Category: Health

Many women experience unexplainable emotional changes after childbirth, one of which is post-partum depression. However, depression after childbirth often worsens because some live in denial while others cannot seek help because of the fear of stigmatisation. OYEBOLA OWOLABI reports that conversations about mood swings after childbirth, and the need to ensure access to help, are scaling up

Omotola Uti, a mother of one, knew nothing about postpartum depression (PPD) till a few weeks to her delivery date. It was mentioned briefly during one of the ante-natal lectures, and this prompted her to further research into depression after childbirth – an illness that affects nothing less than 20 per cent of mothers in developing countries, according to the World Health Organisation (WHO).

This, however, did not exclude her from the experience. “I did not know about postpartum depression until few weeks to my delivery date, and that was because it was mentioned briefly during ante-natal. I then read further to get more understanding. And yes I experienced it after delivery. I was lost; I could not come to the reality of having just delivered my baby. I felt so strange that I avoided my baby sometimes. However my husband and mum gave the needed support, and because I had read about it, I was able to work on myself,” she said.

Praise Agboola is a mother of two who also experienced PPD after giving birth to her first child. She wept profusely during her christening, though she couldn’t explain the reason for her sadness. “I couldn’t eat well, I couldn’t sleep well, I was sad for no reason, I always felt like crying and, some days, I just wanted to walk away because I didn’t want to see anybody come visit me or the baby. But I had a very supportive husband and mother who helped me in all ways and I gradually snapped out of it.”

While Uti and Adeoye were lucky and are now sharing their stories to help others, some others are not. One of such is Bola Olorunyomi (pseudonym) who had one child before she died. This only child she could not even nurse because she died due to postpartum depression. Perhaps, her condition worsened because she was married to a cleric and they were too ashamed to seek medical help. They maybe lived in denial or thought the world would say they didn’t pray enough.

Dolapo Olaoye didn’t experience any of this, but she lost someone to the condition. “Is postpartum depression real? Yes, most definitely! I know someone who had it; so I know it is real. She is late now following some complications. And even if she was alive, she won’t be willing to talk about it because she lived in denial.”

According to medical experts, PPD can occur during pregnancy or after the birth of a baby. Postpartum depression is usually diagnosed within a year after the woman has given birth but can extend beyond that. Postpartum depression suffered by a mother following childbirth, typically arising from the combination of hormonal changes, psychological adjustment to motherhood, and fatigue; postnatal depression.

It is estimated that 10 to 15 per cent of new adult mothers develop PPD within the first year after giving birth, and the percentage increases up to 26 per cent in adolescent mothers, according to monsenso.com, an online health magazine. However, it often remains undiagnosed.

Postpartum depression and its causes explained

According to medical practitioners, depression after childbirth falls under types of mental illnesses that affect human beings, especially women. Mental illnesses are disorders, illnesses, conditions and challenges that affect the way we think, act and behave, says Dr. Maymunah Kadiri, a mental health advocate, psychiatrist and psychotherapist, who is also the Medical Director of Pinnacle Medical Services, Lekki, Lagos.

Dr. Kadiri, however, laments that women are generally twice prone to developing mental illnesses, one of which is depression. “Women generally are twice more depressed than men and there are some types of mental illnesses that are common in women than men, the most common being postpartum depression and this is because of our hormones.

“Studies will tell you that one out of every 10 women suffers postpartum depression. What most women experience is postpartum blues within the first three days of delivery, and over 80 per cent of women experience blues. But if a woman is still repulsive of her child after one week, then it grows into postpartum depression, and if not managed well, can lead to psychosis even after the baby has grown older,” she said.

Dr. Adebayo Awoniyi, a gynecologist at the Lagos University Teaching Hospital (LUTH), Idi-Araba, explains the diversity in the moods experienced by new mothers. “The spectrum starts with baby pink, baby blues, depression and the extreme, which is psychosis. Postpartum pink occurs a few days after a woman gives birth and this happens to all women. The new mother has elevated hormones, excitement, happiness, is hyperactive, and is sometimes unable to sleep.

“Postpartum blues occurs in almost 80 per cent of women, especially after returning from the hospital and has no help. Symptoms could include the inability to sleep because of the baby and the pressure is on. This, if not taken care of properly, depreciates into depression, which could present as low mood, lack of interest in what you enjoy, low energy. Psychosis is the extreme leg of the spectrum. You know it has gotten to this level when the woman hallucinates; some have delusion; while some might even talk of killing the baby.”

Causes of depression after childbirth could vary according to realities, but one generally-accepted cause remains life stressors. According to Mrs. Khadijat Hameed, a traditional health attendant of over 15 years, PPD could be hereditary when it is in the bloodline. “When a pregnant woman breaks certain taboos, either in her family or husband’s, she could suffer postpartum depression. For instance, some women are not allowed to eat anything with salt, pepper and other condiments until seven days after delivery. If she does otherwise, it could result in postpartum depression, and sometimes death. There are also indications of spiritual undertones to it, especially those ones that refuse all forms of treatment. However, this condition is mostly caused by life stressors.”

