Infant and Young Child Feeding (IYCF)

PrintPrintEmailEmailPDFPDF

I.   Profile/Rationale of the Health Program

A global strategy for Infant and Young Child Feeding (IYCF) was issued jointly by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) in 2002, to reverse the disturbing trends in infant and young child feeding practices. This global strategy was endorsed by the 55th World Health Assembly in May 2002 and by the UNICEF Executive Board in September 2002 respectively.

In 2004, infant and young child feeding practices were assessed using the WHO assessment protocol and rated poor to fair. Findings showed four out of ten newborns were initiated to breastfeeding within an hour after birth, three out of ten infants less than six months were exclusively breastfed and the median duration of breastfeeding was only thirteen months. The complementary feeding indicator was also rated as poor since only 57.9 percent of 6-9 months children received complementary foods while continuing to breastfed. The assessment also found out that complementary foods were introduced too early, at the age of less than two months. These poor practices needed urgent action and aggressive sustained interventions.

To address these problems on infant and young child feeding practices, the first National IYCF Plan of Action was formulated. It aimed to improve the nutritional status and health of children especially the under-three and consequently reduce infant and under-five mortality. Specifically, its objectives were to improve, protect and promote infant and young child feeding practices, increase political commitment at all levels, provide a supportive environment and ensure its sustainability. Figure 1 shows the identified key objectives, supportive strategies and key interventions to guide the overall implementation and evaluation of the 2005-2010 Plan of Action. The main efforts were directed towards creating a supportive environment for appropriate IYCF practices. The approval of the National Plan of Action in 2005 helped the Department of Health (DOH) and its partners, in the development of the first (1st) National Policy on Infant and Young Child Feeding. Thus on May 23, 2005, Administrative Order (AO) 2005-0014: National Policies on IYCF was signed and endorsed by the Secretary of Health. The policy was intended to guide health workers and other concerned parties in ensuring the protection, promotion and support of exclusive breastfeeding and adequate and appropriate complementary feeding with continued breastfeeding. (1)

 

GUIDING PRINCIPLES

The IYCF Strategic Plan of Action upholds the following guiding principles:

1. Children have the right to adequate nutrition and access to safe and nutritious food, and both are essential for fulfilling their right to the highest attainable standard of health. (5)

2. Mothers and Infants form a biological and social unit and improved IYCF begins with ensuring the health and nutritional status of women. (5)

3. Almost every woman can breastfeed provided they have accurate information and support from their families, communities and responsible health and non-health related institutions during critical settings and various circumstances including special and emergency situations.(5)

4. The national and local government, development partners, non-government organizations, business sectors, professional groups, academe and other stakeholders acknowledges their responsibilities and form alliances and partnerships for improving IYCF with no conflict of interest.

5. Strengthened communication approaches focusing on behavioral and social change is essential for demand generation and community empowerment.

 

GOAL, MAIN OBJECTIVE, OUTCOMES AND TARGETS

GOAL:

Reduction of child mortality and morbidity through optimal feeding of infants and young children

MAIN OBJECTIVE:

To ensure and accelerate the promotion, protection and support of good IYCF practice

OUTCOMES:

By 2016:

  •  90 percent of newborns are initiated to breastfeeding within one hour after birth;
  •  70 percent of infants are exclusively breastfeed for the first 6 months of life; and
  •   95 percent of infants are given timely adequate and safe complementary food starting at 6 months of age.

TARGETS:

By 2016:

  •   50 percent of hospitals providing maternity and child health services are certified MBFHI;
  •   60 percent of municipalities/cities have at least one functional IYCF support group;
  •   50 percent of workplaces have lactation units and/or implementing nursing/lactation breaks;
  •   100 percent of reported alleged Milk Code violations are acted upon and sanctions are implemented as appropriate;
  •   100 percent of elementary, high school and tertiary schools are using the updated IYCF curricula including the inclusion of IYCF into the prescribed textbooks and teaching materials; and
  • 100 percent of IYCF related emergency/disaster response and evacuation are compliant to the IFE guidelines.

