Hygiene

UHC Day 2025: Unaffordable health costs? We’re sick of it!

Universal Health Coverage (UHC) Day is a global reminder that access to quality health care is a fundamental right, not a privilege reserved for the wealthy. This year’s theme, “Unaffordable health costs? We’re sick of it!”, speaks directly to one of the biggest barriers facing millions of Nigerians: skyrocketing healthcare costs and the widening gap between health needs and the ability to pay.

While achieving UHC requires multisectoral commitment, one of the most critical systems needed to bridge this gap is health insurance, an essential mechanism designed to protect individuals from financial hardship, ensure continuity of care, and promote equitable access to essential services. Yet, despite the existence of the National Health Insurance Authority (NHIA) and state-level schemes, enrolment remains abysmally low. Out-of-pocket payments still account for over 76% of total health spending in Nigeria, pushing millions deeper into poverty every year.

Health insurance providers cannot succeed alone; they face chronic underfunding, limited subsidies, weak enforcement, and low public awareness. Sustainable progress requires stronger government leadership, increased premium subsidies for the poor, upgraded health facilities, and digital systems that make enrolment seamless.

Yet progress is possible, and CFHI is proving it every day.

Through relentless community mobilization and strategic partnerships with philanthropists like Satoshi Koiso and development partners such as the Institute of Human Virology Nigeria (IHVN), CFHI has successfully enrolled 224 vulnerable individuals into NHIA-supported health coverage this year alone.

These are not just numbers.

They are mothers who no longer skip medication.

They are children who can see a doctor without their parents selling assets.

They are families now protected from choosing between medicine and food.

Health insurance must be affordable, accessible, and functional for every Nigerian. It is not just a policy tool; it is a lifeline that protects households from falling into poverty and guarantees timely care, especially for vulnerable groups.

On UHC Day 2025, our message is unequivocal:

No Nigerian should be denied quality care because they cannot afford it.

We call on federal and state governments to:

  • Fully subsidize premiums for low-income and vulnerable households
  • Strengthen primary health care facilities that deliver insured services
  • Enforce mandatory coverage and streamline digital enrolment

It is time to end the era of unaffordable health costs.

Health care is a right for every Nigerian, irrespective of socio-economic status.

Together, we can make “We’re sick of it” a rallying cry that finally delivers results.

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Beyond Stigma: Community-Led Support for Women and Girls Living with HIV

Stigma remains one of the greatest obstacles to ending HIV: globally, according to the latest UNAIDS estimates, about 40.8 million people were living with HIV as of the end of 2024, with women and girls accounting for approximately 53% of all infections [1]. Despite progress in expanding treatment access bringing lifesaving antiretroviral therapy to over 31 million people worldwide millions still face stigma, discrimination, and social exclusion, which continue to limit their ability to seek testing, care, and long-term support [1].

Evidence shows that stigma discourages people from testing, delays linkage to treatment, and undermines adherence; pooled analyses across African surveys and facility studies find that people who experience stigma are significantly less likely to know their status or remain engaged in care, which in turn reduces chances of viral suppression and worsens health outcomes [2,3]. The scientific consensus that “U=U” (Undetectable = Untransmittable) underscores why ending stigma is also a prevention strategy: people on effective antiretroviral therapy (ART) who achieve and maintain an undetectable viral load do not sexually transmit HIV [4]. Despite these advances, gaps remain UNAIDS reports that while millions are on treatment, about 31.6 million people were accessing ART in 2024, leaving a substantial number still unreached by life-saving services [1].

Community-led support is central to bridging those gaps for women and girls. Practical, evidence-based community interventions peer support groups, community health worker follow-up, safe disclosure spaces, integrated mental-health services, and targeted outreach to adolescents have been shown to increase testing uptake, improve retention on ART, and reduce internalized stigma [5,6]. In Nigeria and other countries, facility-level and community studies link stigma with lower adherence and higher loss to follow up, highlighting the need for local, culturally sensitive responses that engage families, faith leaders, youth networks, and women’s groups [3,7]. Gender-sensitive programming is particularly important: women and girls face intersectional stigma driven by gender norms, economic dependence, and the risk of gender-based violence barriers that require combined social protection, livelihood support, and confidential clinical services to overcome [5].

