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Trump Policy on Transgender Uninformed, Reckless and Unwarranted

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Trump Policy on Transgender Uninformed, Reckless and Unwarranted

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By Robert Aseda, (Varaq)

A few weeks ago, Donald Trump, the US president, in his usual style, made a very important public policy declaration on social media: the banning of transgender soldiers from American Army arguing that their inclusion somehow makes the US Army unfocused and disrupted from their main agenda. He further argued that they are expensive to maintain due to the astronomical medical costs involved; Claims that are not only factually untrue and not based on any scintilla of evidence, but are misguided, inflammatory and likely to cause severe physical, emotional and psychological anguish not just to the US Transgender soldiers but to the lesbian, gay, transgender and queer community throughout the globe.

America may be so far away, but this declaration will have ramifications the world over. Like the Biblical city on the hill, which opens its light for all to to see, America definitely plays a huge role in defining global policy on a number of issues. 

Of course it defeats logic for one of the most powerful people on earth to insinuate that somehow who you are or who you love could make you incompetent or render your services and sacrifices unwanted and unappreciated.

Worrying still scrolling through the comments on social media, a huge percentage still felt this action necessary and timely, despite the exclusionist and segregationist agenda that it seeks to spread.

Whereas very unfortunate and grossly misinformed, this ill advised declaration has opened a very important discussion not just on the specific rights of trans soldiers but on the not so discussed and often misunderstood issues of sexual orientation and gender identity.

Gender and sexual minorities including the LGBT community have continued to face untold misery, discrimination and violence due to how they identify or who they love. In his first report to the Human Rights Council, the United Nations Independent Expert on Protection against Violence and Discrimination based on Sexual Orientation and Gender Identity, narrated how throughout the world, this community still face major human rights violations including denial 0f access to crucial services including healthcare, justice, education, security among others.

“Even though human rights are inherent to everyone and propel protection for all persons without exception, regrettably persons with an actual or perceived sexual orientation and/or gender identity diverging from particular societal norms are at times targeted for violence and discrimination including killings, rape, mutilation, arbitrary detention, mental health assault and bullying from a young age, ” a section of the report reads.

It’s very important to remind ourselves, that there’s more to a person than who they love or how they identify themselves. But more fundamentally, the Universal Declaration of Human Rights, the founding human rights law, reminds us that everyone is entitled to all the rights and freedoms without distinction of any kind, such as race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status. The deprivation of a right hinders fulfillment and enjoyment of other human rights.

We may not agree on a number of issues, but we definitely agree that exclusion, discrimination and violence has no place in the 21st century. Not just because it is against international and national instruments, but also because it has no benefit whatsoever, other than entrenching further inequalities.

In many countries throughout the world including Kenya, despite constitutional provisions to non discrimination, the penal code still propagates discrimination and violation of human rights to dignity, association, the right to recognition everywhere as a person among several others. During the last Universal Periodic Review Cycle, Kenya committed to developing a comprehensive anti-discriminatory law. It’s time to walk the talk.

If we are to realize the Kenya and the world we want; if we are to realize Vision 2030 and the global Sustainable Development Goals; then we can’t afford to leave anyone behind, for any reason, the least being sexual orientation and gender identity.

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Non-Communicable Diseases Impoverishing Families

Non-Communicable Diseases Impoverishing Families

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Daniel Otieno

Youth Advocate, Network for Adolescents and Youth of Africa, Naya Kenya.

Much is spent on treating non-communicable diseases and more disturbing is that the spending may be in a life time as some non-communicable illnesses are not curable. There are fears that by 2020 non-communicable diseases may double communicable diseases in developing countries. Kenya is recording progress by availing drugs for the treatment of breast cancer in Kenyatta National Hospital and also setting referral hospitals as well as equipping them with treating equipment.

