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Maternal health in Nepal Nepal, a landlocked country bordering India and China, has a population of approximately 30 million. In 2015, close to 41 percent of births occurred at home in Nepal. Of those home births, just under half were carried out without a trained professional. Due to the alarming rate of maternal deaths seen in the early 2000s, maternal health in Nepal has been a focal point for many years. Even though complications during births at health centers still occur, the presence of trained professionals during birth remains the best way to avoid preventable deaths. Many organizations have partnered with the Nepalese government and are working hard to bring these numbers down even further every year.

4 Facts About Maternal Health in Nepal

  1. Nepal’s maternal mortality rate decreased about 71 percent between 1990 and 2015. The decline is attributed to free delivery services and transport in rural areas, access to safe delivery services and medicines that prevent hemorrhaging. In rural parts of Nepal, it has historically been much more difficult to receive proper healthcare. Through the combined efforts of various organizations and the Nepalese government, the number of facilities in remote areas has increased. Additionally, the incentive to travel to these facilities has risen. In 2005, the government began giving stipends to pay for transportation costs. Four years later, the government passed the Safe Motherhood Programme, which allowed free delivery services to pregnant women. In 2011, the government continued to promote safe pregnancies by adding another incentive of $5 for attending antenatal checkups. Through these efforts, the government has had an enormous impact on the development of maternal health in Nepal.
  2. Midwifery is one of the most important services for maternal health in Nepal. Fast intervention and postnatal suggestions from a skilled midwife allows for better postnatal care for both mother and child. In Nepal, only about 27 percent of women receive care within 24 hours of giving birth. This increases risk of hemorrhaging and heavy-lifting related injuries shortly after giving birth. It also increases risk of possible complications for the baby during and directly after birth.
  3. Midwifery education ensures that midwives are up to date on the most current practices and procedures for successful pregnancy and birthing. Institutions have partnered with the United Nations Fund for Population Activities (UNFPA) to offer combined education for nursing and midwifery. In 2011, Nepal and the UNFPA committed to training 10,000 birthing attendants. However, in a report about midwifery authored by the UNFPA, midwives do not have specific legislation for their work. Midwives are not completely recognized under the law nor are they regulated, which results in issues with proper training and resources. Therefore, greater recognition and accessibility will allow midwives the resources, training and encouragement that they need for success.
  4. Women of lower socioeconomic status have more complications surrounding maternal health. The National Medical College Teaching Hospital in Nepal published an extensive report of the challenges surrounding maternal health in Nepal. A specific challenge mentioned in this report includes the socioeconomic influencers of maternal health. Due to poor nutritional health in women of lower economic status, issues such as anemia can cause mortalities. Additionally, rural areas record about 280 birth complications per day. Although there has been significant work since then to expand access to cesarean sections and birthing centers in rural areas, there are still around 258 women dying per 100,000 live births.

As maternal health in Nepal becomes more of a focus in the healthcare system, there are certain policies and programs that must be expanded upon. Midwifery education and access to services are the most important programs for successful maternal health in Nepal. Many experts in the field continue to push for individual programs that focus primarily on methods for successful midwifery education and overall increased care for maternal health in Nepal.

– Ashleigh Litcofsky
Photo: Flickr

10 Scary Facts About the Zika Virus
The Zika virus was first discovered in Uganda in 1947 through a group of diseased monkeys. In 1952, the first infected human was found in Uganda and the United Republic of Tanzania. The Island of Yap is the first location where a large scale outbreak of the Zika virus was recorded. This incident took place in 2007. There are currently no countries facing a sizeable Zika outbreak, however, there may be a risk of contracting the disease in regions where the Aedes species of mosquito is prevalent. This article looks at the top 10 scary facts about the Zika Virus.

