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SPEAK WEDNESDAY

TABOOS AROUND MENSTRUATION

According to Wikipedia, “Menstruation (also known as a period and many other colloquial terms) is the regular discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina”. Menstruation is a phenomenon unique to girls. However, it has always been associated with shame, stigma and surrounded by taboos and myths that have an impact on girls’ and women’s emotional state, mental health, lifestyle, education and most importantly, health.
Such TABOOS include but not limited to:
1. Women are impure, dirty, or sinful while they’re menstruating. (Suneela and Tanu, 2015).
2. According to Friends of UNFPA (2021), Menstruating women are unclean and that they bring bad luck.
3. Menstruating women are not allowed to touch certain foods as it is believed that they will go bad. (Friends of UNFPA, 2021).
4. Menstruating women are not allowed to walk through agricultural fields in fear that the crops will wilt or die. (Kavya, 2019).
5. Menstruating women are advised not to wash their vaginal region during menses because it is believed to cause infertility. (Kavya, 2019).
6. According to United Nations Children’s Emergency Fund (UNICEF), disposal of menstrual pads and other garbage can lead to sickness or cancer. In some communities, it is believed that the use of tampons and menstrual cups lead to loss of virginity.

However, there are strategies or approaches to improve the status of women and to tackle this problem as highlighted below:

1. Increased awareness among adolescent girls related to menstrual health and hygiene (MHH) management.
2. Increased community-based health education campaigns.
3. Empowerment of women through education and increasing their role in decision-making.
4. Convenience Facilities should have provisions of sanitary napkins and adequate facilities for sanitation and washing.
5. Affordable sanitary towels can be locally made and distributed to girls and women in rural communities.
CFHI in a bid to overcome the challenges surrounding menstruation and menstrual hygiene practices, partners with several local and international bodies in supporting students and households in hard-to-reach communities with water provision, water storage facilities, sanitation and toilets, sanitary pads – and also sensitizing these communities on Water, Sanitation and Health (WASH) and the importance of education for a girl child.

Speak Wednesday is an initiative of the Centre for Family Health Initiative (CFHI) to address issues around gender-based violence and gender bias. Join us every Wednesday on all our social media platforms for more interesting episodes.

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Monday Health Burst

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Cervical Cancer

Cervical cancer is a type of cancer that occurs in the cells of the cervix — the lower part of the uterus that connects to the vagina. Cervical cancer affects the entrance to the womb. The cervix is the narrow part of the lower uterus, often referred to as the neck of the womb. (MNT, 2019). Cervical cancer is the second most common cancer among women in Nigeria. There were 31,955 new cervical cancer cases in West Africa in 2018, and Nigeria accounted for almost half (14,943). There were also 10,403 deaths (28 deaths every day) from cervical cancer in the country in the same year. (Balogun F., 2021).

According to Mayo Foundation for Medical Education and Research (MFMER), Cervical cancer begins when healthy cells in the cervix develop changes (mutations) in their DNA. A cell’s DNA contains the instructions that tell a cell what to do. It isn’t clear what causes cervical cancer, but it’s certain that HPV (Human Papilloma Virus) plays a role. HPV is very common, and most people with the virus never develop cancer. The most common mode of transmission is through sex, but it can also be transmitted through the use of contaminated hospital equipment and from mother to child. The cancer is ranked second in the number of years lost to disability among women in Nigeria.

One can reduce their risk of developing cervical cancer by having screening tests and receiving a vaccine that protects against HPV infection. Screening tests include, Pap test and HPV DNA test. These are secondary preventive measures that detect early-stage cervical cell abnormality and the virus’s presence. However, only 8.7% of Nigerian women had a pap smear in 2018, and fewer had HPV screening. (Balogun. F. 2021). The HPV vaccine is an effective primary prevention measure for cervical cancer. The vaccine is most effective when started before sexual debut, which is the reason for the recommendation of its administration in early adolescence.