Prophetess Mary Famojuro, who runs a government-approved maternity home at Igando-Egan, Lagos State adds her voice to the reasons why women develop PPD. She said depression after childbirth can be acquired in three major ways: spiritual attack, hereditary factors and stress. “The spiritual attack is not very common, but sufferers will take treatment for life because the condition never really leaves them, it comes and goes seasonally. The woman will become pregnant while experiencing the condition, be delivered of her baby, get sane for a while, and become pregnant again in the condition.

“Sometimes, it is hereditary like normal illnesses which affect the bloodline; meaning it could be in the third or fourth generation. I had a patient whose elder sister experienced it for all her pregnancies and they had to always visit Yaba or Abeokuta for treatment. The husband also explained that the condition lasts for the first six months after delivery. His wife was however having it for the first time. If this is traced through their bloodline – paternal or maternal line – it could be discovered that one of their mothers had the problem. If it doesn’t happen in the first to the third generation, it would in the fourth generation.

“Some develop it suddenly perhaps after experiencing life stressors, perhaps following a fight with the husband while pregnant. Women who are maltreated by their husbands during pregnancies are especially prone to developing this condition. However, it takes a lot of spiritual searching to know the source and cause, whether hereditary or otherwise, to be able to understand how to tackle it.”

 

Dr. Kadiri agrees that PPD could be hereditary, but lists other risk factors that could cause the condition. She said PPD can be the result of exposure to certain environmental hazards – exhaust, toxins, alcohol. Others are life stressors – traumatic experiences, which could be relationship-driven, economic or financial challenges, sickness, as well as school or work challenges. Blood chemistry can also cause it, she added.

“There are certain mirror transmitters that cannot be seen in the brain, but when they malfunction, they cause chemical imbalances which trigger maladaptive behavioural issues. They could also be underlying medical conditions such as depression, diabetes, pre-menstrual disorder (which happens during our menstrual cycle) and some others.

“Other major causes of post-partum depression are the physiological changes that happen during and after pregnancy, such as the fluctuation of the hormones which cause very profound chemical changes in women. These changes get regulated with time but could also wreak havoc, especially the estrogen, which is significantly elevated during pregnancy and then rapidly returns to normal within 24 hours of childbirth.

“The estrogen moves from one to 10 during pregnancy, but within 24 hours of having a baby, it goes back to one, that is a rapid return to normal. It is huge for a woman’s brain chemistry to process and that is a primary contributor. Not all women will experience it, but some do and because they cannot cope, they start to behave abnormally.

“Another all-important factor is our lifestyle. In reality, women need more sleep than men, but we don’t sleep. Lack of sleep and the stress associated with it (market runs, child care, school runs and others) force most women not to be intentional and deliberate about their wellbeing, and this can trigger a breakdown. There is also of course the social factor. Poverty is higher in women because most are not gainfully employed; women are not as empowered and employable as men. For example, some establishments do not readily employ a pregnant woman because of the fear of maternity leave. These factors can make women develop mental illness.”

Postpartum depression: Myth or reality

Is PPD real, or is it a social construct following modernisation and technological advancement? Traditional medicine attendants argue that PPD is definitely not new to the Nigerian, nay Yoruba tradition. According to Mrs. Hameed, depression after childbirth is not a new phenomenon. Conversations about it are however not common because society sees it as an abnormality that should not be discussed in the open.

“Postpartum depression, in the Yoruba tradition, is called abisiwin, a condition which forces a woman to temporarily lose her sense of self after childbirth and so she is unwilling or unable to care for her herself or the child. Such a woman misbehaves and speaks incoherently. She could say she wants to throw the baby away. Some could start praying unnecessarily, maybe she was a prayer warrior, but she does it abnormally now. Some could also start cursing.

“Women who suffer it do so in silence, having to lick their wounds in private because they don’t want to be seen as lazy or otherwise. Another reason people keep quiet is because of stigmatisation, cultural beliefs and societal attitudes. Someone close to me was a victim but before she died, she opened up that her husband and siblings were always fighting and, in the process, the one who usually helps them died, and she was pregnant at the time. This caused her a lot of pains and she developed abisiwin which later led to her death.”

Prophetess Famojuro provides a spiritual/religious perspective to it. “I am a midwife with the Christ Apostolic Church (CAC) and I can tell for sure that abisiwin is not new, it has been with us for ages but we usually don’t talk about it because it was viewed as a disease and so should not be discussed. But as we get more knowledge in this job, we realise it is not a disease, but a disorder, the outcome of a particular situation/experience.

“A woman can develop ‘abisiwin’ after childbirth if her husband’s attitude toward her changes during pregnancy, or the woman couldn’t get some baby items; these things could make her moody and destabilise her thoughts. The woman might begin to nag a lot; she reacts excessively to everything and her actions negate the reality of conversations.

