Showing posts with label Basic Child Care. Show all posts
Showing posts with label Basic Child Care. Show all posts

Monday, October 4, 2010

Decision Making and Children Health

Decision making referred to a choice reached after verifying available options to pursue a specific cause –which carried consequences (good and bad). It was as a result of a cost-benefit analysis of having children that a prospecting parent made, rather than making decisions based on urges or feelings because they (urges or feelings) did not think apart from causing excitement.

Attachment denoted the nature of the bond between the mother and the child while level of attachment implied the degree of the existing bond between the mother and the baby or child. And circumstances at conception were merging issues during, or at conception while for environment, experts attribute the term environment to virtually everything visible, invisible, practiced, imagined, or reasoned and about life processes –including man himself, or her self –and all interacting and relating in a certain way with each other.

Children in Uganda have been most marginalized with child-friendly health services only limited to referral hospitals. Elsewhere in the country children share facilities and health care services with adults –an indiscriminate administration of health, yet special care for them was paramount. Direct, structural and institutionalized violence too claims the lives and right morals of children. Domestic violence does not only take the life of one of the parents, but also is psychological violence –moreover the worst a human being can experience that, now, becomes a children affair to deal with or shared experience upon observing parents fight.

Cultural environment –which is discriminative according to gender; never recognizes the rights of children –and the reproductive health rights of women have turned out to be a huge and overwhelming social cost –inclusive of HIV spread and under-development. It becomes a way of life that suffocates the rights of women and children as men behave the way they want as suggested by their cultures.

The economic environment disables parent’s ability to further children’s education, or not even at all affording it, yet it is through child education that the future a community is secured with a productive citizenry. The cycle continues from children dropping out of school and opting to marry or succumbing to wrong and untimely choice to conceive, then the burden becomes a product to be handed over from one generation to another –rendering the talk of children rights a dream.

Now, that way of life is one that begins to dictate the quality of life of a children, level of attachment –where insecurities and future behavioral problems begin, irresponsible parenthood, reckless and risky behaviors of a parents as children observe, low or no health seeking as there will be no money and, ultimately, no motivation to adopt a healthy lifestyle –even when health guidelines are issued –which in turn affects children health, leads to broken family situations, or broken marriage relationships –and which as the saying goes, “if elephants fight it is the grass that suffers,” the consequences accruing from broken-family situation hit children hardest as all the anger gets projected to them in form of abuse and neglect.

And in bid to come out of poverty traps using the much respected cultural or traditional remedy systems, children, still, are the soft target like commodities (without life) to offer to the gods. These are innocent children: why all that? What about the plight children in areas once ravaged by war in northern and north eastern Uganda? How about those affected by annual floods and, in recent years, the landslides? Is our scope of children health catering for that? It is from such grounds that families and communities face accountability for in the child’s teen or youthful years. No shall we have a moral fabric in society, violent free generations because society simply ignores the root causes of structural violence –whose origin is quality of care of children right from conception. And who should save the children of Uganda?

Parenting is, thus, a responsibility one finds himself or herself under voluntarily or involuntary. During adolescence, gradual changes that may be cognitive, emotional, biological, physical and social or environment occur. The qualities of changes are influenced by how well decisions are made at different levels of interaction (cognition, instinct or biology, emotional, social and/or natural environment) in relation to one’s sexuality. It all begins at conception –through important stages of birth, special care of newborns, weaning, and child in playful stage, socialization and learning, gender roles or interests, young stardom, youthful period and adulthood.

Becoming a parent was not only an urge, or by accident as some young women say, but an issue to think about critically before making a decision, not even pressure from elders or traditions counted. It was important to look at children as human capital of the future –through integrating health care, nutrition, and early child care services for young children in developing countries. Problems faced by children in early years, such as stunted mental and physical development and lack of preparation for school set the stage for low academic achievement, high drop out, functional illiteracy, lack of productivity in the work force –and even delinquencies and dependency on society (Young M., 1996).