There are, however, two main obstacles on this path, one of which is its exorbitant cost and secondly, developing countries like Nigeria are yet to identify an organised structure through which most of the eligible adolescents can be reached with the HPV vaccine. Cervical cancer treatment options include surgery, radiotherapy, chemotherapy, or combinations of these. Deciding on the kind of treatment depends on several factors, such as the stage of the cancer, as well as age and overall state of health. (MNT, 2019).

To better fight and overcome the rampage caused by Cervical Cancer especially in Africa and Nigeria particularly, it is essential to carry all stakeholders along especially as regards the introduction of the HPV vaccine to ensure total annihilation of cervical cancer. A concerted effort is required to demonstrate the relationship between HPV and cervical cancer and the role of the vaccine in the prevention of cancer. However, this would require special health education skills and intense awareness or sensitisation.

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Speak Wednesday

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WOMEN IN LABOUR FORCE IN NIGERIA

One of the most striking phenomena of recent times has been the extent to which women have increased their share of the labour force; the increasing participation of women in paid work has been driving employment trends and the gender gaps in labour force participation rates have been shrinking. Especially in the 1980s and early 1990s, labour force growth was substantially higher for women than for men for every region of the world except Africa. (UNPD, 2003). This problem is particularly marked in Northern Africa and the Arab States, where unemployment rates for women exceed 16%. (ILO, 2017).

While vulnerable employment is widespread for both women and men, women tend to be overrepresented in certain types of vulnerable jobs: men are more likely to be working in own-account employment while women are more likely to be helping out in their households or in their relatives’ businesses. From an economic perspective, reducing gender gaps in labour force participation could substantially boost global Gross domestic product (GDP). The regions with the largest gender gaps would see huge growth benefits. Many developed countries would also see their average annual GDP growth increase, which is significant during times of near-zero economic growth. (ILO, 2017).

A report by PwC Nigeria on “Impact of Women on Nigeria’s Economy” in 2020, have it that Nigeria ranked 128th out of 153 countries and 27th out of 53 countries in Africa, on the World Bank’s Global Gender Gap Index 2020. This means, Nigeria has a lot to do to curtail this. 2019 statistics by the World Bank reveals that women accounts for 48.52 per cent of labor force participation in Nigeria. Despite this figure, only about 12% of directors on corporate boards of directors are women. It is discouraging to know that since the history of the Nigeria Labour Congress (NLC), there has been no woman leader.

The relatively lower economic position of women vis-a-vis men can be attributed to some of the prevailing factors such as:

1) The historical discrimination against women in terms of output.

2) The high rate of urbanization which is unmatched by the rate of urban demand for labor in the modern sector of the economy.

3) Low level of female educational attainment and skills which restrict their entry into modern employment.

4) The case of entry into informal sector activities such as petty trading with little capital outlay, flexibility of working hours and the ability to accommodate domestic roles as well as the independence attached to such activities.

5) The widespread assumption that women’s roles in the household are supportive, hence their contributions and rewards in gainful employment are expected to be merely supplementary to those of the males who are supposed to be the bread winners. (Fadayomi, T., 1991)

The data is clear: women want to be in paid employment, but a persistent set of socio-economic barriers keep them out of the workforce. However, identifying and quantifying these barriers allows us to develop smarter policy responses for eliminating them.

Ultimately, closing gender gaps in the labour force is not just good for women and their households, but for the global economy as a whole.

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Monday Health Burst

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Ovarian Cancer

Medical News Today defines ovarian cancer as “any cancerous growth that begins in the ovary”. According to World Cancer Research Fund, Ovarian cancer is the 18th most common cancer worldwide, however, it is currently the 7th most common malignancy globally and the most lethal gynecological cancer (Siegel RL et al) while in Nigeria it is the second commonest gynecological malignance (Adekunle O. Oguntayo et al.).