“The child might cry and instead of petting the baby, the mother shouts on it as if dealing with a three-year-old. She might even handle the baby anyhow and dress the baby in about six clothes. When we have such people, we pray for them and follow up medically. Some misbehave to the extent their baby is taken from them, and some women won’t experience it until the second or third or even last child.

Fear of stigmatisation breeds silence

Because of the fear of stigmatisation, and sometimes self-denial, many women who suffer postpartum depression in Nigeria cannot speak out so they are not perceived as lazy or not women enough. This is perhaps why there is no readily available data to measure its prevalence statistically, and so it is under-reported. According to Dr. Awoniyi, the data available is underreported even in the world.

“People who have depression are about 15 to 20 per cent; almost all women experience postpartum blues, while it is about 0.1 to 0.2 per cent for psychosis. However, we might not have the actual figure here in Nigeria because people are not confident enough to share their experiences for the fear of stigmatisation. But, as a gynecologist, we try to address these issues from when the woman starts attending the ante-natal clinic. We ask if there is any family history of mental disorders, is she having enough rest, is there domestic abuse, etc. It is after these questions that we know how to help the woman. We try as much as possible to work towards prevention.”

Treatment and management of postpartum depression

Just like any other medical condition, PPD can be remedied, according to Mrs. Hammed. “The condition can be remedied with herbs and roots. Some they boil and drink, bath with, while some are used to prepare meals and they sleep off after eating. However, most young ones like me in this profession don’t handle it because it is believed the condition could affect the caregiver if payment is taken for service. But the very elderly in age and experience, who understand the way and nature of the spiritual, have their methods of handling such cases.”

For Prophetess Famojuro, handling a case of PPD requires both spiritual and medical approaches. “In as much as we believe in the power and efficacy of prayers, we do not take the medical perspective for granted. One has to move with modern trends to remain relevant. We have had about five patients here and they all got well, even having more children without experiencing the condition. Some women would willingly open up to you during the discussion, though not stating it outright. And when we hear such, we encourage them to return for the medications after delivery while we support with prayers.”

Dr. Awoniyi, however, breaks the treatment plan into three steps. The first is identifying those who are at risk; the second is breaking them into help groups – education, medication, rehabilitation, support, and level three is for the government to seek ways to deal with the problem, a major one being to encourage women empowerment.

“We identify those who are at risk and then decide how to help them. If they are smokers, we try to dissuade them from smoking. Do we need to collaborate with a psychiatrist, psychologist, or involve the community and religious leaders? After this, we educate, give medication, rehabilitate and give support where needed.

“The third level is where the government should come in. There is a great need to establish special clinics where specialised services would be offered to these categories of women. There is also a need for rehabilitation centres. But, above all, we need to encourage women’s empowerment. Women should be cared for because they are the backbone of every society; they need to be empowered financially because social status also plays a big role in why women suffer postpartum depression.”

·This article was produced with the support of the Africa Women’s Journalism Project (AWJP) in partnership with the International Center for Journalists (ICFJ) and through the support of the Ford Foundation.

The World Health Organisation (WHO), United Nations Children Fund (UNICEF) and the GAVI Alliance (formerly the Global Alliance for Vaccines and Immunisation (GAVI) Thursday hailed the Federal Government’s routine immunisation and COVID-19 vaccination implementation.

They noted that while there is an urgent need to invest in the expansion of the overall cold chain capacity for the storage of vaccines, especially at the local government level, the country has achieved significant progress in childhood immunisation and COVID-19 vaccination.

Latest data from the National Primary Health Care Development Agency (NPHCDA), showed that as of February 23, 2022, 17,430,722 of total eligible persons targeted for COVID-19 vaccination were reached with the first dose while 7,873,702 were reached with the second dose (fully vaccinated).

Speaking during the GAVI Alliance high-level mission delegates’ visit to the National Strategic Cold Store of the National Primary Health Care Development Agency (NPHCDA) in Abuja, the UNICEF Director of Supply Division, Copenhagen, Denmark, Etleva Kadilli, said: “I am happy to see first hand the implementation of the overall vaccination, and of course, we are looking at the routine vaccination but also the COVID-19 vaccine. As you know, UNICEF and the Government of Nigeria and also with other partners in the GAVI Alliance, have been working very closely to address all the needs of children with regards to routine immunisation. We are also working to address the challenges that COVID-19 has put forward.

“We also are seeing first hand the need for the expansion of the overall cold chain capacity, not just at the national level, but also looking at the regional level, which will fast track the distribution of vaccines to where they are needed and much faster.

Read Also: ‘How to vaccinate every Nigerian against COVID-19 in 100 days’

“There is a long way to go. We are here not just to see the success but also the challenges, and support the government in their ambition to not only vaccinate the children, but also the people that are at risk of COVID-19.

