IYCF Assessment in Lugansk Oblast ( ) 1. Pre-natal service (zenskie consultacii). 2.Maternity home (roddom). 3.Post-natal service (children’s poliklinics).

Pre-natal services Generally no difficulties for IDPs to register and also no administrative or other barriers; Hb level is measured twice (at the beginning and about the 30 th week of pregnancy ) Average rate of anemia of pregnant women is more than 60% Medicines are not provided by the state for free, they should be bought by people, they are not always affordable to all.

Pre-natal services Basic tests for pregnant women are done at hospitals for free All manipulations are provided for free, but medicines and additional materials are bought by patients. Special diagnostics is also not affordable for all (uzi and some of blood tests) Vulnerable local people and IDPs (many children families, indigent and lonely mothers) not always can afford the purchase of a set for maternity house (for mother and for a new-born child)

Appropriate breastfeeding Courses for future mothers exist in majority cities, but not all of them are functioning at high level because of lack of equipment, special materials, equipped rooms. There are special informational stands and posters, but usually only for in-hospital usage, there is a lack of distributing booklets. Usually group lectures are held (not everywhere) once a month, somewhere private discussion, but not always they are obligatory.

Appropriate breastfeeding and complementary feeding education Future mothers from rural regions seem to have less access to pre-natal services and of course BF/CF education(transport, time, money). Doctors are generally trusted. About 80% of mothers ask questions about breastfeeding and complementary feeding. There is medical staff which can be additionally taught for further spread of correct information.

Appropriate breastfeeding and complementary feeding education Almost all mothers initiate breast feeding, about 5% don’t because of diseases (HIV, tuberculosis and others) Usually substituters of breast milk are introduced only if really necessary, doctors do their best to support breast feeding, but less educated can do it themselves if quantity of milk seem to be not enough for them. IDP mothers have bigger percentage of hypo lactation because of stresses and irrational diet.

Appropriate complementary feeding education Generally correct advice on complementary feeding is given to mothers Less educated women often use their own experience with elder children or relatives advice(early introduction of water or complementary feeding: egg, juice, biscuits) Mothers trust doctors and listen to their advice, but many people can not afford appropriate diet for a child, so substitute special food with animal milk, ordinary porridges(rice, semolina, buckwheat), and less expensive sorts of meat. In remote regions there are problems with access to products and to medical service

Additional problems About 35% of children have anemia, and there is not much difference between IDPs and local residents Also a problem with vaccination exists(a lack of vaccines, thus untimely vaccination). All residents of Lugansk region are in risk group about thyroid gland.

Assistance Humanitarian assistance is provided occasionally by international organizations and local charitable foundations Food assistance is not always addressed or considers age peculiarities or prior needs This aid is not enough for all IDPs Doctors mention such organizations: UNICEF, Red Cross of Ukraine, R. Akhmetov foundation, Doctors without Borders, A. Romanovskyi foundation.