Thow Anne Marie, Karn Sumit, Devkota Madhu Dixit, Rasheed Sabrina, Roy S K, Suleman Yasmeen, Hazir Tabish, Patel Archana, Gaidhane Abhay, Puri Seema, Godakandage Sanjeeva, Senarath Upul, Dibley Michael J
Menzies Centre for Health Policy, School of Public Health, University of Sydney, Sydney, Australia.
Food and Agriculture Organization of the United Nations, Kathmandu, Nepal.
BMC Public Health. 2017 Jun 13;17(Suppl 2):404. doi: 10.1186/s12889-017-4336-2.
South 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.
We 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.
Policy 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.
The 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.
南亚国家是世界上儿童营养不良问题最严重的地区之一,这与婴幼儿喂养(IYCF)方式不当密切相关。强有力且具有响应性的政策支持对于改善婴幼儿喂养的有效干预措施至关重要。本研究旨在确定加强该地区政策环境以更好地支持适当婴幼儿喂养的机会。
我们基于一个通用矩阵梳理了印度、巴基斯坦、孟加拉国、斯里兰卡和尼泊尔与婴幼儿喂养相关的政策。该矩阵描述了从高层战略政策文件到实施层面指南等潜在相关政策。我们根据关注照顾者与婴幼儿喂养干预措施互动的主题分析了数据:向母亲提供正确信息、对一线工作人员进行培训、使母亲能够与服务提供者接触以及对婴幼儿喂养的战略支持。
在所评估的每个主题方面都存在对婴幼儿喂养的政策支持。在所有国家,国家发展计划中都有对营养的支持,并且所有国家都有一定程度的产假保护以及对母乳代用品营销的限制。部门和实施层面的政策文件包含了加强婴幼儿喂养系统以及对一线工作人员进行培训的规定。
加强婴幼儿喂养政策支持的关键机会在于将战略指令转化为实施层面的文件;改善多部门支持与协调;以及更加明确与母亲互动的一线工作人员的角色和职责。这些发现有助于在国家和地区层面加强婴幼儿喂养政策的工作。