 

II.    Target beneficiaries of the program are infants (0-11 months) and young children (12 to 36 months years old or 1 to 3 years old)

III.   Action/Work Plan

Framework National Plan of Action for Infant and Young Child Feeding 2011-2016

 

KEY INTERVENTION SETTINGS AND SERVICES

 

STRATEGIES,   PILLARS AND ACTION POINTS

STRATEGY1:  Partnerships   with  NGOsand  GOs in  the coordination and implementation of the IYCF Program

1.1   Formalize partnerships with GOs and NGOs working on IYCF program coordination and implementation

a.   Strengthen  the TWG to allow it to effectively coordinate the GOs and NGOs working for the IYCF Program

The national TWG will remain but will be strengthened. It shall be constituted by: NCDPC as Chair, FHO as secretariat and  representatives   from  NCDPC,FHO, NCHP, FDA, DJFMH, DSWD,CWC, NNC, ILO, WHO and UNICEF. This time, members of theTWG will be tasked to focus participation  to the intervention setting where it ismost relevant.

The TWG shall be reporting  regularly  to the Service Delivery Cluster  Head.  At  the  Regional  level,  the Regional Coordinators from the above offices shall collaborate    in   the   implementation   of   the   IYCF Program.  To ensure that  GO and NGO IYCF partners work together,  the composition of  the TWGs and AD Hoc committees  shall be made up of representatives from the government and non-government sectors and the Ad Hoc Committees shall be chaired by the relevant agency where the intervention setting belongs.

At the   provincial,   municipal   and   barangay   levels the  existing  Coordinating  Committees  which has  an interagency composition shall be the coordinating arm of the IYCF Program.  This is where the participation of non-government entities will be facilitated. Mechanisms for coordination shall be devised to build a strong foundation for partnership  between the LGU, the Coordinating Committees and local NGOs or private entities.
 
A memorandum of agreement (MOA) shall be executed between DOH and  other  agencies  invited to  become members of the TWG.
 
b. Organize functional Intervention Setting Committees (this is the same as the ad-hoc committee)
 
The   years   covered   by   this   action   plan   will   be marked  with  many  developmental  activities  in  all the intervention settings.   The TWG shall create a committee for each of the intervention setting.   The committees shall be chaired by the relevant agency/ office. Other government and non-government agencies will be invited to the committees relevant to their mandate.
 
c. Return  the  MBFHI  responsibility  from  NCHFD  to   NCDPC
 
The National Policy on IYCF created in 2005 has affirmed the MBFHI responsibility to NCHFD. Since MBFHI is now under the umbrella of the IYCF Program, it is in a better position to consolidate efforts towards MBFHI compliance. Thus the return of the MBFHI responsibility from NCHFD to NCDPC shall be pursued. The collaboration of NCHFD is still needed though as it has a direct hand on health facility development. At NCDPC the integration of IYCF in the MNCHN Action Plan shall be worked out in all aspects of the program and at the different levels of implementation.
 
d. Augment  human  resource  complement  of  NCDPC- FHO, IYCF program
 
NCDPC-FHO as  the  secretariat  of  the  TWG  and supervising and supporting the IYCF Program will not be able to effectively carry out the technical, management and administrative roles and responsibilities without additional human resource. Funds shall be allotted for job orders for this purpose.
 

e. Programmed contracting out of activities to organizations outside of DOH

To achieve  the  objectives  and  targets   of  the  IYCF program,  it  shall  be  implemented  simultaneously  in the different intervention settings and at a faster pace. This is a gargantuan  task considering the extent of the developmental  work,  the  management  requirements, and  the  mobilization  of the  IYCF network  and  the sourcing of funds for implementation.
 
Organizations  and consultants  that  possess the expertise  and the commitment  to the IYCF program will  be  contracted   out  for  complex  activities  that require time and effort beyond the capacity of the TWG and the Ad Hoc committees. These contracts  shall be arranged based on need and awarded based on merit.
 
STRATEGY 2: Integration  of key IYCF action points in the MNCHN Plan of Action/Strategy
 
2.1   Institutionalize   the  IYCF  monitoring  and  tracking system for national, regional and LGU levels
 
a. Institutionalize the collection of PIR Data and generate annual performance report
 
The established IYCF data set that are being collected during PIRs shall be further reviewed, revised as appropriate and institutionalized through a Department Circular and in collaboration with the other programs in the FHO.
 
