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Thursday, January 27, 2011

Pregnant women need better protection against malaria - study

Too many pregnant women in sub-Saharan Africa are still not receiving adequate protection against malaria, placing them and their unborn children at risk of serious health problems and even death. Writing in the journal The Lancet Infectious Diseases, scientists from Kenya, the Netherlands and the UK explain that in 2007, an estimated 23 million pregnant women were not protected by insecticide-treated nets (ITNs) and 19 million did not receive intermittent preventive treatment (IPT). The researchers warn that if the situation is not remedied rapidly, internationally agreed targets to reduce the incidence of malaria in pregnancy will not be met.

Every year, some 32 million pregnant women in sub-Saharan Africa are at risk of catching malaria. Contracting malaria during pregnancy can have serious consequences for mother and child, raising the risk of maternal anaemia, stillbirth, low birth weight and neonatal death. According to the World Health Organization (WHO), 10,000 women and 200,000 infants worldwide die every year as a result of malaria during pregnancy. The WHO recommends that pregnant women use ITNs and IPTs to lower their risk of developing malaria.
http://cordis.europa.eu/fetch?CALLER=EN_NEWS&ACTION=D&SESSION=&RCN=32998

Tackling malaria in pregnancy contributes to three of the Millennium Development Goals, namely goals 4 (reduce child mortality), 5 (improve maternal health) and 6 (combat HIV/AIDS, malaria and other diseases). In addition, the Roll Back Malaria initiative set itself the target of ensuring that 100% of pregnant women receive IPT and 80% of all people in affected areas use ITNs to keep mosquitoes at bay. Finally, in 2000, African leaders gathered in Abuja, Nigeria, pledged to take steps to provide 60% of pregnant women in malaria-endemic areas with effective intervention measures.

In this study, led by the Malaria in Pregnancy Consortium, researchers investigated how many pregnant women in sub-Saharan Africa are actually benefiting from malaria prevention measures.

The good news is that of 47 countries studied, 45 had policies to provide women with ITNs and 39 had IPT policies for pregnant women. However, the data revealed that despite these policies, many women went through pregnancy unprotected.

In 32 countries with an ITN policy and for which data was available, just 17% of pregnancies (4.7 million pregnant women out of 27.7 million) were actually protected by ITNs. On IPTs, of 31 countries with an IPT policy and data on uptake, only a quarter of pregnant women (6.4 million out of 25.6 million) received at least 1 dose of treatment.

In other words, 23 million pregnant women did not benefit from the protection offered by ITNs and 19 million did not receive IPT. The researchers point out that in the case of IPT, 77% of pregnant women in the countries studied attended an antenatal clinic at least once during their pregnancy, meaning that 13.4 million pregnant women attending these clinics missed an opportunity to receive IPT.

Furthermore, coverage by ITNs and IPT was lowest in areas of high-intensity malaria transmission where pregnant women need protection the most.

'Ten years after the Abuja declaration, it is encouraging that the majority of malaria endemic countries in [sub-Saharan Africa] have now adopted ITNs and IPTp and the number of countries with nationally representative coverage data has increased to 40 out of 47,' comments one of the authors of the paper, Professor Feiko ter Kuile of the Liverpool School of Tropical Medicine in the UK.

'However, very few countries have reached either the Abuja targets or their own policy ambition, and countries are even further away from the more recent [Roll Back Malaria] targets set for 2010. In addition, coverage was lowest in areas with high malaria transmission, where the need is greatest.'

'Despite success in a few countries, coverage of insecticide-treated nets and intermittent preventive treatment in pregnant African women is inadequate; increased efforts towards scale-up are needed.'

The Malaria in Pregnancy Consortium brings together scientists from 47 organisations in 31 countries worldwide. The consortium is funded by the Bill & Melinda Gates Foundation as well as the EU and the European and Developing Countries Clinical Trials Partnership (EDCTP).

Kano Gets Equipment to Fight Maternal Mortality

Kano — The ACCESS/MCHIP, a USAID project, has donated medical equipments for the training of midwives to the Kano State Ministry of Health. The Country Director, ACCESS/MCHIP, Prof Emmanuel Otolorin, said the gesture was borne out of the desire to sustain the training of health workers towards reducing child and maternal mortality in the state.

Otolorin said for the past four years, they had been training health workers in Kano on basic obstetric emergency care skills. Every year, a total of 600 workers were trained, he said, adding that in order to sustain the training, the project decided to supply the training equipment to the school of midwifery so that the students would be trained right in school and graduate after mastering the skills.

Receiving the items, the Commissioner for Health Hajia Aisha Kiru expressed gratitude, saying the donation was timely in view of its need and cost. She said when the ministry wants to supply equipment to its health facilities, they go to as far as Lagos to buy them at an exorbitant prices.
http://allafrica.com/stories/201101260226.html

Wednesday, January 26, 2011

Beyond FG’s task force on MDGs

Five years to the target date for the achievement of the Millennium Development Goals (MDGs), and against the backdrop of the slow pace of Nigeria in attaining the set MDG targets, a presidential task force has been set up to assess and fast track their implementation. It will be headed by President Goodluck Jonathan.

From 2000 when the Millennium Declaration was made, MDGs have become key tools for monitoring human progress in all countries across the world. In particular, eight goals were set for achievement by year 2015 by all countries. They are : Eradication of extreme poverty and hunger; achievement of universal primary education; promotion of gender equality; reduction of child mortality; improvement of maternal health; combating HIV/AIDS, malaria and other diseases; attainment of environmental sustainability and development of a global partnership for development. On its part, the UNDP has turned the eight goals into 18 targets and 48 indicators which are used to monitor the countries’ progress.

In recent time, there was a marked positive trend in the progress made in attaining the MDG targets by Nigeria following several interventions by the Federal Government such as substantial improvement in immunisation, Midwives’ Service Scheme and National Health Insurance Scheme, amongst others.



Also, evidence abounds that Nigeria could meet three out of the eight goals by 2015, namely: achieving universal basic education; ensuring environmental sustainability; and developing global partnership for development. However, the country is still far from achieving the remaining five health-related goals, five years to the target date of 2015 set for the achievement of all the MDGs. Meanwhile, lack of up-to-date data and limited funding for data generation and management are the critical barriers to achieving the MDGs in these areas.

The implication of this is that a lot of action will be needed to improve healthcare delivery in the country to achieve the MDG targets for the sector. For example, the federal government is committed to the Abuja Declaration which stipulates that every government in the ECOWAS sub-region should spend 15 percent of its national budget on health. So far, the government is yet to achieve this as it is spending about nine percent of its national budget on health. Also, Nigeria is one of the few countries still suffering from the scourge of polio. The National Health Bill which, among other things, seeks for additional funding of the health sector, is still before the National Assembly for passage into law.

Only recently, a delegation of the Economic Community of West African States’ Technical Committee on MDGs was in Nigeria to assess the progress being made by the country. Such assessment serves to keep Nigeria and other countries in the sub-region focused on the attainment of MDG targets. Nigeria must stop sloganeering on MDG goals and targets and work hard to achieve every target set in each of the sectors. The country needs action, more so that the government is poised to ensure that Nigeria does not lag behind in meeting its MDG targets.

Constitutionally, Nigeria’s federal structure puts implementation of the MDG goals at the door steps of the states and local governments. Unfortunately, these two levels of government lack the necessary institutional capacity to achieve optimum performance in the attainment of the MDG targets. In particular, they lack the quantum of funding needed to drive the programmes. And at the national level, poor governance, weak monitoring mechanism and low stakeholder involvement, particularly by the private sector and civil society organisations have remained major challenges to federal government’s achievement of the MDG goals.

It is noteworthy that the federal government has woken up from its slumber and is ready to achieve some of the set goals, in the five years remaining for the eight goals to be met. Interestingly, at the federal level, UNDP officials deal directly with the line ministries to actualise the MDG goals. This however, must be extended to the states and local government levels.

Also, these tiers of government must cooperate with the UN agencies to fast track the attainment of MDGs in the set areas, especially in the area of doctor-patient ratio which is still poor in the country, drugs availability in hospitals and in the eradication of polio, malaria and other infant mortality diseases.

Going forward, Nigeria has passed the era of political sloganeering in this regard. What is needed now is action. Many nations are ahead of Nigeria. Nigeria must move faster than it is doing now, otherwise, it will continue to lag behind other nations in the achievement of MDGs.

The federal government must show more than cursory interest in any programme designed to make Nigeria achieve its MDG goals. It must substantially improve funding of the health sector particularly as it relates to the achievement of the MDG goals by 2015.

http://www.compassnewspaper.com/NG/index.php?option=com_content&view=article&id=73869:beyond-fgs-task-force-on-mdgs&catid=39:editorial&Itemid=679

U.S. Students Design Ultrasound for Ugandan Midwives

A low-cost ultrasound system is on its way to Uganda in early summer. Produced by students at the University of Washington, it's intended to help midwives battle the high death rate in the country's rural areas.


