Transcript National Strategy on Infant and Young Feeding Gaps and

South Asia Brestfeeding Promotion
Forum – 3 Meeting at Kabul
20 – 22 November 2006
Prof. Dr. Prakash S. Shrestha
IBFAN, Focal Person
Nepal
Infant and young child feeding
and care in Nepal
Child Death
• IMR
64 per 1,000
• U5MR
91 per 1,000
• 75,000 children below 5 die annually
– 135 children per day
– every 10 minutes a child dies
Child Malnutrition
60
% of children
50
40
30
20
10
0
Stunting
Wasting
Severe
Underweight
Moderate
Source: DHS 2001
Ever Breastfed
Breastfeeding in Nepal is universal
Girl
98.3
Boy
97.1
Total
97.7
0
20
40
60
80
Percent mothers who ever breastfed
100
Breastfeeding Duration
Urban
Rural
Total
0
5
10
15
20
25
Median Duration in Months
30
35
Throwing away colostrum
% discarding colostrum
60
50
40
30
20
10
0
Mountain
Hills
Terai
Total
Breastfeeding Status
100
90
Breastfeeding with
complements
70
60
• Discarding colostrum (36 %)
Issues
50
• Too early and too late complementary
feeding
40
30
20
10
• Too early introduction of water and other
drinks
Exclusive
breastfeeding
• Health workers knowledge often inadequate
35
33
31
29
27
25
23
21
19
17
15
13
11
9
7
5
3
0
1
% of children
80
No
breastfeeding
Age in months
Source: NMIS4
Baby Friendly Hospital Initiative
Districts with Baby Friendly
hospitals, 1999
7 hospitals baby friendly
National Code on Promotion & Protection was
developed in 1994
SAARC Code was developed in 1996
But the implementation of code is not satisfactory.
Maternity Protection Leave is Variable.
In Government Office 45 days for the mother
But in private institute it is variable in some it is
only 30 days.
 But in some organization paternal leave is also
given for 1 week
But we are requesting for 6 month maternal leave & 2
week for paternal leave
Economics of Breastfeeding
It seems not much important has been given to it.
Control on Import of BMS control is not that effective.
Health Care System
During 1994 – 1998 Capacity Building initiative was
Good
But since then the effort in the capacity building
initiative is not sufficient
Recently passed the National Strategy in Infant and
Young Child Feeding
Gaps:1. National Committee on Protection &
Promotion of Breastfeeding not effective.
2. Need of Formation of National Committee on
Infant and Young Child Feeding
3. Lack of proper monitoring of BMS
4. Code of BMS voilation is very common
5. Reassessment of BFHI Hospital not done
regularly
6. Due importance is not given to Infant and
Young Child Feeding in pre-service training
National Priorities/Challenges
•
•
•
•
•
National Advocacy and community promotion
Capacity building of Health Workers
Baby Friendly Hospital Initiative (BFHI)
“Breastmilk Substitutes (Marketing Control) Act,”
Scaling up of community based programmes that are
aimed at improving child feeding and care
• Scaling up of community based programmes
• Integration of IYCF component in neonatal & safe
motherhood
Suggested – Recommendation for IYCF in
Nepal
1. Expansion of National BF Committee to
National IYCF Committee
2. Formation of IYCF working group
3. Appointment of National Coordinator for
IYCF
4. Training and Orientation in IYCF
5. Develop National strategy for IYCF based
upon global strategy for IYCF
6. Strengthening BFHI and other related
activities
7. Initiate action to strengthen pre-service
curricula of health personals on IYCF
Suggested – Recommendation for IYCF in Nepal
Contd …….
8. Revise existing curricula of non-medical institution to
give emphasis on IYCF
9. Strengthen breast feeding & complementary feeding
promotion activities
10. Enforce and monitor the Act/Regulation/Code of
marketing of breast milk substitutes
11. Advocate for optional maternity protection legislation
12. Design comprehensive IEC strategy on IYCF
13. Empower/enable/develop community counselor and
support group to promote & support IYCF
14. Conduct operational research to improve IYCF
Suggested – Recommendation for IYCF in Nepal
Contd …….
15. Obtain support for IYCF from all concerned parties
16. Facilitate linkages between community groups and
health system for referral follow-up
Thank you