By Violet Nakamba Mengo
HIV-positive Bupe Mwamba, 22, lies next to her newborn baby girl at the rural clinic she just gave birth in and wonders if her baby is HIV-positive too.
She has been for counselling throughout her antenatal check-ups and knows there is a chance her baby girl may be HIV-negative. But it still does not eliminate her fears and anxieties.
"It is a moment of reflection about the future of your child and how your child will cope being HIV-positive. It cannot go without (me feeling) some kind of fear as a human being," she said.
Here at the Chipulukuso rural health centre in Ndola, Zambia's Copperbelt province, when an HIV test was done, blood samples were taken and then transported to a central regional hospital for analysis. The results were then sent back to the rural centre in a process that used to sometimes take up to 10 weeks.
And in the lifetime of a newborn baby, it was valuable time wasted during which the HIV-positive infant could have been placed on antiretroviral treatment (ART).
But Mwamba is fortunate. She will not have to wait so long to know her baby's status.
Because of the delays in sending and receiving HIV test results the ministry of health has piloted a short messaging service (SMS) that will now send HIV results of children less than 18 months back to health centres within three to five days.
The blood sample taken from Mwamba's baby, together with other samples from other rural health centres, are couriered to Ndola Arthur Davison Hospital, the central hospital on the Copperbelt region. Here the blood samples are tested for HIV.
The test results of the infants are then sent back to the health centres via a machine that receives information in the form of short messages. The test results will be printed out and the relevant doctor will be able to pass on the diagnosis to the parent.
Director of Public Health in the ministry of health, Victor Munkonka, is optimistic that the programme, once implemented nationally, will reduce the country's infant mortality rate by more that 50 percent.
Mukonka explained that the delay in administering ART to children who are less than 18 months old was contributing to the high death rates of babies in the country.
"We realised that we were losing many babies because of the delay in testing them for HIV, this is mostly because of lack of proper diagnostic machines to detect the virus in infants," he said. He also noted that those in remote areas had difficulty receiving their results once the blood samples were sent to the central hospital.
Mukonka said the SMS project started in January 2010 at selected health centres located in the rural areas of Zambia's Copperbelt, Central and Northern provinces.
"We are targeting 10 health centres on the pilot project which will be assessed after six months. During this period, tests that are sent to Arthur Davison from these health centres will be sent back using SMS within a short period of time," Mukonka said.
Mukonka said the SMS system will save infants' lives through prompt diagnosis and treatment.
Media Network on Child Rights and Development chairperson Felistus Chipako said the decision by the ministry of health to introduce the SMS to address paediatric HIV is a good development.
Chipako said Zambia has in the recent past struggled to address child mortality, which is among the highest in Sub Saharan Africa. Zambia's 2008 Demographic Health Survey showed the country's under-5 mortality rate was 119 deaths per 1,000 live births.
She said the intervention would help treat HIV-positive children in a more prompt manner than has been the case. "The system also calls for intensive counselling for mothers on how to handle the whole thing when given the results," she added.
Mwamba, however, said that the new method of receiving results was exciting, and that she was looking forward to the service working quickly.
Mwamba was discharged the day after her delivery and was scheduled to return to hospital with her baby for a check-up a week later.
When she returned seven days later, she also received the results of her child's HIV test.
Her baby girl is HIV-negative.
"I feel relieved that my baby is HIV negative, I spent the past six days pondering about what life would have been like for the little one living with the virus," Mwamba said.
However, Mwamba was encouraged to bring back her daughter for another HIV test when she is three months, then at six months and finally at 18 months for the last test. This is done to ensure that the baby is truly negative, since Mwamba is breastfeeding her baby.
"I am positive that the project will work if the health staff remain committed to it," she said.
Mumba said she cannot forget the fear, pain and anxiety in waiting for her baby's test results.
Thursday, September 30, 2010
Journalist called to step up in the fight against HIV and TB
By Violet Nakamba Mengo
Journalists must do more to report effectively on HIV, AIDS and TB issues in Africa, according to prominent health organisations.
Speaking at an international training workshop for journalists in Cape Town, South Africa on Thursday, Anthony Harries, head of the Paris-based health organisation International Union Against Tuberculosis and Lung Disease (IUATLD) challenged the media to be responsible for highlighting the pandemic.
“TB is a major killer in Africa,” Harries said. “A lot is still required to be done. Journalists write on it and speak on it, for the African continent to change.”
Awarding wining health experts concurred with a call from journalists demanding African governments to appoint HIV and AIDS ministers to specifically look on the epidemic. Harries, however, declined to be drawn to the political will behind the matter.
The four-day workshop, organised by National Press Foundation (NPF) under its Journalist-to-Journalist programme, is aimed at training journalists on how to report on HIV and AIDS. Fifty-six journalists from around the world gathered for the Cape Town, South Africa training in preparation of the 5th International AIDS Society Conference on AIDS pathogenesis, treatment and prevention that starts on 19 July.
