Transcript IYCF activities

IYCF activities: perspective in
Bangladesh
Dr. S.K.ROY
Senior Scientist, ICDDR,B
&
Secretary, BBF
Dhaka, Bangladesh
Welcome to the
World of Breastfeeding
IYCF in Bangladesh
- survival
- nutritional status
- growth
- development
of infants and young children.
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Successful development in Bangladesh
1980’s -BF promotion
Ratified global commitments to IYCF
1981- WHA passed the resolution on the
International Code of Marketing of BMS
1984- passed
1989- CPPBF
1991- A national conference on
breastfeeding in led to the Dhaka
Declaration- &
A pledge for the protection, promotion
and support of BF signed by the
President and PM
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Cont…
1991- BFHI
1992 WBW observed
1993- Amendments of BMS
1995 -MOHFW introduced BINP
2001-Maternity leave law
2003-Recommended EBF was extended from 5
months to 6 months
• BBF –central office headed by CEO, 7 PM
and other support staff.
• A 15 member BOT govern the foundation and
7 SC provide technical support.
Formulation of strategy
• The MOHFW need for improving
BF and CF practices
• Initiated the development of the
National strategy for IYCF
• The process began in 2004
convened by IPHN with
collaboration WHO and UNICEF.
Goal & objectives
To improve
- the nutritional status
-growth and development
-health, and survival of infants
and young children.
Cont…
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Specific objectives achieved by
2010, are:
Early initiation of BF -from 24% to
50%
Increased EBF rate 42% to 60%
Continued BF-90% of children aged
20-23 months
50%(CF) of children aged 69months receive appropriate CF
Strategies
• The priority strategies for IYCF in
Bangladesh fall into 4 categories:
• Legislation, Policy and standards
• health system support
• Community –based support
• IYCF in exceptionally difficult
circumstances
Legislation ,policy & standards
• Strategy 1:Code of marketing of breastmilk substitutes
• Strategy 2:Maternity protection in the
workplace
• Strategy 3:Codex standards
• Strategy 4:National policies and plans
Health system supports
• Strategy 5: BFHI
• Strategy 6:Mainstreaming and
prioritization on IYCF activities
• Strategy 7: Knowledge and skills of
health service providers
Community based support
• Strategy 8: Community based
support for IYCF
• Strategy 9:IYCF in exceptionally
difficult circumstances
World situation at a glance
Source: www.childinfo.org/eddb/brfeed/index.htm
GLOBAL
bar indicate year 1990 and
bar indicate year 2000
Source: www.childinfo.org/eddb/brfeed/index.htm
Breastfeeding status in 2006
Exclusive Breastfeeding Rates
Non NNP areas
60%
NNP areas
86%
Colostrum Feeding
90%
Baby Friendly Hospitals
498
(out of 550)
Maternity leave
4 months
Code for the marketing of breast milk substitutes
Violation in place
Infant Feeding Situation
• Exclusive Breastfeeding Rate:
Under 6 months 56%
• Initiation with in one hour after birth:
51.8%
• Complementary feeding at 4 to 5 months:
23%
• Continuing breastfeeding upto 1 year:
90.5%
• Continuing breastfeeding upto 2 year:
75%
Source:Surveillance study by BBF:2005
BBF goal & objective
Goal• lower morbidity
• Mortality of
children
• Improve the
nutritional status
of women
Objective• To ensure Exclusive
Breastfeeding upto 6
months
• To improve (CF)
practice after 6
months and continue
breastfeeding upto 2
years
• To improve nutrition
of pregnant and
lactating mothers
Activities of BBF
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Awareness building and social mobilization
Training
Community Development through MSG
BCC and Advocacy
Curriculum development
Hospital development through BFHI
Empowerment of women through gender
sensitization
• Counseling of antenatal and postnatal mother
Action/Achievements
• THE BREAST-MILK SUBSTITUTES
(REGULATION OF MARKETING)
ORDINANCE No. XXXIII of
1984
has been enforced.
