Ten indicators on policy and programmes (1-10), and ve indicators on infant and young child feeding practices (11-15

Background

Introduction The Breastfeeding Promotion Network of India (BPNI) / International Baby Food

Action Network(IBFAN) South Asia developed the World Breastfeeding Trends

initiative (WBTi) in order to assess the status and benchmark the progress of the

implementation of the Global Strategy for Infant and Young Child Feeding at the

national level. At the same time WBTi has the potential to generate local action.

Based on the WHO's “Infant and Young Child Feeding: a tool for assessing national

practices, policies and programmes, the WBTi is designed to assist countries in

assessing strengths and weaknesses of 10 parameters of policies and programmes

aimed at protecting, promoting and supporting optimal breastfeeding and infant

and young child feeding practices and it also monitors 5 indicators of infant feeding

practices. (Table 1).

In 2016, IBFAN's 84-country report based on the WBTi assessments (Has Your

Table 1: Ten indicators on policy and programmes (1-10), and five indicators on infant and young child feeding practices (11-15)

1. National policy, programme and coordination 2. Baby Friendly Hospital Initiative (ten steps to successful breastfeeding) 3. Implementation of the international code of marketing of breastmilk substitutes 4. Maternity protection 5. Health and nutrition care systems (in support of breastfeeding &IYCF) 6. Mother support and community outreach 7. Information support 8. Infant feeding and HIV 9. Infant feeding during emergencies 10. Mechanisms of monitoring and evaluation system 11. Early initiation of breastfeeding 12. Exclusive breastfeeding 13. Median duration of breastfeeding 14. Bottle feeding 15. Complementary feeding

Indicators 1-10: Policy and programmes Indicators 11-15: Infant feeding practices

1Nation done Enough to Bridge the Gaps?) , highlighted several gaps in the implementation of the Global strategy. Infant feeding during emergencies (IFE)

— 1. https://www.worldbreastfeedingtrends.org/uploads/resources/document/84-country-report.pdf

stoodtobethemostneglectedone.Byendof2018, 97countriesreportedonWBTiassessments,which providedvaluableinformationindicatingseveral instancesofchangesinthepolicyandprogrammes. Thisevaluationreportprovidesananalysisand resultsofthestudyconductedtolookintohow WBTigenerateslocalactionandbringsdesired changeinthepoliciesandprogrammesthatremove barrierswomenfacewhilebreastfeeding.

Theoverallobjectiveofthestudywastodetermine theimpactoftheWBTiprocessonnationallevel advocacy,policiesandprogrammesonbreastfeeding/ IYCFincountriesthathavereportedonWBTi. Thespecificobjectives:

i) AssessthedifferenceWBTihasmadeata nationallevelonpolicy,programmesandpractices; ii)Analysefactorsassociatedwiththeuseofthe

WBTireportandreportcards,withaspecial emphasisonfrequency,methods,partnerships, and iii)AssesshowWBTiresultswereusedforadvocacy toimpactpolicyandprogrammes.

WBTiAssessmentProgressinLACRegion

Methodology

ConstitutioN OF THE GLObal technical working group The WBTi global secretariat constituted a technical working group (TWG),

comprising members with from Latin America and the Caribbean (LAC), Africa,

Europe, Asia and Arab world, with the research experience as well as in-depth

knowledge of the WBTi process. The TWG tasks included development of

questions and facilitate analysis.

Drafting and field-testing questionnaire With the study objectives in mind, the WBTi global secretariat drafted a set of

questions for this study and presented these to the technical working group (TWG)

for inputs. After initially nalising of the questionnaire, the TWG eld-tested it in

ve countries. This helped to improve the questionnaire. The TWG in collaboration

with the WBTi secretariat then agreed on the modalities of how the study would be

conducted as well as roles and responsibilities of the key players.

Data collection The global secretariat sent the data collection questionnaire electronically

(Appendix -1) to all the coordinators in the 97 countries in March 2019, and

received responses over next two months.

Analysis and report writing The WBTi global secretariat compiled information from the questionnaires and

managed data entry and analysis. For quantitative data analysis we used the

Microsoft Excel and SPSS to present in the form of descriptive statistics in

appropriate tabular and graphical formats. For analysis of qualitative data we did

the content analysis and applied standard methods of coding and identifying key

themes from what the respondents emphasized. We made efforts to combine the

closely related themes for synthesis into specic notes in order to make them more

workable for analysis. We used the manual coding of keynotes and subsequent generation of nar 2ratives, as recommended by Svarstad (2010) , believing in its advantages over available computer programmes. This helped us to easily interpret the different themes as well as the deeper understanding of the material that could be attained through the process.

— 2. Svarstad, H. (2010). Why hiking? Rationality and reflexivity within three categories of meaning construction. Journal of Leisure Research, 42 (1), 91-110.