At the Centre for Family Health Initiative (CFHI), community-led support is operationalized through sustained activities that go beyond one-day events. CFHI provides community HIV testing and counselling, adolescent-friendly education, psychosocial support, and peer navigation to link women and girls to care and keep them on treatment [8]. The organization integrates stigma-reduction messaging into gender-norms dialogues, trains community health volunteers in respectful care, and runs livelihood and empowerment sessions that reduce economic vulnerability an important factor that often forces women to remain in situations where disclosure is dangerous. CFHI’s community outreach also emphasizes U=U messaging to demystify treatment and encourage adherence and last year’s community testing and sensitization activities in Imo State reached hundreds with counselling and referrals, reinforcing the role of sustained local engagement in improving outcomes [8].

Ending HIV stigma requires action across sectors. Health facilities must adopt anti-discrimination policies and provide confidential, quality services; community leaders and faith institutions must publicly reject harmful narratives; schools and youth groups must deliver age-appropriate HIV education; and social protection programmes should prioritize women and girls so economic dependence does not block access to care. Donors and governments must sustain funding for community-led responses, which evidence shows are cost-effective and essential for reaching the UN targets to end AIDS as a public health threat [5,6].

Now is the time for communities to move from awareness to durable action. Support people living with HIV by learning and sharing accurate facts, joining, or starting peer support groups, encouraging friends and family to test, demanding respectful care at clinics, and supporting empowerment programmes that reduce vulnerability. CFHI and partners stand ready to work with communities, faith groups, schools, and health services to build safe, supportive environments where women and girls living with HIV can thrive. Together we can make stigma a thing of the past because when communities lead, lives change.

 

References

  1. Global HIV & AIDS statistics — Fact sheet. Geneva: Joint United Nations Programme on HIV/AIDS; 2025.
    Available from: https://www.unaids.org/en/resources/fact-sheet
  2. Doyle CM, Kuchukhidze S, Stannah J, Flores Anato JL, Xia Y, Logie CH, et al. The impact of HIV stigma and discrimination on HIV testing, antiretroviral treatment, and viral suppression in Africa: a pooled analysis of population-based surveys.
    Available from: https://www.researchgate.net/publication/391079137_The_Impact_of_HIV_Stigma_and_Discrimination_on_HIV_Testing_Antiretroviral_Treatment_and_Viral_Suppression_in_Africa_A_Pooled_Analysis_of_Population-Based_Surveys
  3. Mahlalela NB, et al. The association between HIV-related stigma and health-seeking behaviour, testing and adherence: a systematic review. J Public Health. 2024.
    Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10896802/
  4. UNAIDS / IAS / Prevention Access Campaign. Undetectable = Untransmittable (U=U) consensus and evidence. Geneva: UNAIDS; 2018–2024.
    Available from: https://www.unaids.org/en/resources/presscentre/featurestories/2018/july/undetectable-untransmittable
  5. World Health Organization. Eliminating stigma and discrimination in HIV responses: evidence and interventions. Geneva: WHO; 2022.
    Available from: https://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/hiv/strategic-information/hiv-data-and-statistics
  6. Community-led monitoring / Community-led responses — evidence and good practice. Geneva: UNAIDS; 2023.
    Available from: https://www.unaids.org/en/resources/documents/2023/community-led-monitoring-in-action
  7. Okunola A, et al. The impact of stigma on ART adherence in Ondo State clinics: cross-sectional evidence. Int J Res Innov Social Sci. 2025.
    Available from: https://rsisinternational.org/journals/ijriss/articles/the-impact-of-stigma-and-discrimination-on-adherence-levels-in-hiv-positive-patients-evidence-from-ondo-state-clinics/
  8. Centre for Family Health Initiative (CFHI). Community HIV services, stigma reduction and outreach report. Owerri: CFHI; 2024–2025.
    Available from: https://www.cfhinitiative.org

 

 

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Ending HIV Stigma: Community Support Beyond World AIDS Day

Ending HIV stigma remains one of the most critical steps in achieving an effective HIV response globally. Even though scientific progress has transformed HIV from a life-threatening illness to a manageable condition, stigma continues to undermine prevention, testing, treatment, and quality of life. Studies show that nearly 1 in 4 people living with HIV report experiencing discrimination in healthcare settings, which discourages timely care-seeking and contributes to poor health outcomes (1). Community stigma also remains widespread; in sub-Saharan Africa, where the burden of HIV is highest, research found that over 35% of adults still hold discriminatory attitudes toward people living with HIV (2). These attitudes are deeply rooted in misinformation, fear, cultural norms, and moral judgments that continue to silence individuals and limit their ability to access support.