“We are also here to strengthen the health system – that routine immunisation is not left behind. COVID-19 response has taken a toll on the overall health system. It is therefore important that we use this opportunity to strengthen the health system and the cold chain capacity.”

Speaking during an assessment visit by the WHO Team to the Garki Primary Healthcare Facility, the WHO Director, Department of Immunization, Vaccines and Biologicals, Dr Kate O’Brien said she was excited about the turn out of mothers at the clinic with their children for immunization.

She further stated that for Nigeria to achieve the seventy (70) per cent global target of COVID-19 vaccination coverage, all hands must be on deck, especially at the local government level.

She said: “You have all the materials and supplies. What is left is for the people to understand how important it is to be vaccinated. This is important because we’ve seen the waves of variants. They come in every four months. Nobody knows if there is going to be another variant. This is an opportunity for us to ensure that everybody is vaccinated.

“We therefore cannot afford to drop our guard. Regardless of where you live, or your age,  you still need to get vaccinated when it’s your turn, with a complete course and booster dose if offered, and continue to take all the other preventive measures, both to protect yourself and others.

“Ending the pandemic requires us to get to much higher levels of vaccination in key target groups and it must include getting all vulnerable individuals and health care workers vaccinated as a priority.”

The Executive Director and Chief Executive Officer of the National Primary Health Care Development Agency (NPHCDA), Dr Faisal Shuaib, added: “Again, we want to reach a situation where all eligible kids in Nigeria are vaccinated. Unless and until we reach those types of numbers, we will not be satisfied. We have to look at not only the coverage but also equity. For those who live in rural areas (desert, riverine and mountainous areas) , the poor, the vulnerable, we want to get the vaccines out there to them and make sure that they are protected from vaccine-preventable diseases.”

 

A public health nurse, Mrs Mojirade Kehinde, has described liver cancer as a silent epidemic that was becoming increasingly common among Nigerians.

Kehinde said this in an interview with the News Agency of Nigeria (NAN) on Friday, in Ibadan.

“Liver cancer is an increasingly common form of cancer that can go undetected and untreated. It is one of the leading causes of cancer deaths globally,” she said.

According to her, excessive alcohol consumption, smoking and hepatitis infection can lead to liver cancer.

READ ALSO: Hepatitis B, C major causes of liver cancer — Hepathologist

She said that a family history of liver cancer was also a risk factor for liver cancer.

Kehinde identified some of the symptoms of liver cancer as abdominal pain, loss of appetite and sudden weight loss.

“Usually, liver cancer is not discovered until it is too late to be treated effectively.

“Therefore, it is important to have a regular health check-up and reduce the risk of this condition,” she said.

She advised Nigerians to shun unhealthy lifestyles, and not indulge in habits that could endanger their health. (NAN)

In order to give more benefits to enrolees, the Lagos State Health Management Agency (LASHMA) has launched three new health insurance products.

This, according to Governor Babajide Sanwo-Olu, was done to expand benefit packages for subscribers of the state health scheme known as Ilera Eko – a gesture borne out of the administration’s commitment to ensuring Lagos residents have access to affordable and quality healthcare and get more value for their money.

He was represented by the First Lady, Dr Ibijoke Sanwo-Olu, during the unveiling of the three new health insurance products in Lagos.

The benefit package was reviewed based on the findings of an actuarial study conducted with support from the Bill and Melinda Gates Foundation-funded Strategic Purchasing for Family Planning, Maternal, New-Born and Child Health (SP4FP/MNCH) Project.

The SP4FP/MNCH Project implementation is led by the Health Systems Consult Limited (HSCL).

The actuarial study, though funded by a family planning project, took an integrated MNCH approach and also included the implication of adding HIV/AIDS, TB, some additional secondary services, as well as cancer care, on cost of care and eventual premium to be paid by enrollees.

The findings showed that integrating the full complement of family planning and some HIV and TB services into the base benefit package didn’t change the premium, because the number of enrollees that will be receiving these services and cost of the services are small relative to the entire pool of insured people and given the risk sharing across all enrollees.

As a result, LASHMA expended its base package to integrate additional FP, HIV and TB services at the same premium of N8,500 ($20.7) per enrollee per year.

In his address during the unveiling of the expanded benefits package of ILERA EKO, Sanwo-Olu said the creation of the new range of plans and expansion of the state health insurance scheme was borne out of the need to cover more health challenges, accommodate prevalent medical conditions and address economic realities of residents, especially those in the informal sector. This, he stressed, prompted the state government, in collaboration with the Bill and Melinda Gates Foundation, to conduct actuarial analysis on the existing benefits package. He explained that the results of the study informed the design of an improved standard health benefit plan at no additional cost to the enrolees as well as the development of other health plans to address the health needs of Lagos residents.