KAMPALA, Uganda (WOMENSENEWS)--A low-cost maternal ultrasound system that began as a class project by a group of college students at the University of Washington in Seattle is to be tested by midwives in Uganda, a country with one of the world's highest maternal mortality rates.

Around 10 Ugandan midwives will be selected to participate in the field test project. The experiment will evaluate whether the device matches the midwives' needs and skills.

The device is designed to enable midwives to detect conditions that can complicate pregnancies and birth, such as multiple births, breech births--when the fetus' head is pointing upward--and blockage of the birth canal by the placenta. Midwives spotting these high-risk conditions in time could refer women to hospitals with facilities to handle them.


"We aim to make an easy-to-learn and easy-to-use device, and the opinions of midwives are crucial to our design process," said Alexis Hope, a graduate student in the university's department of human centered design and engineering. "We hope to use the results of the field test to improve on our design and then return to Uganda with a better device to test again."

The student-designed device connects an ultrasound probe to a laptop computer with a touch-sensitive screen. Students have reduced the number of controls required to allow for easier operation than the type of display set up found in doctors' offices and hospitals.

The notebook has big, touchable buttons, which make it easy to adjust the controls for a clearer image. It also has a built-in system that provides assistance to the midwives and suggests ways to make the scan image better.

To reduce the cost of the device, the students wrote their own software. The device costs about $3,500. Ultrasound machines usually cost $15,000 to $60,000, a prohibitive amount for many African health care providers.

It could also reduce the need for costly remote interpretation and diagnosis.

High Death Rate
The pregnancy-related death rates among Ugandan women stand at 430 per 100,000 live births, according to the World Health Organization. In Sweden, by contrast, the maternal mortality rate is only five deaths per 100,000 live births.

The students' project began in the summer of 2009, when Dr. Rob Nathan, a University of Washington assistant professor of radiology, approached Beth Kolko, also a fellow professor of human centered design and engineering.

Nathan had a pilot project in Uganda that was attempting to show that ultrasound technology could reduce maternal mortality by allowing midwives to refer women with high-risk pregnancies to hospitals for delivery and treatment. But what if midwives could have good diagnostic equipment to help them make that assessment?

Last winter, one of Kolko's classes--Concepts in Human-Computer Interaction--teamed up with computer science lecturer Ruth Anderson, teacher of a course called Designing Technologies for Resource-Constrained Environments. That's how five students set out to design a low-cost maternal ultrasound for use in the developing world.

"We got thrown into it after hearing a brief presentation by Dr. Nathan about what he was looking for," said Hope, one of the graduate students. "We sort of jumped at the challenge."

The project evolved into a senior-level research project in computer science and engineering. More graduate students in the human centered design and engineering department joined the group, many using the project to earn research credits.

The ultrasound unit was tested in November by Seattle-area midwives, including ones with little or no ultrasound experience. They were able to complete tasks similar to the Ugandan midwives' expected tasks.

In November, the students won a $100,000 Bill and Melinda Gates Foundation Grand Challenges Explorations grant, which are designed to help scientists around the world explore ways to improve health in developing countries. The grant will help the team research how to make a cheaper, simpler ultrasound device.

"The Gates grant came through after we had done some initial testing with Seattle-area midwives. It is allowing us to take the critical next step of taking it to the field," Hope said.

Receiving the Gates Foundation grant "was very relieving," said team member Wayne Gerard. "We were not sure where we were going to get funding to travel to Uganda. We're also honored to have such a great foundation backing us. But mostly it is great to know that we have some funds to test our device."

The ultrasound device can't be expected to work miracles on Uganda's maternal mortality problem though.

Janet Obuni, chairperson of the Uganda Nurses and Midwives Union, based in Entebbe City in Uganda, says even when midwives identify rural women as having high-risk pregnancies, often all they can do is refer them to regional hospitals, which may be many miles away and difficult for the women to reach.

Given the relatively sparse health facilities in Uganda, the average distance to a government health unit is 4.6 kilometers, or almost three miles, which often must be covered by foot, according to the 2010 Uganda National Household Survey.

In the rural district of Kyenjojo, midwife Rose Baguma says when high-risk pregnancies are detected by physical examination, most mothers cannot afford the $3 taxi fare to Buhinga Regional Referral Hospital, more than 36 miles away.
By Raymond Baguma

WeNews correspondent


http://www.womensenews.org/story/reproductive-health/110121/us-students-design-ultrasound-ugandan-midwives

World Bank Tasks FG On Health Education

ABUJA - Mr Onno Ruhl, the World Bank Country Director in Nigeria wants the Federal Government to invest more in education and health to boost the country’s development.


Ruhl, who spoke at the Forum in Abuja , observed that the growth rate in the two sectors was on the low side.


“Health and Education that is where the government needs significant help. Unfortunately, that is where Nigeria has some difficult indicators, especially on maternal and child mortality.


“ Education is not enough, there are too many girls out of school,’’ he said.


According to him, Nigeria has some proud higher institutions that people believe that, “if brought to the 21st century standard; it will bring change to the sector’’.


He noted that Nigeria had made tremendous achievements in telecommunications, banking, information and communication technology and agriculture, among others.


Ruhl said these achievements were laudable but said that steps must be taken to ensure that they were reflected in the lives of the ordinary Nigerian.


He said that to create jobs in the country, it was necessary for Nigerians to invest in the wholesale and retail business as well as the hospitality and entertainment industry.


“And I will like to say Journalism because not every person outside Nigeria knows how open the press is and how it gets more professional day by day; that is a great achievement.


“Human development is also very important,’’ the country director added.


Asked whether the bank was satisfied with returns on its investments in Nigeria , Ruhl said:


“I think, first, my observation is that we basically re-engaged in 1999 when democracy happened and obviously that means our portfolio like the Nigerian democracy is young.’’


He also explained that the bank’s objective was to help the governments of different countries to achieve their development objectives and grow their economies.


“That is the component of economic growth we support because it is very important for poverty reduction and human development.


“Because a sustainable growth path for the economy means that you need a healthy, well educated work force; you need a functioning infrastructure,’’ Ruhl said.


According to him, the bank’s portfolio in various projects in Nigeria is still about 4.6 billion dollars, a figure which, he noted, did not vary much as projects were completed and new ones nitiated.


Meanwhile the World Bank Country Director in Nigeria , Mr Onno Ruhl, has said that Nigeria needs a “realistic plan“ to solve some of its basic problems.


Ruhl, featuring on at Forum in Abuja , said the problems included power supply and infrastructure.


However, he said that the Federal Government’s Vision 20: 2020, if well implemented, could address the problems thereby enabling the government to meet the needs of Nigerians.


“So, what the country needs now is a realistic plan to solve some of the most basic problems we all know Nigeria has. Well, you now have the road map; whoever is there after the elections — if implemented, will be able to serve Nigerians well,’’ Ruhl said.


The country director urged the government to create a conducive business environment and partner with the private sector to provide the infrastructure needed in the country.


According to him, a conducive business environment is necessary to attract private investors to the other sectors of the economy as it happened in the telecommunications sector.


Ruhl also urged the government to invest more in human capital development, noting that only the people could sustain development.


The country director also noted that if the majority of the citizens of a country were not empowered and left without opportunities, they could weigh down the nation down rather than propel it.


http://nigerianobservernews.com/24012011/news/Other%20News/othernews11.html

Early childcare, education as foundation for national development .

ALMOST on a daily basis, Nigerians are assailed by the shocking reality of the disturbing falling standard of education and the inability of a large proportion of the masses to afford basic education for their children.

Education, experts posit, remains the bedrock of the development of any nation; youths, and indeed, children are the hope for the development of any nation.

Early childcare/education is therefore a sine qua non for the sustainable development of a nation.

According to the erudite scholar and Head, Department of Psychology, University of Lagos (UNILAG), Prof Kayode Oguntuashe, early childcare/education is foundation of Nigeria’s development.

The professor of Psychology underscored this position in his inaugural lecture entitled: “Early Childcare and Education as Foundation for the Holistic Development of the Nigerian Society,” held recently at the Main Auditorium, UNILAG.



The occasion had in attendance Prof. Tokunbo Sofoluwe, Vice-Chancellor, UNILAG; Prof. Soga Sofola, former DVC, UNILAG; Prof Akin Oyebode, former VC, University of Ado-Ekiti; Prof Olatunde Makanju, Dean, Faculty of Social Sciences, UNILAG; Prof Duro Oni, Dean, Faculty of Arts, UNILAG among other principal officers of the institution, friends, colleagues and students of the lecturer. It was a capacity audience that witnessed the lecture.