An IYCF Program  annual  performance  report  shall be generated  at  the  end of every year  based  on the PIR data, the consolidated data from the unified monitoring and related data coming from research and studies  as  appropriate.   Reports  on the  performance of developmental activities  shall be collected as part of the data  base and to be reported  as needed to the Service Delivery Cluster Head.
 
b. Maximize the use of the unified monitoring tool
 
The CHDs through its Regional Coordinators shall be required to use and consolidate the unified monitoring tool.  A simple  data  management  program  shall  be developed to facilitate  the consolidation of data extracted  from monitoring.   Reports shall be required two weeks after the end of every quarter.
 
c. Collaborate  with  the  National  Epidemiology Center (NEC) and  Information  Management  Service  (IMS) regarding IYCF data
 
The current records and reports being collected by the DOH Field Health Information  System will remain as the main source of data from health facilities.  However, collaboration  with  NEC  and  IMS  to  improve  data quality and include data  on complementary feeding is essential.
 
2.2  Participation of the  IYCF Focal  person  in MNCHN planning and monitoring activities
 
a. Designate   the   IYCF   Focal   Person   as   a   regular member of the team working for the development and implementation of the MNCHN Strategy
 
The IYCF Focal  Person  shall  ensure  that  the  IYCF action   points  become  an  agenda   of  the  MNCHN Strategy and thus ultimately the IYCF services forms a part of the integrated services for mothers and children. In  the  MNCHN planning  and  monitoring,  the  IYCF Focal Person  shall help ensure that  in the multitude of activities, critical IYCF action points and indicators are not overlooked.
 
STRATEGY 3: Harnessing the executive arm of government to implement and enforce the IYCF related legislations and regulations (EO 51, RA 7200 and RA 10028)
 
3.1 Consultation mechanism with the IAC and DOJ for the enforcement of the Milk Code and with other relevant GOs for other IYCF related legislations and regulations
 
 
a. Devise and  implement  a  consultation  mechanism  to bring together the IAC, DOJ and other relevant GOs for IYCF related legislations and regulations
 
 
The Committee  for  Industry  Regulation  shall  devise and implement a consultation mechanism to facilitate the implementation  and enforcement of IYCF related laws and regulations. This will require participation  of higher levels of authority in the GOs.
 
 
The goal of the consultation mechanisms is to develop activities that  will focus on facilitating  the process of monitoring  of compliance  and  enforcement  of IYCF related  laws and regulations  not only at  the national level but also at regional and local levels and in the five IYCF intervention settings.
 
 
3.2  Support Civil Society in the implementation and enforcement of IYCF related laws and regulations
 
a. Institutionalize  enforcement of MBFHI compliance in the regulatory function of the DOH
 
The inclusion of the MBFHI requirements in the unified licensing/accreditation  benchmarks  of the BHFS  and the Licensing Offices shall be pursued more vigorously in collaboration  with BHFS and the Licensing offices of the  CHDs. These offices are  in  a  better  position to enforce compliance in relation  to their  regulatory function and in their power to promulgate penalties for violations.
 
b. Review  and  improve  the  processing  of  reports   on violations on the Milk Code
 
The handling of reports on violations shall be reviewed for thoroughness and timeliness from the time a report is submitted up to the final decision rendered on a case. Problematic  areas  and bottlenecks shall be identified and threshed out.  Measures to ensure that all reports on violations are acted upon shall be devised.
 
To ensure speedy resolution of cases, it is necessary to set deadlines on the processing of reports on violations.
 
 
c. Invite the Professional Regulatory Board as a resource agency of the IAC
 
Apart  from  companies  who are  actively  marketing breastmilk  substitutes,  health  professionals who have direct access and influence on pregnant and postpartum women are also among the most common violators of the law. The PRC as the legal authority that regulates the practice  of the medical and allied professions can contribute to the development and enforcement of the IAC’s regulatory function.
 
d. Augment human resource of FDA as secretariat of the IAC
 
The current  load of violations cases being processed and the fulfillment of other responsibilities with regards to  the  Milk  Code at  FDA require  a  full time  legal officer who will also  assist  the  CHDs. Furthermore, the  strengthened   monitoring  of  compliance  to  the Milk Code will result in a surge on violation reports. FDA should be prepared  to process such reports.   An additional full time legal officer and an administrative/ clerical staff is required to facilitate and help speed up the process.
 
e. Engage professional societies to come-up with measures for self monitoring and regulation
 
Monitoring  of  overt  advertisements  and  marketing of breast  milk  substitutes  is  a  persistent  challenge. Monitoring  of compliance  to  the  Milk  Code among health workers and medical and allied professional organizations  is much more  difficult.   Promotion  of breast milk substitutes is more personal and concealed.
 