Pointing out that the expansion has provided a platform for senior citizens in the state and Lagosians in the Diaspora to have the opportunity of accessing the scheme, Sanwo-Olu added that the health insurance expansion also prioritises the welfare of the vulnerable in the state. The scheme has been prepared to ensure that everyone in Lagos, irrespective of their socio-economic backgrounds, receives the best and most affordable healthcare services in any of their chosen facilities. There is also the Diaspora plan, which enables residents in the Diaspora to buy health plans for their parents and relatives living in Lagos.

The Commissioner for Health, Prof Akin Abayomi, said the launch of the new plans by LASHMA is a push for universal advancement of the health sector in the state and urged Lagos residents to use the opportunity to secure their health now rather than waiting until they are sick. The state needs a radical transformation of the health sectors and the health insurance scheme is the solution to attain universal health coverage as well as affordable health financing for all, he said.

The General Manager of LASHMA, Dr. Emmanuella Zamba, said affordability remains a major part of the new health plans, adding that the good health of residents is the priority of the agency. She explained that the rebranding was necessitated by the need to include the informal sector, which constitutes about 75 per cent of the population of the state into the health scheme, maintaining that the improved benefits package would afford them the opportunity to have quality healthcare. The LASHMA boss, therefore, urged all Lagosians to enrol on the scheme without delay.

In her goodwill message, the representative of the Bill and Melinda Gates Foundation, Dr Caroline Jehu-Appia who is the Deputy Director, Health, Nutrition and Eradication and representing Dr Jeremie Zougrana, the Director, Nigeria Country Office, Bill and Melinda Gates Foundation, congratulated the state as a trail blazer and encouraged other states and the NHIS to toe same line.

With the launch of its new health insurance packages, Lagos is already on track with the implementation of the revised national policy on population for sustainable development launched by President Muhammadu Buhari earlier this month. All stakeholders urged all Lagosians to subscribe to the health insurance scheme so that they can receive healthcare services when they need them, without paying at the point of service delivery.

As part of efforts to increase the COVID-19 vaccination coverage of eligible persons across the country, the Federal Government has launched the service delivery, communication, accountability, logistics, electronic reporting, and supportive supervision (S.C.A.L.E.S) strategy.

The SCALES 2.0 strategy, which will ensure that more Nigerians can easily locate a nearby health facility to get vaccinated by visiting the website (www.vacsitefinder.nphcda.gov.ng), will also integrate childhood immunisation alongside other primary health care services.

Also, eligible persons can now get vaccinated with a single shot of the Johnson and Johnson (J&J) COVID-19 vaccines, as there are over 30 million vaccine doses available.

Nigeria has received over 64 million COVID-19 vaccines – AstraZeneca, Moderna, J&J and Pfizer. Furthermore, 48 million vaccines are expected before mid year.

Latest vaccination data showed that as of February 21, 2022, a total of 17,199,853 eligible Nigerians have received their first dose of COVID-19 vaccination, while 7,663,560 have received their second dose. In total, 24,863,413 vaccine doses have been administered.

The Executive Director and Chief Executive Officer of the National Primary Health Care Development Agency (NPHCDA), Dr Faisal Shuaib, made this known in Abuja during the launch of the SCALES 2.0 strategy with the use of the single dose J&J vaccine.

Dr Shuaib said: “We want to ensure that we not only decentralise COVID-19 vaccination, but make sure that we improve coverage and access to COVID-19 vaccination. Today, we are vaccinating just a little over 200,000 people per day. For us to reach our target of reaching 70 per cent of eligible populations before the end of 2022, we have to hit 550,000 people per day. This will ensure that we reach herd immunity.

“We are also going to be launching the single shot vaccine (Johnson & Johnson) for everyone. We understand that one of the reasons there is a gap between our first and second doses is because people experience adverse events following COVID-19 vaccination. Although the adverse events are very mild, we know that the opportunity to have a single shot not only in the hardest to reach areas, but everybody having access to one single shot will definitely increase our coverage of COVID-19 vaccination.

“The COVID-19 vaccination ‘site finder’ will improve the ability of Nigerians to assess COVID-19 vaccines. If you are able to sign on to this website, you will be shown the nearest COVID-19 vaccination centre.”

In her remarks, the World Health Organization (WHO) Regional Director for Africa, Dr Moeti Matshidiso, hailed the Federal Government’s vaccination strategy and efforts in ensuring that more Nigerians are covered.

She said: “I think we have learnt many lessons on how to leverage the capacities and lessons in delivering such campaigns in a country like Nigeria and internationally.

“I understand that there is going to be a great deal of emphasis on decentralisation – on really leveraging the decentralised nature of the Nigerian system and government to engage decision makers at the state and local government level, so that they can drive the very much action needed to speed up delivery of vaccines to the population.

“There will also be the need to expand the delivery capacity because at the same time the country is carrying out this important work, there is other work of delivering vaccines, responding to public health emergencies going on.”