Ovarian cancer often goes undetected until it has spread within the pelvis and stomach region. It has warning signs, but the earliest symptoms are vague and easy to dismiss. The symptoms of Ovarian cancer are easily dismissible because they are like the symptoms of other common illnesses. The symptoms include: abdominal bloating, pressure, and pain; abnormal fullness after eating; difficulty eating; an increase in urination; an increased urge to urinate; fatigue; indigestion; heartburn; menstrual irregularities; painful intercourse among others. Although some of these symptoms if not caused by Ovarian cancer goes away when treated, however, if caused by Ovarian cancer, the symptoms persists, and the discomfort increases as the tumor spreads.

Cancer Treatment Centers of America says, that although there is no exact cause of Ovarian Cancer, research however, identifies some number of factors that could put one at risk which include: a family history of ovarian cancer; a personal history of breast, uterine, or colon cancer; obesity; the use of certain fertility drugs or hormone therapies; no history of pregnancy or endometriosis.

Unfortunately, there is no routine diagnostic screening available for ovarian cancer and as such unusual or persistent symptoms is advised to be reported to one’s doctor. There are four (4) stages of Ovarian cancer with Stage 1 been the earliest stage of which when detected can be treated, while stage 4 is the advanced stage of this malignance.

Well, treatment depends on how far the cancer has spread, however, it usually includes two or more of the following treatment plan namely: chemotherapy, surgery to stage the cancer and remove the tumor, targeted therapy or hormone therapy.

There are no proven ways through which this malignance can be prevented, however, research outlines factors that have been shown to reduce the risk of developing it, namely: the use of oral birth control pills, breastfeeding, pregnancy or surgical procedures on one’s reproductive organs.

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Speak Wednesday

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Rape Culture

The Merriam Webster Dictionary defines rape as any unlawful sexual activity and usually sexual intercourse carried out forcibly or under threat of injury against a person’s will or with a person who is beneath a certain age or incapable of valid consent because of mental illness, mental deficiency, intoxication, unconsciousness, or deception. Rape was long considered to be caused by unbridled sexual desire, but it is now understood as a pathological assertion of power over a victim. Culture on the other hand has been defined by The Centre for Advanced Research and Language Acquisition (CARLA) as shared patterns of behaviors and interactions, cognitive constructs and understanding that are learned by socialization.

Rape culture can thus be defined as an environment in which rape is prevalent and in which sexual violence against women is normalized and excused in the media and popular culture (WGC, 2019). Behaviors associated with rape culture commonly include victim blaming, slut-shaming, sexual objectification, trivializing rape, denial of widespread rape, refusing to acknowledge the combination of these, etc. Rape culture pressures women to sacrifice their dignity, freedoms and opportunities in order to stay safe, because it puts the burden of safety on women’s shoulders, and blames them when they don’t succeed. According to the “Release of the findings of the Nigeria Violence Against Children Survey” by United Nations Children’s Fund (UNICEF) Nigeria, one in four girls and one in ten boys in Nigeria had experienced sexual violence before the age of 18 and over 31.4 percent of girls said that their first sexual encounter had been rape or forced sex of some kind as reported by Positive Action for Treatment Access.

This goes without saying that indeed there is a rape culture in Nigeria, a society where victims of rape are blamed and shamed and the perpetrators are not punished, a society that blames the woman for her partner’s infidelity, where we think it is okay for a husband to forcefully have sex with his wife because there is a believe that she has no right to consensual sex. Yes, the prevalence of rape culture in Nigeria is high and it is time we did away with this system that espouses the idea of women as possessions or objects and develop instead a society that sees the woman as a human with rights, consents and abilities.

The Women’s & Gender Centre outlines several ways in which Rape Culture can be combated. These include but are not limited to:

· Avoid using language that objectifies or degrades women.

· Speak out if you hear someone else making an offensive joke or trivializing rape

· If a friend says she has been raped, take her seriously and be supportive.

· Think critically about the media’s messages about women, men, relationships, and violence.

· Be respectful of others’ physical space even in casual situations.