For about one hour, Oguntuashe held guests spellbound with his presentation that was marked intermittently with resounding applause given the depth and eloquence of his presentation.

He underscored the relevance and significance of the topic with a quote from the United States President, Barack Obama’s book The Audacity of Hope: “Our task is to identify those reforms that have the highest impact on student achievement, fund them adequately ... a more challenging and rigorous curriculum with emphasis on math, science and literacy skills; early childhood education for every child, so they are not already behind on their first day of school. .. and the recruitment and training of transformative principals and more effective teachers.”

He recalled how his early exposure to books, especially Sanya Onabamiro’s (1949) Why Our Children Die made the deepest and most lasting impression on his young mind.

According to him, because Africans have always placed a high premium on children as resources, the various health campaigns and programmes of the Ministry of Health at that time did not exclude the child.

“Children,” Oguntuashe said, “were inoculated against childhood diseases like small pox, measles etc. Parents were encouraged to boil and sieve water before drinking it, streams were demarcated into bathing, laundry and drinking zones to avoid contamination and children were warned not to wade in guinea-worm infested waters.

“Many of these precursors of primary health care were contained in the good old book popularly called Evans hygiene. Beyond Evans, information on the nutrition and general care of infants and children was put out to mothers, parents and other members of the community using different delivery modes, but the emphasis was on prevention of diseases and the survival of the child.”

He added that all of this was laying a strong foundation for his vocation and career as a developmental psychologist.

The professor noted that the uniqueness of man is to be understood not only in terms of his biological constitution but more importantly as a creator of society and culture and the great institutions contained therein.

He argued that in the process of creation, man himself becomes recreated. Hence, an intricate and inseparable relationship binds the two, such that whatever impinges on one is bound to affect the other.

“Conceived in this manner, man becomes the most important factor in development and so his own development becomes crucial to the development of society. This conception transforms man into a resource for societal development and since the ‘child is father to the man’, then it means that child survival as opposed to child development would have different implications for society. Herein lies the rationale for shifting the paradigm from survival to development.”

Citing examples from research findings, he explained the growth, development and significance of early childcare and education to development.

Interpreting early childcare and development as a multidisciplinary enterprise with components from Infant Stimulation, Health, Nutrition, Psychology, Sociology, Economics, Law, Anthropology, Gender Studies, Women Development and Child Development, the erudite scholar cited efforts made by Nigeria towards early childcare.

“After 20 long years of strong and sustained advocacy which included setting up pilot ECD (Early Childcare Development) centres, building the capacity of implementers, resource mobilisation, curriculum development, setting up steering committees at federal and state levels, building partnerships between international agencies, private sector and NGOs; the Federal Government finally adopted a National Policy on Integrated Early Child Development in 2007,” he said.

The objectives of the ECD policy in Nigeria,according to him, include to provide care and support that will ensure the rights of the child to good nutrition, healthy and safe environment, psycho-social stimulation, and protection and participation; inculcate in the child the spirit of enquiry and creativity through exploration of nature, the environment, art, music and playing with toys; provide adequate care and supervision for children while parents/guardians are at work; effect a smooth transition from home to school; prepare the child to adapt successfully when his current context changes; and develop a healthy, well-nourished, adequately stimulated child who is able to achieve his full potential.

The objectives are, Oguntuashe asserted, firmly anchored in the Convention on the Rights of the Child particularly Article Six which states that a child has a right to develop to “the maximum extent possible. It emphasises the total development of the child through two major instruments, Health and Nutrition on the one hand and Physical, Social and Psychological Stimulation on the other.

The professor of Psychology posited that with the current shift in emphasis in the United Nations programming from Economic Development to Human Development, it is clear that child development should be the starting point of our intervention in human development.

Stressing the benefits of investment in early childcare and development, he said the social and economic pay off is significant.

“Children whose early life development receives support are more productive in later life. They repeat classes less often in primary school, they complete primary school more often, they require less remedial programmes and they are less susceptible to truancy and criminal tendencies. (UNICEF, 1998 Mwaura, 2010). Therefore, investing in ECD appears to be a rational way to tackle the massive failure rates that we observe in our children’s performance in the West African School Certificate Examination (WASCE).

“Candidates who had five credit passes including Maths and English in 2005, 2006, 2007 and 2009 were 19.24 per cent, 20.27 per cent, 23.62 per cent and 29.93 per cent respectively (WAEC 2010). Building 40 universities alone is not the answer. In the short term, expanding the capacity of existing universities would absorb the 12-15 per cent of candidates who pass five subjects at credit level at one sitting. However, a long term and much more effective approach would begin at the beginning by investing in Early Child Development (ECD).

“Investing in ECD facilitates the attainment of social and gender equity by providing a robust base from which children from deprived backgrounds, children with special needs, girls and others who encounter discrimination can draw on in later life.

“Early life intervention enables the child to bond not only with his/her parents but provides an important point of entry into the child’s community. This of course prepares the ground for social mobilisation, civic engagement, participation, patriotism and the like. Does this not put the logic of Kick Against Indiscipline (KAI) on its head? Does this not suggest that national orientation is best done in early childhood when attitudes, dispositions and tendencies are still malleable?

“Results of recent research show that providing children with varied perceptual and motor experiences at an early age affects positively the structure and organisation of neural pathways in the brain during the formative period, favourably affecting learning of all kinds later in life.

“Improvement in early childhood care and development means an improvement in other programmes that are integrated with it, such as Maternal and Child Health (with attendant reduction in maternal and infant mortality/morbidity).

“Early Childhood Care and Development Centres can be used as vehicles for fostering integration and harmony among ethnically and religious diverse groups as children quickly learn to accommodate one another without prejudice to these factors as well as others like physical challenges. Malaysia has exploited this medium to a great advantage,” Oguntuashe said.

His engagement and preoccupation with early childcare and development are not without sacrifices. This comes in the form of his contribution to the course through research, advocacy and the role he has played in the implementation of the IECD policy in Nigeria.

His Ph.D. thesis at the University of Edinburgh, Scotland in 1980 explored the role that question-asking plays in the communication of 3 to 5 year-old Scottish children.

He also outlined Nigeria’s score-card on ECD. This includes baseline surveys carried out in 19 out of 36 states; textbook on ECD produced with an accompanying simplified text on “Caring for the African Child;” development of Growth Monitoring Chart; Development of a 23 page pre-school reader series; inventory and publication of ECD Facilities and Key Household Practices (KHP) in Nigeria; establishment of ECD Centres in all states of the federation; and development and production of National Minimum Standards for ECD Centres (NERDC/UNICEF, 2004).

Others include development of ECD Curriculum for In-Service Teacher Training (National Teachers Institute); inclusion of IECD principles, theories and practices in the ECE Curriculum of Colleges of Education (COE); establishment of IECD Minimum Standards for Colleges of Education by the National Commission for Colleges of Education (NCCE); creation of IECD Centres for children aged 3to 5 years in existing public schools in the 2004 National Policy on Education; adoption of a National Policy on IECD (November, 2007); development of Guidelines for the Implementation of National Policy on IECD (FME/UNICEF).

curtesy: Tony Okuyeme

http://www.compassnewspaper.com/NG/index.php?option=com_content&view=article&id=73781%3Aearly-childcare-education-as-foundation-for-national-development&catid=669%3Acommune&Itemid=690

Thursday, January 20, 2011

Breastfeeding 'not always best'

Breastfeeding exclusively for six months is not necessarily best and may put babies off some foods, experts have said.

UK guidelines are for women to breastfeed for the first six months of a baby's life before introducing solids.

But experts led by a paediatrician from University College London's Institute of Child Health said babies could suffer iron deficiency and may be more prone to allergies if they only receive breast milk.

In 2001, the World Health Organisation announced a global recommendation, adopted by the UK in 2003, that infants should be exclusively breastfed for six months.

The experts said the WHO recommendation "rested largely" on a review of 16 studies, including seven from developing countries, which found that babies just given breast milk for six months had fewer infections and experienced no growth problems.



But, another review of 33 studies found "no compelling evidence" to not introduce solids at four to six months, they said, while some studies have also shown that breastfeeding for six months does not give babies all the nutrition they need.

One US study from 2007 found that babies exclusively breastfed for six months were more likely to develop anaemia than those introduced to solids at four to six months, and researchers in Sweden found that the incidence of early onset coeliac disease increased after a recommendation to delay introduction of gluten until age six months.

The authors said exclusively breastfeeding for six months is a good recommendation for developing countries, which have higher death rates from infection.

But in the UK, it could lead to some adverse health outcomes and may "reduce the window for introducing new tastes".

"Bitter tastes, in particular, may be important in the later acceptance of green leafy vegetables, which may potentially affect later food preferences with influence on health outcomes such as obesity."

http://uk.news.yahoo.com/21/20110114/tuk-breastfeeding-not-always-best-6323e80.html

Jonathan’s wife advocates for reduction of infant mortality .

