Category Archives: HIV / AIDS

Exclusive Breastfeeding Rates in Kenya Still Low

By Maryanne Waweru-Wanyama, Kenyan motherhood blogger and maternal/child health journalist based in Nairobi.

As Kenya joins the rest of the world in marking the World Breastfeeding Week, health experts in the country are calling on more stringent efforts to be put in place that will encourage more women to exclusively breastfeed their babies. Though the country has noted an increase in the exclusive breastfeeding rates over the last decade, the numbers are still not enough.

Data from the Kenya Demographic Health Survey (KDHS) show that in 2003, the exclusive breastfeeding rates stood at 13 per cent, and which rose to 32 per cent in 2008. Despite this remarkable improvement, Kenya’s Health Cabinet Secretary Mr. James Macharia says that the figures are still not at a desirable level, adding that many Kenyan children still miss out on the important nutritional benefits of breastmilk.

“Out of approximately 1.5 million children born each year in Kenya, only 500,000 of them are exclusively breastfed. This means that over 1 million babies are exposed to the unnecessary risk of malnutrition and increased illness which impact negatively on the country’s road to achieving MDG 4 –that of reducing child mortality,” he says.

New mom at PumwaniA new mother at Pumwani Maternity Hospital on August 1 2014, the day of the launch of the World Brestfeeding Week celebrations in Nairobi at the maternity hospital.

The reasons for the low uptake of exclusive breastfeeding among Kenyan mothers are many. A study conducted by the African Population and Health Research Center (APHRC) in two urban slums in Nairobi revealed that only about 2 per cent of children were breastfeed exclusively for the first six months. The study also found out that about 15 per cent of children stop breastfeeding altogether by the end of the first year. Some of the reasons for this low uptake include: poverty, food insecurity, ignorance about best breastfeeding practices, lack of social support, as well as myths and misconceptions about breastfeeding.

Another reason for the low uptake of exclusive breastfeeding is misinformation about breastfeeding when the mother is HIV positive. A significant number of HIV+ Kenyan women think they will transmit HIV to their newborns if they breastfeed them, and so do not offer them breastmilk at all, instead offering them cow’s milk. Notably, and in relation to this, is the fact that the number of Kenyan women who seek antenatal care services (a minimum of four visits during their pregnancy) is only at 47 per cent. Similarly, the number of women who seek postnatal care is 42 per cent. These figures only mean that a large number of women miss out on ideal opportunities for them to receive information about best practices in maternal and newborn health, including information about the extraordinary benefits of breastfeeding.

Working women face barriers too as there are some Kenyan employers who do not adhere to the Kenya Employment Act which offers women a maternity leave of fourteen weeks. Many working women have been called to return work before the end of their maternity leave. Sadly, and despite being aware of the law and its provisions regarding this, many career women agree to return to work before completion of their maternity leave for fear of losing their jobs. Consequently, many middle and upper class working women introduce formula milk to their babies from as early as two months, while the low income women who cannot afford formula milk introduce cow’s milk or porridge to their baby’s diet.

Ignorance also exists among many rural women, who believe that breastmilk alone is not sufficient enough for a baby’s optimal growth and therefore introduce porridge (blended with fish, millet and sorghum) from as early as two months in order to ‘supplement’ the baby’s diet. For many rural communities, a ‘fat’ baby is considered healthy, and many mothers, for fear of reprimand by relatives and health workers about having a ‘think unhealthy baby’ introduce solids to babies (mixed with margarine) at a tender age. Many women in rural communities are yet to be reached with information on the fact that breastmilk alone contains all the nourishment a baby needs for the first six months of life.

Some of the steps the government has made to try and increase the uptake of breastfeeding among Kenyan mothers is the enactment of the Breastmilk and Substitutes (Regulation and Control) Act (2012) which regulates the marketing and distribution of breastmilk substitutes and provides for safe and adequate nutrition for infants through promotion of breastfeeding.

The government has also adopted the Option B+ program, where mothers and their newborns receive ARVs, and which helps keep the baby HIV negative while still enjoying all the benefits of breastmilk.