The Minister of Health, Dr Osagie Ehanire, added: “Let me assure Nigerians that we have adequate stock of the Johnson and Johnson vaccine, as we have over 30 million doses in stock. I call on all eligible persons that are yet to receive their vaccination to go to the nearest COVID-19 vaccination site and get vaccinated. This single dose offers the same protection you get from two doses of AstraZeneca, Pfizer Bio-N-Tech and Moderna vaccines.

“Also, I encourage those who have received their first dose of AstraZeneca, Moderna or Pfizer vaccines to ensure they take their second dose when due, to be fully vaccinated and protected.

“The SCALES 2.0 Strategy, the J&J roll out and the vaccination site finder, are great opportunities for Nigeria to ramp up COVID-19 vaccine coverage and reinvigorate Routine Immunization uptake. The federal government has provided all Nigerians the opportunity to protect themselves and their loved ones against COVID-19, and also enjoy the ease of access to childhood immunization.”

 

The World Health Organisation and UNICEF accuse formula milk companies of targeting pregnant women and young mothers with unethical marketing practices, in a study released on Wednesday.

According to the study, there are misleading and scientifically unsubstantiated messages used to convince mothers to give babies formula instead of breast milk.

The industry was worth 55 billion dollars in 2019.

While breastfeeding rates have slightly increased in the last 20 years, the revenue of formula milk producers has almost doubled in the same time frame.

There are around half a dozen large firms, Nigel Rollins from the WHO department responsible for maternal and child health told dpa.

READ ALSO: Chinese syndicate arraigned for producing ‘fake’ baby formula

He said their practices are similar but did not name individual companies.

Only 25 countries have widely implemented a 1981 code of conduct on baby food marketing, the WHO reported in 2020.

The report says companies started or infiltrated mothers’ groups on social media to promote baby formula and provided health workers with dubious information at conferences or in brochures, which they then passed on to mothers.

This false information included claims that babies sleep longer with formula, breast milk loses quality over time and that certain products could prevent allergies.

According to the WHO, there are lifelong benefits to breastfeeding for the first months of life, including reducing the risk of cardiovascular disease, obesity and diabetes , as well as reducing the breast cancer risk in mothers.(dpa/NAN)

The Nigerian Nuclear Regulatory Authority (NNRA) has raised the alarm about obsolete X-ray equipment in hospitals.

Its Director General, Dr. Yau Idris, who expressed concern over this situation, noted that over 60% of X-ray equipment are not functioning.

He dropped hint in Abuja during his welcome address at the National Workshop on Radiation Protection of Patients and the Public Medical Application of Nuclear Technology for Senior Managers of Hospitals, Medical Centres and Launching of the NNRA Safe-XRay Platform.

According to him, most of the X-rays machines in Nigeria are obsolete, having aged between 10 to 60 years.

He added that the equipment are even operated under sub optimal conditions.

Alluding to an investigation from which a report of the Authority elicited the facts and figures, Idris said: “Several investigations by NNRA show that there is an alarming high number of over 60 of different brand of X-ray equipment in the country, with six brand responsible for 70% of all X-ray machines.

“Most of the X-ray equipment in the country are obsolete: their ages range from 10 to 60 years. And these equipment are operated under sub optimal conditions.”

The NNRA also lamented that second hand X-rays equipment are imported into the country without a view of the age and the availability of the spare parts.

On malfunctioning X-rays machines, he said: “Investigation also shows high level of dis-repairs. Over 60% of X-ray machines in the country are not functioning.”

He added that the report also revealed that inadequate number of qualified professionals for medical purpose in the country.

He stressed that there is also  inadequate number of application of iodixizing radiation service providers.

This, he said, has culminated in poor personnel radiation monitoring in all  radio-diagnostic centres.

He also disclosed that number of reported cases of radiological incidents and accidents in Nigerian hospitals has been on the rise.

The NNRA boss said “radiological nuclear medicine in our hospitals are underfunded.
” In fact they have reported two cases of radiation incidents involving radiation workers in a tertiary institution in the country. One personnel died and the other remains critical.”
Idris added that experts in Nigeria

have reported maladministration radiation cases in one of the radiological facilities in the country.

Proffering a solution, he submitted that “these unfolding events require the enforcement of regulatory requirements for better radiodiagnostic and radiotherapy practice in the country.”

He added that plans were underway to approach about six manufacturers of the X-ray machines to establish their service centres in Nigeria.

Asked why the situation persisted, he explained that it was mostly in public hospitals where half of the machines are not working.

He noted that bureaucracy delays implementation such as repair of faulty machines.
Speaking, the Minister of State for Petroleum Resources, Chief Timipre Sylva, said medical practices involving the use of ionizing radiation is the largest contributor to human exposure from man-made sources of radiation.

Represented by the Director, Human Resource, Dr. Famous Eseduwa, he said “today in Nigeria about 50 million diagnostic X-ray examinations are being carried out and about 3000 radiation therapy patients treated annually.