IUATLD is an international union against TB and lung disease. Its mission is to bring innovation, expertise, solutions and support to address health in low and middle income populations.
The union has its headquarters in Paris and regional country offices serving the Africa, Asia, Europe, Latin America, Middle East, North America and South East Asia regions. Its science departments focus on tuberculosis, HIV, lung health and non communication diseases, tobacco control and research.
Harries also emphasised the urgent need for new tools in early TB detection.
“We need a new diagnostic tool for TB that will allow quick detection of the diseases just like the rapid diagnostic for AIDS,” he said.
Harries said for a long time the TB detection tool has in some cases failed to identify the disease in its infancy until when the disease is in the advanced stage.
Journalists must do more to report effectively on HIV, AIDS and TB issues in Africa, according to prominent health organisations.
Speaking at an international training workshop for journalists in Cape Town, South Africa on Thursday, Anthony Harries, head of the Paris-based health organisation International Union Against Tuberculosis and Lung Disease (IUATLD) challenged the media to be responsible for highlighting the pandemic.
“TB is a major killer in Africa,” Harries said. “A lot is still required to be done. Journalists write on it and speak on it, for the African continent to change.”
Awarding wining health experts concurred with a call from journalists demanding African governments to appoint HIV and AIDS ministers to specifically look on the epidemic. Harries, however, declined to be drawn to the political will behind the matter.
The four-day workshop, organised by National Press Foundation (NPF) under its Journalist-to-Journalist programme, is aimed at training journalists on how to report on HIV and AIDS. Fifty-six journalists from around the world gathered for the Cape Town, South Africa training in preparation of the 5th International AIDS Society Conference on AIDS pathogenesis, treatment and prevention that starts on 19 July.
IUATLD is an international union against TB and lung disease. Its mission is to bring innovation, expertise, solutions and support to address health in low and middle income populations.
The union has its headquarters in Paris and regional country offices serving the Africa, Asia, Europe, Latin America, Middle East, North America and South East Asia regions. Its science departments focus on tuberculosis, HIV, lung health and non communication diseases, tobacco control and research.
Harries also emphasised the urgent need for new tools in early TB detection.
“We need a new diagnostic tool for TB that will allow quick detection of the diseases just like the rapid diagnostic for AIDS,” he said.
Harries said for a long time the TB detection tool has in some cases failed to identify the disease in its infancy until when the disease is in the advanced stage.
School Policy for Teen Mothers a Partial Success
By Violet Nakamba Mengo
Naomi Mulenga is determined to beat the odds by finishing her school education and becoming a nurse - despite being a teenage mother.
At 13, she is the mother of a seven-month-old baby she raises on her own since the father denies responsibility for the child.
Mulenga says she feels bitter about the turn of events in her life, especially because she also heads a household since her parents' death in 2007, and takes care of a younger brother and sister.
Lack of parental guidance coupled with sexual inexperience and peer pressure landed Mulenga in the arms of a young man who promised her marriage, but instead made her pregnant and abandoned her.
Luckily, Mulenga's teachers were understanding and encouraged her to attend school until she gave birth and to return after the delivery of the baby. She currently attends grade eight at Kanakashi Basic School in Kasama, in Zambia's Northern Province, where she is one of the top pupils in her class.
"When the (exam) results came out in January, I was among the girls selected for grade eight. I was happy but also saddened because I did not have the money (to continue to go to school," Mulenga recalled.
Eventually, she was offered a bursary to finish secondary school and enroll for tertiary education through the department of education's Girls Re-entry Policy aimed specifically at teenage mothers. She also received an additional child support grant for poor households.
Mulenga says she is working extra hard to show other girls in similar situations that falling pregnant does not have to be the end of the road. While she is at school, her six-year-old sister takes care of the baby.
Deputy Minister of Education, Clement Sinyinda, explains the Re-Entry Policy tries to address gender
inequalities that have disadvantaged girls from accessing education in the country for many years. The policy is part of a wider strategy to improve education for girls, he explained.
Until 1997, pregnant girls were expelled from Zambian schools, while teenage fathers were not held responsible.
The numbers of teenage pregnancies have been on a steady increase countrywide, according to the education department, with 9,111 reported pregnancies of school-going girls in 2005, compared to 12,370 in 2008.
But thanks to the financial support offered through the Re-entry Policy and the child support grant, more than a third of those teenage mothers returned to school after giving birth, the department noted.
"The ministry is seriously trying to address the challenges of girls becoming pregnant whilst in school," promised Sinyinda. Apart from financial support, strategies include career guidance and counseling sessions, as well as sexual education, he says.
However, the deputy minister admitted that while the Re-entry Policy has helped to increase school enrolment of girls, achieving universal access to education for all still remains a big challenge - not only due to teenage pregnancy, but also because of widespread poverty.
