1. Arun Gupta Central Coordinator BPNI 9th Feb 2017
Where is Right to Health, Nutrition( Life) without a Focus on Breastfeeding?
Arun Gupta
Central Coordinator BPNI
9th Feb 2017

2. Have you ever wondered why?

3. Why Baby Milk Formula Sales are Slow India than China ?
Source:
Euromonitor International (2013) Passport Baby Food in India Report
Euromonitor International (2012) Passport Baby Food in China Report

4. Because we have a law..
Infant Milk Substitutes Feeding Bottles, and Infant Foods (Regulation of Production, Supply and Distribution) Act 1992, and Amendment Act 2003.

5. Still……a fact
2.7 Crore containers of 400gms are sold every years. Meaning thereby one for every baby born…

6. BUT Not implemented well

7. Violations few examplaes are a tip of iceberg…..
E-marketing
Sponsorship

8. Out of these, 2/3rd were given formula without their knowledge
The survey conducted by Breastfeeding Support for Indian Mothers, a Facebook group of 30,000 mothers
950 mothers who delivered in private hospitals were given artificial baby milk
Out of these, 2/3rd were given formula without their knowledge

9. Just half the babies born begin to breastfeed within first hour ?

10. Story in NOT so good !!

11. Protection Promotion and Support 3 elements are needed BUT WE DON’T invest in all

12. Missing in the National Plan of Action
Missing in the introductory text:
Reference to National Guidelines on IYCF in the policies
Reference to The IMS Act
Missing  in the  Key Priority Area 1: Survival, Health, and Nutrition       
Counseling on breastfeeding during pregnancy 
Access to counseling on Breastfeeding and complementary feeding  (0-2 years) under child care services
Access to counseling on Breastfeeding in Preventing HIV infections 
Implementation of the IMS Act
Optimal IYCF during emergencies/disasters 
Maternity entitlements  

13. Himachal Story

14. Where we stand today?

15. Initiation of breastfeeding < 1 hour
Initiation of breastfeeding < 1 hour. 13% rise in 10 years against 80% inst Deliveries

16. Trends in Exclusive Breastfeeding < 6 months.

17. Look at where we stand today in numbers
26 million births
80 % in health facilities
~ 20 Million
12 million begin to breastfeed within first hour
14 million first meal is formula
~6 million completely exclusive
India sells 10,847 Tonnes of Std. Powder Infant formula annually..(for 0-6 months)
~27 million containers of 400 gms.
Most common first food in private hospitals

18. Do we need to invest in breastfeeding and babies?

19. UN Human Rights Statement
In November 2016, the United Nations Human Rights Commission issued a joint statement on protection, promotion and support of breastfeeding, which noted that “Women who choose to breastfeed often lack the necessary support structures. Gaps in knowledge and skills among healthcare providers often leave women without access to accurate information or support”.

20. Lancet Series on Breastfeeding 2016
If India were to universalize breastfeeding in coming years, Reduce 156,000 child deaths (13% of under-5), 3,900,000 episodes of diarrhea, 3,436,560 episodes of pneumonia and 4915 deaths due to breast cancer annually. Over and above this it would add 4300 Crores to Indian economy. Add 3 points to IQ of all children, rich or poor. Reduce obesity by 26% Prevent 1 out of 3 new cases type 2 diabetes

21. World Bank estimates on WHA targets

22. Benefits of Investing !
There is strong body of evidence that shows very high economic returns. (Alderman, Behrman and Puett 2016; Copenhagen Consensus center2015; Hoddinott et al 2013) Benefits of investing on exclusive breastfeeding are particularly high : $35

23. 3 Solutions

24. 1. Cousellors in Health Facilities
MAA Programme is a welcome step by MOH
Needs strengthening
Appoint counselors in each hospital well trained
Get private hospitals on board

25. Support …..
Not all women get it

26. 2. Maternity Entitlements for all women
Extend maternity benefits Act for all women
Maternity Benefit cash scheme may have a counselling component clearly backed by a budget line.

27. 3. Budget Line for Breastfeeding and infant and young child feeding practices
Allocate 1 Crore per district for capacity building and strengthening block level

28. Cost Estimates in India based on our experience
At community level
Health Facility level
INR 435 per birth :
INR 169 Non Recurring includes cost of training and capacity building up to block level
INR 265 Recurring cost includes:
Incentives to frontline workers
New appointments 4 workers per block
Refresher training
Coordination
At a Dist.. Level total cost comes to about 1.06 Crores (Recurring).
Appointment of Lactation Counsellors
In all 20,000 hospitals
Cost about 300 Crores annually (Salary of INR 15,000PM)

29. Thanks !