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TheNetwork-UNICEF Breastfeeding and IDDs Project
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Advocacy, Awareness & Monitoring of Implementation of BF laws and promotion of IDDs legislation enforcement
Introduction:
One of the important factors in child health is infant and young child feeding practices. Of available
interventions, counseling about IYCF (breastfeeding) and fortification or supplementation with Vitamin A and zinc,
have the greatest potential to reduce the burden of child morbidity and mortality.
During this year Lancet series on Maternal and Child malnutrition has brought new dimensions to the debate on
malnutrition. The series has advocated through evidence that 20 countries with high burden of malnutrition adopted
simple but effective interventions at national scale producing exemplary results. These six interventions include
Salt iodization; malaria prevention; breastfeeding counseling; vitamin A supplementation; complementary feeding;
and Hygiene.
The contributing factors for low levels of exclusive breastfeeding include unabated promotion of breast milk
substitutes (BMSs) by the industry; low level of knowledge of infant and young child feeding practices and
adaptation for growth and early childhood development; weak enforcement of laws regulating marketing of BMS; lack
of a national campaign on promotion and protection of infant and young child feeding practices specifically
initiation of exclusive breastfeeding. A brief is provided on enforcement of the law and awareness among
communities.
It has been documented that there is lack of knowledge among health professionals as well as communities and
families regarding infant and young child feeding practices and iodine deficiency disorders in Pakistan. TN
survey shows that 70 percent of health workers do not know the law on protection of breastfeeding. Only 2 percent
of midwives/LHVs; 13 percent of Gynea/Obstetricians; 35 percent of nurses and 27 percent of resident doctors were
aware of the legislation. In addition to lack of awareness, many cultural and traditional barriers exist to
exclusive breastfeeding among communities in Pakistan.
| Pakistan is rated 6th amongst the countries, where iodine deficiency is a serious
public health problem. |
Pakistan is rated 6th amongst the countries, where iodine deficiency is a serious public health problem. According
to a recent research published in Pakistan Journal of Medical Sciences around 50 million people are suffering from
iodine deficiency, 6.5 million of whom are facing severe type of deficiency. Up to 90 per cent population of hilly
areas of NWFP, AJK and Northern Areas and numerous pockets of population in Punjab is iodine deficient. Over a
third of women of reproductive age and children under five suffer from severe iodine deficiency.
As regarding awareness on IDD, the IDD KAP conducted in 2007, by Agha Khan University with support from UNICEF,
shows that people only relate goiter to iodine deficiency with only a negligible number of people aware of other
risks like brain damage.
Tremendous progress has been made in developing countries since 1990. The proportion of households in the
developing world consuming adequately – iodized salt has risen from less than 20 percent in 1990 to over 70
percent now. However, Pakistan is one of the developing countries which are at the verge of make or break
countries. The proportion of households in Pakistan utilizing iodized salt is unacceptably low. According to
estimates this level in Pakistan is 17 percent which is incredibly low even if compared with countries with
similar socio-economic conditions like Bangladesh (78 per cent) and Nepal (93 per cent).
In order to make a substantial dent in the IYCF and IDD indicators, strong government ownership is critical for
creating an enabling environment for change from the national to the community and household level.
About the Project:
The Network’s project “Advocacy, Awareness & Monitoring of Implementation of BF laws and promotion of IDDs
legislation enforcement” is funded by UNICEF. Studies show that early initiation within one hour and Exclusive
Breastfeeding for six months vastly contributes to neo natal, infant and child mortality and morbidity and Salt
Iodization is most effective strategy for sustainable Elimination of IDDs such as preventable mental retardation
and brain damage, extreme physical and mental retardation manifesting in goiter (an enlarged thyroid gland),
speech defects, deafness and cretinism.
Most children born to iodine-deficient mothers appear normal but have also suffered brain damage and loss in IQ
points, affecting their ability to develop to their full potential. These apparently normal children will later
have difficulty learning in school and staying in school.
| Supplementation of small quantities of iodine by just one teaspoon of iodine consumed in tiny amounts on a regular
basis over a lifetime |
Supplementation of small quantities of iodine by just one teaspoon of iodine consumed in tiny amounts on a regular
basis over a lifetime at very little cost (US five cents per person annually) can help prevent the incidence of
this serious disorder.
The project aims at building support for the implementation of the BF Ordinance and promotion of IDDs legislation
enforcement through advocacy and social mobilization, by building networks of support across different sections of
society.
Purpose of the Project
The project aims at a strategic approach to supporting the implementation of the Infant and Young Children
Feeding (IYCF) and Iodine Deficiency Disorders (IDD) control strategies in Pakistan. It is envisaged that it will
prove as a major initiative on the part of stakeholders (Civil Society, Media, Parliamentarians, Health
Professionals and Large consumers) led by The Network. The project will be implemented for a period of 1 year.
There are four specific objectives of the project, these include.
Through monitoring of the law and advocacy for its strict implementation and awareness campaign the benefit will
go to the communities and infants born to mothers living in Rawalpindi and Islamabad. Thus the real beneficiaries
will be mothers and children. The project envisages an impact in general.
Specific Objectives
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Monitoring of the implementation and enforcement of BF Ordinance and IDD legislation
- Advocacy through alliance/networks of NGOs, health service providers, parliamentarians, media, and large consumers for iodized salt.
- Advocacy through alliance/NGO networks (health service providers, parliamentarians, and media) for BF and MNCH.
- Awareness raising on the theme of GBW and celebration of the Global IDD day.
- Capacity building of health workers of selected health facilities on IYCF
Activities of the Project:
- Monitoring of baby food industry’s compliance with the international code of marketing of Breast milk substitutes and ‘Breastfeeding Ordinance 2002’
- Lobbying the Government of Pakistan for the enactment of legislation implementing the international code and monitoring.
- Conducting training workshops for health worker in selected facilities on their responsibilities under the International code and Protection of Breastfeeding and Young child Nutrition Ordinance 2002.
TheNetwork’s role
The rules for BF Ordinance have been approved. However, the draft is in process of notification which might take
more time if not pursued and advocated properly.
Similarly, IDD legislation draft has been presented to the Cabinet for approval prior to submission to the
Parliament for enactment. Policy dialogue and orientation of policy makers will be undertaken through formation of
pressure groups to facilitate and expedite the approval of the proposed Iodine Deficiency Disorders Control Act
2009. Building alliances across different sectors such as Civil Society, Media, Parliamentarians, Health
professionals and large consumers and strengthening the existing networks of civil society for BF promotion and
Salt Iodization would create an environment for achieving the project objectives.
The implementation of BF law would be ensured in the wake of formulation of relevant rules and regulations. The
guidelines and rules are under process of approval at the Nutrition Wing, Ministry of Health. However, well
chalked out advocacy efforts are needed to ensure enforcement of these rules. Enforcement of IDDs legislation will
also require the drafting of rules and regulations and considerable advocacy for the promotion of the legislation
among different stakeholders.
Awareness raising will be undertaken through the celebration of Global Breast Feeding Week and Global IDD Day.
Activities targeting key audiences will be implemented through multiple alliances, electronic and print media;
health education sessions, campaigns, sensitization sessions/seminars.
For further inquiries:
Ms. Rubina Bhatti
Project Coordinator - Protection of Breastfeeding and Young Child Nutrition
+92-51-2261085
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