South Asia Breastfeeding Forum-3. 20-22 Nov. 2006. Kabul, Afghanistan Current Situation Infant and...

South Asia Breastfeeding Forum-3. 20-22 Nov. 2006. Kabul, Afghanistan

Infant and Young Child FeedingCurrent SituationCurrent Situation

BHUTANBHUTAN


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 ,95Situation Analysis)

4. Age at introduction of complimentary foods No data available but anecdotally very early

introduction.


Protein Energy Malnutrition status in under 5 (1999)

Indicators Prevalence

Weight/AgeHeight/Age

Weight/Height

18.7 %40 %2.6 %


Coordinating Mechanisms

Achievements ProgressNational breast feeding committee formed 2000

Sensitization of all parliamentarians on BF policy

BFHI strongly advocated 1993. JDWNR Hospital declared baby friendly

Adopted SAARC code for protection on BF and YCF

Never met, transfer of members

One time activity with no reinforcement

No monitoring. Baby friendly status not expanded to other hospitals

No monitoring. Other sectors not actively involved


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.


Infant feeding in Emergencies/Difficult situation

Main Achievements:

• 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.

Main Gaps: LBW: no guidelineEmergencies: Lack of experience, required training and technical support, collaborate with other sectors and program


BFHI and PMTCT

Main Achievements:

•Strong political will and commitment towards 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


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 & BFTraining of Health workersFormation of national committee


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


Maternity protection

Main Achievements:

•Exclusive BF for 4 months and continue for 2yrs•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


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


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


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


Cont..

• Maternity leave ….3 months

South Asia Breastfeeding Forum-3. 20-22 Nov. 2006. Kabul, Afghanistan Current Situation Infant and...

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