1. Introducing Infant and Young Child Feeding Indicators into National Nutrition Surveillance Systems: Lessons from Vietnam Poster Reference Number: PO2414 BACKGROUND AND OBJECTIVES Background : A comprehensive set of infant and young child feeding (IYCF) indicators exists but is not widely used hampering collection of comparable data on IYCF practices. Vietnam is one of the few countries to have incorporated the 2008 WHO-IYCF indicators into the National Nutrition Surveillance System (NNSS) since 2010. Objectives : (i)Describe the process followed to incorporate IYCF indicators into Vietnam’s National Nutrition Surveillance System (ii)Share lessons learned from the experience and provide recommendations to enable countries to fully integrate these indicators while ensuring data reliability. METHODS WHO Recommended IndicatorsBefore 200920092010-2012 Early initiation of breastfeedingXX Exclusive breastfeeding under 6 months X XX Continued breastfeeding at 1 year X XX Introduction of solid, semi-solid or soft foodsXX Minimum dietary diversityX Minimum meal frequencyX Minimum acceptable dietX Consumption of iron-rich or iron-fortified foodsXX Child ever breastfed X XX Continued breastfeeding at 2 yearsXXX Age-appropriate breastfeedingXX Predominant breastfeeding under 6 monthsXX Duration of breastfeeding- 24 months X XX Bottle-feedingXX Provinces applied 10 provinces63 provinces 2009 Review existing National Nutrition Surveillance Tool Pilot additional 2 page questionnaire focused on IYCF in 10 of Vietnam’s 63 provinces Analyze IYCF and anthropometric data and compile 2 page user friendly profiles for each province 2010 National Nutrition Surveillance tool revised and rolled-out nationwide Succinct 3 page tool applied – Page 1: general information, maternal/child anthropometry, use of vitamin A and iron/ folate supplements. Page 2: breastfeeding. Page 3: Complementary Feeding Data analyzed and compiled into report - national and province profiles 2011 Minor revisions to tool and 4 th page added focusing on exposure to IYCF campaign and behavior change communication efforts 4 page profiles developed for provinces 2012 Tool further refined. Question added on 4 th page on food security Data from 2012 survey analyzed 2013 Tool further refined System capacity built to generate good quality data Current tool 4 pages – 4 th page flexibility to generate data of interest for nutrition- sensitive sectors Process of introducing infant and young child feeding indicators into the National Nutrition Surveillance System in Viet Nam IYCF information in National Nutrition Surveillance Profile of Viet Nam, 2010 DATA UTILISATION & KEY LESSONS LEARNT Data have been used for (1) monitoring anthropometry and IYCF trends over place and time, (2) policy advocacy (e.g. maternity leave legislation, advertisement law), (3) planning at national and provincial levels, and (4) capacity building. Incorporation of the WHO-IYCF indicators into the NNSS has generated state- of-the-art data, which have been applied extensively in various ways –enabling policy change, sensitizing decision makers to increase investments in IYCF, providing an evidence base for planning, and giving health workers a good understanding of national IYCF priorities. Successful countrywide adoption of the new indicators requires strategic timing and systematic phasing. Success is equally contingent on the capacity of the data collection system, and how and when and by whom the data are used. Guidelines are needed on frequency of collecting national anthropometric and IYCF data. CONCLUSIONS IYCF indicators exist, but because they are not widely used collection of comparable data and development of a global evidence base are hampered. Strategic timing, a phased approach, buy-in from key stakeholders and capacity building were critical to incorporation of the WHO-IYCF indicators in the National Nutrition Surveillance System in Vietnam. The surveillance system will continue to be strengthened through improving sampling methodology, instituting quality assurance systems and streamlining data collection, analysis and approval processes. KEY WORDS Infant feeding, nutrition, surveillance, IYCF indicators, Vietnam Hajeebhoy, N 1 ; Nguyen, PH 2 ; Tran, DT 3 ; Tuyen DL 3 ; and de Onis, M 4 1 Family Health International (FHI 360), Hanoi, Vietnam, 2 International Food Policy Research Institute (IFPRI), Hanoi, Vietnam, 3 National Institute of Nutrition, Hanoi, Vietnam, 4 Department of Nutrition for Health and Development, WHO, Geneva, Switzerland Infant Feeding Practices by Age Group Map of Minimum Acceptable Diet