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Lifesaving Human Milk: Strengthening Systems to Ensure All Babies Have Access

Lifesaving Human Milk: Strengthening Systems to Ensure All Babies Have Access. 2 nd World Breastfeeding Conference Johannesburg, South Africa 12 December 2016 Sophy Mabasa Nutrition Advisor PATH South Africa.

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Lifesaving Human Milk: Strengthening Systems to Ensure All Babies Have Access

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  1. Lifesaving Human Milk: Strengthening Systems to Ensure All Babies Have Access 2nd World Breastfeeding Conference Johannesburg, South Africa 12 December 2016 Sophy Mabasa Nutrition Advisor PATH South Africa

  2. Our Shared Goal: Ensuring That ALLBabies Everywhere Receive Human Milk

  3. Achieving Maximum Impact by Incorporating Human Milk Banking into a Comprehensive Package of Breastfeeding Support Services DeMarchis A, Israel-Ballard K, Mansen KA, Engmann C. Establishing an Integrated Human Milk Banking Approach to Strengthen Newborn Care. Journal of Perinatology. 2016 Nov 10. Doi: 10.1038/jp.2016.198

  4. } When a Mother’s Milk is Not Available: Making the Case for Donor Human Milk UP TO 40% OF VULNERABLE INFANTS IN NEONATE WARDS ARE IN NEED OF DONOR HUMAN MILK

  5. Donor Human Milk: An Evidence-Based Approach

  6. Supporting the Provision of Donor Human Milk WHO Provision of safe donor human milk is a critical intervention to save vulnerable lives of infants who do not have access to their own mother’s milk. When human milk banks are part of an integrated newborn care package, including breastfeeding promotion and Kangaroo Mother Care, the impact on reducing morbidity and mortality as well as reducing healthcare costs are significant. ESPHGHAN Universal maternal milk feeding with donor human milk as the preferred Second--‐line AAP All preterm infants receive maternal milk or if not available pasteurized DM should be used.

  7. A Global Picture: The Critical Lack of Human Milk Banks to Ensure Safe Access Brazilian Network of Human Milk Banks >220 human milk banks ~550 human milk banks worldwide is not adequate Demand far outweighs safe supply International Milk Banking Initiative http://www.internationalmilkbanking.org/

  8. Critical Gaps Limiting Expansion of Human Milk Banks Global coordination and standards Effective policy change and advocacy Strengthening data systems and evidence base Integrated systems for a comprehensive approach Technology innovations to improve quality control

  9. Strengthening Systems through Policy and Advocacy to Ensure Ownership, Accountability and Sustainability • Aligning newborn and nutrition policies • Developing Global Implementation Framework • Establishing strategic partnerships to ensure sustainability http://www.path.org/publications/detail.php?i=2433

  10. Quality Control Systems are Needed Along the Pathway to Providing Donor Human Milk No global standards or recommendations exist…

  11. Strengthening Systems to Ensure Systematic Quality Control • Hazard Analysis and Critical Control Point model for foodsafety • HMB systems should develop their own hazard analysis of critical control points in their specific setting to ensure optimal quality and safety.

  12. Providing Tools to Ensure a Systematic Approach to Quality Assurance Training • HACCP approach led by European and Australian milk bank programs • Globally available workshop tools developed to encourage HACCP trainings for all human milk bank programs Available for download at: https://www.path.org/publications/detail.php?i=2679

  13. Systematic Approach to Fostering Ownership in Establishing a Human Milk Banking Program

  14. Utilizing a Systematic Approach for Effectively Establishing a New Program

  15. Strengthening Health Systems Through an Integrated Approach • PATH project locations • South Africa • Kenya • India • Viet Nam

  16. Kenya: Building Capacity to Establish the Country’s First Human Milk Bank Overall goal: • To reduce neonatal and infant morbidity and mortality in Kenya Building capacity through strategic partnerships: • Learning exchange to South Africa • Fostering local technical leadership • Formative assessments to identify barriers and drivers • Develop national guidelines on human milk banking • Determine feasibility of establishing an integrated model and Regional Center of Excellence for Eastern Africa

  17. Viet Nam: Building Capacity to Establish the Country’s First Human Milk Bank Project aims: • Assist national leaders in establishing the first national gold-standard HMB • Use this milk banking “center of excellence” as model for scaling up nationwide in Vietnam Strategic partnerships with FHI 360’s Alive & Thrive project and MOH Early & Essential Newborn Care program by MOH Building capacity through: • Learning exchange to Scotland human milk banking program • Conducting HACCP trainings • Fostering technical leadership • Developing local guidelines • Evaluating impact on access to human milk

  18. India: Strengthening the Expansion of Human Milk Banks • Aim: Developing and scaling up an India-specific Mother Baby Friendly Initiative + integrated approach to new born care. • Working with policy and technical leaders on formulating national guidelines. • Capacity building through learning exchange to Brazil and through generating awareness. • Supporting establishment of the Human Milk Bank Network of India • Strengthening systems at Sion Hospital – India’s first human milk bank – to establish integrated model • Supporting implementation research as well as technology innovation.

  19. South Africa: Strengthening Expansion of Human Milk Banks • Goal: To demonstrate establishment of small scale human milk banks in KwaZulu-Natal • Capacity building of local hospital staff through HMB training and mentorship • Alignment with the KZN Initiative for Breastfeeding Support (KIBS) project • Optimize FoneAstra, a low-cost temperature monitor for pasteurization, in 5 milk banks • Assess protective properties of heated milk • Technology transfer of FoneAstra to local manufacturer for global access

  20. Improving Access of Low-Cost Technologies that Support the Safety and Quality of Human Milk • FoneAstra: low-cost, cell-phone based temperature monitor flash-heat pasteurization system for small-scale milk banking • Locally developed semi-automated pasteurizer in India • Sampling cap and diagnostic for post-pasteurized donor human milk microbial testing

  21. A Shared Vision We can achieve a world where all infants have access to human milk

  22. The Global PATH Human Milk Banking Team Seattle Kiersten Israel-Ballard kisrael-ballard@path.org Kimberly Amundson kamundson@path.org India Ruchika Sachdeva rsachdeva@path.org Praveen Kandasamy kpraveen@path.org Kenya Juliana Muiruri jmuiruri@path.org Viet Nam Nguyen Quynh Nga nnguyen@path.org Thank You! South Africa Sophy Mabasa hmbasa@path.org

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