Stigma does not only affect individuals emotionally; it has direct medical consequences. Evidence shows that people who experience HIV-related stigma are three times more likely to delay or avoid HIV testing and up to 50% less likely to adhere to treatment due to fear of being discovered (3). This delay fuels the cycle of transmission and reduces the chances of achieving viral suppression. Yet, viral suppression keeping HIV levels undetectable is proven to eliminate the risk of sexual transmission entirely, a fact summarized in the principle U=U (Undetectable = Untransmittable) (4). Ending stigma, therefore, is not only a human rights issue but a powerful public health strategy.

Beyond World AIDS Day, communities must unite to promote supportive environments where people living with HIV feel safe to disclose, access services, and receive continuous care. Community-led awareness, inclusive language, youth-friendly education, and culturally sensitive advocacy have proven to reduce stigma by strengthening empathy and understanding (5). Empowering young people with evidence-based information also plays a vital role since adolescents remain vulnerable to societal misconceptions and pressure surrounding HIV.

At the Centre for Family Health Initiative, efforts to end HIV stigma go beyond commemoration events. CFHI continues to create safe spaces within communities through targeted HIV education, gender-sensitive communication, counselling support for adolescents and caregivers, and stigma-reduction sessions integrated into school and community health activities. Through the ASPIRE project and other community interventions, CFHI consistently promotes testing uptake, linkage to care, and treatment adherence especially among vulnerable populations. Last year in Imo State, CFHI carried out a community HIV awareness and testing outreach that reached dozens of individuals with prevention messages, counselling, and referrals, reinforcing the message that HIV is manageable and that stigma must never stand between anyone and access to care. As we move beyond World AIDS Day, CFHI encourages everyone to be intentional about kindness, to challenge myths, to stand against discrimination, and to help build communities where people living with HIV are treated with dignity. Ending stigma begins with each of us, and together we can create a society where support is stronger than silence

 

References

  1. Joint United Nations Programme on HIV/AIDS (UNAIDS). Confronting Discrimination: Overcoming HIV-related Stigma and Discrimination in Health-care Settings. 2020. Available from: https://www.unaids.org
  2. United Nations Children’s Fund (UNICEF). HIV and AIDS Statistical Update. 2023. Available from: https://www.unicef.org
  3. Turan B, et al. The Impact of HIV-related Stigma on Treatment Adherence. AIDS Behav. 2017;21(1):283–291. Available from: https://link.springer.com
  4. Prevention Access Campaign. The U=U Declaration. 2016. Available from: https://preventionaccess.org
  5. World Health Organization (WHO). Global HIV Programme: Eliminating Stigma and Discrimination. 2022. Available from: https://www.who.int

 

 

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World AIDS Day

Today, December 1st, the world once again marks World AIDS Day, a global reminder of our shared responsibility to end HIV and support people living with it. This year’s theme, “Overcoming Disruption, Transforming the AIDS Response,” highlights the urgent need to rebuild stronger, more resilient, and equitable systems that ensure no one is left behind in HIV prevention and care [1]. Despite decades of progress, HIV continues to thrive where misinformation, stigma, poverty, and limited access to health services persist, especially among vulnerable groups such as adolescents, young women, and key populations [2].

Understanding how HIV spreads remains essential. The virus is transmitted through unprotected sexual intercourse, sharing contaminated needles, mother-to-child transmission during pregnancy, birth, or breastfeeding, and rarely through unscreened blood transfusion [3]. It is important to emphasize that HIV cannot be transmitted through casual contact, which means stigma rooted in misinformation must continue to be challenged [4]. Prevention remains powerful when individuals consistently use condoms, access regular HIV testing, utilize PrEP when at risk, avoid sharing needles, and ensure pregnant women living with HIV receive PMTCT services [5]. Effective treatment such as antiretroviral therapy suppresses viral load, making HIV untransmittable when undetectable (U=U), a breakthrough in global HIV care [6].

