Transcript Community Based Breast feeding promotion in Sri Lanka

Breast feeding promotion in
Sri Lanka
Dr.R.Kesavan
Ministry of Health
Sri Lanka
National Consultant/ Emergency Medical Care
WHO/Sri Lanka
Sri Lanka - VITAL STATISTICS
Estimated Population (‘000),2005*19652
Percentage of 0-4 Population ,2003* 8.8
Percentage of 10-24Population ,2003*28.3
Percentage of 60+ Population,2003*9.3
Sex Ratio of Population, 2006*99.1
Crude Birth Rate, 2006*18.5
Crude Death Rate, 2006*5.8
Rate of Natural Increase, 2004*1.3
Life Expectancy For Males71.9 years
Life Expectancy For Females 76.4 years
Literacy Rate of Males 92.6
Literacy Rate of Females 89.7
Infant Mortality Rate11.2(1000 live births)
Neonatal Mortality Rate10.6 /1000 live births
Maternal Mortality Rate1.9 /10000 live births
No of Married Women Per Midwife 576
No of Persons Per Medical Officer 2500
No of Pupil Per Teacher 22
Health and Nutritional Status
The social policies introduced on the eve of
political independence in the 1940s
promoted free health services that were
made increasingly available to women in all
economic strata.
This island-wide network of health services,
especially maternity and child health services
established over four decades ago, has
contributed significantly to the improvement
in the health status of women.
Since independence in 1948, to the 1990s,
the crude death rate fell from 21.9/1,000 to
5.6/1,000,
Maternal mortality rate from 16.5/1,000 to
0.14/1,000,
Infant mortality rate from 140/1,000 to
17.2/1,000.
Life expectancy has risen from 43.6 years
and 41.6 years to 70.1years and 74.8 years
for men and women, respectively.
Crude birth rate declined from 36.1/1,000 to
18.5/1,000,
Fertility rate has declined to 2.2, and
contraceptive prevalence is around 60
percent.
Female mortality rate was lower than
male mortality rate and the male/female
population ratio was 100:101 in 1992.
There has been very little decline in
morbidity.
The incidence of diarrhea, dysentery,
respiratory diseases, is relatively high,
and new threats to health and life have
increased hypertension, breast and
cervical cancers, suicide, and sexually
transmitted diseases including
INTERNATIONAL BREAST-FEEDING
WEEK COMMEMORATED FROM
AUGUST 01 TO 07 Monday, 06
August 2007
The Ministry of Healthcare and Nutrition
has inaugurated an awareness program
for the pregnant women and mothers to
encourage breast feeding under the
theme of "Long life by breast-feeding
within one hour from the time of childbirth", during the International BreastFeeding Week from August 1 to 7.
.
By this awareness program it has been
intensified to encourage breast-feeding
to develop nourishment for the
children, good attachment between
mother and the child, preventing from
infectious disease and developing
intelligence
It has been emphasized that the child
should be breast-fed within half an
hour from the time of birth for
6 months without giving any other
food.
It has been educated to breast-feed
for 2 years with other spare meals
after 6 months to make the child
healthy, intelligent, and psychologically
well balanced, useful person to the
society. It has been specified that the
colostrums in the breast milk prevent
the child from infections and other
diseases.
What is needed is to create an
awareness of the importance of the
breast feeding among the modern
youth (Mrs Amara Peeris)
Sri Lanka: High rate of breastfeeding
`We are fortunate that 98 percent of our
mothers belong to the ever breast fed
category. This had resulted in producing
a healthy child. There is no major
difference in urban and rural mothers
regarding breast feeding. However,
educating them regarding the benefits will
be an effective way to promote breast
feeding` (Mrs Amara Peeris)
6. National Policy, Programme and Coordination -7
7. Baby Friendly Hospital Initiative-6
Concerns percentage BFHI hospitals, training,
standard monitoring, assessment and reassessment
systems
Concerns national policy, plan of action, funding and
coordination issues.