To assist all poor children in the country, government offered almost 95,000 children in grades one to nine bursaries in 2008, with half of them being awarded to girls. This is a more than ten percent increase in bursaries since 2005.
"The provision of a bursary to support orphans and vulnerable children is another intervention to promote the participation of children who could not afford the cost of education," Sinyinda explained.
Permanent secretary of the ministry of tourism, environment and natural resources, Lillian Kapulu, agrees that the Re-entry Policy needs to be combined with a more general educational grant to give all children a second chance at life. "It is difficult, in villages, for parents to find money for school fees and uniforms, so many force their children out of school after grade seven," she said.
But despite the financial support, many teenage mothers continue to drop out of school because they find it difficult to balance their education and the obligations that come with being a parent, notes Kapulu.
Mulenga confirms that life has remained tough. The grant of 30 dollars a month is hardly enough to pay for the daily needs of her siblings, her baby and herself, she says. To put food on the table, she plants maize and vegetables on a small piece of land next to her house.
"It is difficult to be both a parent and a student, because sometimes you lose concentration, especially when the baby is not well and you are in school," Mulenga told IPS.
Unfortunately, one additional avenue of support - an education programme for teenage mothers run by American non-profit organisation Family Health Trust (FHT) - was closed down at the end of last year.
FHT's Community Health and Nutrition, Gender and Education Support (CHANGES) programme ran for three years and helped more than 3,500 teenage mothers to return to school, says FHT acting programmes manager Kilby Lungu.
Naomi Mulenga is determined to beat the odds by finishing her school education and becoming a nurse - despite being a teenage mother.
At 13, she is the mother of a seven-month-old baby she raises on her own since the father denies responsibility for the child.
Mulenga says she feels bitter about the turn of events in her life, especially because she also heads a household since her parents' death in 2007, and takes care of a younger brother and sister.
Lack of parental guidance coupled with sexual inexperience and peer pressure landed Mulenga in the arms of a young man who promised her marriage, but instead made her pregnant and abandoned her.
Luckily, Mulenga's teachers were understanding and encouraged her to attend school until she gave birth and to return after the delivery of the baby. She currently attends grade eight at Kanakashi Basic School in Kasama, in Zambia's Northern Province, where she is one of the top pupils in her class.
"When the (exam) results came out in January, I was among the girls selected for grade eight. I was happy but also saddened because I did not have the money (to continue to go to school," Mulenga recalled.
Eventually, she was offered a bursary to finish secondary school and enroll for tertiary education through the department of education's Girls Re-entry Policy aimed specifically at teenage mothers. She also received an additional child support grant for poor households.
Mulenga says she is working extra hard to show other girls in similar situations that falling pregnant does not have to be the end of the road. While she is at school, her six-year-old sister takes care of the baby.
Deputy Minister of Education, Clement Sinyinda, explains the Re-Entry Policy tries to address gender
inequalities that have disadvantaged girls from accessing education in the country for many years. The policy is part of a wider strategy to improve education for girls, he explained.
Until 1997, pregnant girls were expelled from Zambian schools, while teenage fathers were not held responsible.
The numbers of teenage pregnancies have been on a steady increase countrywide, according to the education department, with 9,111 reported pregnancies of school-going girls in 2005, compared to 12,370 in 2008.
But thanks to the financial support offered through the Re-entry Policy and the child support grant, more than a third of those teenage mothers returned to school after giving birth, the department noted.
"The ministry is seriously trying to address the challenges of girls becoming pregnant whilst in school," promised Sinyinda. Apart from financial support, strategies include career guidance and counseling sessions, as well as sexual education, he says.
However, the deputy minister admitted that while the Re-entry Policy has helped to increase school enrolment of girls, achieving universal access to education for all still remains a big challenge - not only due to teenage pregnancy, but also because of widespread poverty.
To assist all poor children in the country, government offered almost 95,000 children in grades one to nine bursaries in 2008, with half of them being awarded to girls. This is a more than ten percent increase in bursaries since 2005.
"The provision of a bursary to support orphans and vulnerable children is another intervention to promote the participation of children who could not afford the cost of education," Sinyinda explained.
Permanent secretary of the ministry of tourism, environment and natural resources, Lillian Kapulu, agrees that the Re-entry Policy needs to be combined with a more general educational grant to give all children a second chance at life. "It is difficult, in villages, for parents to find money for school fees and uniforms, so many force their children out of school after grade seven," she said.
But despite the financial support, many teenage mothers continue to drop out of school because they find it difficult to balance their education and the obligations that come with being a parent, notes Kapulu.
Mulenga confirms that life has remained tough. The grant of 30 dollars a month is hardly enough to pay for the daily needs of her siblings, her baby and herself, she says. To put food on the table, she plants maize and vegetables on a small piece of land next to her house.
