Filippinerne og Vietnam har i samarbejde med WHO indledt et eksperiment for at nå 2015 målenes punkt 4 og 5 om mødres og børns sundhed.
MANILA, 21 December 2010: Complex problems can sometimes be solved with simple solutions. For maternal and child health, significant progress has been achieved in Viet Nam by providing weekly supplements of iron and folic acid, and in the Philippines by encouraging breastfeeding.
In the process, both countries have taken a step closer to achieving Millennium Development Goal (MDG) 4, which calls for a two thirds reduction in under-5 mortality between 1990 and 2015, and MDG 5, which calls for a three quarters reduction in the maternal mortality ratio.
In a developing country such as Viet Nam, children and young women often suffer from iron and folate deficiency, resulting in anaemia and increased risk of death. In addition, the negative consequences of iron deficiency anaemia on the cognitive and physical development of children and on the work productivity of adults are of major concern for the Government.
A simple solution is to provide a regular supplement of iron and folic acid for women during child-bearing years. Evidence suggests that this is a desirable intervention in those parts of the world where women do not yet have access to fortified foods or to diets that are high in bioavailable iron.
In 1998, the World Health Organization’s Western Pacific Regional Office initiated a weekly iron and folic acid supplementation (WIFS) project. The project was piloted in four Member States: Cambodia, the Lao People’s Democratic Republic, the Philippines and Viet Nam.
The Philippines: a push for breastfeeding
A National Demographic Health Survey conducted in 2003 highlighted the dangerously low breastfeeding rates in the Philippines. The results came just after UNICEF and WHO launched the Global Strategy on Infant and Young Child Feeding (IYCF).
In response to the survey and the strategy, the Philippines launched a national policy on IYCF and a five-year national action plan to provide strategic direction for improving breastfeeding practices in the country.
Among the follow-up initiatives is the Essential Newborn Care (ENC) protocol under the slogan “The First Embrace”, which encourages early skin-to-skin contact and non-separation of the newborn child from the mother in order to promote breastfeeding. The exclusive breastfeeding rate at 28 days of life in the pilot hospital was double the national average for all hospitals.
Supportive supervision for IYCF was stepped up in health centres, with regular visits by national and regional coordinators. Key IYCF indicators were included in the Integrated Child Survival Monitoring Tool.
Progress has been encouraging, but much work remains to be done. Other areas that need attention include:
the implementation of the Essential Newborn Care protocol in hospitals to increase breastfeeding initiation rates within the first hour of life;
– reaching 1 million pregnant women through an integrated marketing communication effort;
– full implementation of the Expanded Rooming-In Act, which includes provisions for breastfeeding breaks and support for working women;
– the integration of IYCF in the curricula of all health workers; and
– the strengthening of implementation, monitoring and reporting of violations of the Milk Code, which regulates the marketing of breastmilk substitutes.
