experts urged that alongside vaccination, women should take other measures such as pap smear screening and condom usage to protect them against cervical cancer, reports Sade Oguntola.

Approximately 75 per cent of the world’s children receive routine basic immunisations. Every country has a national immunisation programme (known by a variety of names) that delivers vaccines to infants, children, and often adolescents. In some countries the programme also delivers vaccines against influenza, pneumococcal infection, hepatitis B, HPV and other diseases, as well as vaccine booster doses, to adults.

The development and demonstration of the safety and effectiveness of HPV vaccines is a major breakthrough in medical science that could prevent most cases of cervical cancer.
Cervical cancer is one of the most common cancers that affect a woman’s reproductive organs and various strains of the human papillomavirus (HPV), a sexually transmitted infection, play a role in causing most cases of cervical cancer.

Shockingly, Nigeria’s Health Minister, Professor Onyebuchi Chukwu stated that Nigeria documents 10,000 new cases of cancer annually with 8,000 of these cases being cervical. Unfortunately, cervical cancer accounts for 15 per cent of female cancers as compared to just about 3.6 per cent in the developed countries.

Ironically, less than 0.1 per cent of Nigerian women have ever had cervical cancer screening in their lifetime and less than 1 per cent is aware of the existence of this silent killer. Consequently, cervical cancer kills a woman every hour in the country. Although 100 per cent preventable, the cancer kills more women aged between 24 to 35 years old in developing countries than any other cancer in other parts of the world.

But Nigeria’s population of 40.43 million women aged 15 years and older are at risk of developing cervical cancer. Worse still, about 23.7 per cent of women in the general population are estimated to harbour cervical HPV infection at a given time.

Currently, Nigeria has commenced the vaccination of girls between the ages of nine and 15 with the Human Papilloma Virus (HPV) as part of a national strategy to reduce the mortality associated with cervical cancer. The launch took off with initial vaccination of indigent girls from Abuja on the February 4, 2011. A month later, the second dose was administered to them. The final dose of the Human-Papilloma Virus vaccine was administered to a set of 186 girls aged between nine and 15 on August 15, 2011.

The government has also procured 4000 doses of the vaccine which would be available at Federal Teaching Hospitals across the six Geo-political zones of the country. “This is a sign of commitment from the Federal Government geared towards protecting future generations of women from the dreaded cancer of the cervix,” said Prof. Chukwu. “The vaccine would protect against 70 per cent of all those possible causes of cervical cancer.”

Certainly deaths associated with cervical cancer, which is due to lack of awareness of the disease, late presentation of patients to the hospital and cultural beliefs, are best avoided. In fact, it is expensive. Similarly, getting all girls vaccinated might be expensive. “Nigeria cannot afford to cover the cost of vaccination for all girls in Nigeria due to paucity of funds, but following negotiations between Global Alliance for Vaccines and Immunisation (GAVI) and the vaccine manufacturers, most Nigerian girls would be able to access the vaccines at subsidised rate,” assured Professor Chukwu.

According to him, “GAVI has been able to negotiate with the manufacturers such that the full cost would not be more than $15 and we think that many homes can afford to spend such money to prevent their daughters from becoming victims of cervical cancer.”

Unfortunately, Professor Isaac Adewole, the principal investigator, Operation Stop Cervical Cancer Nigeria stated that every 10 minutes, two women die from cervical cancer worldwide, affecting more of younger productive women between 20 years and mid 30s. Sadly, he stated “once a woman is affected, it can take between five and 30 years for the virus to develop into full cancer, but since it has no early symptoms, the woman feels very healthy while the virus continues to ravage her. By the time the symptoms begin to show, the situation becomes uncontrollable. Virtually nothing can be done to remedy the situation and the woman waits for death.”

Today vaccines are available for primary prevention of cervical cancer. Theses vaccines are already in use in other places. According to Professor Adewole, the Vice-chancellor, University of Ibadan, Ibadan, Oyo State “the availability of the cervical cancer vaccine is crucial to reducing Nigeria’s maternal mortality, to improving maternal health, to saving Nigeria lots of money.”

“Currently those women with invasive cervical cancer cannot be cured. But when you vaccinate girls, they would not develop cancer and as such we would be saving money. A vaccination programme like this is also cost effective,” Professor Adewole stated.