The medical and allied professional societies are strong and active bodies that foster organizational development and  discipline  among  its  members. An advocating stance  over  a  punitive  approach  may  be  the  more prudent initial approach in this environment. There will be dialogue, negotiations and forging of agreements to push the Milk Code and other  policies on IYCF. The professional societies will be engaged to participate  in the development of the monitoring scheme within their ranks and in health facilities.  They are a good resource in the development of schemes for MBFHI and related technical  matters. Working  arrangements/contracts may be forged to seal responsibilities and partnerships.
 
Representatives from the professional societies will constitute the Speaker’s Bureau which will be organized for the information dissemination/awareness campaign on the Milk Code, the Expanded Breastfeeding Promotion Act and the Policies on IYCF.
 
STRATEGY 4: Intensified  focused activities  to create  an environment supportive to IYCF practices
 
4.1  Modeling  the  MBF  system  in  the  key  intervention settings in selected regions
 
a. Set up Models of MBFHI and MNCHN implementation in key strategic hospitals and referral networks
 
Regional   Hospitals   and   selected   private   hospitals shall be developed as models of MBFHI and MNCHN implementation to help create  an impact and to serve as showcases for other health facilities.
 
If these hospitals  are  currently  training  facilities  for obstetrics   and   pediatrics   residency   program,    the MBFHI  environment will certainly  add  value to  the training.
 
An itinerant  team  will facilitate  the  development of the hospital models. The team will be composed of an Obstetrician with training/background on MNCHN, Pediatrician  with training/background on Lactation Management/Essential  Newborn Care,  Nurse  trainer for  breastfeeding  counseling,  Senior  IYCF Program person with administrative  background  who can deal with  arrangements   and  coordination  with  hospitals and  local  governments  and  who  can  be  a  trainer and an administrative  assistant  who will facilitate administrative   matters.  The team  will facilitate  the activities leading to the organization  and maintenance of the MBFHI in the hospitals. This shall include planning,   setting   up   of   operational    details   and physical structures  when needed, training/coaching  of personnel, keeping records and completing reports and self assessment.
 
Regional   hospitals   shall   be   developed  for   IYCF capacity building. Trainings at Regional Hospitals shall be conducted  in collaboration  with the  CHDs.   This is  so that  training  is  de-centralized  and  monitoring and  evaluation  can  be  done more  frequently  at  the provincial and municipal levels.
 
b. Establish  protocols/standards   on  how to  set-up  and maintain MBF workplaces and integrated in the standards  for healthy workplace
 
The IYCF Program shall focus on the enforcement of the Expanded Breastfeeding Promotion Act of 2009 which mandates workplaces to establish lactation stations and/or grant  breastfeeding  breaks.  Guidelines for the establishment   and  maintenance  of  MBF  workplace shall be developed. It will learn from lessons of already established and successful MBF workplace. In as much as standards for the healthy workplace are already established,  the  MBF  guidelines  shall  be  integrated into those standards.
 
The establishment of MBF workplaces initiated in factories shall be scaled up and efforts shall be expanded to include government and private offices in line with Expanded Breasfeeding Act. The current collaboration partners  in the workplace setting may also need to be expanded  to  promote  the  establishment  of the  MBF workplace  in  government  and  private  offices.  With the multitude  of workplaces scattered  throughout  the country, the expansion may require outsourcing of organizations to continue the MBF workplace efforts.
 
c. Enhance the primary, secondary and tertiary education curricula on IYCF
 
The  enhancement   of  the   primary,   secondary   and tertiary  education curricula on IYCF shall be pursued. If necessary, a review of the curriculum will be done prior to the enhancement. Apart from the curriculum enhancement, training  materials,  books and teachers’ guide shall also be updated.
 
