1. Where and How Much to Invest in Babies Dr M.Homayoun Ludin Kabul Afghanistan 1

2. Why To Invest in Babies? 2

3. Global Infant and Young Child Feeding Practices (%) 135 MILLION 83 MILLION 52 MILLION Negligible progress in the rates of exclusive breastfeeding < 6 months

4. Breastfeeding Saves Lives! Source: Edmons EK et al, 2007Source: Black RE et al, 2013

5. Contribution of undernutrition to child mortality Source: WHO 2009. Global health risks: mortality and burden of disease attributable to selected major risks. Shaded area indicates contribution of undernutrition to each cause of death

6. Protective effect on non-communicable diseases – Obesity – Diabetes – high systolic blood pressure Increased performance in intelligence tests 6 Non Communicable Disease and development benefits WHO, 2013

7. The economic argument US insurers pay US$ 3·6 billion to treat diseases preventable by breastfeeding (Montgomery DL,1997) US would save $13 billion per year and prevent an excess 911 infant deaths if exclusively breastfeeding for 6 months is practiced (Bartick MC et al, 2013) 7

8. Where to invest? 8

9. Policy, Plan and Coordination Communication and Information Health, Nutrition care System Mother support, community outreach BFHI IYCF in difficult circumstances Maternity Protection International Code, WHA Protection Promotion Support

10. Glaring gaps in the state of policy and programmes Source: IBFAN Asia 2012

11. Breastfeeding Gear Model Pérez-Escamilla R et al. Adv Nutr. 2012

12. Coordinated actions improve breastfeeding practices 12 Exclusive breastfeeding among < 6 mo Median Breastfeeding Duration - months

13. How much to invest? 13

14. The Current Estimates Behavior change interventions Breastfeeding promotion and support CF promotion Hand washing with soap and promotion of hygiene behaviors US$2.9 billion 15 USD/Per household in 36 high burden countries Reflects only “Behaviour change interventions to promote breastfeeding.” 14

15. The WB costing does not reflect the full set of interventions needed to improve breastfeeding for Protecting, Promoting and Supporting Breastfeeding 15

16. Costing of Interventions Development of policies and plans AND coordination BFHI Training of public health worker Community services and mother support Media promotion Maternity Protection Implementing the Code Monitoring and Research

17. Action AreaIBFAN estimates USD in billions (214 countries) One Time Cost2.08 billion IYCF policy devp & review0.004 International Code drafting and legislative proccess0.479 Trainings HW Community support Code implementation 1.599 Annual Cost15.48 billion BFHI Implementation2.01 Media Promotion0.722 Monitoring0.081 Maternity Entitlement12.6 Total17.56 billion 17 How Much to Invest

18. World Breastfeeding Cost Initiative (WBCi)

19. Way forward 19

20. Plan and budget for the comprehensive implementation of the GSIYCF Conduct policy and programme assessments on IYCF to find gaps Develop national and sub-national action plans with budgets to achieve results Develop monitoring and reporting systemsInstitutionalise research Report annually on the expenditure incurred on interventions for optimal breastfeeding Take urgent action on policy matters such as maternity leave 20 Governments

21. Allocate specific budgets for increasing optimal breastfeedingRevisit estimates on scaling up nutrition interventionMake a priority commitment of their staff time Report annually the money spent on programmes on improving policy and programmes for optimal breastfeeding Setup a special maternity benefit fund for cash assistance to women below the poverty line 21 Global community

22. 22 Thanks !!!