Glaring Gaps in policy and programmes on infant and young child feeding in 33 countries

IBFANAn experienced 32 year global network IBFAN aims to promote the health and well being of infants and young children and their mothers through protection, promotion and support of optimal infant and young child feeding practices. IBFAN works for the universal and full implementation of International Code of Marketing of Breastmilk Substitutes and subsequent World Health Assembly (WHA) resolutions, Global Strategy for infant and young child feeding, Innocenti Declaration on Breastfeeding 1009, and 2005.For its contribution to the global livelihood, IBFAN received Right Livelihood Award in 1998, popularly known as “Alternative Nobel Prize”

In 2015 among other returns on investment “21.9 million more infants would be exclusively breastfed for the first six months of life”

First year is critical!First year is critical!

Malnutrition strikes the most in infancy , most Malnutrition strikes the most in infancy , most babies die during first month or first year, brain babies die during first month or first year, brain develops the most .develops the most .

Years of life

Brain development

undernourished

Diarrhoea

Neonatal disordersUnknown

Pneumonia

MeaslesMalaria

Other AIDS Neonatal disorders

Diarrhoea

Pneumonia

Source: Robert et al. LANCET 2003;361:2226-34

Three Major Killers

Breastfeeding is the No. 1 preventive intervention compared to any other intervention Lancet Series on child survival, and now on newborn survival : 2003 and 2004

MOSTLY PREVENTABLE

Deaths attributed to sub-optimal breastfeeding among children

53

18

55

20

0

10

20

30

40

50

60

Lower RespiratoryTrach (LRT)

Diarrhoeal Diseases(DD)

0-6 months6-12 months

Public Health Nutr. 2006 Sep; 9(6): 673-85

Neonatal Mortality Risk by early infant feeding practices

1 1.16

2.55

3.57

0

0.5

1

1.5

2

2.5

3

3.5

4

Within onehour

One hour toone day

Day 2 Day 3

Timing of initiation of breastfeeding after birth

Infe

ctio

n sp

ecifi

c m

orta

lity

odd

ratio

Source: Edmond KM et al. Am J Clin Nutr 2007. 86:1126-31

U-5 child deaths (%) saved with key interventions in India

1

2

3

4

6

15

4

6

15

0 2 4 6 8 10 12 14 16

Measles vaccine

Vitamin A

Water, sanitation, hygiene

Clean delivery

Complementary Feeding

Breastfeeding

Newborn resuscitation

Antibiotics for pneumonia

Oral rehydration therapy

Percentages

Lancet Child Survival Series,2003

Millenium Development Goals

Goal 4: reduction of child mortality

gBICS: scaling up early, exclusive and continued breastfeeding

Magnifying glass

WBTi is central to gBICS

Donor partners

WBTi is a lens..Before taking action, the gBICS conducts an important evaluation to establish a participatory process to assess the situation of breastfeeding in a country and establish priorities using the World Breastfeeding Trends Initiative (WBTi).

The WBTi uses innovative web-based technology as well as the participatory involvement of key actors to press for effective policies and programmes at national level.

It has been launched in 73 countries and 33 countries have completed the assessment work and reported.

This is the 33 country analytical report

WBTi countries

Ranking of WBTi 33 countries in 2008-2009

Countries Scores on a scale of 150 & color-coding

Ranking

Sri Lanka 124 1st

Malawi 121.5 2nd

Maldives 119 3rd

Zambia 11.5 4th

Mongolia 107 5th

Ghana 105.5 6th

Mozambique 100.5 7th

Nicaragua 99 8th

Costa Rica 95 9th

Bolivia 90 10th

Pakistan 88.5 11th

Bangladesh 87 12th

Afghanistan 86.5 13th

Uruguay 85.5 14th

Argentina 85 15th

Uganda 81.5 16th

Countries Scores on a scale of 150 & color-coding

Ranking

Brazil 81 17th

China 80.5 18th

Nepal 80.5 18th

Peru 78.5 19th

Colombia 77 20th

Gambia 77 20th

Vietnam 76 21st

Philippines 75.5 22nd

Rep. of Korea 73 23rd

Bhutan 72 24th

India 69 25th

Ecuador 65.5 26th

Dominican Rep 58.5 27th

Indonesia 57.5 28th

Mexico 49 29th

Cape Verde 435 30th

Taiwan 32.5 31st

Average score for indicators on Policy and Programmes in 33 countries on a scale of Ten (10)

6.41

5.23

7.58

4.67

6.17

5.42

6.42

4.67

2.73

5.67

0 1 2 3 4 5 6 7 8 9 10

National Policy, Programme and Coordination

BFHI

Implementation of the International Code

Maternity Protection

Health and Nutrition Care Systems

Mother Support and Community Outreach

Information Support

Infant Feeding and HIV

Infant Feeding During Emergencies

Monitoring and Evaluation

Average rates for the 5 IYCF Practices in 33 countriesIYCF Practices Average

Early Initiation of Breastfeeding (28 Countries having data)

51.2%

Exclusive Breastfeeding for first 6 months (30 Countries having data)

46.0%

Median duration of Breastfeeding Rates (28 Countries having data)

18.6 months

Bottle-feeding Rates (25 Countries having data)

31.0%

Complementary Feeding Rates (30 Countries having data)

67.7%

Key gaps in policy and programmes in 33 countries

Lack of coordinated effort

Lack of budgetary support

Weak maternity protection

Inadequate support to women at health facility

Weak response during HIV and Emergency situations

Continued interference by baby food industry

Key Recommendations

Ensure both policy and programme attention through budgeting, coordination and focus on breastfeeding and infant and young child feeding

Support to women be a reality to stay with babies 0-6 months, maternity protection is critical.

All commercial promotion of baby foods should end.

Accurate information and health system support for early and exclusive breastfeeding for the first six months

Help women during HIV and emergency situations.

Next Step

Reassessment : 2011-12

Take stock in 2012

Share and learn from others in 2012

World Conference on Breastfeeding : Where We stand and Where do we go