First Lady Patience Jonathan has called on all stakeholders to make deliberate policies that can help reduce and check infant and maternal mortality in the country.
The First Lady stated this at the weekend at a Dinner in Abuja to wind up the 42nd Annual General and Scientific Conference of the Paediatric Association of Nigeria (PAN).

She said that Government through the Federal Ministry of Health has intensified efforts to stem the tide of maternal and infant mortality through maternal education, high coverage of immunization, and several other interventions.

The first lady who was represented by the Minister of Health, Prof. C.O. Onyebuchi Chukwu reaffirmed that government has put conscious efforts to ensure that the Millennium Goals target by 2015 were met.

She enjoined members of PAN to work harder to realize the 2015 target, adding that they should evolve a workable roadmap towards meeting the target of reducing infant and maternal death in the country.

She maintained that it was high time they took more practical steps to combat this problem.

She disclosed that her office through her NGO, the A. Aruera Reachout Foundation was doing its best to assist women and children with health related problems, including sponsorship of children with heart problems on surgery to India.

She also said that her Foundation assists women through skills acquisition to check poverty noting that poverty impedes access to medical care and thus enhances infant and maternal mortality.

Earlier, the Chairman of the local Organizing Committee of the Conference, Dr. Iretiola B. Babaniyi explained that PAN is a very strong advocacy group for children and presently, has over 500 specialists in its fold.

It is affiliated to the International Paediatric Association (IPA), Union of National African Paediatric Societies Association (UNAPSA) and other local bodies such as Nigeria Medical Association.

She noted that the annual conferences create an opportunity for members to update knowledge and skills in child healthcare as well as share ideas towards the improvement of child health service in Nigeria.

Issues like “The role of Immunization in Reducing Communicable Disease Burden” and “Children with special needs” as a result of intellectual and behavioral disabilities were discussed at the Conference.

http://www.dailytrust.com/dailytrust/index.php?option=com_content&view=article&id=10184:jonathans-wife-advocates-for-reduction-of-infant-mortality&catid=12:health-reports&Itemid=13

Nigeria - The Edge of Joy

Dawn Sinclair Shapiro
Edge of Joy Production Team

As Nigeria works to “re-brand” itself from a post-colonial military state to a progressive African democracy, political, civic and professional leaders have recognized the most intractable problem for this emerging society is also its most treatable: maternal and infant mortality. The Federal Republic of Nigeria is comprised of thirty-six states and, with a population of 141 million, is the most populous country in Africa. In 2007, Nigeria passed an important milestone: one elected government passed power peacefully to another for the first time since garnering independence from Britain in 1960. Despite a decade of democracy, in 2010, citizen’s of the world’s eighth largest oil producer live in grinding poverty, with more than half of the population without access to even basic healthcare. In early 2010, a political vacuum formed when President Umaru Musa Yar’Adua left for a three-month sick leave to Saudia Arabia, prompting a constitutional crisis. Frequent clashes between Muslims and Christians escalated inside this fragile democracy and fueled speculation that the country will split along its religious fault line. Acting president and Vice-President Goodluck Jonathan, was sworn in as head of state after President Yar’Adua died May 5th, 2010 at his villa in Abuja.



In April 2010, The Lancet published a worldwide study on maternal mortality conducted by The Institute for Health Metrics and Evaluation (IHME) at Washington University. For the first time in decades, researchers are reporting a significant drop in the number of women dying each year from pregnancy and childbirth. From total maternal deaths of roughly 525,000 in 1980 to about 342,900 in 2008, the IHME analyses utilizes new and better country data and a more sophisticated statistical method that draws from birth records, national surveys, censuses and surveys of siblings deaths.

The new findings from 181 countries also show an annual decrease of 1.3% in the maternal mortality ratio (MMR), the ratio of the number of maternal deaths per 100,000 live births. However, Nigeria moved in the opposite direction of this global trend, with a 1.4% increase each year, from 473/100,000 in 1990 to 608/100,000 by 2008. For every woman who dies, twenty will face serious or long-lasting medical problems. Women who survive severe, life-threatening complications often require lengthy recovery times and may face long-term physical, psychological, social and economic consequences. The chronic ill health of a mother puts at risk surviving children, who depend on their mothers for food, care and emotional support. Reducing maternal mortality is one of the targets of the Millennium Development Goal 5 (Improving Maternal Health). It is the Millennium Development Goal that has shown the least progress since 2000, and the one that reveals the greatest disparity between rich and poor.

http://pulitzercenter.org/projects/africa/nigeria-edge-joy

"Edge of Joy" Tells Harsh Truth of Maternal Death in Nigeria

By: Cassandra Gaddo
(Website: www.TCWmag.com)

In a hospital in the Northern Nigerian city of Kano, a woman has given birth to twins behind a flimsy sheet curtain. The second birth was severely delayed; with only four doctors employed by the entire hospital, no ob-gyn saw her during the delivery.

She hemorrhages blood onto the floor, a red pool slowly spreading beneath the metal frame of her hospital bed and creeping toward the toes of her caregivers, exposed in their flip-flops. The nurse midwife, Aisha Bukar, paces, while the woman lies expressionless on the bed. Despite the massive blood loss, there's nothing the Aisha can do for the patient, Sakina. In Murtala Mohammad Specialist Hospital, which sees 30 delivers every 24 hours, there is no blood for this mother, and so her husband, Muhammed, has left on his moped to procure her rare blood type from another hospital or a private blood supplier at the price of $68 per pint--or about three-quarters of his monthly salary. Precious minutes tick by as the stain of blood spreads with no source to replenish it.



Thus opens "The Edge of Joy: Confronting Maternal Death in Nigeria," a documentary by journalist and Chicago native Dawn Sinclair Shapiro. The film, which was screened on January 13 in Chicago as part of The Chicago Council on Global Affair's Women and Global Development Forum, tells the story of the most populous country in Africa, whose 140 million citizens watch 36,000 women die in childbirth every year.

Nigeria's maternal death rate is the second highest in the world; in West Africa, about one in every 12 women will die in delivery. In the U.S., that number is one in 4,800. As Daniel Pellegrom, president of Pathfinder International, said in a post-screening discussion, "No issue divides the haves and have nots more than the simple act of a woman attempting to have a baby."


Dawn's film compellingly demonstrates the causes and potential solutions for this health crisis. Sakina, sadly, is the rule more than the exception: the leading cause of maternal death is blood loss, unsurprising in a country where half of all women deliver outside of a hospital, as Sakina did with her previous two children. The problem, as the Murtala Mohammad Specialist Hospital Head Nurse Midwife Farida Babelle says succinctly, is "how to get blood."


Often compounding these challenges are cultural issues in Nigeria (a nation of about 50 percent Christians and 50 percent Muslims), a topic addressed honestly but respectfully by "The Edge of Joy." For example, for those who follow Sharia, or Islamic law, travel by women without a male relative (or male relative-approached) escort is forbidden, a particular problem when hospitals are often many hours away from the villages where mothers reside; women must continue having children as long as they are able; and a male relative's verbal permission is needed in order to perform a potentially life-saving hysterectomy.


The second point is especially pertinent: in causes leading to maternal death, the ability of mothers to time and space their pregnancies falls not far behind hemorrhage. As pregnancies number more than five, the risk of life-threatening complications increase; same goes if pregnancies are less than two years apart. Family planning is key to solving this crisis. Thirty years ago, about 10 percent of people worldwide used some form of contraception; today, that rate is 60 percent. In Nigeria, that number grew from only 12 to 18 percent in the same time span. As Farida observes after a patient has stated that her husband would not allow her to stop having children, "The reason most of our people don't believe in this family planning is because sometimes they misquote religion."



While women in Africa are slowly becoming more proactive in their own healthcare, the involvement of men in this process is invaluable, explains Professor Oladosu Ojengbede, director of the Center for Population and Reproductive Health. We see him in the Southern Nigerian village of Mele, opening a forthright discussion about sexual needs to a room of men to whom "family planning" means "celibacy," a concept worthy of laughter and derision. He explains birth control pills. He explains condoms. And he explains the financial, health and familial benefits of a wife being able to space her pregnancies. After all, the death of a mother exponentially increases the likelihood that children under 5 will not survive; spacing pregnancies also allows more time for a family to save precious nairas (the Nigerian currency) should a medical emergency, such as a last minute scavenger hunt for blood, arise. "Spacing" opens up the conversation in a non-threatening, and less culturally encroaching, way. Slowly, the men nod. A maternal death is a family death; family planning allows for healthier and more robust families.


