Reproductive Health

Breastfeeding and the Sustainable Development Goals

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Breastfeeding is an essential part of the Sustainable Development Goals (SDGs), and can be mirrored in not only the most obvious ones – like Zero Hunger and Good Health and Well-being – but in many (if not all) of the other goals. Its impact and benefit for the baby, mother and thus society as a whole might not be the main target of the goal, but indirectly many linkages can be recognized.

Breast milk is, and always has been free. The costs for formula on the other hand, can have huge impact on a household’s budget. Our babies don’t need anything else – not even water – for the first six months of their lives, if they are exclusively breastfed (of course, there are always exceptions to the rule). With adequate information and support, nearly all mothers can breastfeed their children, no matter their financial situation. What an amazing, effective and inexpensive intervention in the battle to end poverty!

Zero Hunger and Good Health and Well-Being are essential goals towards global sustainability and equality, and they include plenty. Increased rates of exclusive breastfeeding (EBF) is such an important step towards these goals, since breast milk will always be accessible, available and give the best nutrition possible for children. UNICEF recognizes that the greatest potential impact on child survival of all preventive interventions is optimal breastfeeding of infants under the age of two. Also, in terms of food safety, EBF protects children from infectious diseases by decreasing their exposure to water and food borne pathogens, and improves infant resistance towards infections. In the end, fewer children will suffer from for example diarrhoeal diseases, which is the second leading cause of death in children under the age of five.

The health benefits for mothers include lowered risk for certain cancers, osteoporosis and post-natal depression, just to mention a few. Breastfeeding is vital in both preventing and treating diseases, in the short and long run, both for children and their mothers. 800 000 lives per year could be saved by breastfeeding interventions!

Breastfeeding offers so many benefits both for children and mothers, and it is a human right directly connected to the right to food and health. It is part of a woman’s sexual and reproductive health, and can be such a unique emotional and empowering experience if adequate, unbiased information and support is given. WABA recognizes several globally spreading determinants – such as dominant structures, institutions and social values – that both undervalue and put women’s physical needs at risk, as well as their reproductive and productive contributions. Protection, facilitation, encouragement and (in the end) increased rates of breastfeeding is imperative to reach gender equality.

Optimal breastfeeding is, and encompasses so incredibly much and this needs to be recognized and prioritized when national governments develop their action plans to achieve the global goals. It improves health outcomes for children and mothers, reduces poverty, increases gender equality, saves our planet’s resources by decreasing the use of plastic bottles, contributes to more sustainable consumption, contributes to higher IQs and thus educational attainment, and most importantly: it saves lives.

breastfed-babies

Cover Photo by DFID – UK Department for International Development – The importance of breastfeeding from birth.

Girls Shouldn’t Feel Ashamed at That Time of the Month – Period!

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My name is Barbara Namuddu, a peer educator with Reach A Hand, Uganda (RAHU) and I would like to tell you a story. A story that am not afraid to talk about because I am a girl and am proud to say that being a girl is not a punishment.

I have been volunteering with RAHU for nine months now under the Peer Educators Academy program where I have had an opportunity to interact with my peers in schools. My interaction is mainly premised on listening to their issues so that I, as a peer educator armed with the right information, can help them overcome their challenges.

It’s not a surprise that as a girl, fellow girls always feel open to share problems that they go through with me since they know that I, have also gone through the same. I am sure any girl reading this is nodding her head in agreement.

From the peer learning sessions I conduct, I always find out so many terrible tales happening to young girls in school (but also out of school) as young as twelve.  One of those things are the experiences they go through during menstruation.

Burdened with cramps, heavy flow and surprise menstrual periods (since some are so young to know when the cycle starts), and interacting with rude or unsympathetic boys and men who don’t know how it feels to go through menstruation, girls are still living in terror.

