Transcript Introduction - IBFAN) ASIA

Infant and Young Child Feeding
Current Situation
BHUTAN
South Asia Breastfeeding Forum-3.
20-22 Nov. 2006. Kabul, Afghanistan
Infant and Young Child Feeding
practices
Indicator
Existing status
1.
Percentage of babies breastfed within one hour of birth
81%
(hospital based) (only
24% institutional
delivery )
2.
Percentage of babies exclusively breastfed for 4 months.
42% (National health
survey, 2000)
3.
Duration of breast feeding.
28 months
(Bohler et al ,95
Situation Analysis)
4.
Age at introduction of complimentary foods
No data available but
anecdotally very early
introduction.
South Asia Breastfeeding Forum-3.
20-22 Nov. 2006. Kabul, Afghanistan
Protein Energy Malnutrition status in under 5
(1999)
Indicators
Prevalence
Weight/Age
Height/Age
Weight/Height
South Asia Breastfeeding Forum-3.
20-22 Nov. 2006. Kabul, Afghanistan
18.7 %
40 %
2.6 %
Coordinating Mechanisms
Achievements
Progress
National breast feeding committee
formed 2000
Never met, transfer of members
Sensitization of all parliamentarians on BF
policy
One time activity with no
reinforcement
BFHI strongly advocated 1993. JDWNR
Hospital declared baby friendly
No monitoring. Baby friendly
status not expanded to other
hospitals
Adopted SAARC code for protection on
BF and YCF
No monitoring. Other sectors
not actively involved
South Asia Breastfeeding Forum-3.
20-22 Nov. 2006. Kabul, Afghanistan
Baby Friendly Hospital Initiatives
• 1 hospital certified baby friendly
• Study conducted on BFHI in 2006, data collected
from 3 referral hospitals
• Preliminary analysis:
– None of the hospitals following ten steps
– Lack of knowledge among health workers
– No support groups (Ten steps posters printed and
distributed to all the health centers)
• Lactation manual developed, and training will be
conducted during the 1st quarter of the 2007.
South Asia Breastfeeding Forum-3.
20-22 Nov. 2006. Kabul, Afghanistan
Infant feeding in Emergencies/Difficult
situation
Main
Achievements:
Main Gaps:
• Infant feeding guideline in HIV +
mothers in place
• Severe Malnutrition manual developed
and national level training held in 2003.
•Flip chart on feeding among the HIV +ive
mothers.
LBW: no guideline
Emergencies: Lack of experience,
required training and technical support,
collaborate with other sectors and
program
South Asia Breastfeeding Forum-3.
20-22 Nov. 2006. Kabul, Afghanistan
BFHI and PMTCT
Main
•Strong political will and commitment towards
Achievements: PMTCT
•Training and advocacy conducted in western
region, 2006. (58 VCT counselors trained)
•Provision of free drugs and formula feeds ensured.
Main Gaps:
– No coordination between different programs
(RHU, Nutrition, IMCI, and HIV/AIDS)
– Intervention not yet implemented (lack of
experience)
– Issue of confidentiality, stigma and
discrimination
South Asia Breastfeeding Forum-3.
20-22 Nov. 2006. Kabul, Afghanistan
Infant and Young Child feeding
• No policy on IYCF
• National Breastfeeding Policy incorporates
-Breastfeeding
-Advice on complimentary feeds
-Maternal and paternal leave
-Advocacy and social mobilization
• Calls for: Guidelines for HIV & BF
Training of Health workers
Formation of national committee
South Asia Breastfeeding Forum-3.
20-22 Nov. 2006. Kabul, Afghanistan
Marketing of Breast milk substitute
Main Achievements: •Adopted the SAARC code
•?No domestic market
Main Gaps:
•Implementation of the code not fully
in practice
•Difficulty monitoring
•No coordination with other sectors
•No committee formed
•No authority for compliance
South Asia Breastfeeding Forum-3.
20-22 Nov. 2006. Kabul, Afghanistan
Maternity protection
Main
•Exclusive BF for 4 months and continue for 2yrs
Achievements: •Maternal leave 3 months (paternal 5 days)
•Establishment of NCWC, RENEW with support
from highest authority.
Main Gaps:
•Lack of uniformity between Govt. and Private
sectors in supporting mothers.
•Lack of counselors or support groups
•Health workers not aware/trained
•Lack of coordination- NCWC, RH, Nutrition,
RCSC, Private Sectors, NGOs RENEW
South Asia Breastfeeding Forum-3.
20-22 Nov. 2006. Kabul, Afghanistan
Community support
•
•
•
•
•
Effective outreach program
VHW: 1200 well placed
Traditional birth attendants
NWAB and RENEW
ICB
Requires focus and establish common
goals in terms of infant feeding
South Asia Breastfeeding Forum-3.
20-22 Nov. 2006. Kabul, Afghanistan
Constraints
• Defining priorities: Policy level
• Coordination between all stakeholders and
lack of an authoritative body
• Political will and commitment
• Funding
• Technical resources
• Monitoring and Evaluation
• IYCF not in curriculum of health school
South Asia Breastfeeding Forum-3.
20-22 Nov. 2006. Kabul, Afghanistan
Achievements
•
•
•
•
Three personnel trained
Ten Steps of BFHI Printed and distributed
Lactation manual developed
Guidelines on feeding of Infant of HIV
mothers
• Flip chart on feeding of HIV mothers
• PMTCT and VCT
South Asia Breastfeeding Forum-3.
20-22 Nov. 2006. Kabul, Afghanistan
Cont..
• Maternity leave ….3 months
South Asia Breastfeeding Forum-3.
20-22 Nov. 2006. Kabul, Afghanistan
South Asia Breastfeeding Forum-3.
20-22 Nov. 2006. Kabul, Afghanistan