• Dhaka Declaration, signed in 1991, on protection,
promotion and support of breastfeeding - by
Honorable President Abdur Rahman Biswas and Honorable Prime
Minister
• Extension of paid maternity leave for working
women from 3 months (6 weeks before & 3 weeks
after delivery) to 4 months (after delivery)
on 9 July, 2001
Legal Action on BMS Code
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Three milk companies were sued and fined by the court
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Two companies withdrew their products after sending legal notice
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Five companies changed their products label after sending letter from
BBF
Action in last one year
BBF observed
2nd National Conference on BF & CF (IYCF)
2006
Theme
Breastfeeding and complementary feeding:
Cornerstone for National Development and
the way to achieving MDGs
Summary
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Inaugural Total Participants
Total Registration
Total Organizations
Professional Categories
Total Plenary Session
(Speaker)
• Symposium
(Speaker)
• Scientific Session
• Participants : Professionals Group
700
511
44
35
10
20
4
14
7
Topics of Plenary session
• Breastfeeding Movement – global – History-Now –
National
• IYCF – global Strategies Regional Situation
• BMS – Code Status – global –Regional
• BF – SNL
• Complementary feeding
• New WHO Child Growth Chart - BF
• Maternal Institution optimizing
• Mother Support activity – global/National
• Revitalization and Sustainability of BFHI
• 2nd Child Survival Revolution
Topics of Symposium session
• Breastfeeding Challenges/Opportunities
IYCF – in NNP
• IYCF – Policy/Legislation
IMCI – IYCF
Food Safety – Food Hygiene
• IYCF Breaking Double Burden of
Malnutrition Early Childhood Development
• Childhood Obesity
Food Base Dieting guidelines
IYCF : Way forward of Bangladesh
Scientific session
Excellence of Breastfeeding
Exclusive Breastfeeding
Complementary feeding
Program issues on IYCF
Staff Development Session
(IYCF, Code MSG).
Breastfeeding and Infection/code
Maternal Nutrition and Breastfeedin
Infant and Child Nutrition
Outcomes
To review where we are on global
perspective
• Make awareness on BF, CF, MN
• New prescriptive WHO Growth
Standards
• HIV & infant feeding guidelines.
• Exchange ideas with International
Experts
• Endorsement of Policy Makers,
DP’s,UNICEF, WHO, Stakeholders,
Scientists, Health Service providers and
NGO’S
Action: Awareness building
• Mass awareness increased by commitment of GO,
NGOs, donor agencies and in the electronic and
print media
• Observed World Breastfeeding Week (WBW) in
collaboration
with GO and NGOs over the last 13 years
• National conference on review of BFHI involving
the policy makers and program managers of PHC as
well as the renowned peditricians and
Gynnaechologists
• BCC materials on child nutrition, BF promotion and
MN have been distributed to stakeholders, 498
BFHI and 52 NNP UZs
Action: Training
• Transformation of 30 hospitals (out of 550)
into Baby Friendly (88 %)
• Trained more than 600 health care providers
on the management of BF
• In addition trained 1000 internee doctors on
BF and 500 intern nurse on same issue
• Provided refresher training to 200 doctors
and nurses of different BFH in Bangladesh
• Journalists have been trained up and their
actively engaged in monitoring and follow-up
of BFHI
Action MSG
• Trained 26 core trainers of
MSG formation in 13 NNP
UZ
• Provided refresher training
for 46 core trainers in 23 UZ
• Provided training for 2265
CNO/CNPs on MSG
• Oriented 27465 MSG
members by forming 1831
MSG groups
• Developed resource book
and training booklet for
MSG formation
Four strategy for
completion of
IYCF activities
Nutrition throughout the cycle
Triple A process
Nutrition Triangle
Food Security
Caring practices
Disease control
Task ahead on IYCF
• More 152 Maternity Health facilities have to be
converted into Baby Friendly
• Establish BFMCs in more BFHs
• Implement Mother Support Group (MSG) activities
in 105 NNP upazilas.
• The programme on HIV and breastfeeding will be
updated.
• Develop module of crèche establishment
• Strict monitoring, reporting and urgent legal action
for violations.
• Develop course curriculum on CF on the basis of
IYCF and Maternal Nutrition
Cont..
• There will be a 4 in 1 training programme by
inclusion of BF,CF, MN and HIV & breastfeeding
• Develop and revise policy and legislation on
IYCF and MN.
• Continuous advocacy activities at all level on the
values of IYCF
• Translate Infant and Young Child Feeding
strategy into action.
• Adapting HIV and (IYCF) practices on the basis
of WHO/UNICEF guidelines and “National
Strategy on IYCF in Bangladesh”.
Challenges of IYCF and MN nutrition
programme
• The sustainability of BFH at all levels
• To monitor and revitalize BFHI hospitals
• Monitoring and implementation of the code
for marketing of BMS.
• To improve EBF to over 95%.
• To improve maternal nutrition status to an
acceptable level
• Meeting the targets of second child survival.
• To develop an effective Programme to
improve maternal malnutrition
Opportunities
• BBF is a nodal agency for BF activities having a
secretariat
• Countrywide general awareness on the importance
of BF
• BBF maintains a strong national & international
network
• GoB commitments through Dhaka Declaration,
direct support through NNP and MOHFW
• Legislation on BMS Code
• Legislation on four months maternity leave
• Government endorsement on EBF for 6 months
(180 days)
Global Opportunities
• Breastfeeding identified as a key
intervention to meet the MDG (UN)
• EBF can reduce 13% and proper CF
can reduce 6% of child mortality Source:
LANCET 2000
• Global IYCF policy (WHO/UNICEF)