Nairobi, Kenya, East Africa. After two days of nursing her two-year-old daughter at home, an anxious Maximilla Kangahi made her way to a clinic in her neighbourhood for help.
At the health facility, Maximilla was received by Waida Kasaya, clinical officer at the Beyond Zero clinic in Karanja, one of Kibera’s 18 villages. Located in Kenya’s capital city of Nairobi, Kibera is the country’s largest urban slum area with the highest density of any settlement in the country, with an estimated population of 250,000 (UNHabitat).
It is heartening to see progress in the fight against malaria. Over the past thirty years and with hundreds of millions of dollars invested thus far, the RTS,S malaria vaccine was officially rolled out yesterday in Malawi. In 2017, I wrote about the vaccine trials that began in 2009 and the announcement of the three countries that had been chosen for the vaccine rollout: Kenya, Malawi, and Ghana. In clinical trials, the vaccine was found to prevent approximately 4 in 10 malaria cases, including 3 in 10 cases of life-threatening severe malaria. Now two years later the vaccine is officially in use to curb the unnecessary deaths of hundreds of thousands of African children under the age of five. The Malaria Vaccine Implementation Program will continue through 2022.
Q&A with NACCHO Board Member Sandra Elizabeth Ford, MD, MPH
Director of the DeKalb County Board of Health
A baby is born with a birth defect in the United States every 4.5 minutes, according to the Centers for Disease Control and Prevention (CDC). Birth defects are defined as any structural changes present at birth that affect how the body looks, works, or both, and they can vary from mild to severe. While not all birth defects can be prevented, there are concrete steps pregnant mothers can take to increase the chances of giving birth to a healthy baby. In honor of National Birth Defects Prevention Month, the CDC released a resource guide providing pregnant moms tips for preventing birth defects.
Around 17 percent of American children from age 2 to 19 are classed as “obese”. That’s a level that has remained fairly steady over the last decade. And it’s growing.
Obesity is measured in terms of Body Mass Index (BMI) – a measure that can be used to compare children in terms of their weight. BMI is calculated by dividing a person’s weight in kilograms by the square of their height in meters. For children and teens, BMI is so age- and gender-specific that it is referred to as BMI-for-age. BMI levels among children and teens need to be expressed relative to other children of the same age and gender. Every child is different and that makes it difficult to generalize on something like this.
Overweight is defined as a BMI at or above the 85th percentile and below the 95th percentile for children and teens of the same age and gender. Obesity is defined as a BMI at or above the 95th percentile for children and teens of the same age and gender.
To give an illustration, a 10-year-old boy of average height (56 inches) who weighs 102 pounds would have a BMI of 22.9 kg/m2. He would be considered obese because this calculation puts him in the 95th percentile for BMI-for-age. His BMI is greater than the BMI of 95% of 10-year-old boys in his “reference population”.
I am always happy when World Breastfeeding Week rolls around each year. It gives me a chance to hear about the latest programs that are working around the world to increase breastfeeding rates. This year I learned about how World Vision is promoting breastfeeding in the Philippines through its 7-11 Core Intervention Framework which includes 7 interventions for women and 11 for children 0 – 24 months of age.
The way in which we discuss breastfeeding is different depending on the country and the context. While in the United States we talk a lot about infant feeding choices, in other countries, especially those that have thousands upon thousands of yearly infant deaths caused by diarrheal diseases, infections, and sub-optimal feeding, the context changes. In these cases, it is nearly always critical that mothers breastfeed their children up to two years of age.
In the Philippines, parents spend $240 million on breast milk substitutes and multinational formula feeding companies spend $100 million on marketing in the Philippines alone. Those numbers account for the fact that only 34% of infants under the age of six months are exclusively breastfed. While providing the best start in life for infants, many mothers are convinced that formula is better and easier for their lifestyles. But, often times women in low-and-middle-income countries like the Philippines do not always have access to clean water for formula. Dirty water can cause deadly diarrheal diseases that kill infants.
There’s a growing global recognition of proper infant nutrition in the child’s first 1000 days of life. This can be monitored through encouraging proper nutrition during pregnancy and the first two years of life for optimal growth, health and survival.
Poor breastfeeding and complementary feeding practices are some of the common causes of malnutrition in the first two years of life. Breastfeeding confers both short-term and long-term benefits to the child like reducing the risk of infections and diseases like asthma, obesity, and type 2 diabetes. Mothers who breastfeed also lower their risk of developing breast and ovarian cancer, weak bones, obesity and heart diseases.
For countries to reap the benefits of breastfeeding they need to achieve a baby friendly status. Kenya began promoting the baby friendly hospital initiative approach in 2002. It ensures that health facilities where mothers give birth encourage immediate initiation of breastfeeding and exclusive breastfeeding for the first six months. Unfortunately, this programme was only accessible to women who delivered in the health facilities, leaving out those who give birth at home.
