1. Z AMBIA C OMMUNITY EXPERIENCE ON THE IMPLEMENTATION OF BREAST FEEDING By Agnes M Aongola Chief Nutrition Liaison Officer Ministry of Health Zambia

2. P RESENTATION O UTLINE Country Profile Early childhood mortality breast feeding Factors Enabling success in breast feeding Drivers of breast feeding in the country Challenges Community involvement Cost implication and sustainability Monitoring and evaluation

3. T RENDS IN E ARLY CHILDHOOD MORTALITY RATES Survey ZDHS Approx calendar period Neonatal mortality Postnatal mortality Infant mortality 20072003 -2007343670 2001 -20021997 -2001375895 19961992 - 19963574109 19921987 -19914365107

4. T RENDS IN INITIATION OF BREAST - FEEDINGS WITHIN I HOUR

5. P ERCENTAGE I NITIATION OF BREASTFEEDING BY PROVINCE

6. E XCLUSIVE BREASTFEEDING TRENDS IN Z AMBIA - ZDHS

7. E NABLING FACTORS FOR THE SUCCESS IN BREASTFEEDING (1) Policy framework National Health Strategy NDP National Food and Nutrition Policy Infant and Young Child Feeding Operational Strategy 2006-2010

8. P OLICY FRAMEWORK National PMTCT protocol guidelines Food and Drugs Marketing of Breast-milk Substitutes, 2006 Regulations Essential Nutrition Package of Care in the Health Sector

9. E NABLERS (2) Partnerships IYCF Operational strategy 2006 – 2010 – Printed by the TB programme. Community IYCF counselling training package – Printed by PMTCT programme. Children’s Clinic cards – Child Health PMTCT

10. E NABLERS (3) Health worker IYCF counselling training package PMTCT programme Integrating the new WHO recommendations into other programmes/training package. Developed IEC materials: Availability of a 13 series of IYCF dramatized radio programmes in 4 of the 7 main languages. Posters Brochure

11. D RIVERS Government (MoH and National Food and Nutrition commission). Co-operating partners. No champion

12. C HALLENGES (1) HIV pandemic (14 % ) Inadequate Human Resource – affecting ability to counsel) Though funding has increased it is still inadequate. Limited coverage of health workers trained in various aspects of infant feeding. Few communities trained in IYCF.

13. C HALLENGES 2 Rapidly changing advice regarding HIV and Infant Feeding versus updating training packages, updating trainers and disseminating information to the relevant parties. This leads to mixed messages. Enforcement of the Statutory Instrument (SI) on marketing of breast-milk substitutes still weak- violations from both local and international companies crippling in.

14. C OMMUNITY INVOLVEMENT Community IYCF support groups promoted. Community Infant and young child feeding counselling training package developed.

15. C OST IMPLICATION AND SUSTAINABILITY Zambian policy is to promote breastfeeding hence there is no budget line for commercial milks

16. M ONITORING AND EVALUATION SYSTEM HIMS though very challenging with quality of some indicators collected. Independent Surveys ZDHS

17. T HANK YOU