The status of policy and programmes on infant and young child feeding in 40 countries

Gupta, Arun Kumar; Holla, Radha; Dadhich, Jai Prakash; Suri, Shoba; Trejos, Marta; Chanetsa, Joyce

doi:10.1093/heapol/czs061

Cited by 31 publications

(28 citation statements)

References 25 publications

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“…This study builds on previous research [19] and provides a more detailed review of the content of existing IYCF policies and guidelines in India at both national and state levels, including implementation documents, focusing on how policies enable caregivers to engage with best-practice interventions.…”

Section: Introductionmentioning

confidence: 99%

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Policy content and stakeholder network analysis for infant and young child feeding in India

et al. 2017

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BackgroundOver the last decade, infant and young child feeding (IYCF) indicators in India have improved. However, poor IYCF practices are still apparent, associated with pervasive high rates of child under-nutrition. Interventions to improve IYCF need augmentation by appropriate policy support to consolidate gains. The aim of this study was to identify opportunities to strengthen and support IYCF policies through a policy content and stakeholder network analysis.MethodsIYCF policies and guidelines were systematically mapped and coded using predetermined themes. Six ‘net-map’ group interviews were conducted for stakeholder analysis with data analyzed using ORA (organizational risk analyzer, copyright Carley, Carnegie Mellon University) software. The study was carried out at a national level and in the states of Maharashtra and unified Andhra Pradesh.ResultsThirty relevant policy documents were identified. Support for IYCF was clearly apparent and was actioned within sectoral policies and strategic plans. We identified support for provision of information to mothers and caregivers in both sectoral and high-level/strategic policy documents. At a sectoral level, there was support for training health care workers and for enabling mothers to access IYCF. Opportunities to strengthen policy included expanding coverage and translating policy goals into implementation level documents.At the national level, Ministry of Women and Child Development [MoWCD], Ministry of Health and Family Welfare [MoHFW] and the Prime Minister’s Nutrition Council [PMNC] were the most influential actors in providing technical support while MoHFW, MoWCD, and Bill Melinda Gates Foundation were the most influential actors in providing funding and were therefore influential stakeholders in shaping IYCF policies and programs.ConclusionWe identified a wide range of strengths in the IYCF policy environment in India and also opportunities for improvement. One key strength is the integration of IYCF policies into a range of agendas and guidelines related to health and child development service delivery at the national and state level. However, the lack of a specific national policy on IYCF means that there is no formal mechanism for review and monitoring implementation across sectors and jurisdictions. Another opportunity identified is the development of IYCF policy guidelines in emergencies and for tribal populations.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-017-4339-z) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

“…Analysis of the Adoption of the Global Strategy for IYCF found a systematic lack of attention by policy makers and program planners to enhancing optimal breastfeeding practices [4, 19]. Hence, this research aims to analyze the influence of various stakeholders/actors in shaping IYCF policies and program guidelines.…”

Section: Introductionmentioning

confidence: 99%

Policy content and stakeholder network analysis for infant and young child feeding in India

et al. 2017

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“…Nepal scored only 40.5 out of 100, compared to an average performance of 54.3 among the 40 countries assessed [16]. The report also observed that there has been little improvement in the IYCF policy environment since 2005.…”

Section: Introductionmentioning

confidence: 99%

Policy content and stakeholder network analysis for infant and young child feeding in Nepal

Karn¹,

Devkota²,

Uddin

et al. 2017

BMC Public Health

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BackgroundDespite concerted effort from government and partners, Nepal continues to have a high burden of under nutrition among children. Identifying opportunities to strengthen policy support for infant and young child feeding (IYCF) is a key component to improve child survival, growth and development. This study aims to explore policy support for IYCF and to identify the influential stakeholders for IYCF for effective future policy development and programmatic action.MethodsPolicies relevant to IYCF were identified through web searches and direct approaches to relevant government ministries. Policy content was analysed based on four key domains focussed on mothers, using a qualitative synthesis approach. Three group interviews were conducted using the participatory tool “Net-Map”, to identify the influential stakeholders in IYCF policy and programming processes.ResultsTwenty-six relevant policy documents were analysed for content relating to IYCF. General support for IYCF was found in most of the development plans and high-level health sector policies. Most implementation level documents included support for provision of correct information to mothers. Capacity building of frontline workers for IYCN and system strengthening were well supported through sectoral plans and policies. However, gaps were identified regarding maternity protection, support for monitoring and evaluation, and translation of high-level policy directives into implementation level guidelines, resulting in a lack of clarity over roles and responsibilities.Both government and non-governmental stakeholders, particularly donors, emerged as influential drivers of IYCF policy decisions in Nepal, through technical assistance and funding. The Nutrition Technical Committee under the Ministry of Health, UNICEF, Suaahara, USAID and WHO were identified as key actors providing technical assistance. Key funding agencies were identified as UNICEF and USAID.ConclusionsThis study reveals strong policy support for key dimensions of IYCF, supported by a highly networked stakeholder environment. Opportunities to further strengthen IYCF policy in Nepal include: further support for training of frontline workers and complementary feeding interventions; extending maternity leave provisions; and clarifying roles and responsibilities of actors, particularly non-governmental actors. Engaging technical and funding agencies and developing partnerships with other relevant actors will be crucial for ensuring effective policy translates into effective practice.

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“…The World Breastfeeding Trends initiative (WBTi) monitors policies to support breastfeeding based on the Global Strategy for Infant and Young Child Feeding [15]. The recent WBTi review indicated that while many countries in South Asia had a range of globally recommended policy documents in place, gaps in coverage and implementation remained [16–20].…”

Section: Introductionmentioning

confidence: 99%

Opportunities for strengthening infant and young child feeding policies in South Asia: Insights from the SAIFRN policy analysis project

Thow

Karn²,

Devkota³

et al. 2017

BMC Public Health

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BackgroundSouth Asian countries experience some of the highest levels of child undernutrition in the world, strongly linked to poor infant and young child feeding (IYCF) practices. Strong and responsive policy support is essential for effective interventions to improve IYCF. This study aimed to identify opportunities for strengthening the policy environment in the region to better support appropriate infant and young child feeding.MethodsWe mapped policies relevant to infant and young child feeding in India, Pakistan, Bangladesh, Sri Lanka and Nepal, based on a common matrix. The matrix described potentially relevant policies ranging from high-level strategic policy documents to implementation-level guidelines. We analyzed the data based on themes focused on caregiver interactions with IYCF interventions: provision of correct information to mothers, training of frontline workers, enabling mothers to engage with service providers and strategic support for IYCF.ResultsPolicy support for IYCF was present in relation to each of the themes assessed. In all countries, there was support for nutrition in National Development Plans, and all countries had some level of maternity protection and restrictions on marketing of breast milk substitutes. Sectoral and implementation-level policy documents contained provisions for system strengthening for IYCF and for training of frontline workers.ConclusionsThe key opportunities for strengthening IYCF policy support were in relation to translating strategic directives into implementation level documents; improving multi-sectoral support and coordination; and increased clarity regarding roles and responsibilities of frontline workers interacting with mothers. These findings can support efforts to strengthen IYCF policy at the national and regional level.

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The status of policy and programmes on infant and young child feeding in 40 countries

Cited by 31 publications

References 25 publications

Policy content and stakeholder network analysis for infant and young child feeding in India

Policy content and stakeholder network analysis for infant and young child feeding in India

Policy content and stakeholder network analysis for infant and young child feeding in Nepal

Opportunities for strengthening infant and young child feeding policies in South Asia: Insights from the SAIFRN policy analysis project

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