10 Scary Facts About the Zika Virus

  1. People are more likely to contract the Zika virus in poor countries. Mosquitoes that carry Zika often breed in stagnant water. These buildups of stagnant water are found in areas where communities lack adequate plumbing and sanitation. According to the United Nations Development Programme, poor households are least equipped to deal with the virus and are most likely to be exposed to the disease.
  2. Women face the biggest consequences during a Zika outbreak. Health ministers throughout Latin America have told women not to get pregnant during a Zika epidemic. In poorer countries, women lack access to sexual education, which leaves them vulnerable to misinformation. Furthermore, women may be blamed for contracting the virus during pregnancy, which carries an unfair social stigma.
  3. Zika poses a threat to unborn children. In some cases, when a pregnant woman is infected by the virus it disrupts the normal development of the fetus. This can cause debilitating side effects like babies being born with abnormally small heads and brains that did not develop properly. This condition is called microcephaly. Symptoms of microcephaly are seizures, decreased ability to learn, feeding problems, and hearing loss.
  4. Even though a mosquito bite may be the most well-known way to contract the Zika virus, it is possible to get the disease through other avenues. It is possible to get the disease during unprotected sex with a partner, who already have been infected by the virus. Individuals can also contract the virus during a blood transfusion or an organ transplant.
  5.  Symptoms of a Zika virus infection may go unnoticed. The symptoms can be described as mild. If symptoms do occur they can present themselves as a fever, rash or arthralgia. This is especially dangerous for pregnant women because they may not know that they have been infected, unknowingly passing it on to their unborn baby. There is no treatment available to cure this disease once it has been contracted.
  6. There are other birth defects associated with the Zika virus. Congenital Zika syndrome includes different birth problems that can occur alongside microcephaly. Some malformations associated with congenital Zika syndrome include limb contractures, high muscle tone, eye abnormalities, and hearing loss. Approximately 5-15 percent of children born to an infected mother have Zika related complications.
  7. The cost of caring for a child born with Zika related complications can be quite expensive. In Brazil, each kid born with the disease could cost $95,000 in medical expenses. It would cost approximately $180,000 in the U.S. to care for the same condition. Some experts believe the numbers are higher when taking into account a parent’s lost income and special education for the child.
  8. Even though there are more than 10 scary facts about the Zika Virus, there are also measures being taken to prevent future outbreaks. Population Services International (PSI) is working with the ministries of health in many different Latin American countries to spread contraception devices. This promotes safe sex practices. This also gives the women the power to decide if and when she wants to become pregnant.
  9.  The World Health Organization (WHO) is also implementing steps to control the Zika virus. Some of these steps include advancing research in the prevention of the virus, developing and implementing surveillance symptoms for Zika virus infection, improving Zika testing laboratories worldwide, supporting global efforts to monitor strategies aimed at limiting the Aedes mosquito populations and improving care to support families and affected children alike.
  10. The good news is that there are currently no major global outbreaks of the Zika virus. This is a sign that steps around the globe have been successful to lower the number of Zika cases. However, this doesn’t mean that precautions shouldn’t be taken when traveling to areas where the Aedes species of mosquito is prevalent. Even though they are no major outbreaks the disease still exists and may cause problems if contracted.

Conclusions

Even though the Zika virus may currently not be a threat worldwide, it is still something that needs to be accounted for. Zika has serious repercussions in poverty-stricken countries where people can’t afford adequate medical care. The Zika virus is also more likely to be contracted in poorer regions. The Zika virus has a strong correlation with poverty.

– Nicholas Bartlett
Photo: Flickr

How Poverty Affects PregnancyWomen living in poor rural communities have a higher risk of maternal mortality. An astounding 99 percent of maternal deaths take place in developing countries. More than half of these victims lived in sub-Saharan Africa and one-third lived in South Asia.

The number one cause of death for adolescent females in developing countries is complication in reproduction. The risk of death is higher in girls of the age 15 years and younger. Their country’s health systems often fail to provide adequate health services to survive pregnancy and childbirth.

An estimated 75 percent of maternal deaths are caused by:

  • High blood pressure: during pregnancy preeclampsia should be detected and can be remedied with magnesium sulfate.
  • Infections: when recognized in a timely manner, they can be treated, and good hygiene following childbirth can prevent it.
  • Excessive bleeding after childbirth can kill a healthy woman in a matter of hours. To reduce this risk, oxytocin is injected immediately after birth.
  • Diseases such as malaria and AIDS (during pregnancy) account for all other maternal deaths.

Poor Health Systems

In developed countries, it is typical for women to have at least four prenatal care visits. Postpartum care is also recommended and received by high-income countries. Unfortunately for millions of poor mothers, there is no access to skilled providers to help them.

The lack of access to health workers can be due to lack of information or an issue of distance. At times, cultural practices prevent women from getting the care they need, and most often the nearest health facility is in another community.

The World Health Organization is contributing to the Global Strategy to improve health for women and children. Their goal is to ensure access to a better health system with effective treatments, trained health workers, and health coverage programs. Without access to quality health care during these critical times of development, this is another way in how poverty affects pregnancy.

Food Insecurity Impacts Female Health

Food insecurity is another way in which poverty affects pregnancy. Creating a new life requires a lot of energy from a woman’s body. This is why women facing food insecurity are at risk of health problems. A poor diet can cause:

  • gestational diabetes
  • iron deficiency (the mother becomes anemic)
  • low birth weight.

If women do not intake the appropriate amount of nutrients, the baby will take the vitamins and minerals from their mother’s body. This weakens a woman’s immune system which is needed to fight off disease and infection.