Getting their periods  in school can be such a hassle. Some are constantly running out of class to the bathroom every hour, making sure they are stocked with enough pads, and some try to pretend and seem like they’re not  bleeding profusely out of their vaginas.

To some, If they’re caught off guard and their periods start in class, it  becomes their most embarrassing moment as one girl I interacted with narrated;

“The shame of blood leaking through your skirt, boys calling you names, sores and infections, to mention but a few, makes you hate being a young healthy girl.”

Girls can you hear me?


Watch Barbara’s 6o seconds video on menstruation

This gets worse in a country like Uganda where menstruation is plagued with taboos. “If you’re menstruating and you climb a tree, then that tree will stop producing fruits”, “If you get periods, you must start having sex”, “girls in periods contaminate food”, “girls in periods cannot participate in schools.” etc.

Societies have the tendency to view women and girls as submissive to men and boys, and menstruation as a topic and issue has been stigmatized and made into a taboo topic that should only be discussed in private. This, in turn, prevents women and girls from accessing the information they need about menstruation and their bodies.

In this age and era, the last thing you expect to hear is a man or boy saying that a menstruating girl is dirty or can cause harm to others, and yet my interactions as a peer educator prove otherwise. It is therefore harder for girls to be in school during menstruation because these myths contribute to low confidence and fears of humiliation by others.

We need to make men and boys aware of the fact that menstruation is a completely natural part of life and ensure that girls are not inducted into puberty with feelings of shame. It’s unbelievably upsetting to discover how poorly we treat young girls — kids, really — going through this biological phenomenon that is no fault of their own, and more importantly, nothing to be ashamed of.

To overcome these challenges, we need to move beyond the stigma of menstruation. We need to educate boys and men on the importance of open dialogue on the subject. After all, men still make up a larger proportion of governments and corporate policy-makers in Africa.

It should be accepted that menstrual health is not just a “girl’s issue” but everyone’s issue: women and girls cannot drive development in communities  if their menstrual health is not given due consideration. Oh and also – don’t make us we feel ashamed at that time of the month. We’re not faking it. It’s nature. Period!

Featured image: Barbara conducting a focus group discussion. Image courtesy of Reach a Hand Uganda.

Why We Still Need to Talk about Maternal Mortality, and What We Can Do to Prevent It

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Although women are benefitting from massive healthcare improvements in pregnancy and childbirth in the last century, many of them still die from complications and not all women receive equal access to these healthcare opportunities.

According to the World Health Organization (WHO), approximately 830 women die from pregnancy or childbirth-related complications every day. At the end of 2015, about 303,000 women died during and following pregnancy and childbirth. Most of these deaths happened in developing countries and could have been prevented.

These shocking statistics reflect unequal access to healthcare services and highlight the gap between the rich and the poor. In fact, 99% of all maternal deaths occur in developing countries and more than half of these deaths occur in humanitarian settings. In addition, for every 100,000 live births, the maternal mortality ratio in developing countries is 239 compared to 12 in developed countries. Moreover, the probability that a 15-year-old woman will die from a maternal cause is 1 in 4900 in developed countries compared to 1 in 180 in developing countries.

Many of these women die from complications during and after pregnancy and childbirth. According to the WHO, the complications that account for nearly 75% of all maternal deaths are:

  • Severe bleeding
  • Infections
  • High blood pressure during pregnancy
  • Complications during child delivery
  • Unsafe abortion

A lot of these maternal deaths can be prevented as healthcare providers know the solutions that could prevent or manage these complications. For instance, severe bleeding after child delivery can be managed by injecting oxytocin while infection after childbirth could be avoided by exercising proper hygienic techniques and recognizing possible signs of infection early in the process.

However, many of these women, particularly those residing in remote areas, are still not capable of receiving adequate healthcare services. In fact, according to the WHO, only 51% of women in low-income countries benefit from these healthcare services during childbirth. In addition, poverty, lack of information, and long distance are some other factors that bar women from receiving the proper care they need.

