1. Study of Trends in South Asia: 2004-2016
Dr Arun Gupta
Regional Coordinator, IBFAN Asia

2. Study of Trends in South Asia: 2004-2016

3. South Asia
Tracking the progress of eight South Asian countries along 10 areas of action on policy & programmes and 5 indicators related to IYCF practices using the WBTi tool as outlined by Global Strategy for Infant and Young Child Feeding
Six countries namely Afghanistan, Bangladesh, Bhutan, India, Nepal & Sri Lanka have done 4 assessments, Maldives has completed 3 assessments, and Pakistan has done 2 assessments

4. Policy and Programmes (out of 100)
Five out of six countries having done 4th assessment have shown improved scores, however none have moved to next color coding

5. AFGHANISTAN The good news: it’s uphill, but there’s progress
All articles of Code & WHA resolution as law; made provision for correct information and paid break in official organization;; integrated breastfeeding in in-service training curriculum and orientation programmes for govt. doctors and nurses; integrated indicators on IYCF into nutritional surveillance system
Afghanistan is an example of a country that is making progress once they know what was needed. Their actions are systematic and have clear focus.

6. AFGHANISTAN Indicators 11-15
Data was not available for practice indicators in 2005, WBTi kick started action on all fronts
2012
2012

8. BANGLADESH The good news: there’s government support and it shows
Constituted national breastfeeding committee with coordinators; developed BFHI policy and revised tools in 2014; established the BMS monitoring system; policy change for maternity leave/breastfeeding rooms at workplace; has a national strategy on IYCF which includes counselling services; have comprehensive guideline on prevention of mother to child transmission of HIV
Bangladesh has a strong history of advocacy for breastfeeding since 1989 (BBF). Slowly policies have been put into place and that has led to an increase in breastfeeding and decline in bottlefeeding

9. BANGLADESH Indicators 11-15
Decline in bottle feeding is significant

11. BHUTAN The good news: slow & steady progress
Bounced from lowest in 2005 to fifth among south Asian countries in 2016
On international code have sensitized high level decision makers; Increased maternity leave from 3 to 6 months; training of health workers in basic IYCF to reach all women; developed IEC material to strengthen communication
The government is working towards bridging the gaps and developing further program interventions to PPS breastfeeding

12. BHUTAN Indicator 11-15
since assessment in 2005 led to initiation of national survey to collect information on IYCF indicators.
2012
2016
2008
2005

13. INDIA The good news: it could have been worse
Revived national breastfeeding committee being defunct for for long time; launched a breastfeeding promotion programme
India situation is stagnant and needs to take action fast

14. INDIA Indicators 11-15
Not much progress except early initiation of breastfeeding though not much even when institutional births in India are almost 80%
2012
2015
2012
2015
2005
2008
2012
2015
2012
2015
2005
2008
2005
2008
2005
2008
2012
2015
2005
2008

15. MALDIVES The good news: clear progress & even some excellence
All articles of code and WHA resolutions as law; Developed a comprehensive guideline for prevention of PMTCT
need to put more efforts to maintain progress achieved in both policies and programmes or loose out like in BFHI; IFE etc

16. MALDIVES
Started collecting data on key practice indicators after 2005 assessment
2008
2015
2008
2015
2005
2005
2008
2008
2015
2008
2015
2005
2015
2005
2005

17. NEPAL The good news: a bit better on most counts
Lot needs to be done to bridge the gaps in policy and programme on IYCF

18. NEPAL
Slow progress in the practice indicators; bottle feeding is all time low; stronger push needed to be able to improve rates
2013
2013
2013
2016
2005
2016
2005
2008
2008
2005
2016
2005
2013
2016
2008
2008
2005
2013
2016
2008

19. PAKISTAN The good news: the government has started moving
High time to do third assessment and show progress both in policies and programmes as well as practice indicators

20. PAKISTAN Indicators 11-15
Poor Practice rates shows lack of counseling and maternity support to lactating women
2005
2009
2005
2009
2005
2009
2005
2009
2005
2009

21. SRI LANKA The good news: this is how it should be done
Demonstrated a clear cut coordinated effort to keep policy and programme in place and maintains top slot in South Asian as well as globally in 84 countries

22. SRI LANKA Shows a strong coordinated effort to improve IYCF practices
2012
2016
2012
2005
2008
2016
2005
2008
2012
2012
2016
2016
2005
2008
2005
2008
2012
2016
2005
2008

23. Highlights/Lessons It’s possible to bring change.
High level priority is need as shown by Afghanistan
Coordinated actions is the way forward for sustaining like Sri Lanka.
All actions are important to create enabling environment, most critical being national coordination/policy, Code, maternity protection, and BFHI by creating facility and community based support systems based on availability of skilled counseling.

24. What are next steps
Need to do reassessment after 3-5 years to study trends and review action taken
Need to draw high level political attention to the issues and thus to a policy with plan of action, budget and set time line for implementation

25. Thank you !!