The initial  collaboration  for the  enhancement  of the primary,  secondary  and  tertiary  education  curricula shall take place at the central office of DepEd (Bureau of Elementary  Education  and  Bureau  of Secondary Education) and TESDA. The enhanced curriculum, training materials,  books and teacher’s guide shall be field tested province-wide in three selected provinces, evaluated and further enhanced before a national implementation.
 
 
d. Develop policy  on  IYCF  in  emergencies  (IFE)  and guidelines  on  the  management  of malnutrition,  and IYCF in special medical conditions for the community
 
A clear policy on IYCF is necessary to allow the program to  define the  guidelines  that  can  be  easily  followed by GOs, NGOs and LGUs once such situations  arise. The policy/guidelines shall address  among others  the issue of milk donations. Guidelines on the Community Management of Malnutrition,  IYCF in special medical conditions such as errors of metabolism or HIV positive mothers shall also be developed for implementation.
 
Camp managers and organized local nutrition clusters shall be oriented on the IFE guidelines.
 
Disaster prone areas will be prioritized in the orientation. Training/orientation shall be a collaborative effort between the IYCF Program,  HEMS and the NDCC.
 
4.2 Creation of a Regional and National incentive and awarding systems for the most outstanding IYCF champions in the different sectors of society
 
a. Review and update the existing awarding system
 
The current  awarding  system shall  be reviewed. The search protocol shall be further refined to allow a wider search.   The organization  of the search committees in the local and national levels shall be formalized.  Funds for the awards shall be ensured.
 
b. Establish  a  recognition system  for  health  facilities complying with EO51, RA10028  and the MBFHI National Policy
 
Set up an annual recognition system for facilities, establishments complying with relevant IYCF legislations and regulations. The benefits provided for by the Milk Code to compliant  health  facilities  shall be reviewed and improved/established parallel with the development of the incentive scheme for the Expanded Breastfeeding Promotion Act. Procedures for claiming benefits  shall  be established  and  made  accessible  in collaboration with PhilHealth, BIR and other relevant government offices.
 
 
4.3 Allocate/Raise /Seek resources for IYCF Research activities that document best practices in the Philippines
 
a. Carry out an inventory of best practices on IYCF Identify best IYCF practices by allowing every province
in the country to identify exemplary or creative activities
on IYCF that  boosted program  services/performance. Validate the reports through CHDs and select the best practices for documentation and publication.
 
b. Allocate resources and conduct IYCF related researches focusing on the documentation and measure of impact of noble experiences and interventions
 
The documentation of IYCF best practices is considered a critical area that allows the development of models/ references  for appropriate  IYCF protocols  and guidelines  for  implementation.  Field  personnel  who are able to establish and provide successful models of IYCF services are often deficient in resources and skills to document the  efforts.  Resources to conduct IYCF related  researchers,   focusing  on  the  documentation and measure of impact of noble experiences and interventions, will have to be allocated.
 
 
STRATEGY 5: Engaging the Private Sector and International  Organizations to raise  funds for the scaling up and support of the IYCF program
 
 
5.2  Setting up of a fund raising mechanism for IYCF with the  participation  of International   Organizations  and the Private Sector
 
a. Set-up the fund raising mechanism
 
The development and sustainability  of IYCF activities partly depends on the availability of resources. At the national  level, where  many  developmental  activities will  take  place,  the  regular   sources  of  funds  are not sufficient. At the local levels, the poorer more problematic areas have the least resources to promote, protect and support good IYCF practices.  It is critical for  the  IYCF  Program   to  determine   and  actively source  budgetary  and  other  resource  requirements. The  availability   of  resources   will  guide  the  scale and prioritization of IYCF activities in the annual operational planning.
 
 
To augment the funds for the IYCF program, a funding mechanism/body that will serve as a fund raising arm for the elimination of child malnutrition shall be established.
 
The  effort  should  be  able  to  explore  and  proceed with  the  development of a  funding mechanism  that can encourage public-private partnership and ensure resources to initiate  and sustain critical  interventions nationwide.  The arena of fund raising is not within the expertise of DOH, and it will be important  to discuss with  the  international  and  national  partners  on the most suitable mechanism that can help attain such important goal.
 
 
PILLAR 1: Capacity Building
 
Capacity building shall take different forms and intensity in accordance to the requirement of the intervention settings.
 
In health facilities, training on Lactation Management and  Counseling shall  continue.  A system for  regular  in- service or refresher training to address the fast turnover of health staff in hospitals and to provide necessary program updates shall be put in place. Staggered  training and self- enforcing programs may also be devised to improve access to training  when warranted.  Periodic  evaluation  shall be incorporated  into  the  system to  ensure  effectiveness and efficiency of the trainings.
 