The issue of rape culture cannot be fixed in one day. However, advocacy campaigns have brought attention to the problems fueling rape culture and have helped women to come together in opposition to it. Because rape culture also derives some of its power from unconscious biases and hidden assumptions, simply drawing attention to it is a step towards changing it.

Yet the Government on its own hand can do much more in this fight against violence on women and girls by amongst others creating stricter laws and punishments for perpetrators of gender based violence especially Rape, by enforcing the implementation of certain laws like the Violence against Persons (Prohibition) Act in all states of the nation and by providing fundings to support provision of services for victims of violence.

CFHI since inception has been at the forefront in the fight against violence against women and girls, through funded projects, street/online campaigns, annual activitism called up by recognised international bodies, etc. Recently CFHI being a member of the International Network to End Violence Against Women and Girls (INEVAWG) whose vision is to create a world where all women and girls live without violence and enjoy equality, autonomy, freedom, and justice hosted a National Consultation on violence against women and girls funded by INEVAWG. It had in attendance major key actors ranging from the legislative & judiciary arms of government, CSOs, female vanguard groups all over the country and beyond to share relevant and current information about VAWG, propose solutions and develop action plans to eliminate all forms of violence against women and girls in the public and private spheres.

Speak Wednesday is an initiative of Centre for Family Health Initiative (CFHI) to address issues of gender based violence and gender bias. Join us every Wednesday on all our social media platforms for more episodes.

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Monday Health Burst

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Malaria- Zero Malaria Starts With Me

Malaria is a life-threatening disease caused by parasites that are transmitted to people through the bites of infected female Anopheles Mosquitoes. It is preventable and curable. The World Health Organization. (WHO) estimates that there were as many as 229million cases of malaria worldwide in 2019, with deaths standing at an estimated 409,000. In the same year under study, nearly half the world’s population was at risk of malaria, with most recorded cases and deaths occurring in sub-Saharan Africa.

April 25 every year is an international recognized day set aside to commemorate World Malaria Day. The day aimed to bring global attention to the efforts being made to bring an end to malaria and encourage action to reduce suffering and death from the disease. This year’s theme is “Reaching the Zero Malaria Target”. Since 2000, the world has made historic progress against malaria, saving millions of lives. However, half the world still lives at risk from this preventable, treatable disease, which costs a child’s live every two minutes. In 2015, Centre for Disease Control (CDC), the Nigeria National Malaria Elimination Programme (NMEP), the Nigeria Field Epidemiology and Laboratory Program (NFELTP), and the National Stop Transmission of Polio (NSTOP) program initiated the NSTOP\Malaria Frontline project to improve the effectiveness of malaria control in Nigeria by strengthening the technical capacity of Nigeria’s public health system to reduce malaria, as well as improving the tools and policies used to prevent, detect, and respond to epidemics and other endemic high-impact diseases.

Over the past year, the Malaria Frontline Project provided training, on-site mentorship, and technical support to local government health officials across Kano and Zamfara State. This project allows the monitoring of the stocks of malaria prevention and treatment supplies and trends in local illness cases diagnosed and treated in each of the health facilities. This enables the use of data to spot early trends and target emergency supplies and outreach efforts at the time and place where they will do the best. This effort to collect and utilize malaria data locally is part of a needed reset for malaria programs in densely populated, high-burden places like rural Nigeria.

The major objective of most current National Malaria Control Programs and most malaria activities is to reduce the number of malaria-related cases and deaths. The African Union Catalytic Framework to End AIDS, Tuberculosis, and Eliminate Malaria in Africa by 2030 has set ambitious targets for eliminating malaria by 2030. However, there is only as much the government can do which is why tackling the menace is now approached from the individual level. Numerous studies have outlined measures to effectively prevent the spread of malaria, some of which include:

· Mosquito Control: This is a vital component of malaria control strategy, which involves limiting or eliminating the breeding of mosquitoes. Stagnant water which is one of the major breeding habitats for mosquitoes must be prevented. By preventing the water logging, destroying unwanted water collections and keeping the water containers closed, sources of egg laying can be denied and breeding of mosquitoes prevented.