We conducted a two year study involving 800 pregnant women and their respective children in a rural area in Kenya. The study involved testing feasibility and potential effectiveness of the baby friendly community initiative (BFCI), whereby women in the intervention arm were given home-based counselling on optimal breastfeeding alongside health facility based counselling. These mother-child pairs were followed until the child was at least six months.
Women in low-and-middle-income countries need clean birth kits in order to stave off deadly infections in themselves and their newborns. This is the case not only during home births with midwives but also in institutionalized settings. Zubaida Bai, founder of Ayzh, a social enterprise that creates clean, safe birthing kits for women as well as reproductive, newborn and adolescent kits, discusses how she included women’s voices in … Continue reading [Featured Video] Simple Birth Kit for Mothers in Developing World
For decades, there has been consistent chatter, research, and hope for a potential malaria vaccine. Now, all three are finally coming to fruition to roll out the world’s first clinical malaria vaccine trials. The World Health Organization Regional Office for Africa (WHO/AFRO) announced today that Ghana, Kenya, and Malawi have been chosen for the WHO-coordinated pilot implementation program that will make the world’s first malaria vaccine … Continue reading Three African Countries Chosen for First Malaria Vaccine Trials
War is suffocating every corner of Syria and has been for the past several years. In areas that are close to neighboring countries like Idlib province that borders Turkey, Syrians from all over the country are fleeing there for safety believing that those border regions won’t fall under severe air attack. Unfortunately, as we learned last week, that just is not the case. Chemicals, including … Continue reading How You Can Help Mothers and Babies in Syria’s Idlib Camps
During my visit to Haiti two years ago I had the privilege of visiting two hospitals: L’Hôpital Albert Schweitzer (HAS) in Haiti’s Artibonite Valley and L’Hôpital Sainte-Thérèse in Hinche, Haiti. Many of the patients at both hospitals, I learned, walked or took public transport over long distances for quality hospital care. As the poorest country in the Western Hemisphere, Haitians need many more hospitals and health workers to care after their sick. There are currently only six health workers for every 10,000 Haitians according to USAID. And, Haiti has the highest rate of infant, child, and maternal mortality in the Western Hemisphere. Most Haitians live on less than $1 a day and their life expectancy is only 64 compared to 74 for its neighbor, the Dominican Republic.
Quality health care in Haiti continues to be one of the country’s greatest problems. In fact, Haiti only spends 6 percent of its expenditures on health care and relies heavily on international funding.
When I travel to low-income countries I am most interested in learning about and reporting on maternal and newborn health. As a mother of two daughters it is my biggest passion. Today on Giving Tuesday I am proud to work with one of my favorite international nonprofit organizations: World Vision USA. I had the distinct opportunity to travel with them to the Philippines a few years … Continue reading Double Your Donation Today By Giving to World Vision #GivingTuesday
Nutrition of women before and during pregnancy and when breastfeeding is critical in determining the health and survival of the mother and of her unborn baby.
Undernourished pregnant women have higher reproductive risks. They are more likely to experience obstructed labour, or to die during or after childbirth. Poor nutrition in pregnancy also results in babies growing poorly in the womb and being born underweight and susceptible to diseases. These mothers also invariably produce low quality breast milk.
Maternal malnutrition has inter-generational consequences because it is cyclical. Poor nutrition in pregnancy is linked to undernourishment in-utero which results in low birth weight, pre-maturity, and low nutrient stores in infants. These babies end up stunted and, in turn, give birth to low birth weight babies. Optimal maternal nutrition is therefore vital to break this inter-generational cycle.
In Kenya, women’s nutritional needs during pregnancy has not received much attention. This has exposed a gap in efforts to improve maternal and child health.
The Syrian civil war has entered its fifth year with few signs of ending.
The fighting has forced more than 13.5 million Syrians to flee their homes. Most of the displaced have not left Syria, but have simply moved around the country in an attempt to get out of the way of the fighting.
But approximately 4.8 million others have traveled beyond their nation’s borders in a search for security.
In my book Cultures of Migration, I argue that mass migrations and refugee crises don’t simply happen. They have a history and a trajectory. That work has led me to ask: Who are the Syrian refugees? What made their migration happen?
Sub-Saharan Africa has the highest level of food insecurity in the world. An estimated 220 million people lack adequate nutrition. The nature of the problem is shifting rapidly, with overweight status and obesity emerging as new forms of food insecurity while malnutrition persists. But continental policy responses do not address this changing reality.
Food insecurity is the outcome of being too poor to grow or buy food. But it’s not just any food. According to the United Nations’ Food and Agriculture Organisation’s definition, people need:
… sufficient, safe, nutritious food to maintain a healthy and active life.
Current policy focuses on alleviating undernutrition through increased production and access to food. It does not focus on the systemic issues that inform the food choices people make. This may result in worsening food insecurity in the region.