The Importance of Nutrition for Child Development

A healthy diet when creating a new life is consuming 1,800 calories a day in the first trimester, 2,200 in the second trimester and 2,400 in the third trimester. Essential nutrients include:

  • calcium for healthy growth
  • iron for a baby’s blood supply and
  • folic acid, which reduces the risk of spina bifida and anencephaly (a brain defect).

Without proper nourishment, a child will suffer from chronic malnutrition. This leads to impaired brain development, a weakened immune system and shorter stature. This could mean that some children will be unable to complete schooling. This is yet another factor in how poverty affects pregnancy.

The USAID study shows that girls with stunted growth have their firstborn at approximately four years younger than non-stunted girls. Additionally, these girls who are not fully developed to give birth to a child contribute to the maternal death rate.

It does not stop there. UNICEF estimates the under-performance of these victims will cost their generation’s global economy $125 billion. The five countries where nearly half the population of children under age five are chronically malnourished include Madagascar, Papua New Guinea, Eritrea, Burundi and Timor-Leste.

Overall, without access to a proper health system or proper nutrition, studies indicate the negative ways in how poverty can affect pregnancy. The health of a pregnant woman is vital for childbirth. Prenatal malnutrition stunts the development of children’s bodies and minds. Children can find themselves with learning challenges. This sets generations back from reaching their full potential to advance their communities, fueling the cycle of poverty.

-Crystal Tabares
Photo: Flickr

Prevent the Zika Virus

According to the Center for Disease Control (CDC), the “Zika virus disease (Zika) is a disease caused by the Zika virus which is spread to people primarily through the bite of an infected Aedes species mosquito.” The disease can cause symptoms like fever, rash and joint pain, although most symptoms go unnoticed. Learning to prevent the Zika virus, then, is imperative.

The most severe symptom is microcephaly, which is a birth defect that causes babies to be born with smaller than average-sized heads. This is of grave concern to pregnant women or women who are trying to become pregnant who have traveled or have partners who have traveled to countries where the disease is present.

Although there are currently no vaccines for the disease, there are five easy steps you can take to prevent the Zika virus from reaching you or your loved ones:

  1. Wear the right repellant. The CDC recommends wearing repellant registered by the Environmental Protection Agency because it contains ingredients such as lemon eucalyptus oil and DEET. Repellants registered with EPA are also evaluated for effectiveness.
  2. Use clothing as a repellant. Wearing long sleeves and pants in a place where mosquitos present can also reduce your risk of a Zika virus infection. It is even more effective if the clothes are treated with permethrin.
  3. Avoid exercising outdoors. Mosquitoes are attracted to carbon dioxide and heat, both of which are heavily emitted when exercising. To avoid being swarmed by mosquitoes, it is best to exercise indoors in an air-conditioned room.
  4. Properly secure buildings. Residing in buildings that have screens over its doors and windows and are properly ventilated with air-conditioning can prevent mosquitoes from entering and protect you while you sleep. Placing netting over cribs and strollers can help protect babies as well, especially since they may be too young to safely use mosquito repellant.
  5. Practice safe sex. The Zika virus disease can be transferred from men during unprotected sex. To prevent transferring the disease, using condoms and abstaining from sex are the best methods after or during visitation to a country with the Zika virus. This information is crucial for women who are trying to become pregnant.

The fight to eliminate the Zika virus has skyrocketed, resulting in incredible scientific innovations. For instance, scientists from the U.K. have released genetically modified male mosquitoes who cause populations of local mosquitoes to fall.

Another technique includes inserting a gene drive into mosquitoes to make them unable to host the Zika virus within their bodies.

Researchers are also utilizing cellphones to track and record people’s movements and use this data for documenting Zika hotspots throughout the world.

As more techniques on how to prevent the Zika virus are discovered, all hope that the spread of the disease can be contained effectively.

Julia Hettiger

Photo: Flickr

Malnutrition-and-Pregnancy-Global-Poverty

Malnutrition is a significant problem in developing countries. Without substantial resources, many men, women and children go to bed hungry. Tackling malnutrition should be a priority for everyone, especially pregnant women.

A woman’s nutritional intake impacts both her health during pregnancy and the health of her baby. Without proper care, she is susceptible to illnesses and her baby’s health is at risk. Malnutrition during pregnancy can cause devastating results.

In many countries, tradition forces women to be the last to eat at meals, which may result in them receiving smaller portions. This notion severely impacts pregnant women.

A woman that is undernourished at the time of conception is at risk of serious health issues for both herself and her baby. Not only is it unlikely that her nutritional status will improve throughout the pregnancy, but her body also experiences additional demands due to the growing baby. Without enough food, she will most likely lose weight, which increases the risk of maternal mortality.

When her body is unable to obtain or store enough nutrients required to support embryo growth, the cells may not divide properly, resulting in a chance that the fetus’ development will be impaired. The placental cells, which support the fetus’ growth during pregnancy, are more likely to surround the fetus in large numbers, forcing the fetus to become smaller than it should be. This leads to the baby being born at a low birth weight, which in turn often leads to severe cognitive and developmental deficits.

