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KZN situation

Health services: Recommendations to better promote & support breastfeeding Breastfeeding Consultative Meeting 23 August 2011. KZN situation. Issuing formula led to most mothers mixed feeding: highest risk of transmission & highest risk of morbidity & mortality

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KZN situation

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  1. Health services: Recommendations to better promote & support breastfeedingBreastfeeding Consultative Meeting23 August 2011

  2. KZN situation • Issuing formula led to most mothers mixed feeding: highest risk of transmission & highest risk of morbidity & mortality • Mothers lack adequate resources (e.g. fuel, water, refrigeration, sustainable household income) • Lay counselors struggle to assist HIV positive mothers make the best infant feeding decision for the benefit of the mother and the child.

  3. …KZN issues • Mixed messages from Health workers on IYCF issues • Free formula becomes the easiest route : though most dangerous and costly intervention. • The Formula was associated with being HIV positive: stigma • Facilities run out of stock • Companies that supply formula also ran out of stock often.

  4. Implementation actions The Head of Department approved implementation of Infant & Young Child Feeding counseling on current PMTCT interventions. This included a decision to stop issuing of free infant formula to mothers in the PMTCT programme using a phasing-out approach.

  5. Implementation actions Meetings were held with district management to sensitize them on new IYCF policy for KZN Meeting with partners which included UKZN, 20 000+, Children Rights Centre, UNICEF,WHO was held to discuss the decision with them and lobby for support in taking this forward.

  6. Implementation actions • Three day training courses for doctors were held in August 2010; February & July 2011 where this information was communicated to them. • Trainer of trainers training was also held from October 2010, to capacitate district trainers to do training for all nurses in districts. • The update of nurses was supported by Provincial and District Offices.

  7. Implementation actions • Retraining of all the lay counselors that counsel mothers on Infant Feeding Issues begun in October and continued until February 2011. • A total of 1703 lay councilors were trained. • Training & participants manuals, pocket guides, flip charts and other training tools have been developed.

  8. Implementation actions UNICEF funded the appointment of a communication specialist for 3 months who carried out development of key messages and communicating these to communities. Messages were developed, field tested with pregnant women & mothers in various health institutions, and finalized.

  9. Implementation actions The communication strategy has included the prepared for Radio Ads, Newspaper inserts, Corporate DVD, Community Forums, Press release & district meetings with key community stakeholders.

  10. Implementation actions • An education/information session was held with the media on November 2010. • Media brief organized by MEC also addressed the IYCF policy November 2010. • December 2010; Presentation to Portfolio Committee for Health

  11. KZN Framework for Accelerating Community-based Maternal, Neonatal, Child and Women’s Health and Nutrition Interventions

  12. Monitoring & Evaluation • 2 Indicators on DHIS • Early breastfeeding initiation • Exclusive breastfeeding at 14 weeks • QA/QI – partnership with 20000+ • School of Public Health Proposal

  13. CHALLENGES • Limited training of Professional Nurses • Limited advocacy at community level • Inadequate emphasis on M & E • Documentation of process • “Not a National Policy” • National Support on PMTCT new guidelines not in line with KZN new Policy

  14. Successes • Extensive advocacy and consultation • Management support from MEC & HOD level • Partnering with Programme Managers(MCWH) • Inputs from partners (UNICEF; WHO; UKZN-Paediatrics; 20 000+; Zoe Life; Children Rights; Africa Centre) • Strong support processes e.g. MBFHI, budget allocation (supplementation for lactating mothers; Outside Radio Broadcasts)

  15. THANK YOU

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