As for hemorrhage and access to blood, "The Edge of Joy" presents varied solutions, often low-tech and inexpensive, explains Prof. Ojengbede. One is the "anti-shock garment," originally developed by NASA in the 1970s, which can be used in hospitals as easily as rural villages. Swaddling a hemorrhaging mother's torso and limbs, it shunts blood away from extremities and back toward to vital organs, buying time until blood can be obtained. The garment, Dawn explained after the screening, costs a mere $160-$180 and can be reused up to 50 times.


But it only buys time. In the Murtala Mohammad Specialist Hospital (where Sakina eventually recovered after her husband's three-hour search for blood* but lost the second of her twins), establishing a blood bank devoted solely to the maternal wing of the hospital has reduced waiting times by 75 percent, explains Farida Babelle, who implemented a rigorous evaluation of the hospital's maternal death rates and established the blood bank.


And therein lies a crux of the problem: a gorge between the knowledge of what needs to change and the tools to do so. Throughout the film, I was repeatedly struck by the caregiving provided for those able to travel to a hospital. The nurses were experienced, caring, passionate and eager for change; but intention is an ill substitute for resources. The advocates are progressive and well-versed in the area's culture; but the relationship between religion and modern science is tenuous, a statement that rings true even in the United States. As Prof. Ojengbede explains softly, "You can say women's rights should be well-protected. But for now, we have not put in place all the structures that protect women's rights completely in developing countries. And that's what we must put into context when we're fashioning out programs and projects that would serve women. To find the appropriate way and culturally acceptable way of circumventing the obstructions...The frustration is everywhere. But the resolve is stronger than the frustrations."


*Underscoring the role of economics in maternal health, the filmmakers note that they provided money to purchase the blood after Muhammed was unable to secure funding.

http://www.chicagonow.com/blogs/todays-chicago-woman-jobs-money-opinion/2011/01/edge-of-joy-tells-harsh-truth-of-maternal-death-in-nigeria.html

Wednesday, January 19, 2011

Why Maternal Health Should Be Free- Okonfua


Consultant obstetrician and gynaecologist at the University of Benin, Professor Friday Okonofua has said a mostly free maternal health services in Nigeria would reduce the rate women die from causes related to pregnancy and child-birth.

He is also sure a mostly free maternal health services would reduce poverty among many families in Nigeria as he said, "Free maternal services across most parts of Nigeria would reduce the economic burden on the mostly poor women."

Okonfua told Daily Independent in an interview in Lagos that most of the money spent on treatment and other medical services by women during pregnancies and child-bearing could be converted to money for feeding and other necessary family needs.

He also said a free maternal health would raise the funding stake for the government in Nigeria resulting in a closer attention to the health of women and their children.

He, however, suggested that a free maternal health for most of Nigerians could be achieved easily through the introduction of a Maternal Health tax and community insurance for same purpose to be facilitated by the government.

"Nigeria can reduce the rate at which women die during pregnancies and childbearing by a significant measure if some of these measures are put in place," he said.

Joseph Oeibunor of the department of sociology and Antropology, &University of Nigeria, Nsukka, Okonufua and colleagues stated in a study published in the recent edition of African Journal of Reproductive Health that an estimated 144 women die each day in Nigeria from pregnancy-related complications.

According to the researchers, the figures, which came from the United Nations and World Bank, makes Nigeria one of the worst countries for women to deliver babies in the world.

Estimates given in that study shows that Nigeria's yearly maternal mortality deaths of 59, 000 ranks her second after India in the list of countries with terrible records on maternal health.

"India with a population of over one billion people reduced its maternal deaths from 136, 000 to 117, 000 between 2000 and 2005, by contrast Nigeria's maternal deaths rose from 37,000 in 2000 to 59,000 in 2005 with a population of 150 million," they wrote.

Current indices from the National Demographic and Health Survey also puts the maternal mortality ratio in Nigeria at 984 deaths per 100, 000 live births.

Okonfua said the actual figure might be much higher if statistics of all women giving birth outside the hospital is considered.

http://allafrica.com/stories/201101130514.html

Nigeria’s last case of guinea worm



It’s hard for many of us, living inside the safe and comfortable bubble of existence offered by western civilization, to understand just how disruptive, tragic and dangerous it can be to simply get sick in a poor, rural African village.

It’s probably even harder to imagine living with the threat of a three-foot long worm eating its way through your body and then painfully emerging over a period of weeks as you sit — or lay, or writhe — there waiting for the “fiery serpent” or “little dragon” to be done with you.

Nigeria used to be planet-central for guinea worm, with hundreds of thousands of known cases every year (and probably many more unknown cases). This parasitic disease was painfully crippling farming communities, throwing people into poverty.

That doesn’t happen anymore.

Thanks to decades of effort by the Carter Center, working in collaboration with many other organizations and given financial support by donors (including $93.5 million from the Gates Foundation), Nigerians no longer have to fear this threat.

Once afflicting millions worldwide, including the Middle East and the Soviet Union, guinea worm has been fought into just a few isolated corners of the world. There are less than two thousand cases, in four African countries, Sudan, Ethiopia, Mali and Chad.

Last night, at the U.W., some of us got a sneak preview of a documentary film, “Foul Water: Fiery Serpent.” It describes the Carter Center’s ongoing effort to repeat this success story in Sudan — and also make guinea worm only the second human disease (after smallpox) to be eradicated from Earth.

I was in Nigeria last spring (doing research for a book on global health I keep threatening to write). I visited with Carter Center folks and also met Grace Otubo, then a sturdy 79-year-old woman and migrant farmer, in the eastern Nigerian village of Ezza Nwukbor.

Grace was Nigeria’s last known case of guinea worm.

http://humanosphere.kplu.org/2011/01/nigerias-last-case-of-guinea-worm/

Health System Failing Nigeria's Youngest Citizens

LAGOS, Jan 15, 2011 (IPS) - Despite some progress, Nigeria is lagging behind its peers in reducing deaths among children under five. The mortality rate remains worryingly high for newborn infants - 700 children less than 28 days old die in the country every day.

Nigeria has made progress in reducing deaths among children under five. Though there is still a long way to go to meet Millennium Development Goal targets, the mortality rate for this age group has fallen by about a fifth since 1990.

A new report published by Nigeria's Ministry of Health however acknowledges that the mortality rate for children has fallen by about a fifth since 1990, but this progress has been unevenly spread - with important implications for health policy.

Saving newborn lives

The report, titled "Saving Newborn Lives in Nigeria", finds that each year, 241,000 babies die within a month of being born.

"Several factors are responsible for this," says Dr Abimbola Williams of international NGO Save The Children, which was a partner in the research. "Poverty has a big role to play. Many families cannot afford the services at the health facilities which are sometimes not even there, and where you find them, the quality of service is so low."

A first edition of the study was published in 2009; the latest report significantly updates the findings with new nation-wide data that shows a wide variation in mortality rates between urban and rural areas.

Dr Azebi Korikiye, who has spent several years working as a doctor in rural areas, says pregnant women outside urban centres face major disadvantages.

"People in the rural areas are far away from health facilities, unlike those in urban areas. Pregnant women in rural areas are less likely to attend antenatal clinics and they are more likely to end up in the hands of untrained traditional birth attendants."

More than one-half of the 700 newborns who die each day in Nigeria, do so at home. Nearly two-thirds of women give birth at home in Nigeria, according to the country's 2008 demographic and health survey.

Despite the known risks, there has not been a significant increase in the proportion of births which take place in health facilities.

Policy and practical changes needed

Save the Children's Williams is optimistic that the newly-published report can help guide Nigeria towards achieving its goal of reducing child mortality.

"You need this kind of data to plan. You also need it to have a shift in policy. It will help us focus on the necessary interventions."

Nigeria has under-performed compared to other countries in Africa. Despite per capita incomes of less than $500 - a third that of Nigeria - Burkina Faso, Uganda and Tanzania have newborn mortality rates of less than 35 per 1,000 live births. Nigeria's under-five mortality rate is 157 per 1,000 live births.

The country's rate of improvement also lags behind - the likes of Cameroon and Kenya Cameroon and Kenya have reduce newborn deaths by around 40 percent over the past decade; Nigeria's rate has dropped too, but by only 15 percent.

Williams says the first edition influenced a major shift in health policy in 2009, steering government towards a renewed focus on newborns.

"The government developed the Integrated Maternal, Newborn, and Child Health strategy - it was the first time that the government singled out newborns as a critical area to focus on," she said.

But Azebi says beyond formulating policies at the national level, the Nigerian government must ensure that state authorities implement them.

"Some of the hospitals run by the state governments are no better than mortuaries," he says "The federal government should monitor them effectively so as to enforce standards," he says.

Save the Children is calling on the government to meet its 2001 pledge to allocate 15 percent of the national budget to health. The organisation is also advocating the use of local data to guide decision-making, training to improve community practices around childbirth, the promotion of better management of newborn infections, and of interventions like kangaroo care - where low birth weight babies benefit from skin-to-skin contact with their mothers: especially useful where incubators and regular power supply are absent.

