Teaching Module 3 for BRF

8/12/2019 Teaching Module 3 for BRF

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Saving Newborn Lives by Early Initiation of Breastfeeding and ExclusiveBreastfeeding

Courtesy:HELP [Health Education & Literacy Programme]


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BACKGROUND

Artificial baby feeding commercially started in 1867 and is a billion-dollarindustry worldwide now with Nestle being pioneer and giant share holder

Baby killerby War on Want came in 1974Nestle boycott in 1977

IBFAN formed in 1979 with 6 major campaigner orgs.

WHO-UNICEF meeting on infant and young child feeding with

interpretations, industrys denial to abide by, WHA resolution andguidelines in 1980

The international code on marketing of breast milk substitutes, 1981 &countries started making legislations

PPA strongly

trdrafted a Marketing Code for Pakistan in 1984

Peshawar declaration by Pak Pediatric Association in 1988


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Bringing upbrighterchampions

Malaysia Singapore

The smart formulafor smart babies

Wyeth baby,great future.

China

Exploiting Hopes & Dreams


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CULTIVATING MEDICAL

ENDORSEMENTIN HOSPITALS

Indonesia


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BACKGROUND

Innocenti declaration, 1990 Ten steps tosuccessful breastfeeding

SAARC Model Code for Protection ofBreastfeeding and Young Child Nutrition

was adopted in Islamabad in 1995 160 verities of breast milk substitutes

were available in Pakistani markets in1998. [Ref: The Network (Feeding Fiasco, Milking Profits) ]


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HISTORICAL BACKGROUND

International Code ofMarketing of Breast Milk

Substitutes.

Approved and adopted by W.H.A. 21st

May 1981(34thWHA) 118 votes infavour and one against (USA).


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The World Breastfeeding Trends Initiative(WBTi) 2012


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BREASTFEEDING AND CHILD NUTRITION LEGISLATION

2002

GoP had consultations with experts ofPediatrics, Obstetrics, WHO and UNICEF.

Ordinance evolved and presented to NationalAssembly for adoption.

Legislation approved and passed in 2002.

Delay in formation of Rules and Regulations.

R&R finalized. Approved by MOL. Notified by

MOH in 2009 Infant Feeding Boardnotified by MOH in 2006.

completed term with no output.


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MAIN PROVISIONS OF THE LEGISLATION

The aim of the CODE

To provide guidelines for the marketing of all breast milksubstitutes, bottles & teats; and to ensure that infant feedingdecisions are free from marketing pressures

1. No ads or other direct promotion to consumers (tv, newspapers,etc

2. No free or low cost supplies to the hospital, health facilities, wards

3. No promotion or inducement to health workers (gifts, tours, grants,conferences, medical journals & magazines etc)

4. No gifts to mothers, relatives. No free samples.

5. No promotion of any food or drink for babies less than 6 months

6. No misleading information

7. Only factual and scientific material for the professionals

8. Labels on tins not to idealize formula milk through pictures, text

9. Labels must mention the superiority of BF and the hazards ofbottle feeding.

10. All products should be of high quality.


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OBJECTIVE OF THE LEGISLATION

To ensure safe and adequate nutrition for infants and

young children by promoting and protecting breast-feeding

by

regulating the marketing and promotion of designated

products including breast milk substitutes, and of

feeding bottles, valves of feeding bottles, nipple shields,

teats and pacifier and to provide for matters connected

therewith or ancillary thereto.


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SALIENT FEATURES OF THE LEGISLATION

Board and Committees on National & Provincial level(Administrative setup)

Checks/ Regulations

Labeling, Promotion, Quality Standards,Offering or Making gifts

Responsibilities of Health Workers

Investigation, Prosecution & Penalties


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CHAPTER I

SHORT TITLE, EXTENT AND COMMENCEMENT

This Ordinance may be called the Protection ofBreast-feeding and Child Nutrition Ordinance

2002.

It extends to the whole of Pakistan.

It shall come into force at once.