“In fact, nearly everyone in our urban areas shall undergo exposure to X-ray for medical diagnostic purpose in his or her lifetime.
“Therefore, it is important radiation safety standards are adhered to in order to optimize doses to the patients, workers and the public.”

According to him,  in the health sector, the agency is the only regulatory body saddled with the responsibility of regulating and licensing activities and facilities such as Radiotherapy, Nuclear Medicine and X-ray.

NNRA, he said, has taken steps to emplace a proper regulatory framework, within the context of its enabling Act which is achieved through a system of registration, licensing and inspection of these facilities and activities.

Sylva noted that the agency is always ready to engage stakeholders and discuss overall enforcement of compliance with provisions of the Act.
Ends

 

After over a year working overseas on the international COVID response, I recently was able to return to Nigeria for a joyous family gathering: my sister’s wedding. A few days later, I tested positive for COVID-19.

Just my luck. The test which was carried out at the NCDC National Reference Laboratory was done free of charge. However, it required a trip that took about 45 minutes to the laboratory. While I had to quarantine to protect vulnerable friends and family from possible exposure to the virus, the whole process was easy enough. But astoundingly, I am one of a tiny number of Nigerians who have actually undergone such a test.

Despite the increased transmissibility of the Omicron variant and the spread of other variants, only 2% of Nigerians have ever been tested. This is about the same number of people tested daily in the United Kingdom.

Scientific studies show that testing is critical to contain and mitigate the COVID-19 pandemic. Testing helps to help prevent further person-to-person transmission by identifying infected individuals. Even though there is talk that COVID-19 is moving from a pandemic to an endemic disease that will always be with us, the World Health Organization (WHO) warns that it is too early for that to be definitive. In the meantime, we need to exercise caution. Yet many African countries still struggle to test in sufficient numbers.

By the beginning of January 2022, around 89 million COVID-19 tests had been conducted in African Union Member States since the pandemic started. By comparison, in the United States, over 700 million tests have been recorded, while India has recorded over 600 million. WHO estimates that only one in seven COVID-19 infections is being detected in Africa. The number of undetected cases not only increases the risks of infection between individuals but means the virus is likely to be spreading unnoticed and underreported. With an ongoing Lassa fever outbreak and an already weak health system, a surge in COVID-19 cases could cripple Nigeria’s health system.

This underreporting, due to lack of data, has undoubtedly fueled low-risk perceptions for COVID-19 in Nigeria. In the last month, I have had several friends in Nigeria fall ill but refuse to get tested for COVID-19, as they did not see a reason to worry. I have lost count of the number of taxi drivers who said to me “There is no COVID in Nigeria”, when I tried to strike up conversations with them. I know people with COVID-like symptoms who have presented at health care centres who are not tested but are instead treated for malaria. Getting tested could help an individual prevent the spread of COVID-19 to their coworkers, friends and loved ones who could be more vulnerable to dying from the disease.

At the beginning of the pandemic, the availability of COVID-19 tests was a major challenge worldwide. The main method available was molecular tests which were expensive, with a relatively long turnaround time of 3-4 days. Thankfully, the swift development of Rapid Diagnostic Tests (RDT) soon made testing far more widely available. Although there is a small risk that RDTs produce false negatives, the results are usually available within minutes and are a powerful public health tool.

In much of the world, RDTs enable people to test at home and help health officials to track the virus and advise governments on how to respond. Governments in Africa on the other hand are flying blind – making decisions based on limited data, or only acting after the virus reaches emergency levels.

The provision of RDTs in strategic locations across Nigeria could be a game-changer for COVID-19 control. It would help identify the true burden of the disease and enable more efficient and appropriate levels of response. It could also improve the perception of the risk of COVID-19 which has continued to decline given the low number of cases in the country. While the low caseload is a blessing, the public health analyst in me worries a lot that we are simply under-counting.

READ ALSO: Orientation exercise: COVID-19 test compulsory, says NYSC

To bring testing closer to the people, a number of steps are needed. The starting point should be the development of guidelines to establish RDT testing sites by the Nigeria Centre for Disease Control (NCDC), similar to the approach used in setting up COVID-19 sample collection sites at the beginning of the pandemic. The guidelines could then be implemented by State Governments across the country.

The Government will then need to employ strategic communication initiatives to persuade people of the value of testing. This could be through specific testing messages created as billboards, television, radio or social media adverts.

But where to put the sites? Ideally, they would be in outdoor spaces, staffed by trained health workers. The tests should be provided free of charge which means the government, supported by its development partners, would fund the workers needed to carry out the tests and enter the data. In the United Kingdom where RDTs are widely available for at-home use, many test results are not reported. By establishing RDT test sites, Nigeria can reduce the risk of losing valuable data, and use this data in defining its continued response. With Nigeria’s highly social population and weekly Owambe parties, these RDTs could also be sited in event centres to reduce the risk of infection at gatherings. The establishment of mobile COVID-19 RDT sites could further scale up Africa’s testing rates and perhaps be used in rural areas to track outbreaks.