8. Implementation of the International Code-7
Concerns implementation of the Code as law,
monitored and enforced.9. Maternity Protection-6
Concerns paid maternity leave, paid breastfeeding
break, national legislation encouraging work site
accommodation for breastfeeding and/or childcare and
ratification of ILO MPC No 183.
.
10. Health and Nutrition Care-8
Concerns health provider schools and preservice education programmes, standards
and guidelines for
mother-friendly childbirth procedures, inservice training programmes.
11. Community Outreach-8
Concerns skilled counseling services on
infant and young child feeding, and its
access to all women.
(During pregnancy and after birth)
12. Information Support-9
Concerns national IEC strategy for improving
infant and young child feeding, actively
implemented at
local levels.
13. Infant Feeding and HIV-6
to address infant feeding and HIV issue and
on-going monitoring of the
effects of interventions on infant feeding
practices and health outcomes for mothers
and infants.
14. Infant Feeding during Emergencies-10
Concerns policy and programme on infant
and young child feeding in emergencies and
material on IYCF in
emergencies integrated into pre-service and
in-service training for emergency
management.
15. Monitoring and Evaluation-5
Concerns monitoring, management and
information system (MIS) as part of the
planning and management
Breast feeding in the estate
population
A cross-sectional questionnaire survey, using the
current status method for the assessment of
breastfeeding, was conducted among women
working in the plantations in
Sri Lanka.
The exclusive breastfeeding rate was 32.4 per
cent. The mothers' return to work and the feeling
of having insufficient milk were significantly and
negatively associated with exclusive
breastfeeding. Women will sometimes start with
powdered milk several weeks before going back to
work, suggesting that work itself is not the only
reason for introducing powdered milk.
Promotion of breast feeding in
conflict areas
Almost 200000
IDPs were in the
temporary camps
for one year
Mainly in eastern
and Northern
provinces of Sri
Lanka
All were due to the
present War
Promotion of breast feeding in
conflict areas
Measures to promote Exclusive
Breast feeding initiative was taken by
all possible means
Government sectors were mainly
responsible for MCH
WHO, UNFPA , UNICE supported the
government system
INGOO and NGOO contributed
Promotion of breast feeding in
conflict areas
The Department of Health promoted
through their existing system of
network , Midwifes and Health
volunteers at the grass root
WHO , UNFPA ,UNICEF supported
INGOO and NGOO like Sarvodaya
Womens Movement was dedicated in
the initiative
Promotion of breast feeding in
conflict areas
Promotion of breast feeding in
conflict areas methods used
IEC
Government guide lines in maternal
and child nutrition
Close supervision by the midwifes
and Health volunteers
Monitoring of the supply of the food
and milk food items
Promotion of breast feeding in
conflict areas methods used
Promotion of breast feeding in
conflict areas methods used
Promotion of breast feeding in
conflict areas
SWOT Analysis
Promotion of breast feeding in
conflict areas/Strengths
Strong network of
the government
and partners on the
issue
Most of the
mothers had no
alternatives other
than breast feeding
Promotion of breast feeding in
conflict areas/Weakness
Lack of food for the
mothers
Emotional
disturbances
Lack of privacy for
feeding in the tents
Not enough fluids
for the mother in a
very hot weather
Promotion of breast feeding in
conflict areas/opportunities
Good support from
the UN agencies
and the
INGOO/NGOO
Volunteers could
be recruited easily
A good platform for
the IEC
A good situation for
monitoring and
supervision
Promotion of breast feeding in
conflict areas/threats
Trade factors trying to exploit the
situation
Some NGOO/INGOO possibly
supporting traders indirectly
Unstable situations sometimes
demoralize the caregivers and
volunteers
Promotion of breast feeding in
conflict areas
Good news
The trend of exclusive beast feeding
in conflict areas is increasing
No outbreaks of any pediatric
diseases
Thank you