Professor Oladapo Campbell, a consultant oncologist, Department of Radiotherapy, UI , Ibadan, who lauded Nigerian’s step to make Human-Papilloma Virus vaccine available, stated “if we are able to organise vaccination against HPV, the virus that causes cervical cancer, in effect we will be reducing incidence of this cancer by 60 to 70 per cent. That is a giant step in cancer control in Nigeria by the government.”

But, “the Federal government should really get experts to handle the HPV vaccination. It is a very delicate issue. With experts involved, they would be able to create policy about how to carry out the vaccination exercise.”

HPV vaccination is not all there is to cervical cancer prevention. According to Professor Campbell, “cancer education is very important and this must be at all levels–school, community, in cities and rural areas. In fact, it is better to prevent cancer than to cure. Also, early detection of cancer is important.”

“For instance, with increased cancer education level of cancer stigmatisation has reduced. If you remember about 15 years ago, to pronounce cancer was very difficult but people now accept and face reality about cancer management.”

Since the vaccine only covers some high-risk types of HPV, experts still recommend regular Pap smear screening even after vaccination. In addition, to this is the use of condoms to protect against contracting HPV.

http://www.tribune.com.ng/index.php/your-health/29655-vaccination-easy-way-out-of-cervical-cancer

Nigeria: World Devt Report 2012 - Pushing for Global Gender Balance

The World Bank recently released its World Development Report 2012, which focused on gender equality around the globe. Abimbola Akosile highlights the content of a report which revealed that despite impressive gains in gender equality, nearly 4 million poor women are still "missing" each year in developing countries

The Right Thing

A new World Bank flagship report has revealed that gender equality matters in its own right but is also smart economics.

The detailed report, released in Washington, US, recently also noted that countries that create better opportunities and conditions for women and girls can raise productivity, improve outcomes for children, make institutions more representative, and advance development prospects for all.

Key Findings

The World Development Report 2012, titled 'Gender Equality and Development' detailed big strides in narrowing gender gaps but showed that disparities remain in many areas.

It noted that the worst disparity was the rate at which girls and women die relative to men in developing countries.

According to the findings, globally, excess female mortality after birth and "missing" girls at birth account for an estimated 3.9 million women each year in low- and middle-income countries.

"About two-fifths are never born due to a preference for sons, a sixth die in early childhood, and over a third die in their reproductive years. These losses are growing in Sub-Saharan Africa, especially in countries hard-hit by HIV/AIDS", the report added.

Presidential Concern

"We need to achieve gender equality," said World Bank Group President, Robert Zoellick. "Over the past five years, the World Bank Group has provided $65 billion to support girls' education, women's health, and women's access to credit, land, agricultural services, jobs, and infrastructure.

"This has been important work, but it has not been enough or central enough to what we do. Going forward, the World Bank Group will mainstream our gender work and find other ways to move the agenda forward to capture the full potential of half the world's population," he added.

Tackling Disparities

The report cited examples of how countries could gain by addressing disparities between men and women.

These include: Ensuring equal access and treatment for women farmers would increase maize yields by 11 to 16 per cent in Malawi and by 17 per cent in Ghana.

Improving women's property rights in Burkina Faso would increase total household agricultural production by about 6 per cent, with no additional resources, simply by reallocating resources such as fertiliser and labour from men to women.

The Food and Agriculture Organisation (FAO) estimates that equal access to resources for female farmers could increase agricultural output in developing countries by as much as 2.5 to 4 per cent.

Eliminating barriers that prevent women from working in certain occupations or sectors would have similar positive effects, reducing the productivity gap between male and female workers by one-third to one-half and increasing output per worker by 3 to 25 per cent across a range of countries.

"Blocking women and girls from getting the skills and earnings to succeed in a globalised world is not only wrong, but also economically harmful," said the World Bank Chief Economist and Senior Vice-President, Development Economics, Justin Yifu Lin. "Sharing the fruits of growth and globalisation equally between men and women is essential to meeting key development goals."

Gaps in Education

The report also noted that the world has made significant progress in narrowing gender gaps in education, health and labour markets over the past 25 years.