Terry WefwafwaTerry Wefwafwa, head of nutrition and dietetics at the Ministry of Health. She is hopeful that increased awareness campaigns on breasfeeding will translate into more women taking up the practice.

There have also been awareness campaigns through the media –both mainstream and community radio promoting exclusive breastfeeding. Such campaigns work towards increasing the level of information to not only the women, but also men and other members of the household on the critical role they can play with regard to supporting best breastfeeding practices. It is these awareness campaigns that are giving Kenya’s head of nutrition and dietetics, Mrs. Terry Wefwafwa confidence that the next survey will reveal a significant increase in the number of women exclusively breastfeeding.

“Since the last survey was done in 2008, intense sensitization among communities about the benefits of breasmilk have been done, and I am confident that the uptake on exclusive breastfeeding has increased. This will be evident in the next survey report,” she says.

Maryanne_Waweru pptMaryanne Waweru-Wanyama is a motherhood blogger from Nairobi, Kenya. She tells her motherhood stories on her blog mummytales.com where she also incorporates the experiences of other Kenyan mothers. On her blog, Maryanne provides education on pregnancy, birth, delivery and infant and child care and nutrition. Maryanne is a journalist with over fourteen years experience and who has written, and still writes for various publications in Kenya including: the Daily Nation newspaper, the Star newspaper, the Standard newspaper, Parents Magazine, Healthy Woman Magazine, Healthy Child Magazine and many other publications. Her area of specialty is human interest features, maternal and child health articles. Maryanne is married with two sons.

20 Key Tweets from the #AIDS2014 Conference

"20th International AIDS Conference (AIDS 2014), run by the International AIDS Society at the Exhibition Centre, Melbourne, Australia. "
Through July 25, the 2014 International AIDS Conference (IAC) conference is taking place in Melbourne, Australia. With over 14,000 delegates, including experts, religious leaders, scientists, writers, and staunch HIV/AIDS advocates in attendance, the #AIDS2014 conference in the yearly gathering of the minds who stand on the global forefront of the HIV/AIDS conversation. In light of last week’s tragic crash of Malaysian Airlines Flight 17, several have said the mood of the conference is sad and reserved as 100 AIDS scientists and researchers who were en route to the conference never made it.

Despite the tragedy, organizers assured delegates that the conference would continue as planned, “in recognition of our colleagues’ dedication to the fight against HIV/AIDS” as reported by ABCNews.com.  There have been several opportunities for attendees to reflect and mourn those in the community who were lost. Follow the hashtag through the end of the week at #AIDS2014.

Here are 20 tweets I found give a thorough glimpse of the conference thus far. 

Momina’s Story: International HIV/AIDS Alliance #WAD2013

Meet Momina

Momina is a 22 year old single mother of two who lives in the city of Adama in central Ethiopia and was diagnosed as living with HIV three years ago. Although she wears a smile, sadness is etched across her face when she talks about her younger son, Yerosa. Born HIV positive, he is now three but Momina knows very little of his life save for the occasional photos she is sent by the American family who adopted him. Momina took the agonising decision to give him up for adoption in the hope that he would be able to receive medical treatment.

In telling her story today, Momina hopes that she might help other young women just like her, to know how they can protect themselves from contracting HIV and get the care and support they need through projects like Link Up being led by the International HIV/AIDS Alliance.

Momina

When Momima was a teenager, she left her family home as she was afraid that her parents would marry her off to an older man as they did with her older sister – who later died of AIDS. After falling pregnant with her first child Rapira, and without the support of her parents, she was forced to move from community to community, taking temporary jobs where she could, to try to provide food and shelter for her son.

“I don’t want my child to starve or get hurt,” says Momina.

“There are times when I feed my child and I do not eat at all. I sometimes come home late from work, there are times when I wake him up and feed him because I don’t want him to sleep on an empty belly.”

Without life being tough enough already, three years ago Momina was diagnosed as living with HIV. At that time she had no idea that she was pregnant and subsequently she was not able to receive the treatment needed to protect her unborn child from onward transmission of the virus. When her youngest son, Yerosa was just four months old, Momina learned that he was HIV positive and took the agonising decision to give him up to a family in the US with the hope that he would receive the medical care he needed.