The Centre for Family Health Initiative (CFHI) remains committed to strengthening the HIV response through coordinated community engagements that include HIV testing, counselling, prevention education, PMTCT support, stigma reduction activities, and linkage to care for individuals and families. Over the years, CFHI has collaborated with partners such as Excellence and Friends Management Care Centre (EFMC), the Catholic Caritas Foundation of Nigeria (CCFN), and the Institute of Human Virology Nigeria (IHVN). These partnerships have supported CFHI in reaching over 14,000 children and caregivers with essential HIV-related services. Currently, CFHI continues to work actively with IHVN alongside support from the FCT Social Development Secretariat (SDS) to provide ongoing care, and treatment adherence services to about 6,000 children and their caregivers. Through its OVC programming, CFHI remains committed to improving long-term health, resilience, and stability for vulnerable families affected by HIV.

As Nigeria joins the global community in commemorating World AIDS Day 2025, it is essential for the government to strengthen its leadership in the national HIV response. This includes increasing investment in public health systems, ensuring consistent availability of testing kits and antiretroviral medications, expanding prevention programs such as PrEP and PMTCT, and improving data management for timely decision-making. Government action is also needed to address stigma through nationwide awareness campaigns, to support state-level implementation of HIV programs, and to create enabling environments where community organizations, healthcare workers, and development partners can scale interventions effectively. HIV is preventable and treatable, and with informed choices, prioritizing equitable access to services, sustaining political commitment, and collective action, Nigeria can accelerate progress toward ending AIDS as a public health threat.

Everyone is encouraged to take responsibility by getting tested, reducing risk, supporting those living with HIV, and rejecting stigma in every form.

 

References

  1. World Health Organization. World AIDS Day 2025 Theme: Overcoming Disruption, Transforming the AIDS Response. Geneva: WHO; 2025. https://www.who.int
  2. UNAIDS. Global HIV & AIDS Statistics — Fact Sheet 2025. Joint United Nations Programme on HIV/AIDS; 2025. https://www.unaids.org/en/resources/fact-sheet
  3. Centers for Disease Control and Prevention. HIV Transmission Overview. Atlanta: CDC; 2024. https://www.cdc.gov/hiv/basics/transmission.html
  4. UNAIDS. Confronting HIV Stigma and Discrimination. Joint United Nations Programme on HIV/AIDS; 2024. https://www.unaids.org/en/key-programmes/stigma-discrimination
  5. World Health Organization. HIV Prevention Guidelines. Geneva: WHO; 2024. https://www.who.int/health-topics/hiv
  6. UNAIDS. Undetectable = Untransmittable (U=U) Scientific Update. Geneva: UNAIDS; 2024. https://www.unaids.org/en/resources/presscentre/featurestories/2024/u-u
  7. Centre for Family Health Initiative. Community HIV Services and OVC Support Report. Abuja: CFHI; 2024. https://www.cfhinitiative.org

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Protecting Our Children from Common Illnesses

Children remain highly vulnerable to common illnesses, and preventing these diseases is essential to safeguarding their growth and wellbeing. In Nigeria, infections such as diarrhea, malaria, and acute respiratory infections continue to be among the leading causes of sickness and death in children under five, despite being largely preventable. Evidence shows that environmental and structural factors contribute significantly to this burden. Research highlights that improved water, sanitation, and hygiene (WASH) are strongly associated with reduced childhood diarrhea and respiratory infections (1). Additionally, findings from Nigeria’s Demographic and Health Surveys indicate that poor housing conditions including overcrowding and inadequate ventilation are major predictors of child illness across the country (2).