"Disparities between boys and girls in primary education have closed in almost all countries. In secondary education, these gaps are closing rapidly, and in many countries, especially in Latin America, the Caribbean and East Asia, it is now boys and young men who are disadvantaged.

"Among developing countries, girls now outnumber boys in secondary schools in 45 countries, and there are more young women than men in universities in 60 countries.

"Similar progress can be seen in life expectancy where women in low-income countries not only outlive men but live 20 years longer than they did in 1960. And in much of the world, gaps in labour force participation have narrowed with over half a billion women having joined the workforce in the last 30 years.

Remaining gaps include the lower school enrollments of disadvantaged girls; unequal access for women to economic opportunities and incomes, whether in the labour market, agriculture or entrepreneurship; and large differences in voice between women and men both in households and societies.

The report argued that these patterns of progress and persistence in closing gender gaps matters for development policies. "Higher incomes help close some gaps, as in education. As schools expand and more jobs open up for young women, parents see clear benefits to educating their girls", it noted.

"But too often, markets and institutions (including social norms around house and care work) combine with household decisions to perpetuate disparities between men and women. As part of this, gender gaps in earnings remain stubbornly unchanged in much of the world", the WDR added.

Calls for Action

The WDR 2012 called for action in four areas: addressing human capital issues, such as excess deaths of girls and women and gender gaps in education where these persist; closing earning and productivity gaps between women and men; giving women greater voice within households and societies; and limiting the perpetuation of gender inequality across generations.

"Focused domestic public policies remain the key to bringing about gender equality," said Ana Revenga, WDR Co-Director.

"And to be effective, these policies will need to address the root causes of gender gaps. For some problems, as with high maternal mortality, this will require strengthening the institutions that deliver services. For other gaps, as with unequal access to economic opportunities, policies will need to tackle the multiple constraints - in markets and institutions - that keep women trapped in low productivity/low earning jobs."

To ensure that progress on gender equality is sustained, the international community needs to complement domestic policy actions in each of these priority areas. It can also support evidence-based action by fostering efforts to improve data, promote impact evaluation and encourage learning.

To all Policymakers

The report recommended that policymakers focus on the most stubborn gender gaps that rising incomes alone cannot solve. It is by fixing those shortcomings that the payoffs to development are likely to be greatest, and where policies changes would make the most difference, it added.

"Development partners can support domestic policies in many ways -- more funding, greater innovation and better partnerships," said Sudhir Shetty, WDR Co-Director.

"Additional financing for clean water and sanitation and maternal services, for instance, will help the poorest countries. More experimentation, systematic evaluation and better gender-disaggregated data can point to ways of improving women's access to markets. And, partnerships can fruitfully be expanded to include the private sector, civil society groups and academic institutions," he added.

Local Flavour

Nigeria is trying hard to fulfil her Millennium Development Goal (MDG) on gender empowerment, with President Jonathan Goodluck's support for Affirmative Action and greater representation of women in his administration.

While that is commendable, the greater focus ought to be on breaking down the barriers holding women, youth and the girl-child from fulfilling their inherent potential, and creating a more conducive economic clime for the women in Nigeria to reach the zenith of their ambition, either at the local or national levels QUOTE.

Until women are free to vote who they actually want into political power without any marital censorship or communal strictures; and until the girl-child naturally assumes her place in the hallowed halls of learning alongside her often-favoured male counterpart, gender equality may be hard to realise in Nigeria. But the signs appear favourable to reach that goal.

http://allafrica.com/stories/201110130761.html

Nigeria: Kano Seeks Partnership With Canada On Maternal Health

Kano — The Kano State government has indicated interest to partner the Canadian High Commission in Abuja towards reducing maternal mortality in the state.

Receiving the Counsellor (Development) of the High Commission Mr. David Ross, Governor Rabi'u Musa Kwankwaso said his administration was ready to partner the commission to reduce maternal and child deaths to the barest minimum.

His administration on inception, according to him, introduced free maternal and child healthcare in the state, and that the gesture was aimed at enhancing the health condition of mothers and children.

The governor, who said that one of the thematic areas of his government is provision of quality and affordable healthcare to the people, added, "We need to partner with you not only on maternal and healthcare, but on all other areas that can be beneficial to the citizenry".