“I convinced myself that it’s better to see my child well. If he had not been seriously ill, I would have not given him away. I would have fought until the end. I am praying for him to be well wherever he is.”

Living with HIV

Determined not to be defined by her HIV status, even when her own mother will not allow her into her family home for fear that she might infect her siblings, Momina remains candid about her condition with friends and colleagues. But in a country where HIV stigma and discrimination still prevail, her openness sometimes costs her and she is presently between jobs.

“I do not let myself down because I live with HIV and have my own objectives.”

“I want to continue my education and qualify as a nurse. I have always had a passion and love for the profession and I want to serve people like me, people living with the virus. I would be happy if I could do that. My biggest aim is to get educated, get a job and live my own life but at the same time I don’t want to cry over split milk”

Momina is assisted with access to HIV treatment and care by Ethiopia’s largest NGO working on HIV, the Organization for Social Services for AIDS (OSSA), who in turn is supported by the International HIV/AIDS Alliance. Every fortnight she attends a support group meeting organised by OSSA where she and other members of her community living with HIV meet to share their experiences.

OSSA have also helped contribute to her son Rapira’s annual school fee. Momina is determined to see that he gets a good education.

“I wish for him something much greater than I had,” she says with feeling.
“I hope he can go all the way and graduate which I was unable to do.”

In another world, life for Momina and her family could have turned out so very differently. If she had known how to protect herself against HIV. If she had gone through proper antenatal care when she was pregnant with Yerosa. If she had not felt compelled to run away from home for fear of early marriage. If she was able to work freely without worrying about becoming a target for discrimination.

“I would like people to see me a strong person,” she smiles. “I know that there is strength in me; I got that strength from the life I have had. I want young people of my age to be strong and to have the strength to face and overcome challenges.”

The International HIV/AIDS Alliance and Link Up

Ethiopia is one of five countries currently being targeted by the Alliance and its partners through Link Up, an initiative that aims to improve the sexual and reproductive health and rights of more than one million young people living with and affected by HIV.

Over the course of the next three years, Link Up will reach more than one million young people aged 15-24 by implementing tailored HIV and sexual and reproductive health interventions to increase uptake and access to services and reduce unintended pregnancies, new HIV infections and HIV-related maternal mortality. In Ethiopia the initiative aims to reach 140,000 young people to improve their sexual health.

What can you do to help?

Show your support to Momina, Link Up and the International HIV/AIDS Alliance by:

1. Sharing Momina’s story (Click to Tweet) (Share on Facebook) #LinkUp
2. Keeping up to date with the work being carried out through Link Up at www.link-up.org
3. Follow the International HIV/AIDS Alliance on Twitter @theaidsalliance and on Facebook

Thank you for taking the time to read Momina’s story today. It means a lot to everyone involved in this project.

Photo credit: Benjamin Chesterton\duckrabbit\International HIV/AIDS Alliance

Living, Thriving with HIV/AIDS: A Mother’s Story

Can you imagine newly arriving to the United States from Dar es Salaam, Tanzania as a happy, expecting 22-year-old newlywed to attend college and then finding out through a routine prenatal visit that you are HIV positive? This is precisely what happened to Fortunata Kasege in 1997. What turned out to be a dream of coming to America to study journalism quickly turned into a nightmare when she discovered her HIV status.

Fortunata Kasege: Living with HIV and raising a HIV-negative child, I developed a desire to become a part of advocacy and community outreach. Today, I use my story to educate people about HIV/AIDS, to give hope to those who are infected and affected, and to eliminate stigma and stereotyping. Source 

“I couldn’t believe what I was hearing,” said Kasege. “I was shaking. I was screaming. They were basically telling me that I was going to die. Everything was really, really spinning around my head at that time. I had a high level of anxiety. I had deep depression.”

That was then. Today, life is measurably better for Fortunata Kasege.

Today I hung out on Google+ with the Elizabeth Glaser Pediatric AIDS Foundation and had the opportunity to speak with and hear Kasege’s uplifting story of hope and survival. It’s moments when I hear true stories of those who have triumphed in the face of despair that I am humbled beyond words by their courage and drive to help others. Today Kasege is a HIV/AIDS advocate and ambassador who spreads the word of hope to other mothers who are also HIV positive. “I feel so lucky,” said Kasege. “I feel like I am the one who got the gift. I am the one who got this incredible gift to be a mom.”