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CHAPTER II

ADMINISTRATION

National Infant Feeding Board Chairperson: Minister of Health

Board shall consist of members notified in officialGazette by the Federal Govt.

50% of the members should be technical e.g.Obstetricians, Pediatricians, etc.

One member representing the designated productindustry

Provincial infant feeding committee

Powers and functions


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CHAPTER III

LABELS

The contents of labelingNo discouragement of BF1.MOTHERS MILK IS BEST FOOD FOR YOUR BABY AND

HELPS IN PREVENTING DIARRHOEA AND OTHERILLNESSES(Urdu)

2.Not used emotional expressions and not compared with

breast milk , neither uses expression such asMATERNALIZED or HUMANIZED

3.No photos, drawings, & graphics except4.Name and add of Manu & Distributor of Designated Product5.Instructions in Urdu or regional languagepreparation,

composition, ingredients, batch no, expiry date, warningabout implementation


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CHAPTER III

PROHIBITIONS

Prohibited practices

1. No promotion of designated products

2. No assertion on designated products as sub for Mothers Milk

3. No gifts or free samples etc to Health workers, families and employees

of the board or committees

4. No donation of designated products & related equipment to the

Professional Association5. No person can instruct in the use or preparation of designated products

6. No contacts of Distributor & Manufacturer whether directly or indirectly

with general public in a Health Facility

7. No Informational or educational material about infant & young child

feeding shall be provided by Distributor & Manufacturer


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CHAPTER IV

INFORMATION AND EDUCATIONAL MATERIAL

No manufacturers, distributors or any person engaged by them

shall produce or distribute any educational or informationalmaterial relating to infant and young child feeding to general public

Informational and educational materials, whether written, audio or

visual, which refer to infant feeding shall contain only correct

information and shall not use any pictures, graphics or text that

encourage bottle-feeding

Informational and educational materials, whether written, audio or

visual, which refer to infant feeding may be provided to a health

professional only after its submission and approval by the board,

and shall not imply or create a belief that bottle-feeding is

equivalent or superior to breastfeeding.


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CHAPTER VI

PENALTIES AND PROCEDURES

1. Federal Govt will suspend the license of a guilty person (exceptmedical practitioner) found to have contravened any of the

provision of the ordinance or the rules.

2. In case of medical practitioner, the matter would be referred to

the PMDC.

3. In case of Manufacturer or Distributor violating provisions of

Section 7 and 8 (but not all of them), a punishment of

imprisonment for a term which may extend to 2 years or with fine

(Rs. 50000-500000)

4. Any other contravention of the Ordinance/rules would attract a

fine of maximum Rs.500000.


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PROCESS OF IMPLEMENTATION

With the passage of 18th

Amendment to theConstitution of Pakistan on April 8, 2010,Health was transferred to the Provinces.

The adoption of GoP

s Code of Marketingof Breast Milk Substitutes

became the

responsibility of the Provinces. Provincial Assemblies of Punjab, Sindh and

Balochistan passed the Legislation in 2009,2013 and 2014 respectively.


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PROCESS OF IMPLEMENTATION

Infant Feeding Board/Committee to benotified.

Finalization of Rules and Regulations by

Infant Feeding Board/Committee. Vetting and approval by Department of

Law.

Endorsement by Department of Health

and Notification of Rules and

Regulations.


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FUNCTIONS OF THE BOARD/COMMITTEE

Make the rules and regulations

Receive reports of violations of Code.

Recommend investigation of cases.

Plan and co-ordinate dissemination of informational and

educational materials. Advise government on policies for promotion and

protection of BR.F, IYCF, designated products.

Advise on campaigns related BRF and IYCF, organize

health education of same. Conduct regular meetings, maintain minutes.


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WHAT NEEDS TO BE DONE

Advocacy to promote Breast Feeding Bring about Behavior Change among HCP

and medical college students

Regular monitoring of the Legislation Appropriate penalties to the defaulters

Support by Provincial Govt.

Cooperation of all stake holders across theboard.

Documents

Teaching Module 3 for BRF