At present we just don’t know enough about the rates of COVID-19 infection in Nigeria or most other African countries. Perhaps we have been lucky, but public health policy needs to rely on more than luck. Governments should be encouraging far more people to be tested and increasing access to RDTs is the game-changer we need.

Oyeronke Oyebanji, a Nigerian public health professional and 2021 Aspen New Voices Fellow, is Strategy Coordinator at the Coalition for Epidemic Preparedness Innovations (CEPI). She worked as an Analyst at the COVAX Strategic Coordination Office from April to November 2021. The views expressed in this opinion piece are the author’s

Amid lingering crisis generated by importation of adulterated fuel, the President of the Society of Testing Laboratory Analysts of Nigeria (SoTLAN), Prof. Olugbenga Ogunmoyela, has warned that the country will continue to put the health of its citizens in jeopardy until it starts involving local laboratory analysts in products testing.

Addressing a press conference in Lagos, Ogunmoyela, who warned that adulterated fuel increases the risk of cancer in Nigerians, urged the government to stop putting the fate of the nation in the hands of foreign labs that are not  superior to many of Nigeria’s lSO 17025 accredited local laboratories.

“It is clear that the nation has a challenge of scarcity of foreign exchange and has demonstrated an avowed commitment to look inwards. Yet, for many years, it has persistently chosen to patronise mainly foreign laboratory companies in the analysis and certification of imported petroleum products into the country. It is said that the government agency in charge has come out to claim that the imported fuel had high methanol content, which was somehow not detected during testing, because this is not in the normal testing protocol, before being released to depots for lifting.

“As we have noted, as far as laboratory testing or analysis is concerned, the institution recognised by law in Nigeria to regulate and register analytical laboratories owned by members and non-members alike, is the Institute of Public Analysts of Nigeria established under the IPAN ACT CAP 116 LFN 2004

“Over 1,200 professional members of this institute belong to our association known as the Society of Testing Laboratory Analysts of Nigeria. Yet, because of financial incapacitation, we have fewer than 50 registered laboratories in Nigeria that have achieved international accreditation due to lack of support, compared to over 500 such laboratories in South Africa.

“It is, therefore, our opinion that, as key stakeholders of high integrity, we should be involved in all forms of laboratory testing of products in Nigeria. This unfortunate experience, therefore, presents an opportunity for us to re-examine our present policy and look inwards to help strengthen the capacity of our local analytical laboratories by patronising them, building capacity where necessary, and encouraging the growth of the sector, rather than continued dependence on foreign firms. As we now know, they are not in any way superior to many of our ISO 17025 accredited local laboratories.”

Stakeholders in the health sector have lamented that health insurance coverage still remain poor.

They spoke at a Strategic Stakeholders Meeting on Draft National Policy on Incentivising the Health Service Industry and Healthcare Investments, hosted by the Healthcare Federation of Nigeria (HFN) in Lagos.

The meeting, which was tagged “Forging a new paradigm,” discussed the health insurance coverage in the country.

It had the Chairman Senate committee on health, Ibrahim Yahaya Oloriegbe, who also stated the reasons  strengthening structures in the health sector are multidimensional. As it has been said, health insurance should be mandatory for all. However, due to the poor coverage with less than four per cent of population, there is room for wider coverage.

During the presentations from various health care providers, challenges were discussed and how solutions for areas  such as the biomed engineering sector, nursing, mental health, healthcare business network could be made.

One of the speakers, Dr Jimi Coker, made a presentation on healthcare business network; while the establishment of Nigeria National Health Service  and other vital points were tabled.

Oloriegbe, representing Kwara central, explained how Nigeria could strengthen the  structure in the sector. “Structure strengthening are multidimensional. One, there are ones that require improvement in the implementation of existing policy like the first issue that was raised was about quality and standard and with national health act has already provided for certificate on standards.

“So, what we don’t have is implementing that so strengthening will be now to advocate and push for the implementation of that particular law. The other one where you say strengthening will be where we have capacity gap to build and strengthen capacity to enable people have better knowledge and skills to implement policy existing policy or do their work very well.”

On the best approach in solving the problems the healthcare providers brought to the table, Oloriegbe said: “Human beings are there to have problems and to solve problems. Essentially, that is why we come together to have government and to live as human beings. In terms of approaches, first when you identify a problem, you identify appropriate strategies to be able to solve them, which is what we have done here. We have had discussions; we come up with various approaches.

“So, when you say the best, it depends on which one of the challenges. One, we agree on some that require new policy and we set up modalities for such policies. We identify some that require new law, which will be to regulate to guide whatever it will be and we identify some that require multi-sectorial collaborations and coming together.”