The impact of these illnesses extends far beyond short-term discomfort. Children who frequently experience diarrhea or respiratory infections are at increased risk of stunting, and spatial health research in Nigeria reveals that these conditions often overlap, creating compounded threats to child growth and development (3). Preventable infections such as measles also have long-term consequences on immunity and overall health in later life, as demonstrated in studies tracking early-life measles exposure (6). Even though effective vaccines exist, childhood immunization coverage remains suboptimal in many regions, prompting the introduction of innovative solutions such as artificial intelligence systems to increase vaccine uptake (5). Reliable hospital data further confirm that pneumonia, malaria, and diarrheal diseases remain major contributors to child mortality in Nigerian healthcare settings (4). Alongside medical treatment, community-based interventions such as hygiene promotion, nutrition counselling, and timely referral are essential to reducing morbidity. Globally, standardized caregiver resources like UNICEF’s “Facts for Life” continue to guide families on preventing and responding to common childhood illnesses (7).

The Centre for Family Health Initiative (CFHI) plays a critical role in reducing the burden of childhood illnesses through targeted community programs. CFHI supports maternal, newborn, and child health activities, including MNCH weeks where children receive essential interventions such as vaccinations, deworming, vitamin A supplementation, growth monitoring, and malnutrition screening (8). The organization also drives WASH improvements aimed at reducing disease spread and implements extensive community health education on hygiene, sanitation, immunization, and early care-seeking. Through capacity-building efforts, CFHI strengthens the skills of health workers and volunteers to deliver quality child health services (9). CFHI’s approach is evidence-based and community-centered, ensuring that interventions respond to local needs and contribute meaningfully to child survival and development.

Protecting children from preventable illnesses requires collective responsibility. Caregivers should ensure full vaccination, practice proper handwashing, maintain clean household environments, and seek medical care early when their children show signs of illness. Community members must actively share health information and support local awareness programs. Policy and government actors should invest in clean water systems, sanitation infrastructure, and housing improvements to create healthier environments for children. Finally, individuals and organizations can strengthen CFHI’s efforts by volunteering, partnering, or supporting programs that promote child health. Together, these actions can secure a safer, healthier future for every child.

 

References

  1. Oyebanji TO, Chandra-Mouli V. Burden of Common Childhood Diseases in Relation to Improved Water, Sanitation, and Hygiene (WASH) among Nigerian Children. PubMed [Internet]. 2018 [cited 2025 Nov 23]. Available from: https://pubmed.ncbi.nlm.nih.gov/29895758/
  2. Olusanya BO, Odeyemi OA, Abimbola S, Adebowale SA. Housing conditions as predictors of common childhood illness: Evidence from Nigeria Demographic and Health Surveys, 2008–2018. PubMed [Internet]. 2021 [cited 2025 Nov 23]. Available from: https://pubmed.ncbi.nlm.nih.gov/33476186/
  3. Gai T, Cunningham E, Chukwuogo O, et al. Spatial Co-Morbidity of Childhood Acute Respiratory Infection, Diarrhoea and Stunting in Nigeria. PubMed [Internet]. 2022 [cited 2025 Nov 23]. Available from: https://pubmed.ncbi.nlm.nih.gov/35162859/
  4. van den Berg GJ, von Hinke S, Vitt N. Early life exposure to measles and later-life outcomes: Evidence from the introduction of a vaccine. arXiv [Internet]. 2023 [cited 2025 Nov 23]. Available from: https://arxiv.org/abs/2301.10558
  5. Kehinde O, Abdul R, Afolabi B, et al. Deploying ADVISER: Impact and Lessons from Using Artificial Intelligence for Child Vaccination Uptake in Nigeria. arXiv [Internet]. 2023 [cited 2025 Nov 23]. Available from: https://arxiv.org/abs/2402.00017
  6. Morbidity and Mortality Pattern of Childhood Illnesses Seen at the Children Emergency Unit of Federal Medical Center, Asaba, Nigeria. AMHSR [Internet]. [cited 2025 Nov 23]. Available from: https://www.amhsr.org/articles/morbidity-and-mortality-pattern-of-childhood-illnesses-seen-at-the-children-emergency-unit-of-federal-medical-center-asaba-nigeria.html
  7. Facts for Life. [Internet]. [cited 2025 Nov 23]. Available from: https://en.wikipedia.org/wiki/Facts_for_Life
  8. Centre for Family Health Initiative. 2020 Annual Report. Abuja: CFHI; 2020. [Internet]. [cited 2025 Nov 23]. Available from: https://www.cfhinitiative.org/wp-content/uploads/2022/10/CFHI_2020-Annual-Report.pdf
  9. Centre for Family Health Initiative. Who We Are. [Internet]. [cited 2025 Nov 23]. Available from: https://www.cfhinitiative.org/who-we-are/