It did not matter what age of pregnancy, but from the time of conception. But for the purposes of this submission care had to start from the time one started developing feeling to become mother or father, because ultimately the quality of decisions made counted in determination child health. Brain studies demonstrated that early years were critical in the development of intelligence, personality, and social behavior before the age of three. Environment, thus, dramatically affected how the infant brain developed –moreover the impact of early childhood programs on personality and behavior became significant and long-lasting. Indeed childhood education reduced social costs, juvenile delinquencies and drug use (Young M., 1996).

Under difficult or challenging parenting environments, HIV/AIDS emerged as an environment problem as young people and parents were pressured to adopt risky behaviors as means to “survive.” According to Tigawalana D. (Sunday Monitor Sept. 19, 2010), Young people between the ages of 15 and 24 constituted young women as most vulnerable –unexplainable by biological factors, but gender inequalities that existed in African society.

More than 5000 women still died every year in child birth across the globe –with the majority of deaths occurring in developing countries –where health systems were weak or non-functional –and health workers scarce (Lirri, Sunday Monitor July 31, 2010).

In the review on orphans and vulnerable children policy, ministry of gender, labor and social development (2004), 38 of the population lived in absolute poverty –constituting 62% of children. And the number of children living below the poverty line was likely to rise due to high fertility rates, HIV/AIDS, other preventable diseases and insecurity. The causes of poverty included limited access to productive assets (especially women), limited utilization of improved production technologies, large families, alcoholism, unemployment, lack of markets, inadequate opportunities for education and lack of information.

“…so many children in need of education but numbers are so overwhelming. If there’s any support your organization can give us, that’s welcome. Government has given due attention to basic education resulting into substantial increase in enrollment. Unfortunately, there has been decline in primary school retention in the past few years due to high drop-outs."

Geoffrey Muzusa,
Community Development Officer, Jinja

Child care was a cost the prospecting parents needed to think about long before deciding to conceive. In fact, child care began at conception. Pregnancy as physiological stress when various body functions of the mother underwent strain, need an excellent died to keep replenishing the body. With ante natal requiring time, rural areas were located several distances from health centers, so it was less likely that affected parents would visit ante natal clinic as advised.

Yet because of the need for PMTCT, to help the mainly teenagers to conceive safely, and those with height related defects (short parents) associated to difficulty delivery as well as to receive counseling on issues related to physiological reactions of the mother, appropriate dressing of mother and child, appropriate diet, preventive measures against malaria, handling of sibling rivalry and children discipline (Ebrahim G.J., 1971).

While appreciating Ebrahim G.J. (1971) understanding of pregnancy as a physiological reaction, one important component ought not to be underestimated –the psychological implications (e.g. anxiety and depression). Successful child care ought to put that into consideration, otherwise the psychological implications potentially turned out to be the most damaging to the child, or baby. Cumberbatch CJ Eta l (2005) revealed that conditions that were, themselves, psychosocial: anxiety disorders (GAD, OCD, panic disorder, PTSD), mood disorders, and schizophrenia, all of which were a background for a disturbed pregnancy would complicate pregnancy denominated high risk for some other reason.

25% of adolescents became pregnant at 19 as by 2006. Fertility was high at 6.9 children per woman (2001). Contraceptive prevalence rate was at 22.8% in 2001 and 23.7% in 2006. Only 14% of the people were employed in wage employment and the rest in self employment in the informal sector. Females constituted majority of the population at 51%, 32% females at the age of 10 were illiterate, 36% reached primary level, and 18% secondary (National Population Policy for Social Transformation and Sustainable Development, 2008). It was, however, impressive to note improvement in decision making by adolescents as by 2006 could conceive at 19 years. With wage employment at 14% and contraceptive use at 23.7%, the situation was getting better. If decision makers embarked on developing the education sector to have more children complete secondary and train in skills formation, then Uganda would be in a pole position to not only improve livelihoods but make child care as a right real.