 

A major challenge, however, is the limited financial allocations to the health sector, Limited prioritization of prevention of non-communicable diseases and inadequate implementation of policies relating to elimination of non-communicable diseases. A good example is the national school health policy that targets the elimination of non-communicable diseases among school going children. Non-communicable diseases impact negatively on the economy of households. Eliminating non-communicable diseases begins with setting a health financial strategy. This will ensure adequate money is allocated for treatment and setting screening equipment in public health facilities.

 

This will make treatment affordable. Prioritization of non-communicable diseases should also take equity in resource allocation. Persons in marginalized areas should be able to access affordable treatment, services, and information on non-communicable diseases.  Policies that will promote screening on NCDs at the community level will also increase the number of people seeking treatment. This will promote the preventive aspect of non-communicable diseases. Policies implementation also includes making effective the national school health policy which will enable reduction of non-communicable diseases among children. Finally public and private partnership will subsidize the cost of treating non-communicable diseases. In allocating resources for treating non-communicable diseases, let us strike a balance in prevention and curative aspects of non-communicable diseases.

 

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Equal Distribution Of Health Resources Will Enable Reduction Of Noncommunicable Diseases Within Counties

Equal Distribution Of Health Resources Will Enable Reduction Of Noncommunicable Diseases Within Counties

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By Daniel Otieno.

Network For Adolescents And Youth Of Africa, Naya Kenya

Photo Courtesy: internewskenya.org.

The promulgation of Kenya constitution in 2010 made health a devolved function. Through this devolution, each county was to manage its own health system with resources from the national government. However, Kenya counties still lack adequately trained health workers and drug supplies needed to manage the provision of health services including prevention of non-communicable diseases. The Abuja declaration requires each country to allocate 15% of its national budget to the health sector.

 

However, Kenya’s allocation to health is still below the target. A limited number of health workers, a few screening equipment, cost of treatment, unequal distribution of resources among counties and limited drug supply are responsible for increased cases of non-communicable diseases. Marginalized areas bear the greatest burden of non-communicable diseases due to poverty, distance to health facility, adherence to drugs and lack of efficient health services. In addition, there has also been limited implementation of national school health policy that is to address noncommunicable diseases among learners.

 

According to world health organization, cardiovascular disease, cancer, diabetes and respiratory diseases are the major non-communicable diseases that negatively impact on individual health. Poverty at county level not only increases the prevalence of non-communicable diseases due to poor nutrition or unhealthy eating habits but also poor health seeking behavior’s that are characterized by a delay in screening. Reducing the prevalence of non-communicable diseases at the county level will contribute to reduction at the national level. In order to achieve this, we must first identify needs of the counties in relation to prevention of non-communicable diseases, for instance, the capacity of medical personnel, availability of drugs and screening equipment. Secondly, we must ensure the limited resources are prioritized to provide the minimal standard of services required.

Immediate allocation of 15% of national budget to health may not possible but we can have a starting point and make it progressive. Progressive reduction of noncommunicable diseases at the county level will then lead to a reduction in the national prevalence of non-communicable diseases.

 

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Early Education Best Way to Protect Young People from Non-Communicable Conditions

Early Education Best Way to Protect Young People from Non-Communicable Conditions

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Daniel Otieno

Published by the standard on May 8, 2017.

Image courtesy: Aga Khan Foundation

There is need to sensitize young people on how to prevent non-communicable diseases. This is because diseases such as cancer and heart conditions can be prevented if treatment is sought early or if healthy eating habits are adopted. The world Health Organization identifies cancer, diabetes, and respiratory and heart conditions as the four main non-communicable diseases. Poor eating habits, use of alcohol and tobacco, and lack of exercise are the main causes of these conditions. In 2009, the Ministry of Education adopted the national school health policy, with one of the targets being reducing the prevalence of non-communicable diseases among school children.

The policy has been instrumental in ensuring that smoking zones and bars are away from learning institutions. Physical activity has also been made part of the curriculum. School feeding programs should be accompanied by sensitizing on healthy eating habits and learners should be encouraged to always eat healthily. It is a reality that all young people prefer junk food that is often rich in cholesterol, thereby increasing chances of obesity and heart problems.