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MONDAY HEALTH BURST

Hygiene and Health for Every Man

Good hygiene is not only a personal responsibility but a fundamental aspect of disease prevention, dignity, and overall well-being for men across all ages. Research shows that poor hygiene contributes significantly to the global burden of infectious diseases. According to the World Health Organization, inadequate hygiene practices account for nearly 432,000 deaths annually from diarrheal diseases alone (1) with millions more suffering from preventable infections linked to poor personal and environmental hygiene. Studies also reveal that men are statistically less likely than women to engage in consistent hygiene routines, including regular handwashing, oral care, and preventive health screenings. A 2022 global survey noted that over 65% of men admit to skipping basic hygiene routines (2) increasing their vulnerability to infections, skin diseases, urinary tract complications, and communicable illnesses. Poor hygiene also affects mental health, social interactions, productivity, and overall quality of life, especially in environments where men are primary earners and caregivers.

The implications of poor hygiene for men extend far beyond physical health. Lack of proper personal and environmental cleanliness can affect workplace productivity, family health, and community wellness. For example, studies show that effective handwashing alone can reduce respiratory infections by over 21% (3) yet many men either neglect this simple act or lack access to clean water and safe sanitation facilities. Globally, 3.5 billion people still lack safe sanitation (4) and this affects men in marginalized communities disproportionately, often exposing them to contaminated environments and increasing their risk of illness. Oral hygiene is another overlooked aspect; research indicates that men are 40% less likely than women to seek dental care (5) leading to higher rates of gum disease, which has been linked to heart disease, stroke, and diabetes. Hygiene is not just cleanliness it is a cornerstone of preventive health.

As we commemorate International Men’s Day and World Toilet Day, we encourage, admonish, and advise men everywhere to stay true to hygiene and neatness. Cleanliness is strength. Hygiene is responsibility. And taking care of your health is an act of leadership and self-respect. Men must break free from harmful cultural norms that label hygiene awareness as weakness or unmanliness. True masculinity includes caring for one’s body, environment, and overall well-being. A healthy man becomes a healthier father, partner, colleague, and community member. The global theme for this period emphasizes dignity, safe sanitation, and improved well-being for everyone and men must be active participants in this movement.

Wash your hands often, maintain proper grooming, care for your oral health, keep your environment clean, use toilets responsibly, practice safe sanitation, and seek regular health checks. Small habits save lives. Hygiene is health, and health is power. Let this be a reminder that healthier men build stronger families, stronger communities, and a stronger nation.

For enquiries, partnerships, or to invite CFHI for sensitization programs, kindly contact us via: info@cfhinitiative.org 

 

References

  1. World Health Organization. Diarrhoeal disease. 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/diarrhoeal-disease
  2. Global hygiene behaviours survey results. 2022. Available from: https://yougov.co.uk/topics/health/articles-reports
  3. Centers for Disease Control and Prevention. Show Me the Science – How to Wash Your Hands. 2023. Available from: https://www.cdc.gov/handwashing/show-me-the-science-handwashing.html
  4. World Health Organization & UNICEF. Progress on household drinking water, sanitation and hygiene 2023 update. Available from: https://www.who.int/publications/i/item/9789240073347
  5. American Dental Association. Oral health and men’s health. 2022. Available from: https://www.ada.org/resources/research/science-and-research-institute

 

 

 

 

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CFHI and Imo State Ministry of Health Unite for World Diabetes Day 2025!

The Centre for Family Health Initiative (CFHI) partnered with the Imo State Ministry of Health to mark World Diabetes Day 2025, at the Ministry of Health Block, Imo State Secretariat, Port Harcourt Road, Owerri, reaching 50 individuals with vital diabetes awareness and screening services.
focusing on the theme “Diabetes and Well-being: Creating Supportive Environments in the Workplace”.