The Milk Code monitors at FDA, CHDs and local levels shall be trained on the latest guidelines to help ensure that provisions on regulation  and enforcement in the RIRR of the Milk Code are closely adhered to. The monitors should be prepared  to handle incidents of actual  violation of the code during inspection/monitoring. The local monitors shall be equipped with user friendly monitoring tools.
 
The competencies  of teachers  and  administrators   to teach the new IYCF updated curriculum and to appreciate the  importance  of MBF  environment shall  be enhanced. A training/seminar  program on IYCF for teachers/ administrators  will be developed. A core of teacher trainers in every region will be developed and organized to conduct the training/seminars  nationwide.
 
IV. Status of the Program
A REVIEW FROM 2005 TO 2010
 
Objectives and Targets set in 2005-2010 Status of Achievement Remarks
OBJECTIVE 1: TO IMPROVE, PROTECT AND PROMOTE APPROPRIATE INFANT AND YOUNG CHILD FEEDING PRACTICES CHILD FEEDING PRACTICES
 
   
- 70% of newborns initiated to breastfeeding   within   30   minutes 53.5% (NDHS 08) 40.7%(NDHS 1998)
- 80%   of  0-6   months   infants   are exclusively breastfed
34% (NDHS 2008) 33.5%(NDHS 2003)
- 50%  of  infants   are   exclusively breastfed for 6 months
22.2% (NDHS 2008) 16.1%(NDHS 2003)
- median duration  of breastfeeding is 18 months
15.1months (NDHS 2008) 13 months (NDHS 1998)
- 90% of 6- <10 months infants are given timely, adequate and safe complementary foods 58% (NDHS 2008) 57.9%(NDHS 2003)
- 95%    of   children   6   months   to 59   months   received   Vitamin   A
75.9% (NDHS 2008)

 

76% (NDHS 2003)
NDHS 2008 and 2003 data refers to those that received vitamin A in the past 6 months from the interview
- 70% of low birth weight babies  and iron deficient 6 months to less than 5 years received complete dose of iron supplements
37% of children age 6-59 months received iron supplements in the seven days before the survey
(NDHS 2008)
 
78.3% of children 6-59 months consumed foods rich in iron in the past
24 hours from the time of the survey
72.8% of 6-59 months received iron drops /
syrup (not specified if complete dose, MCHS 2002)
- 80%  of  pregnant  women  have  at least 4 prenatal  visits 77.8% (NDHS 2008) 67.5% (MCHS 2002)
- 80%  of  pregnant  women received complete dose of iron supplements 82.4% (NDHS 2008) 82% (not specified if complete dose, MCHS 2002)
- 80%  of  lactating   women received vitamin A capsule 45.6% (NDHS 2008) 44.6% (NDHS 2003) NDHS 2003 and 2008 data represents the % of women that received Vitamin A dose during post-partum
- 80% of household using iodized salt

41.9% (NDHS 2008)

81.1% household positive for iodine in salt (NDHS 2008)

38%, household using iodized salt and
56.4% household positive for iodine in salt (NNS 2003)
OBJECTIVE 2: TO INCREASE POLITICAL COMMITMENT 
AT DIFFERENT LEVELS OF GOVERNMENT, INTERNATIONAL ORGANIZATIONS, NON- GOVERNMENT ORGANIZATIONS, PRIVATE SECTOR, PROFESSIONAL GROUPS , CIVIL SOCIETY, COMMUNITIES AND FAMILIES
   
- Approved and  widely disseminated National Infant and Young Child Feeding Policy IYCF Policy approved May 25, 2005 and disseminated to all Regions and LGUs.  
- Approved   multi-sectoral    National
IYCF Plan of Action
IYCF Plan of Action 2005-2010 approved.  
- IYCF policy enhancement for emerging issues AO 2007-0017: Guidelines on the Acceptance and Processing of Local and Foreign Donations During Emergency and Disaster Situations was signed May 28, 2007.  
- Increase   number  of  organizations actively involved in IYCF New groups were active in supporting activities on IFE mostly during the post-Ondoy interventions and in relation to breastfeeding support. Active organizations include Latch, La Leche League, Save the Children, Plan International  and Arugaan.
- Increase budget for IYCF
From 1 million pesos in 2005 to 20 million pesos in 2010.
 
