Abstract
BackgroundOver the last decade, infant and young child feeding (IYCF) indicators in India have improved. However, poor IYCF practices are still apparent, associated with pervasive high rates of child under-nutrition. Interventions to improve IYCF need augmentation by appropriate policy support to consolidate gains. The aim of this study was to identify opportunities to strengthen and support IYCF policies through a policy content and stakeholder network analysis.MethodsIYCF policies and guidelines were systematically mapped and coded using predetermined themes. Six ‘net-map’ group interviews were conducted for stakeholder analysis with data analyzed using ORA (organizational risk analyzer, copyright Carley, Carnegie Mellon University) software. The study was carried out at a national level and in the states of Maharashtra and unified Andhra Pradesh.ResultsThirty relevant policy documents were identified. Support for IYCF was clearly apparent and was actioned within sectoral policies and strategic plans. We identified support for provision of information to mothers and caregivers in both sectoral and high-level/strategic policy documents. At a sectoral level, there was support for training health care workers and for enabling mothers to access IYCF. Opportunities to strengthen policy included expanding coverage and translating policy goals into implementation level documents.At the national level, Ministry of Women and Child Development [MoWCD], Ministry of Health and Family Welfare [MoHFW] and the Prime Minister’s Nutrition Council [PMNC] were the most influential actors in providing technical support while MoHFW, MoWCD, and Bill Melinda Gates Foundation were the most influential actors in providing funding and were therefore influential stakeholders in shaping IYCF policies and programs.ConclusionWe identified a wide range of strengths in the IYCF policy environment in India and also opportunities for improvement. One key strength is the integration of IYCF policies into a range of agendas and guidelines related to health and child development service delivery at the national and state level. However, the lack of a specific national policy on IYCF means that there is no formal mechanism for review and monitoring implementation across sectors and jurisdictions. Another opportunity identified is the development of IYCF policy guidelines in emergencies and for tribal populations.
Highlights
Over the last decade, infant and young child feeding (IYCF) indicators in India have improved
Plan of actions and guidelines were included in the analyses; three policy documents that were related to nutrition and had no reference to IYCF were excluded
India; three were legislation related to maternity benefits, one each was on the Infant Milk Substitute (IMS) Act and the National Code for Promotion and Protection of Breast Feeding
Summary
Infant and young child feeding (IYCF) indicators in India have improved. Over half of child deaths associated with under nutrition are attributed to inadequate breastfeeding and/ or complementary feeding [1]. To accelerate progress on child survival there is heightened global interest in increasing rates of optimal infant and young child feeding (IYCF) practices, that include early initiation of breastfeeding, exclusive breastfeeding for the first six months of life, and beyond six months, timely and age-appropriate complementary feeding, with continued breastfeeding up to two years of age [1, 3]. WHO and UNICEF jointly adopted the Global Strategy for IYCF to focus on impact of feeding practices on survival, nutritional status and growth and development of infants and young children [4, 5]. The critical challenges in India are to support early initiation of breast feeding, exclusive breast feeding, and optimum complementary feeding [15,16,17]
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