The Counsellor (Development) at the Canadian High Commission, Mr. David Ross earlier said that maternal and child healthcare are some of the core areas of the Commission's concern.

He expressed the Canadian High Commission's readiness to partner Kano State government, saying they would look into the modalities and see where they could partner the state government.

http://allafrica.com/stories/201110130306.html

Childbirth: Grim statistics of a journey of no return

BY SOLA OGUNDIPE
SENTENCED to death by pregnancy” has been a common cliché in Nigeria for decades. Nigeria has had a very poor record regarding maternal and child health outcomes. An estimated 53,000 women and 250,000 newborn die annually mostly as a result of preventable causes.

Every 10 minutes, a Nigerian woman dies as a result of complications of pregnancy or childbirth. Countless others are disabled in birth related accidents every year. The statistics are scary, the numbers of deaths numbing. For every woman that dies, 15 – 20 other women suffer short or long-term disabilities including obstetric fistulae, ruptured uterus and paralysis and complications.

It is an undisputed truth that too many women in the country are dying before, during or after childbirth. High maternal mortality and morbidity rates in Nigeria have remained a worrisome pattern.

High Risk: Statistics from the World Health Organisation (WHO) and UNICEF, reveal that a woman in Nigeria has a 1-in-18 risk of dying in childbirth or from pregnancy-related causes during her lifetime, which is higher than the overall 1-in-22 risk for women throughout sub-Saharan Africa.

Although the risks of maternal death are greater for women, in the northern region, the rural areas, and low income women without formal education, essentially, from east to west, north to south, the story that women are dying while giving life is sad. High maternal mortality in Nigeria is one problem that has simply refused to go away.

This distressing and disturbing fact is extrapolated from findings which show that the country has one of the highest maternal mortality rates in the world contributing an approximate 10 per cent of the total world estimate of maternal deaths.

Maternal death, according to the World Health Organisation is the “death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.”

Expectedly, preventable maternal death and disability are increasingly recognised as pressing human rights issues, encompassing questions of resource allocation and political commitment, for which governments must be held accountable.

While government has repeatedly identified maternal mortality and morbidity as a pressing problem and developed laws and policies in response, the big question is just how much have these actions translated into a significant improvement in maternal health throughout the country?

Midwives Services Scheme

Nigeria has always had a very poor record regarding maternal and child health outcomes, hence it must have been a big relief when the Midwives Service Scheme (MSS), was established by the National Primary Health Care Development Agency (NPHCDA), under the 2009 Appropriation Act. The MSS is a public sector initiative and a collaborative effort between the three tiers of government in Nigeria.

Mothers and their babies: Many women die trying to attain motherhood

A memorandum of understanding between the Federal, State and Local governments sets out clearly defined shared roles and responsibilities, which are supported by the strategic partners of the MSS.

Mobilising midwives

This MoU has been signed by all 36 states of Nigeria and is designed to mobilise midwives, including newly qualified, unemployed and retired midwives, for deployment to selected primary health care facilities in rural communities. The aim is to facilitate an increase in the coverage of Skilled Birth Attendance (SBA) to reduce maternal, newborn and child mortality.

However, even this may not be enough, as experts point to a major challenge of ensuring that skilled personnel are present at all deliveries with access to emergency care where necessary is the most effective means of saving the lives of mothers.

A consultant gynaecologist and Managing Director, Optimal Specialist Hospital, Surulere, Lagos, Dr. Ugochukwu Chukwuneye noted: “The MSS will definitely make some contributions down the line. It is a relatively new scheme but the improvement observed in our maternal mortality status, cannot just be attributed to MSS and to extension workers alone.

Many of the patients that die in pregnancy and childbirth, midwifery cannot help them. The only thing midwifery can do is that if they see such patient on time they can encourage a referral to where they can be helped but they cannot help them.”

Referral System

Chukwuneye, who challenged government to look beyond the widely acclaimed MSS as a means to curtaining the menace of maternal and infant deaths in the country, admits the scheme does provide skilled birth attendants and community health workers in villages and remote settings to help reduce maternal mortality in the country, but attributed its major limitations to the poor referral system in the country.

On addressing infant death at childbirth, he said it was up to the government at every level to provide adequate services in their facilities. “Government should provide enough operating teams or operating theatre or get into a kind of arrangement with good private hospitals who can be contacted and they can immediately take such a patient to that facility for the operation to save the life of mother and baby.”

