Investing in breastfeeding - the world breastfeeding costing initiative.

Radha Holla-Bhar,Arun Gupta,Alessandro Iellamo,Julie P Smith,Jai Prakash Dadhich

doi:10.1186/s13006-015-0032-y

Radha Holla-Bhar, Arun Gupta + Show 3 more

Open Access

https://doi.org/10.1186/s13006-015-0032-y

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Abstract

BackgroundDespite scientific evidence substantiating the importance of breastfeeding in child survival and development and its economic benefits, assessments show gaps in many countries’ implementation of the 2003 WHO and UNICEF Global Strategy for Infant and Young Child Feeding (Global Strategy). Optimal breastfeeding is a particular example: initiation of breastfeeding within the first hour of birth, exclusive breastfeeding for the first six months; and continued breastfeeding for two years or more, together with safe, adequate, appropriate, responsive complementary feeding starting in the sixth month. While the understanding of “optimal” may vary among countries, there is a need for governments to facilitate an enabling environment for women to achieve optimal breastfeeding. Lack of financial resources for key programs is a major impediment, making economic perspectives important for implementation. Globally, while achieving optimal breastfeeding could prevent more than 800,000 under five deaths annually, in 2013, US$58 billion was spent on commercial baby food including milk formula. Support for improved breastfeeding is inadequately prioritized by policy and practice internationally.MethodsThe World Breastfeeding Costing Initiative (WBCi) launched in 2013, attempts to determine the financial investment that is necessary to implement the Global Strategy, and to introduce a tool to estimate the costs for individual countries. The article presents detailed cost estimates for implementing the Global Strategy, and outlines the WBCi Financial Planning Tool. Estimates use demographic data from UNICEF’s State of the World’s Children 2013.ResultsThe WBCi takes a programmatic approach to scaling up interventions, including policy and planning, health and nutrition care systems, community services and mother support, media promotion, maternity protection, WHO International Code of Marketing of Breastmilk Substitutes implementation, monitoring and research, for optimal breastfeeding practices. The financial cost of a program to implement the Global Strategy in 214 countries is estimated at US $17.5 billion ($130 per live birth). The major recurring cost is maternity entitlements.ConclusionsWBCi is a policy advocacy initiative to encourage integrated actions that enable breastfeeding. WBCi will help countries plan and prioritize actions and budget them accurately. International agencies and donors can also use the tool to calculate or track investments in breastfeeding.

Highlights

Despite scientific evidence substantiating the importance of breastfeeding in child survival and development and its economic benefits, assessments show gaps in many countries’ implementation of the 2003 World Health Organization (WHO) and UNICEF Global Strategy for Infant and Young Child Feeding (Global Strategy)
More than 800,000 under five deaths a year could be prevented globally by achieving optimal breastfeeding practices, as recommended by the World Health Organization (WHO) and UNICEF – initiation of breastfeeding within the first hour after the birth; exclusive breastfeeding for the first six months; and continued breastfeeding for two years or more, together with safe, nutritionally adequate, age appropriate, responsive complementary feeding starting in the sixth month [1]
The absence of economic perspectives has been cited as a barrier to the practical implementation of the Global Strategy [7], economic and financial factors are crucial to its justification and success

Summary

Introduction

Despite scientific evidence substantiating the importance of breastfeeding in child survival and development and its economic benefits, assessments show gaps in many countries’ implementation of the 2003 WHO and UNICEF Global Strategy for Infant and Young Child Feeding (Global Strategy). More than 800,000 under five deaths a year could be prevented globally by achieving optimal breastfeeding practices, as recommended by the World Health Organization (WHO) and UNICEF – initiation of breastfeeding within the first hour after the birth; exclusive breastfeeding for the first six months; and continued breastfeeding for two years or more, together with safe, nutritionally adequate, age appropriate, responsive complementary feeding starting in the sixth month [1]. Markets fail to provide incentives for the achievement of optimal breastfeeding [8] and do not adequately promote and protect the associated potential for large international economic gains [9] These economic and financial benefits for health systems in developed and developing countries have been demonstrated at both macro and microeconomic level [10,11,12,13,14,15]. Of available interventions, counselling about breastfeeding (and fortification) is said to have the greatest potential to reduce the burden of child mortality and morbidity [17]; breastfeeding programs cost from $100 to $200 per death averted, making them or more costeffective than measles and rotavirus vaccination [18]

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