ZAMBIA COMMUNITY EXPERIENCE ON THE IMPLEMENTATION OF BREAST FEEDING

By

Agnes M Aongola

Chief Nutrition Liaison Officer

Ministry of Health

Zambia

PRESENTATION OUTLINE

Country Profile Early childhood mortality breast feeding

Factors Enabling success in breast feeding Drivers of breast feeding in the country Challenges Community involvement Cost implication and sustainability Monitoring and evaluation

TRENDS IN EARLY CHILDHOOD MORTALITY RATES

Survey ZDHS

Approx calendar period

Neonatal mortality

Postnatal mortality

Infant mortality

2007 2003 -2007 34 36 70

2001 -2002 1997 -2001 37 58 95

1996 1992 - 1996 35 74 109

1992 1987 -1991 43 65 107

TRENDS IN INITIATION OF BREAST-FEEDINGS WITHIN I HOUR

2001/2 200748

49

50

51

52

53

54

55

56

57

within 1 hr

PERCENTAGE INITIATION OF BREASTFEEDING BY PROVINCE

Natio

nal

Centra

l

Coppe

rbel

t

East

ern

Luap

ula

Lusa

ka

North

ern

North

wes

tern

Sout

hern

Wes

tern

0102030405060708090

100

Within 1 hrWithin 1 dayRec Prolacteal feeds

EXCLUSIVE BREASTFEEDING TRENDS IN ZAMBIA - ZDHS

0

10

20

30

40

50

60

70

1996 2002 2007

ENABLING FACTORS FOR THE SUCCESS IN BREASTFEEDING (1)

Policy framework National Health Strategy NDP National Food and Nutrition Policy Infant and Young Child Feeding Operational

Strategy 2006-2010

POLICY FRAMEWORK

National PMTCT protocol guidelines Food and Drugs Marketing of Breast-milk

Substitutes , 2006 Regulations Essential Nutrition Package of Care in the

Health Sector

ENABLERS (2)

PartnershipsIYCF Operational strategy 2006 – 2010 –

Printed by the TB programme.Community IYCF counselling training

package – Printed by PMTCT programme.Children’s Clinic cards –

Child HealthPMTCT

ENABLERS (3)

Health worker IYCF counselling training packagePMTCT programme

Integrating the new WHO recommendations into other programmes/training package.

Developed IEC materials:Availability of a 13 series of IYCF dramatized radio programmes in 4 of the 7 main languages.

Posters Brochure

DRIVERS

Government (MoH and National Food and Nutrition commission).

Co-operating partners.No champion

CHALLENGES (1) HIV pandemic (14 % ) Inadequate Human Resource – affecting ability to

counsel) Though funding has increased it is still

inadequate. Limited coverage of health workers trained in

various aspects of infant feeding. Few communities trained in IYCF.

CHALLENGES 2

Rapidly changing advice regarding HIV and Infant Feeding versus updating training packages, updating trainers and disseminating information to the relevant parties. This leads to mixed messages.

Enforcement of the Statutory Instrument (SI) on marketing of breast-milk substitutes still weak- violations from both local and international companies crippling in.

COMMUNITY INVOLVEMENT

Community IYCF support groups promoted. Community Infant and young child feeding

counselling training package developed.

COST IMPLICATION AND SUSTAINABILITY

Zambian policy is to promote breastfeeding hence there is no budget line for commercial milks

MONITORING AND EVALUATION SYSTEM

HIMS though very challenging with quality of some indicators collected.

Independent SurveysZDHS

THANK YOU