Key Highlights:
Free BP and Blood Sugar Testing
Expert Dietitians on ground for personalized meal planning
Empowering individuals with diabetes to thrive at all life stages.
Integrated care and support for physical and mental well-being.

Our mission was to spark a movement! We aimed to educate, empower, and encourage employers, employees, and the global community to act towards healthier workplaces.

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MONDAY HEALTH BURST

EFFECTS OF FEMALE GENITAL MUTILATION (FGM)

According to World Health Organization, more than 200 million girls and women alive today have undergone female genital mutilation (FGM) in 30 countries in Africa, mostly in the Middle East and Asia. All forms of FGM are associated with increased health risk in the short- and long-term. Below are some of the health risks.

Short-term health risks of FGM

Severe pain. Cutting the nerve ends and sensitive genital tissue causes extreme pain. The healing period is also painful.

Shock. Can be caused by pain, infection and/or haemorrhage.

Genital tissue swelling. Due to inflammatory response or local infection.

Infections. May spread after the use of contaminated instruments (e.g. use of same instruments in multiple genital mutilation operations), and during the healing period.

Excessive bleeding (haemorrhage). Can result if the clitoral artery or other blood vessel is cut.

Human immunodeficiency virus (HIV). The direct association between FGM and HIV remains unconfirmed, although the cutting of genital tissues with the same surgical instrument without sterilization could increase the risk for transmission of HIV between girls who undergo female genital mutilation together.

Urination problems. These may include urinary retention and pain passing urine. This may be due to tissue swelling, pain or injury to the urethra.

Impaired wound healing. Can lead to pain, infections and abnormal scarring.

Death. Death can result from infections, including tetanus, as well as haemorrhage that can lead to shock.

Mental health problems. The pain, shock and the use of physical force during the event, as well as a sense of betrayal when family members condone and/or organize the practice, are reasons why many women describe FGM as a traumatic event.

 

Long-term health risks of FGM

Infections:

  • Chronic genital infections. With consequent chronic pain, and vaginal discharge and itching. Cysts, abscesses and genital ulcers may also appear.
  • Chronic reproductive tract infections. May cause chronic back and pelvic pain.
  • Urinary tract infections. If not treated, such infections can ascend to the kidneys, potentially resulting in renal failure, septicaemia and death. An increased risk of repeated urinary tract infections is well documented in both girls and adult women who have undergone FGM.

Painful urination. Due to obstruction of the urethra and recurrent urinary tract infections.

Vaginal problems. Discharge, itching, bacterial vaginosis and other infections.

Menstrual problems. Obstruction of the vaginal opening may lead to painful menstruation (dysmenorrhea), irregular menses and difficulty in passing menstrual blood, particularly among women with Type III FGM.

Excessive scar tissue (keloids). Excessive scar tissue can form at the site of the cutting.

HIV (Human immunodeficiency virus). Given that the transmission of HIV is facilitated through trauma of the vaginal epithelium which allows the direct introduction of the virus, it is reasonable to presume that the risk of HIV transmission may be increased due to increased risk of bleeding during intercourse, because of FGM.

Sexual health problems. FGM damages anatomic structures that are directly involved in female sexual function and can therefore also influence women’s sexual health and well-being. Removal of, or damage to, highly sensitive genital tissue, especially the clitoris, may affect sexual sensitivity and lead to sexual problems, such as decreased sexual desire and pleasure, pain during sex, difficulty during penetration, decreased lubrication during intercourse, and reduced frequency or absence of orgasm (anorgasmia). Scar formation, pain and traumatic memories associated with the procedure can also lead to such problems.

Childbirth complications (obstetric complications). FGM is associated with an increased risk of caesarean section, postpartum haemorrhage, recourse to episiotomy, difficult labour, obstetric tears/lacerations, instrumental delivery, prolonged labour, and extended maternal hospital stay. The risks increase with the severity of FGM.

Obstetric fistula. A direct association between FGM and obstetric fistula has not been established. However, given the causal relationship between prolonged and obstructed labour and fistula, and the fact that FGM is also associated with prolonged and obstructed labour, it is reasonable to presume that both conditions could be linked in women living with FGM.

