WHO – Page 5 – Centre for Family Health Initiative

MONDAY HEALTH BURST

Breast Care, Gender, Health, WHO, Women / cfhinitiative

MOTHER TO CHILD TRANSMISSION OF HIV DURING BREASTFEEDING

Human Immunodeficiency Virus (HIV) is a virus that attacks the body’s immune system and is spread through the blood and certain body fluids, including breast milk. Mother-to-child transmission of HIV is the primary mode of HIV infection in infants. If neither the mother nor baby is on consistent HIV treatment, there is a high chance that the baby will be infected through breastfeeding.

Several factors can increase the risk of perinatal transmission. Having a high viral load implies that the white blood cells (CD4) which provides immunity to the body is low. A viral load indicates how much of the HIV is present in the body of an infected person. A high viral load may mean a recent HIV transmission, an untreated or uncontrolled HIV. Positive pregnant women and breastfeeding mothers with a CD4 count lower than 200 are at a greater risk of transmitting the virus to their infants.

HIV screening is essential during antenatal appointments at any health centre to ascertain the HIV status because the earlier the virus is detected the better the chances of living longer and enjoying a normal life. Test should also be repeated every three months and a Post Exposure Prophylaxis (PEP) should be received if exposed to an infected blood within forty eight hours.

Accumulating evidence has also shown that giving antiretroviral medicines to the mother or the infant can significantly reduce the risk of HIV transmission through breastfeeding. Antiretroviral prophylaxis should be made available to HIV infected mothers and mothers-to-be in all health settings and should be administered to HIV exposed infants immediately after birth. The duration for antiretroviral care and treatment for the infant is dependent on the mothers’ choice of feeding either exclusive breast feeding or replacement feeding. However, World Health Organisation recommends HIV infected mothers to only do exclusive breastfeeding except replacement feeding is acceptable, feasible, affordable, sustainable, and safe. Mixed feeding on the other hand is strongly discouraged as a breastfeeding option for reactive mothers.

All exposed infants should be tested for HIV at birth, at six (6) weeks and eighteen (18) months. This is done to monitor the HIV status of the newborn.

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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SPEAK WEDNESDAY

Gender, Politics, WHO, Women, Women in Leadership / cfhinitiative

GENDER ROLES IN LEADERSHIP

With the increasing interventions and awareness to promote equal rights and opportunities for boys and girls in Africa, more females are raising their voices against gender inequality. Women are now asserting their power as global ground breakers dominating fields and positions of leadership that were exclusively reserved for men. Women are seizing opportunities and attaining heights of success.

Around the world, women are leading countries. Queen Elizabeth II of the United Kingdom has been the reigning queen since 1952. Africa is not left out. Ellen Johnson Sirleaf was the first elected female head of state in Africa. She served as the President of Liberia from 2006 to 2018. Catherine Samba-Panza served as interim President of the Central African Republic from 2014 to 2016. She was the first to hold that position in the country. Dame Virginia Ngozi Etiaba served as the governor of Anambra State, Nigeria, from 2006-2007.

Anyone irrespective of gender who possesses leadership skills and qualities can be a leader. Thus, men and women show distinct leadership traits and qualities. Many argue that women cannot withstand the challenges that come with leadership because their biological formation detests stress and pressure. Women are judged to be reserved and soft so they can be easily swayed. Well, these qualities are more of strengths than weaknesses. The soft nature of women makes them considerate leaders that listen to the plight of the masses and strive to protect the interest of the people they serve. This is a unique leadership quality called selflessness.

Compassion is an asset every leader must possess. A leader must be compassionate, deferential, submissive, self-effacing, and treat everyone with the same level of dignity. A compassionate and humble leader will learn from others and accept mistakes because he/she is not all knowing. Women are not just compassionate and humble, they are innovative, creative, and logical thinkers. Selecting leaders based on these attributes would definitely produce more female than male leaders. These attributes earn female leaders the collaboration and cooperation of the followers to advance for a better future.