Representatives of professional associations of obstetricians, paediatricians and midwives have responded to the study with a stated commitment to improving communication and colalboration amongst themselves, and supporting advocacy, data collection and task-shifting to make best use of available personnel.

The country's health ministry has pledged to create a specific budget line for newborn care. Newly-designated resources will go to support training at the community level, six regional centres to promote care of low-birth-weight infants, among other things. The ministry has also pledged to report on progress annually.
http://ipsnews.net/interna.asp?idnews=54142

Events of 2010: Killer Diseases Still on the Rampage


Poor funding and general neglect of the health sector account for a lot more deaths of Nigerians

The battle against maternal mortality was one of the major activities in the Nigerian health sector in 2010. Globally, of the 536,000 maternal deaths recorded in 2005, developing countries accounted for over 99 percent out of which 50 percent of the deaths took place in sub-Saharan Africa.

An estimated 36,000 women in Nigeria die each year due to post-delivery complications. Niger Republic has one out of seven live births, making it the highest in the world. it is also ranked second with lifetime risk of one out of 13 live births. in Ireland, the lifetime risk is one out of 47,600 live births.

According to the 2010 Millennium Development Goals, MDGs, report released by the United Nations Department of Economic and Social Affairs, progress on maternal health has been limited and the gap between the rich world and the poor remains unacceptably high.

The annual assessment report, released in June by Ban Ki-moon, secretary-general of the United Nations, states that while the world has reduced maternal mortality ratio, which is the number of women who die as a result of pregnancy or childbirth by 5.4 percent, there has been no appreciable progress in sub-Saharan Africa, including Nigeria. serious maternal under nutrition is still very common in Nigeria. Studies have shown that an infant whose mother dies within the first six weeks of his lives is more likely to die before their second birthday relative to others whose mothers are alive.

Several workshops, seminars, conferences and campaigns were held in Nigeria to devise strategies to fight the scourge. for instance, as part of efforts to reduce the current high rate of maternal mortality in Nigeria, the National Primary Healthcare Development Agency, NPHCDA, assigned 2,819 midwives to rural communities in Nigeria. the midwives were trained on life saving skills, integrated management of childhood illnesses and other initiatives to improve quality of care.

Muhammad Ali Pate, executive secretary, NPHCDA, said the midwives were deployed under its Midwives Service Scheme to 652 primary health care facilities which were linked to 163 general hospitals in all the 36 states and the Federal Capital Territory, Abuja. “the agency is working closely with the Nursing and Midwifery Council of Nigeria and appreciates the support of the registrar of the council and her team. we have mutual responsibility for the survival of mothers and children in Nigeria,” he said.

The Jigawa State government on its part, inaugurated a 10-man committee for parental songs competition. Aminu Muhammad, commissioner for Information, Jigawa State, said Nigeria’s position was alarming and as such, governments at all levels needed to do something to reverse the trend. She noted that the present administration introduced various programmes including the Safe Motherhood Initiative Programme being handled by the ministries of women affairs and health.

But a new report, tagged: “Trends in maternal mortality,” by the World Health Organisation, WHO, the United Nations Children’s Fund, UNICEF, the United Nations Population Fund, UNFPA and the World Bank report released in September, states that maternal deaths has dropped by one third in Africa. the report which covered the period from 1990 to 2008, showed that maternal mortality fell from 540,000 deaths worldwide in 1990 to 358,000 in 2008.

Margaret Chan, director-general of WHO, said the global reduction in maternal death rates was an encouraging news. “Countries where women are facing a high risk of death during pregnancy or childbirth are taking measures that are proving effective, they are training more midwives, and strengthening hospitals and health centres to assist pregnant women. no woman should die due to inadequate access to family planning and to pregnancy and delivery care,” she said.

Maternal and infant mortality was not the only health issue that was tackled during the year. the war against malaria was also intensified. As at 2009, about 300,000 Nigerians were at risk of infection each year, according to Roll back Malaria, a global initiative aiming to eradicate the disease. but a report released in December by WHO said a massive malaria control programme since 2008 has helped to reduce infections across Africa and eradicated the disease in Morocco and Turkmenistan. Globally, the number of infections decreased slightly from 233 million at the start of the millenium to 225 million in 2009, even as populations in poor countries swell. Deaths fell to 781,000 last year, compared with 985,000 in 2000.

WHO observed that there was a slowdown in funding risks which consequently affected its achievements. Chan said the funding for the UN’s anti-malaria programme which reached $1.8 billion last year, assisted in purchasing insecticide, drugs and bed nets for millions affected by the mosquito-borne disease thereby, resulting in a drop of more than 50 percent malaria cases in 11 African countries, and in two-thirds of the 56 malaria-endemic countries outside Africa, Chan warned that the goal of eliminating malaria deaths worldwide by 2015 was at risk because the amount of money needed to combat the disease as estimated by the WHO is $6 billion a year which is still a long way off being met.

In the area of drugs, a new report by the WHO indicated that only a third of the countries where malaria is endemic are attempting to monitor the efficacy of antimalaria drugs. Should drug resistance spread to these countries, it is likely to go undetected for sometime, hampering subsequent efforts to contain it.

The Aquired Immune Deficiency Syndrome, AIDS, also dominated the health activities in Nigeria in 2010. in 2008, more than two and a half million adults and children became infected with the Human Immunodeficiency Virus, HIV, the virus that causes AIDS while an estimated 22.4 million adults and children were living with HIV in sub-Saharan Africa at the end of 2008 and by the end of the year, an estimated 33.4 million people worldwide were living with HIV/AIDS. the year also saw two million deaths from AIDS, despite recent improvements in access to anti-retroviral treatment. an estimated 1.4 million Africans died from AIDS, about 14.1 million children lost one or both parents to the epidemic, and an estimated 1.8 million children were living with HIV. in Nigeria, statistics from the National Agency for the Control of AIDs, NACA, indicates that out of the 2.9 million Nigerians living with the virus, 650,000 are in need of treatment but only 350,000 are actually receiving the drugs.

At the 2010 International AIDS Conference which attracted more than 19,000 participants from 197 countries to Vienna in July, it was the cost of global HIV treatment programme that dominated the talk. some HIV/AIDS advocates used the conference as an opportunity to voice their criticisms of the Barack Obama’s administration, which many have accused of reneging on a commitment to continue big annual increases in global AIDS spending.

The conference examined how under the Obama administration, global HIV/AIDS funding has been folded into the president’s $63 billion, six-year Global Health Initiative, GHI, whereas, the portion devoted to HIV and tuberculosis, an infection to which AIDS patients are particularly prone, is $44 billion.

In 2010, a study found that microbicide gel containing HIV Drug lowers infection risk in women. the drug used by women before and after sex could reduce their risk of HIV infection by 39 percent. The Centre for the AIDS Programme of Research in South Africa, CAPRISA, trial showed that the gel “curbed the risk of HIV infection by 39 percent overall, but by 54 percent among those women who used it most consistently.” Agence France-Presse reported stated that “the gel also reduced the risk of contracting genital herpes by 51 percent, a factor which could slow the spread of HIV even further, given that people with genital herpes have double the risk of getting HIV.”

Despite gains in the delivery of available treatments, the Tuberculosis, TB, a chronic infectious disease grew more complex and difficult to control due to drug resistant forms of TB, including multi-drug resistant, MDR and extensively drug-resistant, XDR TB, and the deadly relationship between TB and HIV. TB is the leading cause of death among people living with HIV/AIDS in Africa and is a major cause of death for women of child bearing age.

The 2010 annual report of the MDGs, states that despite its devastating impact, people who suffer from TB garner far less attention and resources that they deserve. “Policymakers and opinion leaders must recognise TB as a growing global threat and marshal significantly greater resources to support vaccine research and the ambitious plan to save millions of lives with them,” the report stated.

In 2010, two new tuberculosis studies by UT Southwestern Medical Centre researchers provide both good and bad news about the bacterium that infects nearly a third of the world’s population. the good news is that a type of blood pressure medication shows promise at overcoming some drug-resistant tuberculosis. but the bad news is that the Mycobacterium tuberculosis bacterium, which causes the disease, might be resistant to treatment in more people than previously thought.

There was also a relentless battle against cancer, a leading cause of death in the world which costs more in productivity and loss of lives than any other illness. according to a report by an American Cancer Society, cancer cost the world $895 billion in 2008, equivalent to about 1.5 percent of the world’s entire gross domestic product. a number of advocacy groups have been urging health officials to devote more funding to combat noninfectious causes of death, including cancer. this was also the expert opinion in 2010.