Broken-family events are a result of extended family system to stand the test of times (twentieth and twenty first century new world order). As the urge to have children arose as traditionally demanded from the ages of 18 and above or less, the new order, instead, required productivity of prospecting parents before, at all, they decided to have children. Having children is thus no longer fashionable, nor marrying until one’s decision was in agreement with the new order.

Those who are there even when economically liberated will tell you that things are not really good while gaining confidence that God will provide. The question of sustainability of care and love within a family set-up is ignored yet critical. It is, therefore, important that policy makers embark on massive gender-conscious literacy or education program intertwined with aspects that address reproductive health concerns, impart life skills, or vocational skills –all of which empower communities with tools of rightful decision making that go as far as influencing health children development, or for that make transform children rights talk from theory to practice. When structural change is registered, no more shall see Bukedde news paper pictures of sacrificed children or domestic violence, among other concerns.

Jacob Waiswa

Graduate Peace and Conflict Studies Program
Makerere University
P.O. Box 7062,
Kampala-Uganda
jwaiswa@arts.mak.ac.ug

Sunday, January 27, 2008

FACTS ABOUT HIV/AIDS

BY WAISWA JACOB, waiswajacobo@yahoo.co.uk

Introduction

This chapter basically, gives relevant literature about HIV/AIDS and existing relationships between variables of; Positive Living and Resilience, Spirituality and Positive Living, as well as Spirituality and Resilience among Adolescents Living With HIV/AIDS (ALWAs).
HIV/AIDS

Recent studies revealed that HIV/AIDS originated from Haiti . It invaded US from Haiti in 1969, most likely, by a single infected migrant who set a stage for it to sweep the world (Reuters, Washing to n: Wednesday, Oc to ber 31st, 2007, Daily Moni to r pg 7). It has affected mainly the developing world thereby, affecting persons regardless of their sex, race and age. China has about 650,000 people living with HIV/AIDS, (Reuters, Beijing ; 8th November, 2007). In Uganda , initial cases were first recognized twenty-five years ago. It was, as of 2005, estimated that over 1million were infected with HIV/AIDS that has devastating consequences to families and communities (World Bank, 2005: pg 26). Recent estimates show about 1.1 million people living with the virus (Kaiser daily report, Oc to ber 10th, 2007, Kaisernetwork.org). UNAIDS and WHO report (January, 2006) showed AIDS, as having killed more than 25 million people since it was first recognized on December 1st, 1981 -making it one of the most destructive pandemics recorded in his to ry. Twenty-five years after its introduction in Uganda , many children have been left orphans amidst looming poverty and un-productiveness. In 2005 alone, AIDS claimed an estimated 2.4–3.3 million lives, of which more than 570,000 were children. 90% of the transmissions are reportedly through hetero-sexual (Namirembe, 2007).
In respect of HIV/AIDS national sero-survey ( Uganda ), the prevalence increased from 6.1% five years ago to 7.1%. This would, there fore, call for scaling up of interventions to reduce HIV/AIDS prevalence especially among the vulnerable groups ( Republic of Uganda Budget Speech Financial year, 2006-2007).

It is widely believed that Uganda has been one of the most successful Countries in reducing the spread of HIV/AIDS. This was been attributed due to strong political leadership and successful multi-sec to r strategy focused on prevention (World Bank, 2005 pg 26). But, Jinja singly, registered an increase to 20 percent from the previous year’s 18 percent -attributed to declining moral standards among the married women. They (Jinja people) perceived HIV like any other disease as a way of copying with fear (Thursday, May 31st, 2007, Daily Moni to r pg 6).
According to Uganda AIDS Commission (UAC) report (2007), 130,000 got AIDS in 2005, which was an increase from 70,000 in 2003 (Lirri: December 3rd, 2007, Daily Moni to r pg 4). UAC, further reported an increase in the number of people contracting the HIV virus from 132,000 in 2005 to 135,000 last year (2006). The points of concern, according to UAC report (December 2007), are adults above 30 years, the married people and the fishing communities (Nafula: December, 2007, Sunday Moni to r pg 4). Static prevalence was threatening Uganda ’s AIDS success s to ry (Lirri: December 1st, 2007).