Fifteen years ago all Kasege knew about HIV/AIDS is what she saw in her native Tanzania. When people contracted HIV/AIDS they rapidly died from the disease. “I come from a completely different world where people die from HIV,” Kasege remembered. “You just prepare yourself for the worst. I didn’t want to die at 22.”

In those days HIV/AIDS ravished the African continent. Little did Kasege know after her diagnosis that there was medication to treat her and prevent HIV transmission between she and her unborn daughter. Today Fortunata Kasege is doing well and is healthy. Her daughter, Florida, who is now a teenager, is HIV-free thanks to the medications Kasege received when she initially learned of her HIV status fifteen years ago.

Like Kasege, this Mother’s Day you can celebrate your mom and mothers around the world. Visit the Elizabeth Glaser Pediatric AIDS Foundation site, A Mother’s Fight, and leave a comment and tell them how your mom inspired you.

Infographic of the Week: An Integrated Approach to HIV/AIDS and Family Planning Services

An integrated approach to healthcare no matter the setting is a more effective and rights-based approach to healthier outcomes. When family planning services are available at HIV/AIDS clinics, Population Action International (PAI) believes patients will receive better care, health workers will be more efficient, and dollars will be saved.

In sub-Saharan Africa integrated clinic settings are critical to healthier outcomes. In addition to this infographic, PAI created this film last year, In One Place, to drive home the importance of integrated services to family planning and HIV/AIDS services.

PAI Infographic

When HIV Positive Mothers Speak: Preventing HIV in Infants

This post was originally published on the Gates Foundation’s blog, Impatient Optimists.

“After I lost Nomthunzi, my life was never the same again. I cried for a long time.” Despite the grief of losing her husband and baby, Nomthunzi, to AIDS, Florence Ngobeni-Allen pressed on and became an ambassador for the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) to educate women about the importance of HIV testing and stopping the transmission of HIV to their babies.

Times have certainly changed for many who live with HIV/AIDS.  Where once being diagnosed HIV positive was a definite death sentence, particularly in the developing world, many people can now live and thrive with HIV/AIDS, including babies.

Nine-hundred babies are born with HIV each day, according to the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF). In a recent online discussion with the foundation, bloggers were told that without treatment 50 percent of these babies will die before their second birthday. Today, around the world, 34.2 million people are estimated to be HIV positive and 3.4 million of them are children.

Two of the foundation’s ambassadors, Florence Ngobeni-Allen and Martha Cameron, are HIV-positive. They are also mothers who spread awareness to other mothers about mother-to-child transmission of the virus (passing the virus from the pregnant mother to her baby, in utero).

They stress to mothers globally that even though they may be HIV-positive their babies don’t need to be born with the HIV virus. In fact, 100 percent of all mother-to-child transmission of HIV is preventable. During the discussion both Ngobeni-Allen and Cameron repeated that the first step in decreasing the rate of mother-to-child transmission of HIV is through testing. When a woman knows her status she can prevent her baby from being born with HIV.

Martha Cameron grew up in Zambia and watched as countless members of her family passed away from AIDS, including her mother when Cameron was only 23-years-old. After severe bouts of illness both in the United States and Africa, Cameron tested positive for HIV in 2003. Despite her status, Cameron got married in 2007 and shortly thereafter she and her husband decided to have children.

“For African women it is such a big deal,” said Cameron. “It’s dignity for a woman to have children.” Through education from her doctors and prevention of mother-to-child transmission of HIV Cameron has delivered two HIV-negative babies and her husband continues to be HIV-negative as well.

Florence Ngobeni-Allen’s story is different because she lost her husband and her baby daughter, Nomthunzi, to AIDS in South Africa in 1996 and 1997 respectively.

In those days there were “no antiretroviral medicines available for children at that time in South Africa,” Ngobeni-Allen wrote in her personal story. Now, Ngobeni-Allen is a wife and mother of a HIV-negative son and husband.

