World Breastfeeding Trends Initiative (WBTi) Perspectives in challenges and future actions Name of the Speaker : Seela Ebert Name of the Country: SRI LANKA

What has changed since 2005 Assessment Comparison with 2005 Assessment Table: Indicators 1-5: Trends in Infant feeding practices Indicator Status in the last Current status(2006/7) Assessment in 2005 Current status(2006/7) 1. Percentage of babies breastfed within one hour of birth 75% 80% 2.Percentage of babies of 0<6 months of age exclusively breastfed in the last 24 hours 58% 76% 3. Babies are breastfed for a median duration of how many months 26 months 33 months 4. Percentage of breastfed babies less than 6 months old receiving other foods or drink from bottles 12% 24% 5. Percentage of breastfed babies receiving complementary foods at 6-9 months of age 98% 85%* (6-8mths) * Please note : 85% is for babies in the category 6-8 months and NOT 6-9 months; 9-11 months % are given complementary foods. In 2005 Exclusive Breast Feeding Policy in Sri Lanka was only up to 4 months. In 2006 it was changed to 6 months as a Govt. policy. Unfortunately only Govt. servants are entitled to 84 days full-pay leave.

Trends in Infant Feeding Practices Assessment in 2005 / Current Status 2006/2007

List of partners for the assessment process 1. UNICEF. 2. Ministry of Health & Nutrition. 3. WHO. 4. Provincial, Ministry of Health, Siyambalanduwa. 5. Department of Census & Statistics. 6. Sarvodaya Women's Movement.

Sources of Information Demographic Health Survey 2006/2007 (Final Report) Anthropological Study on the Determinants of Child Under-Nutrition in Sri Lanka, UNICEF Sri Lanka (Draft) Ministry of Health & Nutrition Family Health Bureau World Health Organization Dept. of Census & Statistics

Challenges faced during the process Lack of data especially for the conflict areas of North & East. This was overcome during the last year as data was collected for the East. Still 5 districts in the North out of 25 districts in Sri Lanka have not been covered in the surveys on censuses. This has to be taken into account when Sri Lanka data is taken as a whole. Publications prepared by different sources on data collected by individual organisations. As such, it was very difficult to get one source of information in Sri Lanka, although, the recognized authority for the Government is the Department of Census & Statistics. Difficulty in getting the co-operation of all stakeholders. Inconsistency of Indicators. - Up to 2006, Sri Lanka considered 4 months only as Exclusive Breast Feeding. In 2006, as a Policy, it was changed to 6 months. Complementary feeding, the age cohorts are not consistent with other countries.

Methods used to tackle the challenges Contact the highest authorities of relevant organizations. Collected data from all possible sources for comparison. Cordial discussions with stakeholders.

Positive experiences during the process Availability of latest data from timely reports as Sri Lanka Demographic & Health Survey conducted in 2006/2007 and final report printed in April 2009, which includes comprehensive data needed for WBTi. Dissemination of data gathered to the regional structures especially CBOs at ground level. Some people were not aware of the Code nor the legal provisions for breast feeding which they have not made use of. As an outcome of the process, SWM was able to send messages to the SWM membership to encourage breast feeding among mothers. Publication of simple material on the importance of breast feeding in local languages of Sinhala and Tamil. Contd…

Continuation : A Memorandum - to Promote, Protect and Support Breastfeeding and 10 Steps of Actions for Advocacy, was handed-over to the First Lady of Sri Lanka, Madam Shiranthi Rajapaksa and the Hon. Minister of Health & Nutrition. This Memorandum was printed in English, Sinhala and Tamil and was disseminated to the Media and other Stakeholders

Suggestion for improving the process IBFAN should contact the Ministry of Health & Nutrition, WHO and UNICEF as main stakeholders, for assistance in the WBTi process. This would help the focal point to have access to latest statistics and other relevant information. This would also strengthen the co-ordination between the Government and the Non- Governmental sectors to achieve the goal of breast feeding initiatives. If possible, IBFAN should give the sources of data from other countries for easy comparison.