 
Additional funds were secured by the Joint program on MDG-F, wherein UN Agencies (Unicef, FAO, ILO
and WHO) with NNC and DOH, started implementing key IYCF interventions.
 
Additional funds for IYCF were secured since April 2007, the start of the AHMP with intensive IYCF training.
 
September 2009,  signing of the JP for Ensuring Food Security and Nutrition for Children 0-24 months in the Philippines, funded by the
Government of Spain through the MDG Achievement Fund.
OBJECTIVE 3: PROVIDE SUPPORTIVE ENVIRONMENT THAT WILL ENABLE PARENTS, MOTHER, CAREGIVERS, FAMILIES AND COMMUNITIES TO IMPLEMENT OPTIMAL FEEDING PRACTICES FOR INFANTS AND YOUNG CHILD    
PROGRAMME MANAGEMENT    
- Functional IYCF Program  authority and responsibility flow at the national, regional and LGU level
National TWG active and 11/12
Regions confirmed having established a TWG.
 
 
At the LGU level 7/80 provinces,
9/120 cities and 175/1425 municipalities have passed a resolution/ordinance in support of IYCF.
Data as of Dec 2009. Although the national TWG is
considered active, the collaboration between agencies can be considered deficient.
- Existing local committees functioning as IYCF committees   No available data
INSTITUTIONAL SUPPORT    
- 1,426  currently certified MBF hospitals sustained 10 steps
AO 2007-0026: Revitalization of the MBFHI in Health Facilities with Maternity Services was signed and endorsed on July 10, 2007.
 
 
PhilHealth Circular No. 26 S-2005: Requirement for Accredited Hospitals to be “Mother- Baby Friendly” was issued on October 11, 2005.
Within 2 years after the issuance of COC, 0/47 hospitals applied for accreditation  to become MBF based on the new standards  and requirements.
- 300 additional hospitals/lying-in certified as MBF
Only 47/1487 have received a COC
since 2007
 
- 100%  of hospitals rooming–in their newborns   No available data
- All offices of government  agencies who are members of the IYCF IAC will be MBF RA 10028:  Expanded Breastfeeding Promotion Act of 2009 was enacted on March 16, 2010. RA 10028  set the standards  to becoming MBF.
- At  least  one  model workplace  per province/city certified as MBF 6/16 Regions reported that there are at least 88 breastfeeding friendly workplaces.  
- At least  one model IYCF resource center 1 province and 1 city in each region No resource center established  
- At  least  3  IYCF model  barangay/
municipality per province and city
10/16 Regions reported that there are at least 2159 breastfeeding support groups at the barangay level.  
- Functional milk bank in all medical centers
Milk bank is functional in 3 Medical
Centers: PGH, DJFMH and PCMC
RA 10028  encourages other Medical
Centers to set up their own milk bank.
IMPROVING SYSTEMS    
- 100% of national, regional and LGU health facilities have integrated IEC on IYCF into regular  MCH services with clearly stated protocols on how to provide key IYCF Based on monitoring visits and reports from CHDs, public health facilities have ensured the integration. No available data on private health facilities.
- Functional  and effective Milk Code
Monitoring system
Only 4/13 Regions reported some sort of Milk Code monitoring activities.
 
At the FDA, from 2007 to 2009, there were 67 reports of violations and only 3/13 Regions reported filing a complaint for the alleged violations.
 
- Institutionalize   facility  IYCF  MIS
system in place by end of 2009
Draft tool developed and used in two  key instances. No institutionalization  yet.  
-Improving skills of health manpower
28,063/34,298 staff were trained on
IYCF Counseling.
NCDPC and NNC combined report
- Available national  / regional  IYCF
trainers
16/17 Regions reported conduct of training on IYCF.  
- Active IYCF Speakers’ Bureau   No available data
- Available IYCF counselors in 50%
of health facilities
28,063/34,298 staff were trained on
IYCF Counseling.
NCDPC and NNC combined report.
- At least 10 Filipino health professionals internationally accredited as breastfeeding counselors by the International Board of Lactation Consultants Examiners DOH focused on capacitating  health workers on Counseling and Lactation Management. With the support of NNC.
- A lactation  specialist is available in tertiary hospitals 9/13 Regions reported having trained a total of 1485 hospital based health workers on Lactation Management with the support of DJFMH, NCDPC,CHDs and NNC. No denominator available.
- Improved   curricula   for   IYCF  of medical / nursing / midwifery schools In June 2010 a workshop on integration/updating of good IYCF practice into the medical, nursing, midwifery and nutrition curricula was conducted. The process of integration is on-going.
- Inclusion of  breastfeeding in elementary education RA 10028:  Expanded Breastfeeding Promotion Act of 2009 mandates the integration.
RA 10028  was enacted on March 16,
2010.  The IRR is yet to be signed.
- Community  level  support   systems and services 10/16 Regions reported that there are at least 2,159  barangay level BF support groups and more than 40 BF friendly public places.
As of Dec 2009.
 