Today there is no reason for babies to be born HIV-positive. Through early testing, education, and prevention of mother-to-child transmission of HIV every baby can be born HIV-free.

Meeting Key US Players in Zambia’s National Health #ZambiaHealth

After spending nearly a week and a half in Zambia during the second half of July with nine other new media journalists we concluded our final day with an official visit to the United States Embassy in Lusaka. We met with representatives from USAID, PEPFAR, the Peace Corps, and the CDC. We also met with the US Ambassador to the Republic of Zambia, Mark. C. Storella. The visit provided a capstone to all of the site visits and panel discussions we had reporting from Zambia. It also provided a tightly wrapped conclusion to the information we learned on the ground not only in Lusaka, Zambia’s capital, but also in some of the rural areas in Zambia’s Southern Province.

Ambassador to the Republic of Zambia, Mark Storella
Ambassador to the Republic of Zambia, Mark Storella

Dr. Lawrence Marum, the country Director for the CDC in Zambia mentioned that for two decades HIV transformed countries and now the best prevention is through early detection. “We have gone through a transformation I didn’t think I would see in my lifetime,” Marum said. “Five hundred thousand people are alive today in Zambia and on ARVs who otherwise would be dead.”

Marum also underscored the skepticism many in the west had in the early 1990s about African doctors’ ability to prescribe ARVs. Today thousands of Zambian doctors can prescribe ARVs which shows a significant sustainability and capacity change.

In Zambia, through work with these four key US partners as well as through the Department of Defense, Zambia is creating a climate of increased access to HIV testing, education, and counseling, PMTCT, access to ARVs, cervical cancer screening, voluntary male circumcision, and the reduction of maternal mortality. In fact, Zambia is one of three countries that is on track to eliminate PMTCT (Prevention of Mother to Child Transmission) and could create an AIDS-free generation. Zambia is also working diligently to rampantly reduce the maternal mortality rate of 591 per 100,000 live births. Compare that to 4 per 100,000 live births in the United States. Working in select districts in Zambia, the maternal mortality is dropping significantly. It’s only a matter if the interventions can be scaled.

Under the leadership of Ambassador Storella, Zambia is gradually becoming an active part in financing countrywide health services and is moving to accept country ownership of health programs. This is a process to be sure. Zambian officials have responded and have increased budget allocations for HIV/AIDS detection and treatment.

“Zambia is moving in the right direction,” Storella said.

In fact, Zambia has increased their health budget by 45 percent. Storella realizes that there will come a point where despite budgets health programs will have to be sustainable. “We cannot just provide treatment,” he said. “We have to ramp up health systems.”

One of the main goals of Ambassador Storella is to ensure that US-funded programs produce measurable results and that he shows good stewardship of the American taxpayer’s money. “Diseases don’t know borders,” Storella said. “We are the front line of protecting the American people and the world.”

I reported about HIV/AIDS, TB, and malaria as an International Reporting Project Zambia fellow.

Sanitation Wisdom from a Zambian Chief #ZambiaHealth

As you may know I am in Zambia with the International Reporting Project as a New Media fellow. Ten of us are here in the country to report on HIV/AIDS, malaria, tuberculosis and other rarely covered stories in the region.

SONY DSC
Yesterday we visited Macha, a small Southern province town 60 miles from the nearest city, Choma. Macha is the home of the Malaria Institute at Macha, an institute that has successfully reduced the number of malaria cases in the area by 90 percent. The vast majority of the residents of Macha are subsistence farmers who live on small homesteads.

In order to achieve such an unprecedented reduction in malaria cases,  the will of the community must first be achieved through the area chief. Chief Macha was the conduit through which much of the malaria success took place.

We were invited to Chief Macha’s palace to speak to him about how he fights HIV/AIDS, but instead he wanted to speak to us about sanitation and health. Now that malaria has been controlled in Macha, Chief Macha has taken up a new cause – village sanitation. In fact, last year Chief Macha was honored as a UNICEF Zambia Supporter for Sanitation.

He spoke to us about his philosophy about ensuring every homestead has its own pit latrine and how he created a 100 percent Open Defecation Free community.