As an outcome of the Abuja summit in Nigeria (2001), aimed at addressing the challenges of HIV/AIDS and TB, members saw the need to increase their national budgets by 15% in bid to boost under-funded and corrupt-stricken health sec to r. They agreed to prioritize national resources to fight HIV/AIDS. Oketcho parliamentary report (2007/2008) indicated the budget for health sec to r in Uganda as having been increased from 381B in 2006/2007 financial year to 386B in 2007/2008, (Lirri: May 1st, 2007, Daily Moni to r pg 26).
About 0.6% of the world’s living populations are infected with HIV. A third of these deaths are occurring in sub-Saharan Africa, and consequently; retarding economic growth and increasing poverty. UNICEF, UNAIDS and WHO joint report, showed infection-rates highest in Botswana and Swaziland -where a one in three young woman were infected and; Lesotho and South Africa –where it was one in four.

Current statistical predictions indicate that HIV is set to infect 90 million people in Africa, which would result in to a minimum estimate of 18 million orphans. About 13 million of the 16 million people, who have died of HIV/AIDS, are in Africa . And, 33.6 million people have HIV/AIDS (around the World), 70% of whom live in Africa (Brough, 2000). Sadly, In Africa, nearly 20 million people with HIV are not aware that they have the virus. As a result, the UN health officials called on nations with severe AIDS epidemic to offer routine HIV tests to all patients at public health facilities. 80 percent of the people with HIV in poor and developing countries were ignorant of their HIV status. However; Malawi, Botswana, Kenya and Uganda adopted such a policy as carrying out routine HIV tests in instances -where infection rates exceed 1 percent. Everyone seeking medical care would be offered HIV test regardless of their symp to ms or reasons of seeking care (Agencies, Johannesburg : Friday, June 1st, 2007, Daily Moni to r).

In Malawi , one million people are reportedly living with HIV/AIDS. Urban areas have up to 25% of the populations infected and many more are affected directly or indirectly. HIV/AIDS has been devastating not only to individuals, but also, to their families and communities in which they live. Malawi , as one of the very poorest in the world, has; HIV/AIDS, poverty, malnutrition, and gender inequity cases that have conspired to completely undermine socio-economic development in its new and fragile democracy. Yet, anti-retroviral treatment, which reduces both the mortality and the morbidity of HIV infection, cannot be routinely accessed, and is still not available to all countries (Guardian Unlimited, 2007).

HIV/AIDS and Adolescents

United Nations reported more than 3 billion young represent nearly a half of the Earth’s people. As of March, 2007, Uganda had the youngest population in the World: reported, (Nyanzi, Daily Moni to r reporter, March 15th, 2007). Unfortunately, they were the most vulnerable. Adolescence, being a time for expanding relationships and friendships outside the family circle, establishing greater au to nomy, and for intensified development of interpersonal and social skills could be met with HIV/AIDS to cause distress to them, their families as and communities. How young people develop their understanding of the biological, emotional and social changes they experience in adolescence was closely related to their sense of social identity and purpose, self-perception and self-esteem, thoughts and feelings, and capacity to establish caring relationships and intimacy with others. It would thus, be most important that young people received the necessary guidance and support they need -considering that worldwide, most people become sexually active during this stage of life -whether within or outside of marriage. They, to o, could under go physical, emotional and psychological changes associated with growing up. Actually, men hardly believed grown-up ALWAs whenever they (ALWAs) disclosed their HIV+ status. Men thought ALWAs were trying to get rid of them (Onyalla and Nabusoba: November 10th, 2007, Saturday Vision pg 11). Here, justifying sexual advances on the basis of virginity would cease to help control HIV/AIDS spread.