Women led nations seem to be particularly successful in fighting COVID-19. New York Times reports that the Chancellor of Germany, Angela Merkel has had fewer death rates than France, Italy and Spain. 34 year old Sanna Marin who is the Prime Minister of Finland with collaboration of 4 female led parties has had far lower deaths than nearby Sweden. Without a total national lock down, Tsai Ing-wen the female president of Taiwan has achieved one of the most successful efforts in the world at containing Corona Virus.

Women should be given more opportunities to occupy positions of leadership. Instead of criticizing the leadership abilities of women, men should be encouraged to embrace unique leadership traits of women leaders. The world will advance for the better when this is achieved.

Speak Wednesday is an initiative of Centre for Family Health Initiative to stop the cycle of domestic violence by breaking the silence around gender-based violence. Join us every Wednesday on all our social media handles for more episodes.

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MONDAY HEALTH BURST

Breast Care, Exclusive Breastfeeding, Gender, Health, Viral Hepatitis, WHO, Women, World Breastfeeding Week / cfhinitiative

BREASTFEEDING WITH HEPATITIS B INFECTION

Hepatitis B is a liver infection caused by the hepatitis B virus (HBV) which is transmitted by blood, semen or other body fluid from an infected person. A pregnant woman with hepatitis B can infect the fetus through the placenta especially in cases of preterm labour, depending on the mother’s viral load. At birth and during breastfeeding, infants may also be infected with the virus through contact with blood and body fluids.

According to World Health Organization, Breastfeeding has been suggested as an additional mechanism by which infants may acquire HBV infection, because small amounts of Hepatitis B surface antigen (HBsAg) have been detected in some samples of breastmilk. This study also found no association between maternal e-antigen status and transmission rates. In other words, any risk of transmission associated with breastmilk is negligible compared to the high risk of exposure to maternal blood and body fluids at birth. This is because breast pathology such as cracked or bleeding nipples or lesions with serous exudates could expose the infant to infectious doses of HBV.

To avoid any form of HBV transmission from mother to child. Center for Disease Control (CDC) opined that all infants must receive hepatitis B immune globulin (HBIG) and the first dose of hepatitis B vaccine within 12 hours of birth. The second dose of vaccine should be given at age 1–2 months, and the third dose at age 6 months. This includes infants born to HBV-infected mothers. The infant should be tested after completion of the vaccine series at age 9–12 months, to determine if the vaccine worked and that the infant is not infected with HBV through exposure to the mother’s blood during the birth process.

In conclusion, the risk of HBV mother-to-child transmission through breastfeeding is negligible if infants born to HBV-positive mothers receive the HBIG/HBV vaccine at birth. Hence, hepatitis B infected mothers can breastfeed the babies provided the necessary precautions are taken. There is no need to delay breastfeeding until the infant is fully immunized.

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SPEAK WEDNESDAY

Cultural practices in Africa, Gender, Health, Hygiene, WHO, Women / cfhinitiative

SPEAK WEDNESDAY – SEXISM

According to Wikipedia, Sexism is prejudice or discrimination based on a person’s sex or gender. Sexism can affect anyone, but it primarily affects women and girls. It has been linked to stereotypes and gender roles, and may include the belief that one sex or gender is intrinsically superior to another.

Sexism manifests in various forms and due to stigmatization from the society, women are forced to accept abuse and neglect. Some females are denied access to proper health care, good nutrition, education and legal rights which is an infringement on their basic human rights as humans. Child marriage, female genital mutilation and other traditional harmful practices, objectification, women trafficking, forced labour, and unequal school participation are other instruments of sexism.

It is pertinent to know that not just violence but other forms of sexism have devastating consequences. Some of these repercussions affect the physical and mental health of the individuals. Sexual transmitted infections, mental disorders, depression, anxiety, low birth weight and sometimes death of the fetus of teenage mothers, obstetric fistula, death of the victim, excessive bleeding, urinary tract infections, neuroses, hatred for any form of sexual relation and psychoses fall into this category.

