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Translating the International Code of Marketing of Breast-milk Substitutes into national measures in nine countries.

ABSTRACT: The International Code of Marketing of Breast-milk Substitutes (the Code) adopted by the World Health Assembly (WHA) in 1981 and regularly updated through subsequent WHA resolutions, represents the international policy framework for protecting breastfeeding against inappropriate marketing practices. By March 2016, at least 135 countries had some measures covering provisions of the Code in their legislation. The translation of the International Code into national measures was investigated in the context of the advocacy efforts undertaken by the Alive & Thrive (A&T) initiative with UNICEF and partners. A real-time evaluation was carried out over 22 months in seven Southeast Asian countries (Cambodia, Indonesia, Lao People's Democratic Republic [Lao PDR], Myanmar, Thailand, Vietnam, and Timor-Leste) and two African countries (Burkina Faso and Ethiopia). Drivers of policy change and progress were examined. Two theory-based approaches were used: developmental evaluation and contribution analysis. Data collection methods included participant observation, key informant meetings, in-depth interviews, reflective practice, and desk review. Overall, countries made significant progress in translating the International Code into national measures and in moving forward throughout the policy cycle. The main driver of policy change was the creation of a strategic group, which engaged key relevant actors and supported the government in the performance of 15 critical tasks, which the analysis reveals is a second driver. Those critical tasks are described in this paper and could help public health advocates to anticipate the stages and challenges of policy change and develop more effective strategies to translate the Code into their legal framework.

SUBMITTER: Michaud-Letourneau I

PROVIDER: S-EPMC6519018 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Translating the International Code of Marketing of Breast-milk Substitutes into national measures in nine countries.

Michaud-Létourneau Isabelle I Gayard Marion M Pelletier David Louis DL

Maternal & child nutrition 20190201

The International Code of Marketing of Breast-milk Substitutes (the Code) adopted by the World Health Assembly (WHA) in 1981 and regularly updated through subsequent WHA resolutions, represents the international policy framework for protecting breastfeeding against inappropriate marketing practices. By March 2016, at least 135 countries had some measures covering provisions of the Code in their legislation. The translation of the International Code into national measures was investigated in the ...[more]

PMID: 30793543

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Project description:Policy research can reveal gaps and opportunities to enhance policy impact and implementation. In this study, we use a theoretically informed qualitative approach to investigate the implementation of two policies to promote breastfeeding in Vietnam. We conducted semi-structured interviews with national and local policy stakeholders (n = 26) in 2017. Interviews were audio-recorded, transcribed verbatim and then translated to English by certified translators. Transcript data were analysed using an integrated conceptual framework of policy implementation. Respondents identified several positive outcomes resulting from implementation of an extended maternity leave policy (Labour Code No. 10/2012/QH13) and further restrictions on marketing of breast milk substitutes (Decree No. 100/2014/ND-CP). Decree No. 100, in particular, was said to have reduced advertising of breast milk substitutes in mass media outlets and healthcare settings. Key implementation actors were national-level bureaucratic actors, local organizations and international partners. Findings reveal the importance of policy precedence and a broader set of policies to promote the rights of women and children to support implementation. Other facilitators were involvement from national-level implementing agencies and healthcare personnel and strength of government relationships and coordination with non-governmental and international organizations. Implementation challenges included insufficient funding, limited training to report violations, a cumbersome reporting process and pervasive misinformation about breast milk and breast milk substitutes. Limited reach for women employed in the informal labour sector and in rural communities was said to be a compatibility issue for the extended maternity leave policy in addition to the lack of impact on non-parental guardians and caretakers. Recommendations to improve policy implementation include designating a role for international organizations in supporting implementation, expanding maternity protections for all working women, building local-level policy knowledge to support enforcement, simplifying Decree No. 100 violation reporting processes and continuing to invest in interventions to facilitate a supportive policy environment in Vietnam.

Project description:Chenopodium quinoa Willd., a high quality grain crop, is resistant to abiotic stresses (drought, cold, and salt) and offers an optimal source of protein. Quinoa represents a symbol of crop genetic diversity across the Andean region. In recent years, this crop has undergone a major expansion outside its countries of origin. The activities carried out within the framework of the International Year of Quinoa provided a great contribution to raise awareness on the multiple benefits of quinoa as well as to its wider cultivation at the global level. FAO is actively involved in promoting and evaluating the cultivation of quinoa in 26 countries outside the Andean region with the aim to strengthen food and nutrition security. The main goal of this research is to evaluate the adaptability of selected quinoa genotypes under different environments outside the Andean region. This paper presents the preliminary results from nine countries. Field evaluations were conducted during 2013/2014 and 2014/2015 in Asia (Kyrgyzstan and Tajikistan), and the Near East and North African countries (Algeria, Egypt, Iraq, Iran, Lebanon, Mauritania, and Yemen). In each country, the trials were carried out in different locations that globally represent the diversity of 19 agrarian systems under different agro-ecological conditions. Twenty-one genotypes of quinoa were tested using the same experimental protocol in all locations consisting in a randomized complete block design (RCBD) with three replicates. Some genotypes showed higher yields and the Q18 and Q12 landraces displayed greater adaptation than others to new environmental conditions. The Q21 and Q26 landraces were evaluated with stable and satisfactory levels of yield (>1 t.ha(-1)) in each of the different trial sites. This production stability is of considerable importance especially under climate change uncertainty. While these results suggest that this Andean crop is able to grow in many different environments, social, and cultural considerations remain crucial regarding its possible introduction as a staple food in new cropping systems around the world.

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Translating the International Code of Marketing of Breast-milk Substitutes into national measures in nine countries.

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Translating the International Code of Marketing of Breast-milk Substitutes into national measures in nine countries.

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