Use and meanings of the terms ‘young people’, ‘youth’, and ‘adolescents’ vary in different societies around the world, depending on political, economic and socio-cultural context. The following are considered by UNFPA: 1) Adolescents, as 10-19 year olds -with early adolescence at 10-14 and late adolescence at 15-19. 2) Youth, as 15-24 year olds and 3) Young People, as 10-24 year olds. The 1991 Population census showed one-quarter of Uganda’s to tal population as being between the ages of 10 and 19 years while the average age of Ugandans’ 28 million people is just 15.3 years, indicating the largest proportion of children being less than 14 years in the World (a report by the UN population division, 2007). The 2006 revision of the official UN population estimates and projections report titled “World Population Prospects” showed Global average age for the World’s 6.7 billion population as 28 years (released in New York on March 13th, 2007) -with half of those newly infected with HIV each year as under the age of 25 years, globally (Kakaire: Thursday, November 15th, 2007, Daily Moni to r pg 25)

Africa stood out as the only region whose population was still relatively young, and where the number of the elderly population, although increasing would be far below the number of children by 2050. A number of priority areas for joint actions were identified through a coordinated action plan for global STI prevention and control strategy, which involved; seeking support to increase skilled health attendants in target countries as well as developing plans to increase reproductive health, maternal health, new-born baby’s health and adolescent health (Population Headliners, N0. 312, May-June, 2006). One of the One of UNICEF goals is to protect and support Children affected by HIV/AIDS and it was projected that by 2010, it would reach 80% of children most in need. Already, it is estimated that HIV prevalence among girls aged between 12 and 17 is 5%: a notch lower than the national prevalence (in Uganda ) of 7% (Onyalla and Nabusoba: November 10th, 2007, Saturday Vision pg 11).

It was interesting to note, however, that children infected with HIV at birth would survive in to adolescence, overturning previous assumptions that virtually all die before the age of five (Well-come Trust: March, 2007). Researchers, who set out to study the older children arriving at a clinic in Harare, Zimbabwe demonstrated reflected numbers as being significant. Half a million babies were estimated to be infected with HIV at birth or during breastfeeding last year alone (2006) and, as many as one in four would survive in to adolescence (The Guardian: March 12th, 2007).

As for the Ministry of Health in Uganda , estimates of children living with HIV/AIDS indicated 110,000. Out of them, about 50,000 children need accessed anti-retro-viral therapy. But, only 10,000 received it. Globally, Mother-To-Child-Transmission was responsible for 90% of HIV/AIDS among children under 15 years, and every year one million babies were born to HIV+ mothers, of which at least 25,000 get infected with the virus (Lirri: Saturday, November 10th, 2007, Daily Moni to r pg 4). In Uganda, Mother-To-Child mode of transmission was and as of now, the second most common mode of transmission of the virus –accounting for 21% of the new HIV/AIDS cases in the country.

Everyday 1,600 children die of HIV. According to the UNAIDS, over 2 millions children (defined by UNAIDS as those between 0-14 years old), are living with HIV across the World, and 1.9 million of these children lived in the Sub—Saharan Africa. In the World over, 40 million people were reported having HIV and, as the fastest growing infection in the UK and Ireland . It was estimated that 7.3% of reported AIDS cases are children less than 12 years (ACP Surveillance report March, 1999). In 1998, UNAIDS estimated 930,000 Ugandans as living with HIV/AIDS. For adults, the infection rate was estimated to be 9.5%. And, everyday, there are nearly 1,800 new infections in children under 15 mostly due to mother- to -child transmission. 1,500 children under 15 died of AIDS-related illness.

More than 6,000 young people between the ages of 15-24 years are newly infected with HIV. Unfortunately, less than one third of young women between the ages of 15-24 in sub-Saharan Africa fully unders to od how to avoid HIV. Millions of children, adolescents and young people in the path of the pandemic, are at risk and in dire need of protection. HIV/AIDS continues to redefine the very meaning of childhood for millions of children, depriving them of; care, love and affection of their parents, teachers, and other role-models -in the areas of education and options for the future, of protection against exploitation and abuse, (UNICEF report publication, 2005). It was, further estimated that 2.3 million under the age of 15 were infected with HIV and experienced; poverty, homelessness, school dropping-outs, discrimination, loss of life opportunities, and early death.

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