Capacity Building Training Course on Infant and Young Child Feeding Counselling for Development of Middle Level Trainers Mr. P.K. Sudhir Coordinator, Training & finance Breastfeeding Promotion Network of India

Evidence Optimal IYCF is the most effective single intervention to improve child health, prevent malnutrition and reduce neonatal, infant and child mortality. It is well documented that breastfeeding is the optimal nutrition for infants and reduces the risk of infectious diseases like diarrhoea and pneumonia substantially. Breastfeeding may also enhance the effect of some vaccines. Improvements of complementary feeding could substantially reduce stunting and related burden of disease. Thus, effective interventions to improve IYCF will have positive effects on child morbidity and mortality, as well as adult human capital. Despite the importance of nutrition in early life, there are few examples of large-scale effective interventions from India, where 42.5% of children under 5 are underweight. Optimal IYCF is the most effective single intervention to improve child health, prevent malnutrition and reduce neonatal, infant and child mortality. It is well documented that breastfeeding is the optimal nutrition for infants and reduces the risk of infectious diseases like diarrhoea and pneumonia substantially. Breastfeeding may also enhance the effect of some vaccines. Improvements of complementary feeding could substantially reduce stunting and related burden of disease. Thus, effective interventions to improve IYCF will have positive effects on child morbidity and mortality, as well as adult human capital. Despite the importance of nutrition in early life, there are few examples of large-scale effective interventions from India, where 42.5% of children under 5 are underweight. An assessment of different interventions to reduce undernutrition showed that counseling about breastfeeding has one of the greatest potentials to reduce the burden of child morbidity and mortality. Complementary feeding could also be improved through nutrition counseling, although additional measures may be necessary in food insecure settings. An assessment of different interventions to reduce undernutrition showed that counseling about breastfeeding has one of the greatest potentials to reduce the burden of child morbidity and mortality. Complementary feeding could also be improved through nutrition counseling, although additional measures may be necessary in food insecure settings.

Statistics (Punjab) National Family Health Survey (NFHS-3) Infant Mortality Rate – 42/1000 Infant Mortality Rate – 42/1000 Under weight children – 25% Under weight children – 25% Early breastfeeding within one hour – 12.7% Early breastfeeding within one hour – 12.7% Exclusive breastfeeding rate – 36% Exclusive breastfeeding rate – 36% Complementary feeding rate – 50% Complementary feeding rate – 50%

IYCF Counseling Training in 2 District (Ferozpur and Gurdaspur) of Punjab, India

Objective To reduce infant mortality & morbidity as well as under nutrition through Infant and young Child Feeding Counselling: A Training Course – The 3 in 1 course (An integrated course on breastfeeding, complementary feeding & infant feeding & HIV – counselling) To reduce infant mortality & morbidity as well as under nutrition through Infant and young Child Feeding Counselling: A Training Course – The 3 in 1 course (An integrated course on breastfeeding, complementary feeding & infant feeding & HIV – counselling)

Strategy To develop Middle Level Trainers (Medical Officer, staff nurses) and Frontline workers (ANM, ASHA etc.) To develop Middle Level Trainers (Medical Officer, staff nurses) and Frontline workers (ANM, ASHA etc.)

Process Meetings with Mission Director, National Rural Health Mission (NRHM), Government of Punjab Meetings with Mission Director, National Rural Health Mission (NRHM), Government of Punjab Memo of Understanding (MOU) Memo of Understanding (MOU)

Role of Partners Breastfeeding Promotion Network of India (BPNI), State Health Society (SHS) under NRHM Punjab Breastfeeding Promotion Network of India (BPNI), State Health Society (SHS) under NRHM Punjab Meetings at District Level – Civil Surgeon Meetings at District Level – Civil Surgeon

Training of Middle Level Trainers 6 days training on IYCF counseling at district HQ by National Trainers of BPNI 6 days training on IYCF counseling at district HQ by National Trainers of BPNI –2 training at Ferozpur  12 Medical Officers trained  36 Staff nurses trained –2 training at Gurdaspur  17 Medical officers trained  41 Staff nurses trained

Course structure Lectures Lectures Demonstrations and role play Demonstrations and role play Clinical Practice Clinical Practice Lecture by trainees Lecture by trainees

Training programme for Middle Level Trainer

Criteria and Guideline for Middle Level Trainer

Lectures

Demonstrations

Clinical Practice

Lecture by trainees

Training of Frontline Workers Three days training on IYCF counseling of ANM & ASHA at CHC/PHC. Three days training on IYCF counseling of ANM & ASHA at CHC/PHC. Approximately 3500 frontline workers (ANM & ASHA) have been trained in these 2 districts by Middle Level Trainers Approximately 3500 frontline workers (ANM & ASHA) have been trained in these 2 districts by Middle Level Trainers

Supervision Supervision of 3 days training of ANM & ASHA by National Trainers of BPNI Supervision of 3 days training of ANM & ASHA by National Trainers of BPNI

Evaluation The evaluation of the training process has been conducted by an independent agency. The evaluation of the training process has been conducted by an independent agency.

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