Education is the key for women to achieve economic independence, yet, Unite Nations (UN) estimates that women make up more than two-third of the world’s 796 million illiterate people. If a nation must achieve sustainable success, education and proper sensitization is essential. According to a popular quote by African Proverb “If you educate a man, you educate an individual. But if you educate a woman, you educate a nation”.

Proper sensitization with full participation of all genders should be encouraged to end gender stereotypes and harmful cultural practices that affect women and girls. The goal is to create a balanced system for everyone.

Speak Wednesday is an initiative of Centre for Family Health Initiative to stop the cycle of domestic violence by breaking the silence around gender based violence. Join us every Wednesday on all our social media handles for more episodes.

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SPEAK WEDNESDAY

Gender, Health, WHO, Women / cfhinitiative

GIRL – CHILD EDUCATION

According to World Bank, Girls’ education goes beyond getting girls into school. It is also about ensuring that girls learn and feel safe while in school; complete all levels of education with the skills to effectively compete in the labor market; learn the socio-emotional and life skills necessary to navigate and adapt to a changing world; make decisions about their own lives; and contribute to their communities and the world.

130 million girls between the age of 6 and 17 are out of school and 15 million girls of primary school age with half of them in sub-Saharan Africa will never enter a classroom according to UNESCO undermining the fact that education is the greatest value a child can receive irrespective of if it is a boy or girl child.

Education is included as a fundamental right every child must receive irrespective of gender, religion, age, race and culture because it is child empowerment. Women should be sent to school not because being a graduate will make them more marketable for marriage but because it empowers them to attain heights of success. The mental, physical, social, spiritual, psychological and emotional developments of a child are dependent on the value placed on them.

A popular philosophy says “When you educate a man, you educate a person but when you educate a woman you educate a nation.” The first form of education received is informal education done at home. The mother is the teacher. An educated mother therefore translates to educated and empowered children who will make positive impacts in the society. Education also presents a girl child the opportunity to compete with the male counterparts for positions and careers of interest. The female acquires knowledge and skills needed to advance their status for self-actualization, self-improvement and social interactions.

The society remains the beneficiary of girl-child education because it produces functional citizens who make informed decisions that promote a healthy society. The boy and girl child in Africa should be given equal rights, resources, protections, and opportunities. Just like the boy child, a girl child has goals she intends to achieve. Equal education for all genders involves quality compulsory education received in a child-friendly environment with equal participation. It is time to join the movement to empower all women and girls through education.

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MONDAY HEALTH BURST

Gender, Health, WHO, Women, World Breastfeeding Week / cfhinitiative

BREAST FEEDING METHODS

Breastfeeding is the act of feeding an infant with human breast milk. According to the American Academy of Pediatrics, the antibodies in breast milk can help a baby resist infections. Hence, it is recommended for all infants.

Successful breastfeeding depends on the positioning and attachment of the baby to the breast. A baby needs to be able to take a large mouthful of breast milk and feed effectively without causing any discomfort. Some of the breastfeeding positions that can be adopted include: Laid-back breastfeeding or reclined position, cradle hold, cross-cradle hold, rugby ball hold, side-lying position, upright breastfeeding or koala hold, dangle feeding, nursing in a sling, and double rugby ball hold.

LAID-BACK BREASTFEEDING OR RECLINED POSITION – The laid-back breastfeeding position, also known as biological nurturing, where baby is placed on mother’s chest or tummy as soon as he is born.

CRADLE HOLD – This is the classic position most people picture when the thought of breastfeeding comes to mind. It involves sitting upright with the baby positioned on the side, and the head and neck laying along the mother’s forearm. The baby’s body should be against the mother’s stomach in a tummy-to-mummy position.

CROSS-CRADLE HOLD – This looks similar to the cradle hold but mother’s arms switch roles so the baby’s body lies along the mother’s opposite forearm. The aim is to support the baby around the neck and shoulders to allow him/her to tilt the head prior to latch.

RUGBY BALL HOLD – In this position also known as the underarm or clutch, mother sits with the baby resting along her forearm. The baby’s body tucks alongside the mother’s side with feet towards the back of the chair or whatever the mother is sitting on.