“There is definitely a problem with the referral system in the country. The other problem is education. A lot of people don’t know for instance when they are already in trouble and that they should be asking to be moved to better facilities.

Some factors that inhibit the provision and availability of maternal health care in the country including: the inadequacy or lack of implementation of laws and policies, the prevalence of systemic corruption, weak infrastructure, ineffective health services, and the lack of access to skilled health-care providers worsened by separation of responsibilities for the provision of health care among the country’s three tiers of government.

MDG 5

But there indications in several circles that the pace of progress towards reaching the Millennium Development Goal, MDG, on maternal health, which calls for a 75 per cent reduction in the maternal mortality ratio between 1990 and 2015, has been too slow in Nigeria and throughout the developing world in general.

The MDG on maternal health has as target reduction of maternal mortality ratio by three quarter by 2015, but is Nigeria realistically approaching this target?

Are there things such as better health care particularly during pregnancy, delivery and in the post-partum period with interventions that improve maternal health such as antenatal care, provider-initiated HIV testing and counseling, skilled attendance at birth, emergency obstetric care, post-partum care and family planning?

Expectations today are that the pace towards the MDGs must be accelerated if the intended goal is to be reached. “To achieve the MDG target, maternal health must be addressed as part of a continuum of care that connects essential maternal, newborn and child health services and levels of maternal mortality often reflect the overall performance of a country’s national health system particularly during delivery and in the postnatal period, when mothers and newborns are most vulnerable.”

‘Nigeria has highest VVF prevalence rate in the world’

by Segun Olaniyan katsina

Senior Special Assistant to the President on Millennium Development Goals (MDGs), Dr. Precious Gbeneol, has lamented the prevalence of the Vesico Vaginal Fistula (VVF) in the country, saying that the problem in Nigeria is the highest in the world.

Dr. Gbeneol disclosed this at the weekend during the closing ceremony of a training programme on VVF for 22 doctors and 32 nurses at the Babar Ruga VVF Centre, Katsina.

She said Nigeria has the highest prevalence of VVF in the world with about 400,000 – 800,000 women living with the problem and about 20,000 new cases occurring annually with 90 per cent untreated.

She attributed the problem to the inadequate and unequal distribution of VVF experts among Nigerians.

The SSA on MDGs who noted the need to intensify training for more doctors and nurses to handle the backlog of VVF in the country said there are thirteen centers currently offering surgical care to about 4000 VVF affected women per year to reduce the unacceptable high rate of maternal morbidity.

“It is against this backdrop and consequently in the bid to curb the high maternal morbidity and to fasttrack the attainment of the MDGs that my office, in collaboration with the Federal Ministry of Health, agreed to embark on this training since available hospital data has shown that VVF cases are prevalent in the country.”

She added that the objectives of the training is to improve the capacity of indigenous doctors and nurses on how to handle VVF diseases across the country and to update them on the best practices in general management of VVF.

Dr. Gbeneol, however, commended the state governor’s wife and people of the state for their passion and interest in curbing VVF prevalence in the state. She also commended the trainers for ensuring the passage of adequate knowledge and skills to the trainees.

While challenging the trainees to adequately use the skills and knowledge they acquired to properly manage the VVF cases in their various health facilities, the SSA on MDGs called on all stakeholders, including development partners in the health sector, to support VVF programme in the country to save the lives of women.

http://www.tribune.com.ng/sun/news/5463-nigeria-has-highest-vvf-prevalence-rate-in-the-world

Tuesday, October 11, 2011

5 Million May Die of Non-Communicable Diseases By 2015

Ruby Leo

The Health Reform Foundation of Nigeria (HERFON) yesterday warned that the country would experience an epidemic of Non Communicable Diseases (NCD) by 2015.

Speaking during a pre-public launch press conference of its book 'Nigeria Health Review 2010,' in Abuja yesterday, HERFON Chairman, Dr. Ben Anyene, said "5 million Nigerians may die of NCDs by the year 2015, he also said that deaths from diabetics alone is projected to rise by 52% by 2015.