Secondly, there is need for more awareness on drug abuse and its role in cancer and respiratory diseases. Due to peer pressure, affordability and availability youth have fallen prey to drug and substance abuse. Preventive education would, therefore, reduce cases of cancer and respiratory diseases. Physical education should also incorporate sensitization on good health including fighting obesity and stroke. Peer education should also be encouraged to increase information flow on non-communicable diseases among children.

 

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Breast Cancer drug a step in the right direction

Breast Cancer drug a step in the right direction

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By Daniel Otieno, Nairobi

Friday, March 31, 2017, DAILY NATION

Breast cancer survivors will now be receiving their free dose of medicine at Kenyatta National Referral Hospital. This is thanks to the efforts of the government and advocates of resource allocation towards the treatment of cancer and other non-communicable diseases.

But as the government makes Herceptin, the breast cancer drug, available, it must also focus on sustainability of the program. It should encourage competition in the medical field by ensuring county governments have a greater role in training medical personnel.

Health workers’ role in the program cannot be underestimated. They must be motivated through refresher courses, incentives and an enabling environment that includes the availability of screening equipment.

The community, particularly the youth, must be sensitized and motivated to adopt health-seeking behaviors, including an early screening of cancer. The national school health policy, which, among other things, targets elimination of non-communicable diseases among learners, should be implemented.

Besides increased financial allocations, the state should also strengthen referral mechanisms to other public health facilities. Sensation should target everyone, including hoteliers, as young people who consume junk food and develop cardiac problems and obesity is their kin.


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Breast Cancer drug offers reprieve for many patients

Breast Cancer drug offers reprieve for many patients

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By Daniel Otieno, Nairobi

Friday, March 31, 2017, The Standard

Survivors of breast cancer now have a reason to smile as they receive their first free dose of medication from Kenyatta National Hospital. This is thanks to efforts by the Government and everyone who has been advocating for resource allocation for the treatment of cancer and other non-communicable diseases. As we make Herceptin, the breast cancer drug, more readily available, we must also focus on the sustainability of free cancer treatment. How? By encouraging competition in the medical field and ensuring that county governments have a greater role in training medical personnel.

The role of health workers in the implementation of free cancer treatment cannot be underestimated.We must motivate health workers through refresher training, good incentives and enabling environments that include the availability of screening equipment. In addition, young people, in particular, must be sensitized and motivated to adopt health conscious behaviors including early screening for cancer.

We must use this opportunity to implement school health policies that, among other things, target the elimination of non-communicable diseases including cancer among learners.The community must be educated on the benefits of seeking treatment early, healthy eating habits, physical activity and avoiding drug and substance abuse. Finally, the availability of cancer drugs should not stop with Kenyatta hospital but extend to other counties. We must also strengthen referral mechanisms to ensure that cancer survivors in other counties are able to seek specialized services in public health facilities. Sensitization should target everyone.


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Enact National School Health Policy Urgently

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By Daniel Otieno (Network For Adolescents and Youth of Africa)

Sunday, March 12, 2017, The Standard

In 2009, the government through the Ministry of Education in partnership with the Ministry of Public Health and Sanitation launched the national school health policy.

This was in recognition of the numerous health and other social challenges identified among young people. Key among the challenges identified was disease prevention and control, including prevention of non-communicable diseases.

The World Health Organization information series on school health: Document 2 identifies tobacco use, behaviors that result in injury and violence, alcohol and substance use, dietary and hygienic practices, sedentary lifestyle and sexual behavior as major contributors to mortality, morbidity, and disability among the age group of 5-18 years. The development of national school health policy was therefore meant to promote health seeking behavior and enhanced knowledge on the linkages between environment and health. Progress has been made in some thematic areas, for instance, nutrition. However eliminating non-communicable diseases still experiences hitches.