SIDE-LYING POSITION – Ideal for relaxed night feeds and breastfeeding in bed or on the sofa. Mother and baby need to lie on the sides next to one another, belly-to-belly. Side-lying can be more comfortable than sitting if one had a caesarean or stitches.

UPRIGHT BREASTFEEDING OR KOALA HOLD – In this method, baby sits straddling mother’s thigh, or on her hip, with the baby’s spine and head upright as he/she feeds.

DANGLE FEEDING – It involves lying the baby on the back while the mother crouch over the child on all fours and dangle the nipple in the baby’s mouth.

NURSING IN A SLING – This can be done when carrying a baby in a front carrier or any kind of sling. Mothers must make sure she can see the baby’s face and chin are not pressed against the chest.

DOUBLE RUGBY BALL HOLD – The double rugby ball hold also known as the double clutch is a great breastfeeding position for twins, as the mother can feed them in tandem while having her hands relatively free.

DANCER HAND NURSING POSITION – Cup the breast with hand underneath, fingers on one side and thumb on the other, then edge the hand forwards so the thumb and index finger form a ‘U’ shape just in front of the breast. The three remaining fingers should continue to support the breast underneath. Rest the baby’s jaw on the thumb and index finger as he/she feeds with the chin at the bottom of the ‘U’. The mother’s thumb should gently hold one of the cheeks and index finger the other. This hold gives the baby enough support and the mother can easily have control over the position as well as a great view of the latch.

The most important part of successful breastfeeding is the latch. In a case where the child is not properly latched on to the breast, feedings could be painful which could lead to the baby not getting enough breast milk. Signs to confirm a good latch include; the circular movement of the jaw rather than rapid chin movement, wiggling ears, rounded cheeks, absence of clicking or smacking noises, tongue is seen when the bottom lip is pulled down, sound of swallowing, chin is seen touching the breast, when the baby comes off the breast, the nipple is not flattened or misshaped, any form of discomfort disappears as soon as the baby latches on, baby shows signs of satisfaction after breastfeeding.

In order to breastfeed successfully, it is important that the mothers and babies are relaxed and comfortable. Finding the most comfortable method will go a long way in ensuring successful breastfeeding.

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SPEAK WEDNESDAY

Child Trafficking, Gender, Health, WHO, Women / cfhinitiative

SPEAK WEDNESDAY – CHILD TRAFFICKING

Child Trafficking is a form of human trafficking and is defined by the United Nations as recruiting, transporting, transferring, and harboring a child for the purpose of slavery, forced labor and exploitation. Child trafficking occurs when children are taken away from safety and exploited. Children who are trafficked are often forced into some form of work, used for sex or simply sold.

Globally, 21 million people are trapped in forced labor or slavery. Of these, one in four are under the age of 18. Every year, 300,000 children are taken from all around the world and sold by human traffickers as slaves according to International Labor Organization (ILO).

Nigeria is not an exception. The alarming number of children being trafficked on a daily basis in Nigeria is worthy of immediate action. The 2015 re-enacted Trafficking in Persons Law Enforcement and Administration Act, and Nigeria 2003 Child Rights Act criminalize child trafficking, yet, this has not seemed to reduce the rate of child trafficking in Nigeria. Children are still being abducted despite measures that are put in place by necessary agencies.

Collective responsibility should be adopted to curb this silent menace globally. Individuals must support the government and necessary agencies to report suspects and suspected locations. At Centre for family Health Initiative, we totally condemn every form of trafficking and gender based violence. Every child deserves the right to grow and strive in a secured environment.

#SayNoToChildTrafficking #NoToChildAbduction #StopChildLabour #CFHISpeakWednesday

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MONDAY HEALTH BURST

#ViralHepatitis, Health, Viral Hepatitis, WHO / cfhinitiative

VIRAL HEPATITIS

Hepatitis is a viral infection that affects human and destroys liver cells. Got the name “Hepa” from the word “liver”. According to the World Health Organization (WHO), after tuberculosis, the second major killer infectious disease is Hepatitis. The different strains of hepatitis viruses are Hepatitis A Virus (HAV), Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), Hepatitis D Virus (HDV), and Hepatitis E Virus (HEV).

