The issue of exclusive breast-feeding for the first year has been an area of confusion for many mothers in developing nations, especially following the marketing practices of many formula companies to push products in a misleading manner, an issue about which I have previously written.

However, for mothers who are HIV-positive, especially in sub-Saharan Africa, exclusive breastfeeding is the most practical option.  According to a large African study Kesho Bora, placing HIV-positive mothers on a combination of three antiretroviral (ARV) treatments during pregnancy, delivery and breastfeeding cuts HIV infections in infants by 43 percent by the age of 12 months, and reduces transmissions during breastfeeding by 54 percent.  The African study and practice comes into direct conflict with the World Health Organization’s (WHO) 2006 recommendations, which advises that ARV drugs be given to mothers only through the time of delivery.

Yet the WHO 2010 guidelines recommend exclusive breastfeeding with an ARV treatment intervention for the first six months of a child’s life to reduce transmission, and continued breastfeeding, with formula or other foods, until the child is at least a year old.  Alternatively – where it is acceptable, feasible, affordable, sustainable and safe – WHO recommends complete avoidance of breastfeeding.  The biggest problem has been that the latest guidelines on infant-feeding options for HIV-positive mothers in Africa have not been disseminated in many countries, leaving women confused about the best nutritional path to protect their children from contracting the virus, and therefore leaving infants at greater risk.

 ”The six months of exclusive breastfeeding is what is crucial for mothers to understand – that not doing it is what raises the child’s HIV risk; but we are finding that while many countries have officially adopted the WHO guidelines, they have not trickled down, and health centres, policy-makers and communities are still unclear on what advice to give mothers,” said Aditi Sharma, of the International Treatment Preparedness Coalition (ITPC), and coordinator of  the report The Long Walk: Ensuring comprehensive care for women and families to end vertical transmission.

Another view can be found in a new report by community health workers from Cameroon, Cote d’Ivoire, Ethiopia and Nigeria, that was launched at the 16th International Conference on AIDS and STIs in Africa (ICASA) in Addis Ababa, Ethiopia. Research found that prevention of mother-to-child transmission programs were focused too narrowly on the provision of ARVs to HIV-positive pregnant women, rather than more comprehensive approaches that involved family planning, maternal healthcare and exclusive breastfeeding.

It is clear that a clear and concise plan must not only be established but promoted on a global scale by all development agencies to ensure that mothers and children are safeguarded and a sustainable effort to lower HIV transmissions is in our future.   According to the International Treatment Preparedness Coalition (ITPC), more in-depth delivery prevention of mother-to-child services in Africa are greatly needed.

“Countries must ensure that policy filters down to the women in all aspects of PMTCT – from HIV prevention for women to family planning, to the best ARV prophylaxis option to proper infant feeding to proper healthcare for the mother, child and family,” Aditi Sharma, Co-Coordinator of the Treatment Monitoring and Advocacy Project (TMAP) said. “It is the only way we can achieve the 2015 targets of reducing vertical transmission by 90 percent (IRIN).”

Polio climbs in Nigeria, spreads to neighboring countries
Polio is spreading throughout Nigeria at a time when the success of polio eradication in Africa rests on Nigeria stopping the virus, according to the World Health Organization. Observers in the country’s Kano State, which has recorded 16 new polio cases and accounts for nearly half of a fourfold increase nationwide, blamed the rise there on a lack of funding and commitment by the state’s 44 local governments.

New lanterns, cookstoves for poor Indian women
More than 200,000 members of a trade union for poor, self-employed women in rural India will be provided with energy-efficient cookstoves and solar lanterns over the next three years in what is being billed as one of the world’s largest clean-energy projects. Lars Thunell, head of International Finance Corp., which will guarantee loans from local banks to the women, said the initiative will “help low-income households increase savings and cut expenses for firewood, kerosene and electricity.”

Unite for Girls tours California
Young girls are leading the Unite for Girls campaign across California this month in a bid to raise awareness on the challenges girls in developing countries face on issues related to education, health care and gender inequality. The program, part of the United Nations Foundation’s Girl Up campaign, aims to promote equal opportunities for girls in developing countries.

Fate of child brides goes prime time on Turkish TV
A two-minute trailer for a highly anticipated Turkish soap opera focuses on the fate of a 15-year-old girl from a poor family in the region of Anatolia who is married to a 70-year-old man. The soap opera, which is scheduled to debut Friday on Turkish television, coincides with the release next week of a documentary film, “Child Brides,” following a women’s rights group’s 18-month information and awareness campaign in a country where every second woman was married off as a teenager. 

India faces scourge of bridal slavery
Women’s and children’s rights activists are sounding the alarm over the abuse of young girls as part of a growing trend for bridal slavery. Young girls are sold into marriage for as little as $120, then forced to work as day laborers and sex slaves to the men who purchase them.

UNICEF expresses concern for Somali children
Drought-affected Somali children are facing additional risk from intensifying armed conflict and sexual violence, UNICEF warns. The number of children killed due to fighting doubled in October and will probably rise even further, UNICEF officials said.

Women in Cameroon protest rapes, assault in land dispute
Ongoing attacks by herdsmen on farmers in a dispute over grazing rights in northwest Cameroon have led to protests by thousands of women, who are refusing to return to the fields until they are protected from rapes and assaults. An 11-year-old girl talked to a reporter about narrowly escaping a sexual assault by two herdsman.

UNICEF seeks additional help for East Africa famine
UNICEF has issued an appeal for $30 million in additional donations before the end of November to maintain aid to hundreds of thousands of children affected by famine in East Africa. Kenyan and Somali officials have reported increased violence in the region and clashes with al-Shabab militants that further complicates aid efforts.

Afghan child bride is denied a divorce despite abuse, beatings
In an interview, a rural Afghan woman who was given, as a 6-year-old girl, to a man and his extended family — along with eight of her sisters and female cousins — talks about the beatings and abuse she sustained after she was married to a considerably older man at the age of 12. She ran away while still a teenager after several suicide attempts.

Women can lead Pakistan’s pneumonia fight
Pakistan’s 90,000 “Lady Health Workers” may hold the key to the country’s battle against pneumonia, the world’s largest killer of children under five, according to a study published in The Lancet medical journal. The study found that children are more likely to recover if treated at home rather than a health facility.

Raids are rescuing girls trafficked to brothels in Cambodia
A raid on a brothel in northern Cambodia has unmasked the underlying rape and child abuse against young girls as young are trafficked and forced into prostitution. The raid was carried out with the participation of Cambodian author and anti-trafficking advocate, Somaly Mam, whose memoir, “The Road of Lost Innocence,” recounts being sold into prostitution in Cambodia, then escaping.

Groups struggle to combat Somali gender violence
Women’s rights advocates are raising the alarm over a sharp increase in gender-based attacks on internally displaced Somali females in the Mudug region as a result of a deteriorating security situation and a lack of accountability. Women’s groups are reaching out to religious leaders and community elders as part of campaigns to raise awareness about the issues.