Keeping tobacco and alcohol joints away from learning institutions will also reduce cases of drug abuse. We also promote healthy eating habits through improved programs.


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WHAT WE SHOULD BE TALKING ABOUT; BUT WE NOT

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By Michael Oliech Okunson (@MikeOkunson)

Image Courtesy: afromum.com

Abortion is a medical process of ending a pregnancy and is also known as termination of pregnancy. It is estimated that 1 in 3 women in the world will have an abortion in her life time.

There are two types of abortion; safe abortion is the termination of pregnancy by a well-trained, recognized, professional and licensed person/doctor at a medical facility while unsafe abortion is the termination of pregnancy by unskilled person or in an environment that does not conform to minimal medical standards.

It is estimated that 42 million women and young girls worldwide with unintended pregnancy choose to have abortions and half of all these abortions are unsafe. Furthermore 68,000 women die of unsafe abortion annually in the world making unsafe abortion as one of the leading causes of maternal deaths. Most of these deaths occur in sub-Sahara Africa Kenya included. Moreover, according to the World Health Organization, every 9 minutes in a developing country, a woman will die due to complications arising from unsafe abortion.

In Kenya some of the unsafe abortion methods include drinking toxic fluids such as detergents, inserting sticks and hangers in the vagina or cervix and inserting inappropriate medication in the vagina. Quacks also perform unhygienic abortion hence causing infection in the womb.

Restrictive laws against abortion and lack of access to contraception services and information are some of the factors that has contributed to the high cases of unsafe abortion. In Kenya Abortion is not permitted unless, in the opinion of a trained health professional, there is need for emergency treatment, or the life or health of the mother is in danger, or if permitted by any other written law (Article 26 of the Kenya constitution).  Furthermore 70% of all pregnancies in Kenya occur to women who are not using any form of contraception.

If we are to achieve the sustainable development goal number 3 which recommends to ensure healthy lives and promote well-being for all at all ages, then we must end unsafe abortion. Unsafe abortion is easiest preventable cause of maternal deaths.

Preventing unintended pregnancies should be a priority for Kenya if we are to end cases of unsafe abortion. This can be done through both the national and county governments investing more in comprehensive sexual and reproductive health services and information. When people have access to correct, accurate, affordable and quality sexual and reproductive health information and services, they are more likely to delay their first pregnancy. Also providing women with better access to affordable and quality safe abortion services can help reduce maternal deaths caused by unsafe abortion.

Amending laws that are against abortion can also help reduce abortion mortality. By amending the law to only allow skilled practitioners to practice safe abortion services will discourage people from going to quacks.

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Let’s Implement Adolescent Sexual and Reproductive Health Policy

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By Michael Oliech Okunson (@MikeOkunson)

 

Adolescent account for 24% of the Kenyan population. They face severe challenges to their lives particularly in relation to their sexual and reproductive health as they transition to adult hood. High cases of HIV infection and unintended pregnancies are some of the main problems young people face in Kenya.

According to the National Aids Control Council, one in five young people aged 15 to 24 years reported sexual debut before the age of 15 years. New HIV infection among girls between the age of 15 to 19 years stands at 70% and for young boys in the same age group it stands at 30%. 13,000 new cases of HIV infection are among children below the age of 14 years. Comprehensive Knowledge on HIV prevention is very low among the adolescents. Moreover AIDS is the leading cause of morbidity and mortality among the adolescents and young people in Kenya. In 2014 alone 9,720 adolescents and young people died of AIDS.

In addition, according the Kenya Demographic Health Survey 2014 one in five girls aged 15 to 19 years have begun child bearing and 47% of these pregnancies are usually unintended leading to school dropout, unsafe abortion and serious health complication which may lead to maternal death. Maternal mortality is the leading cause of death among adolescent girls and young women in Kenya. Furthermore Adolescent girls and young women account for 70% of all pregnancies in Kenya.