Heart attack, a cardiovascular ailment, was also identified by medical experts as one of the leading killer diseases. the ailment and other cardiovascular diseases account for the death of more than 17 million people in the world every year. about 489,439 Nigerians suffer from the disease every year. the figure is far more than Sierra Leone, a fellow West African nation which records 162,239 yearly and Botswana which has one of the lowest in the continent with 45,199 annually. Nigeria’s figure is still ahead of that of the United States which has an estimated 249,851. John Ogbadu, proprietor of JEC Hospital, Abuja, said: “Heart attack occurs when the supply of blood and oxygen to an area of heart muscle is blocked usually by a clot or reduced caliber of vessels supplying blood to the heart.”

http://howtogetridofgenitalwarts.org/photos-of-genital-warts/newswatch-magazine-events-of-2010-killer-diseases-still-on-the-rampage/

Saving Newborn Lives in Nigeria: Newborn Health in the context of the Integrated Maternal, Newborn and Child Health Strategy


Summary
Recent progress has been made towards reducing child mortality but Nigeria is currently off track for Millennium Development Goal (MDG) 4 – a two-thirds reduction in child mortality (on 1990 levels) by 2015. According to UN mortality estimates, Nigeria has achieved only an average of 1.2% reduction in under-five mortality per year since 1990; it needs to achieve an annual reduction rate of 10% from now until 2015 to meet MDG 4 (Figure 1).
While some progress has been made to reduce deaths after the first month of life (the neonatal period), there has been no measurable progress in reducing neonatal deaths over the past decade. About 5.9 million babies are born in Nigeria every year, and nearly one million children die before the age of five years. One quarter of all underfive deaths are newborns – 241,000 babies each year. Many deaths occur at home and are therefore unseen and uncounted in official statistics. Given that the country’s population is the largest in Africa, Nigeria’s failure to make inroads regarding the MDGs significantly influences Sub-Saharan Africa’s achievement of these goals as a whole and contributes disproportionately to global childhood mortality.
In 2009, the first edition of Saving Newborn Lives in Nigeria: Situation Analysis and Action Plan for Newborn Health was produced in order to provide a more comprehensive understanding of newborn survival and health in Nigeria, to analyse the relevant data by state and to present concrete steps to accelerate action to save newborn lives in Nigeria in the context of the Integrated Maternal, Newborn and Child Health (IMNCH) strategy. This second edition of the report includes updated national and state-level data profiles in line with the global Countdown to 2015 for Maternal, Newborn and Child Health process; a new chapter on maternal, newborn and child nutrition; updated recommendations; and a renewed call to action, including letters of commitment from key stakeholders in maternal, newborn and child health in Nigeria.
Report’s 2nd edition unveils critical findings:
• The 2nd edition of this report draws on NDHS 2008 data, whereas the 2009 edition used data from the 2003 NDHS and the 2007 Multiple Indicator Cluster Survey (MICS).
• Under-five mortality fell by 22% from 201 deaths per 1000 live births in 2003 to 157 deaths per thousand live births in 2008. Neonatal deaths improved marginally from 48 per 1000 live births to 40 per 1000 live births during this period.
• While mortality decreased, the gains for many indicators of coverage of care for women and children were less signifi cant. In 2008, 58% of pregnant women attended one or more antenatal visits, slightly lower than 61% in 2007. Around 39% of deliveries were with a skilled birth attendant in 2008, down from 44% in the 2007 MICS. Exclusive breastfeeding among children less than 6 months fell from 17% in 2003 to 13% in 2008. Treatment for childhood diarrhoeal disease, malaria and pneumonia have dropped or remained stagnant. Coverage of care remains on average much worse in the North East and North West of the country.

http://www.healthynewbornnetwork.org/resource/saving-newborn-lives-nigeria-newborn-health-context-integrated-maternal-newborn-and-child-h

Tuesday, January 4, 2011

EXPERTS WANT INSTITUTE FOR MATERNAL HEALTH

PIQUED by the non-existence of a specialised centre to cater for reproductive, newborn and child health issues, the Society of Gynaecology and Obstetrics of Nigeria (SOGON) has advocated the establishment of a maternal and child health institute.
Meanwhile, about 48 medicine shops have been sealed in Aba and Umuahia, Abia State between October 26 and December 1, 2010.
Speaking at a media forum at the weekend in Abuja on the post-SOGON 8th international conference and 44th yearly general meeting recently held in the nation’s capital, the body’s President-elect, Dr. Fred Achem, said the proposed institute would reduce maternal and newborn mortality in the country.
He added: “The issue of maternal health has become topical for a very long time. This issue that has to do with preparing for childbirth has to be treated in such a way that people have approached to it.”
Referring to the planned institute as a compendium and encyclopaedia of information to the public and researchers for analysis, comparison, development and budgeting sake, he disclosed that it would be headed by an obstetrician with both an academic and clinical background.
According to Achem, the institute would be regional and also situated at the Federal Capital Territory (FCT).
He appealed to the National Assembly to consider benefits of such an institute and to expedite efforts on a bill to establish it.
However, the closure of the medicine shops was carried out by the Abia State branch of the Pharmaceutical Society of Nigeria (PSN) in collaboration with the Pharmaceutical Inspectors Committee of the Pharmacists Council of Nigeria.
According to the state’s PSN Chairman, Mr. Emeka Ogbonna, 26 shops were sealed at the notorious Tenant Market in Aba on October 26, 2010 while 22 were sealed in Umuahia.
He added that the culprits would be prosecuted by the relevant government agencies in the state.

http://www.nigerianbestforum.com/generaltopics/?p=80032

Ekiti moves to reduce maternal, child mortality

Ekiti State Government has promised to strengthen medical care at the University Teaching Hospital, Ado-Ekiti, to eliminate maternal and child mortality.

The governor’s wife, Mrs Bisi Fayemi, made this known, at the weekend, when she presented gifts to the first baby of the year, in Ado-Ekiti, the state capital.

A statement yesterday by the Special Assistant (Media) to the governor’s wife, Bola Eben-Durodola, said Mrs Fayemi expressed satisfaction with existing medical facilities, adding that the Fayemi administration would make the health sector one of the best in Nigeria.

She described babies as special gifts from God and advised that they should be nurtured with the fear of the Almighty.

According to him, having a baby on the first day of the year is a divine favour and the beginning of good things for any family.

Mrs Fayemi urged parents to care for the children and nurture them with prayers.

The first baby of the year, a male, was born at 12.01 at the University Teaching Hospital, Ado-Ekiti to Mr and Mrs Dare Oni of Ayegunle Ekiti. He weighed five kilogrammes.

Mrs Oni thanked the government for the gifts and prayed God to make the government successful.

Mrs Fayemi also presented gifts to the second and third babies, also boys who were born at 12.04am and 12.05am. They weighed 4.2kilogrammes and 2.9kilogrammes.

Other babies received various gifts from Mrs Fayemi.

Dr Idowu Adeojo, who represented the Chief Medical Director, hailed the government, saying the hospital recorded 350 per cent reduction in maternal and child mortality rate in the last two years.
http://thenationonlineng.net/web3/news/23566.html

A giant with clay foot in health

Nigeria is not only the most populous country in Africa, it is also the eighth most populous country in the world.

It is listed among the ‘Next Eleven’ economies. International Monetary Fund (IMF) has announced that Nigeria is the third fastest growing economy in the world after China and India, as a result of the increase in the rate of growth of the nation’s economy from 6.9 per cent in 2009 to 7.4 per cent in 2010.

It is also the largest exporter of oil in Africa. But its citizen’s life expectancy is 49 years for males and 45 years for females.

Health indicators include life expectancy, diabetes rates, surgery wait times, income levels and household crowding. These are important in monitoring population health, factors that influence health and the effectiveness of health services.

Nigeria is yet to get it right as it citizens still suffer and die from different diseases yearly. Heart attack, a cardiovascular ailment, has been identified by medical experts as one of the leading killer diseases. Other top leading diseases killing them are cancer, kidney (renal) failure, diabetes, HIV/AIDS and infant and maternal mortality.

This is despite the fact that Nigeria has been reorganising its health system since the Bamako Initiative of 1987 which promoted community-based methods of increasing accessibility of drugs and health care services to the population, in part by implementing user fees.

The new strategy dramatically increased accessibility through community-based health care reform, resulting in more efficient and equitable provision of services. A comprehensive approach strategy was extended to health care, with subsequent improvement in the health care indicators and improvement in health care efficiency and cost. This is what the new National Health Insurance Scheme (NHIS) attempts to sustain but for potholes such as ‘Global Capitalisation’ and enrollees being short-changed by service providers, especially in pharmaceutical services.

The draconian reign of military rules and uncompassionate leaders maimed the progress of the Bamako Initiative.