He said: "The economy cost of NCDs in Nigeria in 2005 was $400 million from premature deaths due to heart diseases, stroke and diabetics and by 2015, the economic cost will rise to $8 billion from premature deaths due to NCDs."

According to Anyene, "Deaths from NCDs will increase by 24% by 2015 and deaths from infectious diseases, maternal and peri-natal condition and nutritional deficiencies combined will increase by 6%.

According to him, the rising trends are a threat to Nigeria's national development, adding that the United States of America in 2010 alone spends $76.6 billion on direct and indirect costs related to care for cardiovascular diseases alone.

He pointed out that this calamity can be prevented if "we start now, we can raise a heightened level of awareness around lifestyles choices, regular screening, disease surveillance and pre-emptive management. It will be far less devastating economically and physically than waiting for the full blown manifestation of the epidemic before we act."

He said the book 'Nigeria Health Review 2010' which will be launched in Abuja on Thursday will stimulate national conversations and actions towards the control of the epidemics of NCDs in Nigeria.

The highlights of status of NCDs also indicated the prevalence of childhood obesity by 5%, with more girls affected, adolescent obesity, 3%, with more girls affected, the number of overweight women to rise b y 40% in 2015, while the number of overweight men is also expected to rise to 39% in 2015 from 29% in 2005.

http://allafrica.com/stories/201110110564.html

Health and 'Sector Wide Approach'- How Realistic? (1)

Dr Aminu Magashi
At a health stakeholders' meeting that was held in Bauchi State Government House on Sunday, 2nd October 2011, the Minister of State for Health, Dr Ali Muhammaed Pate proposed that the state consider sector wide approach in an attempt to ensure proper coordination of donor funded projects.

It was a unique meeting for the state and 'the 1st of its kind' according to a senior and retired colleague. All those that matters in health sector especially indigenes of the state as well as those in public and private sector, international development partners and friends of Bauchi State were in attendance to brainstorm on how to improve maternal and child health services in the state.

It will be good to properly understand 'sector wide approach' as one of the panacea that improves coordination among international partners as well as helping not only Bauchi but other states that has an avalanche of international donor organizations in the health sector and doing almost the same thing but with different approach and strategies.

In an article 'the sector-wide approach: a blessing for public health? Written by Guy Hutton and co published by WHO (http://www.who.int/bulletin/volumes/82/12/editorial21204html/en/), the authors observed that there is compelling evidence that improved health system performance is key to improved health, and necessary to meeting health-related international development targets such as the Millennium Development Goals .

In contrast, the strategies on how this is achieved are still open to debate. Since the mid-1990s, a new approach to health sector development has taken hold in a number of developing countries: the sector-wide approach.

The paper argued that 'there are persuasive arguments for supporting a sector-wide approach (SWAP) as opposed to the traditional project approach: increased health sector coordination, stronger national leadership and ownership, and strengthened countrywide management and delivery systems.

These are variously claimed to reduce duplication, lower transaction costs, increase equity and sustainability, and improve aid effectiveness and health sector efficiency. Furthermore, the SWAP has become an integral part of poverty reduction strategies, and its ideology has enjoyed a growing acceptance from donor agencies as well as aid recipients.'

To understand the potential impact of this approach on population health, four key areas are strengthened which indirectly, but importantly, have implications for public health: country leadership and ownership, institutional and management capacity, flow of resources, and monitoring and evaluation.

First and foremost, a SWAP explicitly mandates the ministry of health with the leadership. However, this role has been partly problematic owing to limited leadership capacity (e.g. Rwanda), poor relationship with the ministry of finance (e.g. Mozambique), slow shift of ownership (e.g. Cambodia), change of senior management (e.g. Zambia), little ministry of health leverage to secure additional funds (e.g. the United Republic of Tanzania), and low priority of cross-sectoral collaboration.

As the paper put it succinctly the SWAP emphasizes strengthened health sector management through the development or adaptation of management tools, combined with strengthening of implementation capacity. For example, under SWAP greater attention is given to health sector planning, financial management, and improved health information systems. SWAps also tend to emphasize strengthening district level management capability within existing decentralization policies (e.g. Ghana, Uganda and the United Republic of Tanzania).

Another dimension is that under a SWAp, 'recipient governments and donors only fund activities in the national health sector plan. Donor funds are pooled and earmarked for high priority activities, such as essential health package (e.g. Uganda, Tanzania).