Number don’t lie at all. The Kenya National Examination Council released data of young people in secondary schools and majority of these young people are between the age brackets of 15 to 19 years. This means one of the most vulnerable group in Kenya and are found in secondary schools.

We need age appropriate comprehensive Sexuality education in our school. When young people have correct, accurate and the right information about sexual and reproductive health, they will be able to make informed choices on their sexual behavior, delay sex, reduce multiple sex partners, use a condom during sex hence preventing STIs and unintended pregnancies, and choose whom to have sex with and when to have sex. Comprehensive sexuality education is the key to ending new cases of HIV infection and unintended pregnancy among young people. Knowledge is power.

Comprehensive sexual and reproductive health education is a human right and everyone is entitled to it. Article 35 of the Kenyan Constitution states that every citizen has the right of access to information held by the State and information held by another person and required for the exercise or protection of any right or fundamental freedom. Every person has the right to the correction or deletion of untrue or misleading information that affects the person.

One of the key objective of the National Adolescent Sexual and Reproductive Health Policy that was launched by the ministry of health in 2015 was to increase access to adolescent sexual and reproductive health information and age appropriate sexuality education. We Call upon both the national and county government to implement this policy to the latter.

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Adolescents are Too Important To Be Ignored

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By Michael Oliech Okunson (@MikeOkunson)

Over 9 million Kenyans are adolescents aged 10 to 19 years. In Kenya adolescents face many sexual and reproductive health challenges such as early pregnancies, STIs and HIV. According to the Kenya Demographic Health Survey 2014, 11% of girls and 20% of boys aged 15 to 19 years started to have sex before the age of 15 years. The unmet needs of contraception among young girls between the age of 15 to 19 years stands at 20%. Furthermore 20% of girls in this same age group have begun child bearing and most of these pregnancies are usually unintended. New HIV infection among boys and girls between the age of 15 to 19 years stands at 70% for girls and 30% for boys. Moreover 23% of adolescents aged 15-to 19 years know their HIV status and out of those aged 10 to 19 years, 105,680 are in need of ART. Comprehensive knowledge of HIV among the adolescents is very low.

Inadequate access to Comprehensive sexuality education and access to quality, affordable, youth friendly and stigma free sexual and reproductive health information and services has contributed to the rising cases of unintended pregnancies and new case of HIV infection.

Comprehensive sexuality education empowers young people to make healthy choices and decision about their sexual behavior. Global evidence shows that this program helps young people abstain or delay sex, reduce the frequency of unprotected sex and the number of sexual partners which helps reduce the spread of HIV. Moreover Comprehensive Sexuality Education increases the use of contraception among young people to prevent unintended pregnancies, sexually transmitted infections and helps delay that first birth to ensure a healthier mother and a safer pregnancy in future.

In addition to education access to youth friendly health services are very important to young people because they help young people address a range of sexual and reproductive health needs. The services should always be available, accessible and affordable so that young people can use these services. They should also be acceptable to all youth and the staff in these facilities should be well trained to provide services with privacy, confidentiality and respect.

On the 3rd of September 2015 the ministry of health launched the Revised National Adolescent Sexual and Reproductive Health Policy to reaffirm its commitment to ensure that adolescent have access to comprehensive sexuality and reproductive health services and education/ information. The objective of the policy are: to promote adolescent sexual and reproductive health and rights, increase access to adolescent sexual and reproductive health information and age appropriate comprehensive sexuality education, reduce STIs and HIV, reduce unintended and early pregnancies, reduce harmful traditional practices, reduce drug and substance abuse and to address the needs of marginalized and vulnerable adolescents.

County and national government need to prioritize implementation of the policy by allocating resources  to strengthen capacities of institutions, service providers and communities to provide appropriate information and services.

Reproductive health is a crucial part of general health and a central feature of human development. Just like a tree adolescents go through many transition as they mature to adulthood. Investing in their sexual and reproductive health will enable them stay healthy. When right policies and programs are implemented to the later, we will ensure that young people live successful lives and ensure social and economic development.

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