These led to Nigeria health care system being continuously faced with a shortage of doctors known as ‘brain drain’ due to the fact that many highly skilled Nigerian doctors emigrate to North America and Europe.

In 1995, it was estimated that 21,000 Nigerian doctors were practising in the United States alone, which is about the same as the number of doctors working in the Nigerian public service.

Attempts to look at the accessibility level of Nigerians to available medical practitioners will further give an idea about the deplorable health situation.

Out of a population of about 89 million in 1991, Nigeria had only 20,210 medical doctors which give a ratio of one doctor to about 4,400 people. Similarly, with only about 106,453 hospital beds in 1991, bed space per head in Nigeria was at the ratio of one bed to 800 persons.

Poor funding and neglect of the health sector account for a lot more deaths of Nigerians. Teaching hospitals cannot boast of wheel chairs and stretchers. Other amenities available will claim vintage position in any Museum of repute. Though the medical expertise is available, the unavailability of the medical and epileptic power supply or cut throat diesel cost is frustrating to the management and workers of these facilities, be public or private.

The move by the Federal Government to put in place VAMED Project is commendable but for a government that does not believe in perfection but putting the cart before the horse, the project is yet to achieve an ovation in spite of the huge resources committed to it.

Statistics from the National Agency for the Control of AIDs, (NACA), indicates that out of the 2.9 million Nigerians living with the virus, 650,000 are in need of treatment but only 350,000 are actually receiving the drugs.

The crude death rate and infant mortality rates are still very high at in deaths per 1,000 population and 119 deaths per 1,000 live births.

To reduce the current high rate of maternal mortality in Nigeria, the National Primary Healthcare Development Agency, (NPHCDA), assigned 2,819 midwives to rural communities. The midwives were trained on life saving skills, integrated management of childhood illnesses and other initiatives to improve quality of care. The agency is yet to evaluate the step.

It is daunting when would be patients and out-patients have to wake up early to pick numbers or queue up to see doctors. Many hours are lost for services that are not impeccable.

This is riddled by industrial actions by doctors and other health workers intermittently across the country, both at federal state levels.

This is exemplified by the Ibadan chapter of the Association of Resident Doctors (ARD), University College Hospital (UCH), Ibadan, Oyo State.

Its President, Dr Amaechi Nwachukwu, had asked the Federal Ministry of Health to withdraw its circular that excluded some cadres of medical doctors from receiving teaching allowances.

Dr. Nwachukwu said the Federal Ministry of Health needed to redefine what was meant by teaching allowance because different cadres of doctors teach despite their primary assignments.

According to him, the job of medical doctors is not primarily to teach. But every cadre of doctor no matter how junior they are in medical profession teaches at one level or the other. The consultants teach senior registrars, who go for Part Two fellowship examinations and even the medical officers teach house officers who go for their final MBBS examination.

"That is exactly what we are saying. If they want to go by the circular that they wrote, then every cadre of doctors must be paid."

He stated that without the review of the circular dated December 6, 2010 and signed by the Minister of Health, Prof. Onyebuchi Chukwu, industrial crisis in the health sector might occur in the New Year.

Nigeria is known for its paper work, implementation remains its challenge. Going by the launch of the National Strategic Health Development Plan (2010 to 2015) in Abuja, the health sector may however, scale the hurdles.

The document, which incorporates a clearly defined Framework with which to measure performance based on eight priority areas to be given attention: Leadership and governance for health; health services delivery; human resources for health; financing for health; national health information system; community participation and ownership; partnerships for health research is to ensure alignment and harmonisation of efforts between the government (federal and states) and development partners.

http://thenationonlineng.net/web3/health/23615.html

A giant with clay foot in health

Nigeria is not only the most populous country in Africa, it is also the eighth most populous country in the world.

It is listed among the ‘Next Eleven’ economies. International Monetary Fund (IMF) has announced that Nigeria is the third fastest growing economy in the world after China and India, as a result of the increase in the rate of growth of the nation’s economy from 6.9 per cent in 2009 to 7.4 per cent in 2010.

It is also the largest exporter of oil in Africa. But its citizen’s life expectancy is 49 years for males and 45 years for females.

Health indicators include life expectancy, diabetes rates, surgery wait times, income levels and household crowding. These are important in monitoring population health, factors that influence health and the effectiveness of health services.

Nigeria is yet to get it right as it citizens still suffer and die from different diseases yearly. Heart attack, a cardiovascular ailment, has been identified by medical experts as one of the leading killer diseases. Other top leading diseases killing them are cancer, kidney (renal) failure, diabetes, HIV/AIDS and infant and maternal mortality.

This is despite the fact that Nigeria has been reorganising its health system since the Bamako Initiative of 1987 which promoted community-based methods of increasing accessibility of drugs and health care services to the population, in part by implementing user fees.

The new strategy dramatically increased accessibility through community-based health care reform, resulting in more efficient and equitable provision of services. A comprehensive approach strategy was extended to health care, with subsequent improvement in the health care indicators and improvement in health care efficiency and cost. This is what the new National Health Insurance Scheme (NHIS) attempts to sustain but for potholes such as ‘Global Capitalisation’ and enrollees being short-changed by service providers, especially in pharmaceutical services.

The draconian reign of military rules and uncompassionate leaders maimed the progress of the Bamako Initiative.

These led to Nigeria health care system being continuously faced with a shortage of doctors known as ‘brain drain’ due to the fact that many highly skilled Nigerian doctors emigrate to North America and Europe.

In 1995, it was estimated that 21,000 Nigerian doctors were practising in the United States alone, which is about the same as the number of doctors working in the Nigerian public service.

Attempts to look at the accessibility level of Nigerians to available medical practitioners will further give an idea about the deplorable health situation.

Out of a population of about 89 million in 1991, Nigeria had only 20,210 medical doctors which give a ratio of one doctor to about 4,400 people. Similarly, with only about 106,453 hospital beds in 1991, bed space per head in Nigeria was at the ratio of one bed to 800 persons.

Poor funding and neglect of the health sector account for a lot more deaths of Nigerians. Teaching hospitals cannot boast of wheel chairs and stretchers. Other amenities available will claim vintage position in any Museum of repute. Though the medical expertise is available, the unavailability of the medical and epileptic power supply or cut throat diesel cost is frustrating to the management and workers of these facilities, be public or private.

The move by the Federal Government to put in place VAMED Project is commendable but for a government that does not believe in perfection but putting the cart before the horse, the project is yet to achieve an ovation in spite of the huge resources committed to it.

Statistics from the National Agency for the Control of AIDs, (NACA), indicates that out of the 2.9 million Nigerians living with the virus, 650,000 are in need of treatment but only 350,000 are actually receiving the drugs.

The crude death rate and infant mortality rates are still very high at in deaths per 1,000 population and 119 deaths per 1,000 live births.

To reduce the current high rate of maternal mortality in Nigeria, the National Primary Healthcare Development Agency, (NPHCDA), assigned 2,819 midwives to rural communities. The midwives were trained on life saving skills, integrated management of childhood illnesses and other initiatives to improve quality of care. The agency is yet to evaluate the step.

It is daunting when would be patients and out-patients have to wake up early to pick numbers or queue up to see doctors. Many hours are lost for services that are not impeccable.

This is riddled by industrial actions by doctors and other health workers intermittently across the country, both at federal state levels.

This is exemplified by the Ibadan chapter of the Association of Resident Doctors (ARD), University College Hospital (UCH), Ibadan, Oyo State.

Its President, Dr Amaechi Nwachukwu, had asked the Federal Ministry of Health to withdraw its circular that excluded some cadres of medical doctors from receiving teaching allowances.

Dr. Nwachukwu said the Federal Ministry of Health needed to redefine what was meant by teaching allowance because different cadres of doctors teach despite their primary assignments.

According to him, the job of medical doctors is not primarily to teach. But every cadre of doctor no matter how junior they are in medical profession teaches at one level or the other. The consultants teach senior registrars, who go for Part Two fellowship examinations and even the medical officers teach house officers who go for their final MBBS examination.

"That is exactly what we are saying. If they want to go by the circular that they wrote, then every cadre of doctors must be paid."

He stated that without the review of the circular dated December 6, 2010 and signed by the Minister of Health, Prof. Onyebuchi Chukwu, industrial crisis in the health sector might occur in the New Year.

Nigeria is known for its paper work, implementation remains its challenge. Going by the launch of the National Strategic Health Development Plan (2010 to 2015) in Abuja, the health sector may however, scale the hurdles.

The document, which incorporates a clearly defined Framework with which to measure performance based on eight priority areas to be given attention: Leadership and governance for health; health services delivery; human resources for health; financing for health; national health information system; community participation and ownership; partnerships for health research is to ensure alignment and harmonisation of efforts between the government (federal and states) and development partners.

http://thenationonlineng.net/web3/health/23615.html