· Use of Insecticides: Insecticides or larvicides can be used both on breeding grounds and in enclosed dwelling spaces to kill both the developing larvae and the adult mosquitoes to prevent growth and inevitable bites.

· Make sure the windows and doors of your room are covered with a screen/mesh. Make sure the mesh has no holes through which mosquitoes can enter.

· Keep room fully air conditioned or fans switched on. The circulating air seems to deter mosquitoes to an extent.

· Antimalarial drugs: Antimalarial medicines can also be used to prevent malaria. For travelers, malaria can be prevented through chemoprophylaxis, which suppresses the blood stage of malaria infections, thereby preventing the malaria disease.

The total elimination of malaria is a collective effort with the dividends quite substantial. However, this process starts with the individual efforts of everyone!

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Protecting Well-being: Vaccination

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The Centers for Disease Control and Prevention (CDC) recommends vaccinations throughout one’s life to protect them against many infectious diseases. When vaccines are skipped, one is left vulnerable to illnesses such as shingles, pneumococcal disease, flu, and human papilloma virus (HPV) and hepatitis B, both leading causes of cancer.

What exactly is vaccination? According to Wikipedia, Vaccination is the administration of a vaccine to help the immune system develop protection from disease. Vaccines contain a microorganism or virus in a weakened, live or killed state, or proteins or toxins from the organism. They work with your body’s natural defenses to build protection.

According to the World Health Organization (WHO), “Each year, vaccines prevent 2 to 3 million deaths every year. An additional 1.5 million deaths could be avoided, however, if global vaccination with a vaccine for the purpose of inducing immunity coverage improves.“

Getting vaccinated is important for at least two reasons: to protect oneself and those around you. Currently, vaccines are the best ways we have to prevent infectious disease, these diseases can result in severe complications and sometimes death. Vaccination has been one of our most successful tools for protecting the public’s health. If one vaccinates, they contribute to wiping out diseases that could spread now and into the future.

The United Nations Children Funds (UNICEF) states that, if all children were vaccinated with the existing vaccines, at least 25 million lives could be saved. Children who get vaccinated are protected from serious illness and complications of vaccine-preventable diseases which most often include: paralysis of limbs, hearing loss, convulsions, amputation of an arm or leg, brain damage, and death.

Thanks to the emergence of vaccines, diseases could have been imported and quickly spread through a population, leading to epidemics. According to WHO, between 2000 and 2017, vaccination reduced global deaths from measles, a contagious viral disease marked by fever, the eruption of red circular spots on the skin that can be deadly to young and weakened individuals by 80% worldwide (preventing an estimated 21.1 million deaths). Vaccines have led to large reductions in illness and death—for both the young and old alike.

Recently, the world was brought to its knees with a global pandemic, Corona Virus that killed over 3,035,109 (according to Worldometers.info) globally. To reduce this death toll rate, vaccines have been developed by scientists. These vaccines are critical in combating against COVID 19; it is really encouraging to see so many vaccines proving successful. On the 2^nd of March 2021, Nigeria received nearly 4 million doses of the COVID 19 vaccine. The arrival of the vaccine marked a historic step towards the goal to secure an equitable distribution of COVID 19 globally. It is therefore imperative for everyone to get vaccinated to stop the spread of the virus and bring it to its end.

Getting vaccinated costs less than getting treated for the diseases that the vaccines protect you from. However, much work still needs to be done as indicated by WHO “far too many people around the world – including nearly 20 million infants each year – have insufficient access to vaccines”.

Monday Health Burst is an initiative of Centre for Family Health Initiative (CFHI) to tackle issues of basic health concerns. Join us every Monday for more health-related articles on all our social media platforms

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Effects of Gender-Based Violence on Health

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According to the European Union, “Gender-based violence (GBV) is violence directed against a person because of that person’s gender or violence that affects persons of a particular gender disproportionately.” GBV is often perpetrated against women and girls and by far the most pervasive form of violence, yet the least acknowledged in society. It is regarded as a violation of human rights.