HBV and HCV are mainly transmitted via infected blood or body fluids and they cause severe damage to the liver. HAV and HEV on the other hand, are transmitted orally through contaminated food or water, while HDV can only infect people who are already infected with Hepatitis B virus.

Hepatitis B virus which is the most common type of hepatitis viruses is not yet curable but preventable via the use of vaccine. The primary treatment goal for patients with HBV infection is to prevent progression of the disease, particularly to cirrhosis, liver failure, and hepatocellular carcinoma (HCC). The use of antiviral treatment such as PEGylated interferon (PEG-IFN) or nucleotide analogues are used to prevent HCC.

For HCV, with the use of antiviral agents (>95%) Spontaneous resolution of acute HCV, infection may occur in 15% to 50% of patients hence, monitoring for spontaneous clearance for a minimum of 6 months before initiating treatment is recommended. Patients with acute HCV infection appear to have an excellent chance of responding to 6 months of standard therapy with Interferon (IFN). However, IFN-sparing regimens are safer and are currently recommended for the treatment of acute HCV infection as with chronic HCV infection. Treatment of chronic HCV infection has two goals. The first is to achieve sustained eradication of HCV which is defined as the persistent absence of HCV RNA in serum 12 weeks after completing antiviral treatment. The second goal is to prevent progression to cirrhosis, hepatocellular carcinoma (HCC), and decompensated liver disease requiring liver transplantation.

Hepatitis A is also preventable especially in individuals with chronic liver damage with the use of Hepatitis A vaccine. A synergistic approach of suppressing viral load and boosting the patient’s immune response with immunotherapeutic interventions is needed for the best prognosis.

According to WHO, 325 million people are living with HBV and HCV, 900,000 annual deaths caused by HBV infection, 90% of people living with HBV, and 81% of people living with HCV are unaware of their status. World Hepatitis Day, observed on July 28 every year aims to raise global awareness of Hepatitis and encourage prevention, diagnosis and treatment. Most strains of hepatitis viruses are not curable but preventable by the use of vaccines aside HCV. Hence, screening of Individuals and vaccination of the unaffected population is important in reducing the spread of the Infection.

Monday Health Burst is an initiative of Centre for Family Health Initiative 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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SPEAK WEDNESDAY

Gender, Health, Teenage Pregnancy, WHO, Women / cfhinitiative

TEENAGE PREGNANCY – THE SILENT MENACE

Pregnancy is a biological process indicating the possibility of motherhood. The most common form of conception is through sex whether consensual or not once a female begins to experience ovulation. This means that at any age while still ovulating, a female can be pregnant. Pregnancy at an early age is called teenage or adolescent pregnancy. The threshold for teenage pregnancy is 19 years and below counting from the verified date when the pregnancy ends. A female who conceives at 19 then delivers on her 20^th birthday or after that day is not considered as teenage pregnancy.

According to World Health Organisation, an estimate of 21 million girls aged 15-19 years in developing regions become pregnant and approximately 12 million of them deliver. In developing countries, there are at least 777,000 births from girls younger than 15 years old. Demographic and Health Survey 2013 estimated that 23 percent of Nigerian girls between ages 15-19 have started the process of child bearing. 17 percent out of the 23 have had their first child and 5 percent are pregnant with the first child.

Adolescents get pregnant or are at the risk of conceiving due to certain factors. Some females experience early puberty. As the physical changes begin to occur, the desire to explore these changes become more intense as a result of peer pressure or information, videos and images relating to sex from the media. The girls are overwhelmed by this desire and succumb to engaging in sexual activities without knowledge or access to contraceptives. The repercussion may be pregnancy.

In the African society, some cultures encourage young females to get pregnant out of wedlock and birth the children for the fathers/family. This traditional practice is allowed in situations where the girls’ family wants a male child and sees her as an only option to providing one, the girl is the only child, or the girls’ father died leaving few children. A healthy man from an illustrious family is chosen by the girls’ family to impregnate her. The birth of the child is celebrated as a gift from the God of fertility to expand the family’s lineage.