SONY DSC
“You cannot do anything without your health.” – Chief Macha

SONY DSC

“Food and sanitation must be fought the world over. – Chief Macha

SONY DSC

“We should all be sanitation drivers.”  - Chief Macha

SONY DSC

“I have given myself to sanitation.” – Chief Macha

SONY DSC

“Without clean water you have a problem with disease. If you drink dead water you come down with diarrhea.” – Chief Macha

SONY DSC

“If you have the will, things can be done.” – Chief Macha

Photos:  Jennifer James

Reporting from Zambia with the International Reporting Project

As I mentioned a few weeks ago I will be reporting from Zambia as an International Reporting Project Zambia Fellow starting on July 15. I will be in Africa with nine stellar new media journalists. We all have our own beats and will report on different angles about HIV/AIDS, tuberculosis, and malaria. I personally will report on how these infectious diseases acutely affect mothers and children.

You can follow my work on the Gates Foundation blog, Impatient Optimists. You can follow all of our work at the #ZambiaHealth hashtag. You can also follow my personal observations at jjamesonline.com.

Photo:

Children sing at the Fountain of Hope centre in Lusaka, Zambia, during a visit from Secretary-General Ban Ki-moon. The centre helps to rehabilitate thousands of children living on the streets of the Zambian capital.
25 February 2012
Lusaka, Zambia

George W. Bush Praises Zambia’s HIV/ AIDS National Efforts

In less than a month I will join nine other new media journalists on a reporting trip to Zambia as an International Reporting Zambia Fellow. We will be charged with learning more about HIV/AIDS, malaria, and tuberculosis and their affects on the  Zambian citizens, report on the problems and Zambia’s national and community-led efforts to combat them. Leading up to, during, and after our trip to Zambia at the end of July I will report on these communicable diseases and how they acutely affect women, children, and families. You can read all of my content on the ZAMBIA tag.


This week George W. Bush will visit Zambia and Tanzania along with former first lady Laura Bush. They will be in Africa at the same time as the Obamas this week who will visit Tanzania, Senegal, and  South Africa. Bush will be visiting Zambia to refurbish a health clinic used primarily to diagnose and treat cervical and breast cancer through the Bush Institute’s Pink Ribbon Red Ribbon initiative. Michelle Obama is slated to join Laura Bush for the Investing in Women: Strengthening Africa event ad forum in Dar es Salaam, Tanzania, for African first ladies.

Last week Bush praised Zambia for its ongoing efforts to get a handle on the HIV/AIDS crisis in the country that ranks tenth in the highest HIV rates in the world even though Zambia showed a greater then 50 percent decrease in HIV infection since 2001 according to UNAIDS latest global report on HIV/AIDS released in November 2012.  Additionally, according to the same UNAIDS report, Zambia also recorded a greater than 50 percent reduction in its HIV death rate from 2001 – 2011.

Lusaka Times reports that Bush told Zambia’s Ambassador to the United States of America, Palan Mulonda, “I am happy with the Zambian government for its commitment to the fight HIV/AIDS as evident by the budgetary allocation to the health sector.” Between 2009 – 2011 Zambia has received $153 million dollars through, the United States President’s Partnership Emergency Plan for AIDS Relief (PEPFAR).

Based on data gleaned from the Global Fund 450,000 Zambians are currently on ARTs. To date, 76% of the $582 million of grants is dedicated to HIV/ AIDS.  It is also important to note the Global Fund grant performance for Zambia has hovered around adequate as opposed to exceeding or meeting expectations. The grants that have experienced some of the most success have been given to Churches Health Association of Zambia’s Program to Combat HIV/AIDS and United Nations Development Programme, Zambia, both with an A1 scored in grant performance.

At a glance, 11 percent of Zambia’s adults have HIV/AIDS according to UNICEF.  460,000 women and 170,000 children  in Zambia have HIV/AIDS.  The country is moving rapidly to prevent increased HIV/AIDS especially as the country experiences a youth bulge and many young girls have early sex.

You can follow all of my coverage about Zambia at mombloggersforsocialgood.com/tag/zambia.

Photo: United Nations