A baby’s organs develop during the first five weeks of pregnancy. In order for the organs to grow properly, it is imperative for women to be healthy and have food supplies readily available.

A woman’s caloric needs increase with pregnancy. An additional 150 calories per day is needed to support the baby in the first three months of the pregnancy. In month four, the additional calories needed increase to 300 per day.

In addition, women must have the proper nutrients in their diet, such as foods with folic acid, iron calcium, protein, vitamin B12, vitamin D and vitamin A. According to the World Food Programme, half of all pregnant women in developing countries are anaemic (having an iron deficiency), which causes around 110,000 deaths during childbirth per year.

Without enough nutrients, a baby is at higher risk of neural tube defects, brain damage, premature birth, underdevelopment of organs, death and more. If a child becomes malnourished in the womb, the damage can be permanent.

Improving nutrition is an investment that could save the lives of women around the world; it will also decrease the number of birth defects and disabilities seen in newborns and young children. In many developing countries, nutrition is essential to promoting a happy and healthy lifestyle where no person goes to bed hungry.

Kelsey Parrotte

Sources: Livestrong, Mother and Child Nutrition, Virtual Medical Center, World Food Programme
Photo: The Visible Embryo

Poverty in Iraq
Dozens of pregnant Iraqi women are being admitted to the hospital with life threatening conditions every month. According to UNICEF, maternal mortality rates in the war torn country have increased by 65% since 1989, a number that is much higher than neighboring countries. Until political conditions improve and citizens gain better access to healthcare and basic necessities in Iraq, doctors in the region fear the problem will get worse.

Dr. Mayada Youssif, a gynecologist in Baghdad, attributes “insecurity and poverty that Iraqis live with due to conflict” to the increasing mortality rate.  “Insecurity has forced women to stay at home during their whole period of pregnancy,” Youssif says, “and they look for a doctor only when they are feeling really ill or feel, near delivery time, that conditions have become too dangerous.”

UNICEF recommends three basic needs that should be available for pregnant women and their babies: good nutrition, access to antenatal care  and access to emergency care if a problem were to arise. All of these services are impeded in Iraq because of issues such as curfews and fear of violence, meaning that sometimes help isn’t sought out until it is too late.

That is exactly the situation Salah Hussein found himself in when his wife died during childbirth. The doctors attributed her death to a combination of malnutrition and the effects of constant stress from living in a war torn country. Now Hussein faces having to raise his child alone. Malnutrition is still a problem, as he cannot afford formula for his child.

Even if women can get to a doctor, many hospitals are ill equipped to deal with common pregnancy issues, such as anemia. The UN is currently looking into fortifying flour with iron and folic acid to help combat anemia, but presently the issue remains.

There is a rising call to increase investment in the health department to combat rising mortality rates. The main issue is the lack of specialized care that is available to all pregnant women. Some live in areas where they cannot get to a doctor, or worse, there is not a doctor in the area at all.

Colleen Eckvahl

Sources: Global Research, IRIN News
Photo: Global Research

Eclampsia_Global_Poverty_Nigeria
During an orientation on women’s maternal health, The Target States High Impact Project (TSHIP), a non-government organization funded by USAID, released its findings that Eclampsia is the cause of 80% of deaths that occur during childbirth in Nigeria.

Eclampsia is a condition when the infected woman experiences extreme bleeding while giving birth. Pregnant women suffering from Eclampia will experience chest pains, convulsions, seizures, and hallucinations. The disease then attacks all of her multiorgans like the brain, lungs, livier, and chest.

The good news is that Eclampsia can be cured if the infected woman is treated in time. Testing urine samples and changes in blood pressuring during pregnancy can identify the disease before the woman goes into labor. Once Eclampsia is detected, it can be treated with Magnesium Sulphate, an injection that brings the woman back to consciousness while she is in labor. The best way to ensure a safe birth is by going to a doctor once labor begins.

Dr. Habib Sadauki, TSHIP Deputy Chief of Party Maternal, warned women of the dangers of giving birth at home. When having a home birth and severe bleeding occurs, the woman is at high risk of dying during labor. If pregnant women would “seek adequate antenatal services” when they are in labor, maternal deaths could be reduced by 70%.

At the conference, Dr. Sadauki explained how malaria and anemia are the other two main causes of deaths during pregnancies. Once again, he urges women to seek medical attention and also to sleep in insecticide-treated mosquito nets. Childbirth can a very dangerous time for the mother and child and Dr. Sadauki hopes that pregnant women will seek medical attention to prevent possible disease and death.

– Mary Penn

Source: Vanguard
Photo: School Work Helper