Some adolescent mothers are victims of non-consensual traumatizing sexual encounters that lead to pregnancy. These girls may be in abusive relationships, molested through coercion, deception, assault, raped, and threats is an unpleasant mode of conception. The law does not consider a minor (below 18) eligible to consent to any form of sexual behavior because it is believed that the minor is deficient in making informed decisions concerning sex. Hence, any act of sex before the age of 18 is considered child molestation.

Poverty is an underlying risk factor of teenage pregnancy. It makes the girls more vulnerable to predators and sexual abusers. Poverty denies the adolescents’ access to basic personal needs such as food, shelter and clothing, and this forces these females to lose their sense of dignity and they are easily enticed by those who provide or promise to provide these basic needs.

Pregnancy at an early age comes with catastrophic consequences for both the mother and the baby. For the mothers, that might be the end to education due to stigma, lack of support from friends and family and to meet their economic needs while pregnant. The girls may never go back to school. A lot of pregnant teenagers and mothers live in poverty because they have no educational qualifications to get jobs and earn a dignified income. For the children who are products of teenage pregnancies, the lack of social support and affection may convert them to juvenile delinquents.

Comprehensive sex education should be taught in schools and even introduced in the curriculum in schools where it is not taught. Male involvement is also crucial in the protective and preventive process of teenage pregnancy. The government should develop public policies that are culturally relevant and will be accepted and practiced by various cultures relating to teenage pregnancy. Education is one of the effective keys to combating teenage pregnancy because it empowers the teenagers and exposes them to more information. Free education should be implemented and support groups should be organized for proper counselling when needed. Preventing teenage pregnancies and supporting pregnant teenagers is the desired target.

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MONDAY HEALTH BURST – JUVENILE ARTHRITIS

Health, Hygiene, WHO, Women / cfhinitiative

MONDAY HEALTH BURST – JUVENILE ARTHRITIS

Formerly known as Juvenile Rheumatoid Arthritis (JRA), Juvenile Arthritis according to the initial word “Juvenile” occurs in children, which of course dispels the myth that only adults or the elderly suffer from arthritis. Juvenile Arthritis occurs when the body’s immune system attacks its own cells and tissues and it begins in its patients before the age of 16. However, for it to be referred to as chronic arthritis, symptoms must have persisted for more than 6 weeks.

According to the American College of Rheumatology, United States of America, 1 in a 1000 children develops chronic arthritis. In Nigeria according to Olaosebikan et al (2017) in the journal of advanced rheumatology, there is a fair share of JRA cases but due to lack of paediatric rheumatologists, awareness and diagnosis of cases is low. Hence, the urgent need for awareness creation.

The cause of juvenile arthritis is not yet known, but they may likely be due to a combination of genetic factors, environmental exposures and the child’s immune system, as it is the case with most autoimmune diseases. Symptoms may include but not limited to joint pain, rashes, stiffness, swelling, and fever.

Pain: The child may complain of pains at joints, mostly the leg joints.

Stiffness: Noticeable limping of the child in the mornings and after moments of sleeping.

Swelling: The large joints that bear weight like the knee joint and ankle joints are the first site seen to having swellings.

Fever: Spikes in fever especially at night with accompanying rashes at the trunk and palpable lymph nodes.

Complications of Juvenile Arthritis include inflamation of the eyes which can lead to blindness, growth distruptions, and joint damage. It is also important to note that there is a high ratio of females to males being affected.

To diagnose Juvenile Arthritis, there are a series of blood and body fluid tests as well as Imaging tests that can help the child’s doctor get to the disease, identify the type and possible management which can include medications, physical therapy, improving of child’s nutrition and academic involvement.

There is presently no known means of preventing Juvenile Arthritis, however, breastfeeding, avoiding smoking and not abusing antibiotics are known ways of improving the immune system.

CFHI Monday Health Burst is an initiative of the organization 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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