Importantly, pooled donor funding supports government budgets, giving a much needed boost to recurrent expenditures. Lastly emphasis on monitoring and evaluation of the health sector is very key and need to be institutionalized under a SWAp.

The "one voice" of donors has strengthened their position to create conditions. The once or twice yearly joint review meeting is an important instrument providing an open forum to review the progress and performance of the health sector. These large meetings are complemented by more frequent meetings with key development partners. The success of these processes depends mainly on the people involved and their experience, expertise and sensitivity to developing partnerships.'

Another technical approach paper written by HLSP, a UK based institute titled 'Implementing a sector wide approach in health: the case of Mozambique has emphasized that 'In the year 2000 the Government of Mozambique and its development partners made the strategic decision to establish a Sector Wide Approach to Programming (SWAP) in health. The Mozambique health SWAP soon became widely cited in international health policy circles, particularly as the agreements and processes linked to it - the partner code of conduct, sector strategy, and coordination and review mechanisms - were developed and implemented fairly rapidly.

To many external observers, the health SWAP in Mozambique epitomized all the advantages of working sector wide: improved government leadership, greater sector policy and strategic focus, more effective use of aid to the health sector and lower transaction costs.'

In the part 2 of this article, I will elaborate more on the Mozambique experience vis-a- vis the practicability of implementing SWAP in Bauchi as well as the states across the federation.

http://allafrica.com/stories/201110110599.html

Health security, necessary for development, says Lagos Commissioner

Health security has been identified as a pre-requisite to the attainment of global, national and individual development.  

According to Lagos State Commissioner for Health, Dr Jide Idris, no individual or country can grow without health security, hence it is indispensable to development.

  Idris spoke at the Annual General Meeting of the Medical and Dental Consultants Association of Nigeria (MDCAN). The topic is,

The Millennium Development Goals (MDGs) in Lagos, a Megacity: So far, how far?.


He said there is hope despite notable setbacks after the 2008/2009 economic crises as corroborated by 2011 MDG report released on July 7 by the United Nations Secretary-General, Mr. Ban Ki-Moon.

  Idris said: "As doctors, our area of competence is the health sector, and the reality however, is that other sectors impact directly or indirectly on health. The implication of this is that health has multiple determinants, including some in sectors other than health. Hence, multiple sectors of government should collaborate and pay attention to their impact on health."

  He noted that the MDGs and its goals represent the most ambitious commitment ever made by the international community, adding that its achievements would make the most difference in the lives and future prospects of impoverished populations in the history of humanity.

  Idris said: "If these goals are met, ancient impediments to human development long considered intractable, such as poverty, ignorance, diseases, unhealthy environments and premature death from preventable causes would be overcome."

  He said though Lagos State is the smallest out of the 36 states in terms of land mass, it is the most populous accounting for over 10 per cent of the country’s total population  and it has been projected by UN Habitat that it will emerge as the third largest megacity in the world with a population of 24.5million after Tokyo and Mumbai by 2015.

  "The number one challenge of health service delivery in the state is the population which is as a matter of necessity taken into consideration when planning for the attainment of the MDGs, and indeed, the public health sector in particular," he added.

Idris said as a result to this urbanisation are the emergence of urban slums, over-crowding and associated diseases such as tuberculosis and measles, challenges of environment, water and sanitation that have impacts on health itself.

  "Improvement has been made to health with regards to child mortality, maternal health and combat of HIV/AIDS, malaria and other diseases, which are emerging on a global level and constituting public health challenges. These challenges of the epidemiological shifts from communicable diseases to non-communicable diseases, principal among, which are cardio-vascular diseases, diabetes and cancers are here with us," he said.

 Idris said MDGs have always been of major areas of concern to the government, hence it is no coincidence that the state government’s 10-point agenda bear striking similarities to the MDGs, adding that some the state government’s accomplishments on the MDGs include the eradication of extreme poverty and hunger, provision of Universal Primary Education, promotion of gender equality and women empowerment, reduction of child mortality, and improvement on maternal health, among others.

By Wale Adepoju

http://www.thenationonlineng.net/2011/index.php/health/22439-health-security-necessary-for-development-says-lagos-commissioner.html