Perinatal risks. Obstetric complications can result in a higher incidence of infant resuscitation at delivery and intrapartum stillbirth and neonatal death.

Mental health problems. Studies have shown that girls and women who have undergone FGM are more likely to experience post-traumatic stress disorder (PTSD), anxiety disorders, depression and somatic (physical) complaints (e.g. aches and pains) with no organic cause.

Pain. Due to tissue damage and scarring that may result in trapped or unprotected nerve endings.

Though FGM may be normative and considered to be of cultural significance in some settings, the practice is always a violation of human rights, with the risk of causing trauma and leading to problems related to girls’ and women’s mental health and well-being. (WHO,2020)

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MONDAY HEALTH BURST

HEALTHY DIETING

According to the Dietary Guidelines for Americans 2015–2020, a healthy eating plan includes eating of fruits, vegetables, whole grains and fat free or low-fat milk and milk products. They are low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars. While unhealthy diet includes overeating of fatty and greasy food, and of milky products, sweet foods, highly flavoured food, too pungent food, as well as drinking too much alcohol, leading to the formation of Damp-Heat.

Increased production of processed foods, rapid urbanization and changing lifestyles have led to a shift in dietary patterns. People are now consuming more foods high in energy, fats, free sugars and salt/sodium, and many people do not eat enough fruits, vegetables and other dietary fibre such as whole grains. Healthy eating is all about balance. Hence, it is possible to enjoy ones favorite meals, but the key point is eating them less often and balancing them with healthier foods with more physical activities.

Some general tips for healthy dieting include less intake of high-calorie foods and intentionally replace them with lower-calorie versions. Consuming a healthy diet throughout the life-course helps to prevent malnutrition in all its forms as well as a range of non-communicable diseases and conditions.

Monday Health Burst is an initiative of Centre for Family Health Initiative (CFHI) to tackle issues of basic health concerns. Join us every Monday for more health-related articles on all our social media platforms.

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MONDAY HEALTH BURST

RABIES: SYMPTOMS, CAUSES, PREVENTION AND TREATMENT

Rabies is a viral disease that causes inflammation of the brain in humans and other mammals. It is caused by lyssaviruses, which includes the rabies virus and Australian bat lyssavirus. Some of the known ways of spreading rabies are scratches or bites from an infected animal on human or other animals, and infected saliva’s contact with the eyes, mouth, or nose.

According to World Health Organization (WHO), dogs are the most common animals infected with rabies globally. In countries where dogs commonly have the disease, majority (99%) of rabies cases are the direct result of dog bites. However in America, bat bite is the most common source of rabies infection in humans, and less than 5% of cases from dogs.

After a bite or other rabies exposure, the rabies virus has to travel through the body to the brain before symptoms can surface. This time between the exposure and the appearance of symptoms is called the incubation period. The incubation period may last for weeks to months depending on the distance between the bite wound and the brain, the type of rabies virus, and existing immunity.

The first symptoms of rabies may be very similar to those of the flu like general weakness, fever, or headache. Symptoms may also be discomfort or a prickling or itching sensation at the site of the bite, progressing within days to acute symptoms of cerebral dysfunction, anxiety, confusion, and agitation. As the disease progresses, the person may experience delirium, abnormal behavior, hallucinations, hydrophobia (fear of water), and insomnia. The acute period of disease typically ends after 2 to 10 days. Generally, by the time the symptoms appear, it is usually too late to save the patient.

Rabies is a serious disease, but individuals and governments can take actions to control and prevent the spread. These preventive strategies include: Regular ant rabies vaccinations for all pets and domestic animals; bans or restrictions on the importation of animals from infected countries; widespread vaccination of humans in high risk areas, and awareness creation.

Once clinical signs of rabies appear, the disease is nearly always fatal, and treatment is typically supportive. After exposure and before symptoms begin, a fast-acting dose of rabies immune globulin should be delivered as soon as possible, close to the bite wound to prevent the virus from infecting the individual. Also, rabies vaccine should be given to train the body to fight the virus whenever it is exposed.

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