"It is difficult to be both a parent and a student, because sometimes you lose concentration, especially when the baby is not well and you are in school," Mulenga told IPS.
Unfortunately, one additional avenue of support - an education programme for teenage mothers run by American non-profit organisation Family Health Trust (FHT) - was closed down at the end of last year.
FHT's Community Health and Nutrition, Gender and Education Support (CHANGES) programme ran for three years and helped more than 3,500 teenage mothers to return to school, says FHT acting programmes manager Kilby Lungu.
Zambia tacles CARMMA
By Violet Mengo,
It is one of the most depressing to lose a life due to preventable health causes, worse off for a mother loosing her life in order to give life. However, this is a reality for thousands of expectant mothers the world over that have continued to die everyday from complications arising from pregnancy and childbirth.
Death of mothers due to known and mostly avoidable causes at delivery reduces by almost half chances of survival of their new babies. Statistics on the number of women and newborn babies dying from preventable causes around the world have shown that tackling maternal complications remain a challenge for many countries.
In Africa, the maternal mortality rate continues to be one of the continent‘s major health problems. The rate remains high despite political commitment evidenced by the adoption of various policies and strategies.
These include the Cairo Consensus in 1994, Maputo Plan of Action in 2006 and the African Health Strategy 2007 to 2015 Millennium Development Goals (MDGs).
While several countries have managed to record some successes in addressing maternal health, a lot remains to be done in ensuring that every woman’s right to health and life is upheld.
Better health facilities will entail that every woman, regardless of location, station in life, experiences safe motherhood and that her life and that of her baby are saved within 42 hours following delivery.
The major causes of maternal death are from various medical complications including hemorrhage, sepsis, eclampsia, obstructed labour, abortion and other direct and indirect causes, notably cultural and traditional practices.
Neonatal sepsis is a serious blood bacterial infection in an infant less than four weeks of age while eclampsia is a condition in pregnancy characterised by abrupt hypertension.
Adolescent pregnancy, harmful traditional practices, low social status of women and high fertility rate, low male involvement and participation in reproduction health, poverty and HIV and AIDS contribute significantly to maternal deaths.
The causes of new born deaths include sepsis, tetanus, diarrhea, preterm and asphyxia (impaired or impeded breathing). Other causes are complications during pregnancy and delivery, poor care of newborns at household level, inadequate health care for sick newborns and poverty.
The African Union’s response to tackling maternal mortality was the 2009 launch of the Campaign on Accelerated Reduction on Maternal Mortality for Africa (CARMMA) with the theme: Africa Cares, no woman should die while giving birth.
The CARMMA concept aims to accelerate and scale up high impact interventions through high level advocacy and sensitisation. And because of the direct impact the campaigns has on individual countries in terms of reducing maternal mortality rate, many African countries including Zambia, have adopted and are localising CARMMA.
The campaign also aims to raise the profile of maternal mortality to elicit the vital high political will and commitment at national level and accelerate the reduction of maternal mortality.
The implementation of CARMMA includes safe motherhood activities in selected districts of the country, family planning, postnatal care and using men in advocacy at antenatal clinics.
In Zambia Zambia
She is the patron for CARMMA and has been traveling throughout the country to promote the campaign.
“We aim to ensure that the lives of mothers and babies are saved before, during and after delivery as poor maternal and newborn health have diverse consequences and impact negatively on the development of any nation, Mrs Banda said.
The first lady said it was unfortunate that hundreds of women and newborn babies continue to die every day from preventable causes.
She said it was important for all people to get involved and advocate for improved health services for expectant mothers and newborn in Zambia
However in order to reap the intended benefits, strengthen policy and programmatic environment to accelerate the attainment of MDG four and five, the campaign has incorporated some stakeholders such as media, private sector, NGO and business house.
Ministry of Health Director Public Health Dr Victor Mukonka said it was important to highlight progress and challenges affecting maternal mortality so that women can be educated on the importance of seeking healthcare service when they fall pregnant.
About K16 billion has been set aside for the effective implementation of CARMMA.
In Zambia
“We shall no longer allow pregnant mothers to go with buckets to hospitals when the time for delivery comes, all hospitals have been stocked with enough buckets for expectant mothers,” the minister said.
Ministry of Health spokesperson Dr Kamoto Mbewe said the decision to make women's and children's health the theme of this summit was a sign Africa's policymakers are getting the message.
"Issues of maternal mortality need the urgent action of our heads of state if we are to reverse the negative image of women dying on our continent," said Dr Mbewe.
He said the health of women is important and must be protected. Health women contribute to Zambia
He said “it is important to scale up interventions and sensitise people on the interventions. This is the only way they will be able to make informed decisions on their health.
To improve the health status of women and children, Zambia
The country risks losing investments not less than K1 trillion if no improvement is made in maternal health.
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