Abstract
BackgroundInfant and young child feeding practices (IYCF) play a critical role in growth and development of children. A favourable environment supported by appropriate policies and positive contributions from all stakeholders are prerequisites for achieving optimal IYCF practices. This study aimed to assess the IYCF-related policy environment and role of stakeholders in policy making in Sri Lanka, in order to identify opportunities to strengthen the policy environment to better support appropriate IYCF and reduce childhood malnutrition.MethodsWe mapped national level policy-related documents on IYCF, and conducted a stakeholder analysis of IYCF policy making. A matrix was designed to capture data from IYCF policy-related documents using a thematic approach. A narrative synthesis of data from different documents was conducted to achieve the first objective. We then conducted an analysis of technical and funding links of stakeholders who shape IYCF policies and programmes in Sri Lanka using the Net-Map technique, to achieve the second objective. A total of 35 respondents were purposively selected based on their knowledge on the topic, and individual interviews were conducted.ResultsTwenty four policies were identified that contained provisions in line with global recommendations for best-practice IYCF, marketing of breast milk substitutes, strengthening health and non-health systems, maternity benefits, inter-sectoral collaboration, capacity building, health education and supplementation. However, there is no separate, written policy on IYCF in Sri Lanka.Participants identified 56 actors involved in shaping IYCF policies and programmes through technical support, and 36 through funding support. The Government Health Sector was the most connected as well as influential, followed by development partners. Almost all actors in the networks were supportive for IYCF policies and programmes.Conclusions and recommendationsAll evidence-based recommendations are covered in related policies. However, advocacy should be targeted towards strategic support for IYCF in high-level policy documents.The stakeholder analysis confirmed a network led by the government health sector. Enhancing the multi-sectoral commitments stressed in policy documents is an opportunity to strengthen IYCF policy process in Sri Lanka.
Highlights
Infant and young child feeding practices (IYCF) play a critical role in growth and development of children
Policies and guidelines etc. that enables mothers/ caregivers to engage with best practice interventions
Policies and guidelines etc. that enable mothers/ caregivers to engage with best practice interventions)
Summary
Infant and young child feeding practices (IYCF) play a critical role in growth and development of children. This study aimed to assess the IYCF-related policy environment and role of stakeholders in policy making in Sri Lanka, in order to identify opportunities to strengthen the policy environment to better support appropriate IYCF and reduce childhood malnutrition. Stunting in the same age group was 17.3% in 2006/7, again similar to the prevalence of 18% in year 2000 [1] This is in the backdrop of a well-established service delivery structure for Infant and Young Child Feeding (IYCF) care. The health sector in Sri Lanka comprises curative and preventive services. In the preventive health sector, the frontline healthcare worker delivering maternal and child health services is the Public Health Midwife. There is a Public Health Midwife for an average population of 3000, who is responsible for IYCF care. Healthcare delivery is devolved to the nine Provinces, yet policy level decisions are taken at National level
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