RA 10028  will help boost the number of breastfeeding friendly public places.
- 100% of target communities with functional community level monitoring system of IYCF practices and changes   No available data
- At least 50%  of city and poblacion municipalities with adequate number of trained IYCF peer counselors
10/16 Regions reported that there are at least 2,159  BF support groups at the barangay level.
 
- At least  one functional  BF / IYCF support group in poblacions and selected communities
10/16 Regions reported that there are at least 2,159  BF support groups at the barangay level.
 
 
OBJECTIVE 4: ENSURE SUSTAINABILITY OF INTERVENTIONS TO IMPROVE, PROTECT AND PROMOTE INFANT AND YOUNG CHILD FEEDING    
- Functional   self  assessment   health facility  tools  for  IYCF in  certified MBFH and main health centers Tool Drafted. Not yet institutionalized.  
- Annual  progress  reports  of  status of implementation of Milk Code, Rooming In and Breastfeeding Act, ASIN  Law, Food Fortification  and ECCD Law / IYCF Policy
1st IYCF PIR: 2007
 
2nd IYCF PIR: 2009
 
- IYCF integrated into Philippine Plan of Action for Nutrition  and annual planning and health monitoring systems at all levels
IYCF integrated in PPAN 2005-2010.  PIR was conducted last quarter of 2010.
Key result of integration was the intensive training on IYCF Counseling in AHMP target areas.
- Periodic  feedback  of  IYCF  status during annual conventions of health professionals/Leagues  of Provinces/ Cities/Municipalities and Barangays
Regular Presentations  are offered by DOH on IYCF status (2005:
1st presentation during National
Convention Liga Ng Barangay)
 
 
V. Program Manager

VICENTA E. BORJA, RN, MPH

Supervising Health Program Officer

Family Health Office

National Center for Disease Prevention and Control

Department of Health

Telephone no. 7329956

E-mail Add: vicentaborja@hotmail.com

 

Partner Organizations/agencies

 

 NGO Partners:

Local:

  •          Employers Confederation of the Philippines
  •          Trade Union Congress of the Philippines
  •          Beauty, Brains and Breastfeeding
  •          ARUGAAN
  •          Action for Economic Reforms
  •          Save Baby e-group
  •          Philippine Pediatric Society
  •          Philippine Obstetric and Gynecology Society
  •          Philippine Academy of Family Physicians Inc.
  •          Philippine Society of Newborn Medicine
  •          Philippine Society of Pediatric Gastroenterology
  •          Philippine Neonatology Society
  •          Philippine Society of Obstetric Anesthesiologist
  •          Philippine Academy of Lactation Consultant
  •          Perinatal Association of the Philippines
  •          Philippine Medical Association
  •          Integrated Midwives Association of the Philippines
  •          Maternal and Child Nurses Association of the Philippines
  •          Philippine Nurses Association
  •          National League of Philippine Government Nurses Inc.
  •          Malls: SM , NCCC
  •          Union of Local Authorities of the Philippines
  •          CODHEND

 

Government Partners:

  • Department of Labor and Employment
  • Department of Social Welfare and Development
  • Department of Justice
  • Department of Trade and Industry
  • Department of Local Government
  • Food and Drug Administration
  • National Nutrition Council
  • Council for the Welfare of Children
  • Department of Education
  • Commission on Higher Education
  • Nutrition Council of the Philippines

International Organizations:

  •          World Health Organization
  •          UNICEF
  •          PLAN International
  •          Helen Keller International
  •          Save the Children-US
  •          World Vision