Global Strategy On Infant and Young Child Feeding State of Implementation in the context of MDG4 Country – India South Asia Breastfeeding Partners Forum – December 2007; New Delhi Presented by Dr. Saroj K Adhikari Assistant Director Ministry of Women & Child Development Government of India

MDG –4 Mortality Rates IndicatorStatus 1990Target 2015Status 2007 Under Five Population million in 2005 (UNICEF 2007) Under Five Mortality 123 (UNICEF 2007) 4174 (UNICEF 2007) IMR79 (NFHS 1, ) 2857 (NFHS – ) NMR5637 (Calculated) 43 (WHO,2005)

MDG 1 Nutritional Status of Children U5 IndicatorStatus in 2005Status in 2007 % low birth weight 30 (UNICEF 2006) % under-fives stunted -38 (under 3 NFHS ) % under-fives underweight -46 (under 3 NFHS )

MDG 4 Tracking IndicatorCoverage Level DPT immunization55.3% Children months, received 3 doses of DPT - NFHS 3 Measles immunization58.8% Children months who have received measles vaccine- NFHS 3 Use of improved drinking water facility 42.0 % Piped drinking water – NFHS 3 Use of improved sanitation facility 44.5% Have access to a toilet facility – NFHS 3 Skilled attendant at delivery48.3 % Births assisted by a doctor/nurse/LHV/ANM/other health personnel ORT for Diarrhea26.2 % Children with diarrhea in the last 2 weeks who received ORS

IYCF Practices IndicatorStatus in 2005 (NFHS 2: ) Status in 2007 (NFHS 3: ) Initiation of breastfeeding within 1 hour 15.8%23.4% Exclusive Breastfeeding for first 6 months 46.9%46.3% Median Duration of Breastfeeding 25.4 months24.4 months Bottle Feeding (< 6 mo.)13.7%16.4% Complementary Feeding (6 - 9 months) 35%55.8%

Children Under-3 who are breast fed within 1 hour of birth (NFHS-3) – Wide variations across the States

Children age 0-5 months exclusively breastfed (NFHS-3) - Wide variations across the States

Children 6-9 months receiving solid/semi-solid food & breast milk (NFHS-3) - Wide variations across the States

IYCF Policies and Programmes Action taken during after the assessment in 2005

National Policy, Program and Coordination National Guidelines on Infant and Young Child Feeding has been amended and updated by MWCD, GOI (2006) A draft national plan of action developed by MWCD, GOI Two regional advocacy meetings held on IYCF in Important inputs on IYCF proposed for the 11 th Five Year Plan

Implementation of the International Code All articles of the code are incorporated into a law – IMS act 1992 – amended in 2003

Maternity Protection Women covered by the legislation are allowed at least 14 weeks of paid maternity leave Necessary modalities being worked out for increased maternity benefits for the 11 th Five Year Plan

Health and Nutrition Care – Capacity Building Pre service training (job training) of AWW strengthened on IYCF during and Collaborative efforts by MWCD, NIPCCD and BPNI Key officials at different levels of implementation of ICDS program being trained in IYCF 3-IN-1 training program on IYCF prepared and being used by various state governments to impart training

Community Outreach Counseling services being envisaged by various state governments

Information Support Technically correct, sound, IEC messages based on national or international guidelines are being used for campaigns

Infant Feeding and HIV NACO has included IYCF as a major component in integrated counseling and testing centers (ICTC) program

Monitoring and Evaluation Existing MIS in ICDS does not capture IYCF indicators. Focus on operational aspects, coverage and nutritional status of children (IAP Growth Standard). During 11 th Plan, MIS being revamped. It includes some of the IYCF indicators.

Thank you!