While there has been an increase in political will, as demonstrated recently in The Global Strategy for Women’s, Children’s and Adolescents’ Health 2016-2030 campaign launched by the UN Secretary General, these efforts are not enough. We invite you to join us and the WHO in raising awareness of this global crisis. To learn more about these statistics, please visit the Maternal Mortality page of the WHO website.

Cover photo credit: Robert Yates/Department for International Development/Wikimedia

Let’s Talk About Sex – The Importance of Sexual Education

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When I was in the seventh grade we started having classes about sex. Everyone thought this was an awkward thing to talk about and no one really understood why we had to do it. Everyone knew that we were supposed to wait until we felt ready and use a condom, right?

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few weeks ago I visited an upper secondary girls’ school in Tanzania and one of the girls came to me with a question. She was 17 years old and asked me what I thought about sex before marriage. Since sex is something that  you shouldn’t have before marriage according to the prevailing norms and and religious views in Tanzania, I felt quite uncomfortable. I didn’t want to step on her toes and say something ”wrong”. So I told her that in Sweden, having sex before marriage is quite common and nothing that is considered weird or abnormal. I was a little nervous of how she would react since it is a tricky and very personal question.

This girl continued to tell me that just a few days before I arrived to the school they had a class about sex. My first reaction was that this was a positive thing, since it is an important topic to talk about. She went on to tell me that the whole class had been about not having sex before marriage. The teachers were standing in front telling these young women that it was almost forbidden to have sex before they have found their husband. And when they do have sex, it will be only to bring children for their man. She also told me that she didn’t listen to a single word they said and that she had already had sex.

This is where the problem lies: this seventeen year old girl was very smart and had good grades but she didn’t know anything about having safe sex. No one have ever told her about using protection since they can’t even think about her being sexually active before marriage.

In Tanzania alone, 1.4 million people are living with HIV and in Africa as a continent as much as 26 million people are suffering from this disease. This is a huge and terrifying number and it is definitely time to react. In Sub-Saharan Africa women represent 58% of all people living with HIV or AIDS and for women in their reproductive years this is the most common reason of death. Looking at teenage girls, pregnancy is the most common reason why they die, either because of illegal abortions or from complications during childbirth.

The failure to provide young people proper sex education and information about and access to contraceptives in countries like Tanzania is resulting in devastating consequences. I believe it’s safe to say that every single person in the world agree that we need to eradicate HIV and AIDS and also lower the number of teenage girls dying from pregnancy, and of course decrease the number of unwanted and unplanned pregnancies in the first place. Proper sex education is crucial for us to achieve this goal, and a necessary part of securing young women’s future life and living as well. We can’t close our eyes from the fact that some young women – probably more than we think – will have sex before they get married even if the norms and religious views of the country tell them otherwise.

After my talk with this young girl I realized that my teachers talking to me and my classmates about sex when we were in seventh grade wasn’t a bad thing at all. But I also realized that I grew up in a society were the norm is to use protection when having sex if the goal isn’t to conceive. I have been raised with information about safe sex, contraceptives and the risks of unprotected sex.

So maybe I sat there in seventh grade giggling and thought it was quite funny and weird when my teacher showed us a condom, but at that time I didn’t knew how grateful I should be about knowing those things. I didn’t realize that there were other girls around the world not knowing that condoms even existed – or, if they did, not having access to them. We need to realize that sex is a part of young people’s lives, and while some girls and boys will choose to wait until they are married, many more won’t  – and we need to teach them how to prevent diseases and unplanned pregnancies. Additionally, even when women do get married, they should still have the necessary information and tools to postpone pregnancy until they themselves decide, with their partners, that they are ready to have a child.

Teaching youth about sex isn’t the same as encouraging them to have sex – and the consequences of failing to provide girls and boys access to sexual education and contraceptives are much too severe and negative for us to accept any longer.

Cover photo credit: UNFPA Flickr