Gender-based violence is deeply rooted in discriminatory cultural beliefs and attitudes that perpetuate inequality. GBV can have devastating short- and long-term threatening consequences on victim’s physical, sexual and reproductive, and mental health as well as on their personal and social well-being. The health consequences of violence against women include injuries, unwanted pregnancy, sexually transmitted infections (STIs) including HIV, pelvic pain, urinary tract infections, fistula, genital injuries, pregnancy complications, depression, anxiety, post-traumatic stress disorder (PTSD), the limited ability to complete daily tasks, suicidal thoughts and chronic conditions.

The health impacts of GBV sometimes extend to future generations. According to Bahgam & Mukhatari, “Study on child marriage in Afghanistan” in 2004, the health of mothers is a major determining factor in the health of their children, which indirectly affects the formation of human capital. Mothers are normally the ones responsible for the health, nutrition and education of their children. A mother who does not have access to good health, nutrition and education is more likely to pass bad habits and poor general well-being onto her children. The International Center for Research on Women (ICRW) reports that stunted growth in underfed girls increases the risks of obstructed labour later in life. Malnourished mothers and their babies are vulnerable to premature death and chronic disability. Even anaemia, which sometimes leads to postpartum haemorrhage, afflicts 50-70 per cent of pregnant women in developing countries.

The prevention and management of GBV require collaboration and coordination among members of the community and agencies. Adequate funding, adequate resources, reliable accountability systems, comprehensive and integrated approach in GBV programs would go a long way in abating the prevalence of GBV and its consequences.

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WOMEN AS AGENTS OF SOCIAL CHANGE

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According to Wikipedia, Social change involves alteration of the social order of a society. It may include changes in social institutions, social behaviors or social relations.

Family is considered the first agent of socialization and women are seen as the primary caretakers of the young ones in the family. Women play an important role in facilitating or hindering changes in family life which affects the society inadvertently. Women are naturally the doctors, educators and caretakers within the family, and they become the glue that holds the family together and connects it to the larger community to address common needs and concerns. As women take up essential roles within the family, the roles naturally expand to the community, nation, and world, because they are raising the next generation of people who will become contributors to not just the family but the society at large.

There is a growing consensus that women’s equal rights and opportunity is linked to peace, prosperity, human development and democracy. How a country taps the talents and capacity of its women greatly determines its economic, social and political progress. Women in most societies, whether developed or developing are regarded as currency with which political and economic alliances are established.

In Nigeria, women have made some remarkable impact in contributing to the development of the nation. Such as the late Mrs. Margaret Ekpo, Prof. Dora Akunyili, Mrs. Janet Mokelu, Mrs. Funmilayo Ransome-Kuti, Hajia and Mrs. Maryam Babangida. There is also able Mrs. Ngozi Okonjo-Iweala, who in her capacity as Finance Minister in Nigeria, instituted various reforms in Nigeria, thereby making the country one of the best economies in the world.

Truth is envisioning a world where girls and women are fully active agents of change means planning a change for the better.

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The Economically Empowered Mother of Four

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Joy Umoru is a reactive mother of four children who resides in Gosa community . she has a viral load that is undetectable because she adheres to her drugs.

During the time of enrollment, she had nothing doing, she was living with her four children with no means of livelihood to cater for their education and well being.

She was then empowered with ten thousand naira (N10, 000) in May through the house hold economy empowerment which she used to start a business of yam flower. She started selling with 10 mudus of yam flower, which she sells to her neighbors and supplies from house to house.

After a while, She joined the savings group (SILC) in the community, where she was consistent in attending meeting and saves money regularly. Now, she has a space in the market where she sells and has advanced from 10 mudus of yam flower to buying in bags, she also added garri and maize to her business.

Feeding is no longer a challenge as she continues her business and pay bills from the little profit, she makes from her Yam Flower business.

Joy Umoru said she is grateful to CFHI and her funders for adding value to her family.

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