CODE IMPLEMENTATION: SHARING EXPERIENCES FROM PORT HARCOURT, NIGERIA Alice Nte Department of Paediatrics University of Port Harcourt Teaching Hospital, Port Harcourt

PRESENTATION OUTLINE Introduction Nigeria’s efforts at Code implementation Activities of Infant food manufacturers and distributors The way forward Conclusion

Introduction-International Code of Marketing of Breastmilk Substitutes Article 1: The Aim of the Code: To contribute to the provision of safe and adequate nutrition for infants, by: – the protection and promotion of breast- feeding, – ensuring the proper use of breast-milk substitutes, when these are necessary, on the basis of adequate information and through appropriate marketing and distribution.

Nigeria and the Code Signatory to the Code Produced its Code implementation documents from 1986 and reviewed in 1990 and 2005 Produced training materials on the Code Designated the National Agency for Food and Drug Administration and Control to monitor and ensure compliance with the Code Promotion of breastfeeding by working mothers

Activities of Infant food manufacturers and distributors

Understanding Marketing How do Companies get to Mothers & Babies? COMPANIES Discounts Tied Sales Shelf Space Credit Brochures Baby Books Gifts: Bibs, diapers towels, bottles Samples Telephone counselling Mothercraft nurses, help advice, (in)direct promotion Equipment Supplies Posters Architectural Services Grants Travel Equipment Literature Gifts Support in $ Services Congresses Research Grants Advertising MOTHERS & BABIES Doctors Nurses Midwives Professional Associations Hospitals Retail Outlets (Shops) Mass Media Advertising Newspapers Magazines Billboards Coupons Information Brandawareness Attractive Labels Displays Gifts T-shirts Special Sales Posters/Tags Supplies (house brands) Samples (on discharge) Booklets, pamphlets Gifts (bounty boxes) Lunches Conferences Travel Literature Services Advice Prescriptions Samples Booklets 6

Nestle Poster on Infant feeding displayed in a company hospital in Port Harcourt

Nestle poster on breastfeeding displayed in a company hospital

Part of the Nestle poster on breastfeeding from the company hospital

Sponsorship of Neonatal Resuscitation Workshop for a teaching hospital Source of Information about the workshop

The foot wears donated for and in use at the Special Care baby Unit after the Workshop sponsored by Nestle

Gifts to new mothers The photograph of the formula and feeding bottle from the mother’s phone The mother breastfeeding her baby

The baby bag donated by Mead Johnson The current content of the bag(feeding bottle, pink container for powered milk, water and flask ) The inside cover of the bag The covered bag wit the attached 10 tips for parents

Pack of 10 Healthy Tip Cards donated by Mead John

“Parenting Tips for a healthy and safe baby” pack of cards American Academy of Pediatrics

Gifts to health workers

Support of Professional Associations

Support for the Paediatric Association of Nigeria and Challenges Sponsorships of different activities in the Association’s Conferences Supported the production of Breastfeeding materials for mothers Support of members for conference participation Use of members as resource persons in their programmes Enrolment into the Nestle Nutrition Institute, Africa Support of programmes at International Conferences Declining support for Professional Associations by WHO and UNICEF

Where we started

The Flexes at the entrance of the Conference venue

Nestle

Friesland Campina

Where we ended

The non health professionals in the Conference

GSK-On the stairs

Nestle-On the stairs

The stands for Nestle

The stand for Friesland Campina

Other forms of Support- Educational Support

The Way forward Capacity development for health workers for the promotion, protection and protection of breastfeeding. Training on Code implementation and monitoring Establish partnership with NAFDAC to enforce Code compliance Integrate Code Monitoring into pre and post graduate training programmes for health workers

The Way forward Participation of WHO and UNICEF in professional Conferences Reviewing practices in the web and the International Professional Conferences Sanctions for Professional Associations that are not compliant Closing the gaps in the International Code Addressing the Nutritional Claims at local and international levels