A Qualitative Study on Infant Feeding Policies and Monitoring Systems


eMediNexus    14 December 2022

Optimal breastfeeding practices have long been identified as crucial for infant survival and maternal and infant health. Therefore, to aid countries in protecting and supporting breastfeeding, the World Health Assembly (WHA) adopted the Global Strategy for Infant and Young Child Feeding in 2002. WHO further developed a technical tool to support countries to evaluate their implementation of the Global Strategy, based on which the Breastfeeding Promotion Network of India and the International Baby Food Action Network (IBFAN) were built to create the World Breastfeeding Trends initiative (WBTi). The aim of the WBTi is twofold: to help countries monitor their progress in the implementation of the Global Strategy and to generate recommendations for action.


However, the implementation of the Global Strategy for Infant and Young Child Feeding varies widely among countries. As a result, a study published in the journal Maternal and Child Nutrition explored the processes behind the development and implementation of national infant and young child feeding policies and monitoring systems in Europe. 


For the analysis, a qualitative study design was employed to analyze open-text responses from six European countries, namely Croatia, Germany, Lithuania, Spain, Turkey, and Ukraine using inductive thematic analysis. A 33‐item online questionnaire was distributed to country representatives and completed by country teams. Based on the questionnaire, key obstacles, and enablers, along with strengths, weaknesses, opportunities, and threats contributing to the implementation of strong national policies and monitoring systems were identified, both by inductive thematic and SWOT analysis. 


The analysis of the questionnaires showed that in the six countries, weak government leadership, the strong influence of the industry, lack of adequate national legislation on the International Code, and cultural norms which devalued breastfeeding were particularly noted as obstacles. The study suggested that to overcome the low performance of all six countries on the International Code, two important factors should be addressed. 


First, for EU countries, the updating of the EU regulation to include all the provisions of the International Code and subsequent relevant resolutions, as urged and instructed by the WHA in 2016. Second, the prevention and control of conflicts of interest that threaten policy setting and program implementation, especially in health professional education.


On the other hand, it was suggested that strong and continuous government commitment to infant and young child feeding, an operational national breastfeeding authority, national and active monitoring, and evaluation system, implementation of the International Code of Marketing of Breastmilk Substitutes in national legislation, the integration of skilled breastfeeding supporters, the implementation of the Baby‐friendly Hospital Initiative, and positive cultural norms and traditions supporting optimal infant and young child feeding are the key enablers and strengths contributing to the implementation of the national policies. Hence, it was concluded that government commitment, funding, and protection of optimal infant and young child feeding are essential to the implementation of strong national policies and monitoring systems.


Source: Maternal & child nutrition vol. 18,4 (2022): e13425. doi:10.1111/mcn.13425

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