IBFAN Africa and Cameroon Link have conducted a three-day workshop from 24-28 October 2012, to orient the government of Cameroon on how to conduct periodic monitoring and evaluation of infant and young child feeding practices, policies and programmes using a simple to use World Breastfeeding Trends Initiative (WBTi) tool. The workshop was held at Hotel du Rail Bonaberi-Douala for 16 participants who came from the government, Civil Society Organisations (CSO), Infant Feeding
advocacy groups. Being gender sensitive, training and the breastfeeding trends reassessment included men, women and youth group representatives.
The workshop was facilitated by the Regional Coordinator of IBFAN Africa, Mrs. Joyce Chanetsa, and the Coordinator of IBFAN Cameroon Link Group, James Achanyi-Fontem, who triples as the National President of the Federation of Cameroon Breastfeeding Promotion Associations (FECABPA) and Liaison person of COL Cameroon Link Partnership and Men’s Initiative coordinator.
The objectives of the workshop were to sensitize participants on the Global strategy on Infant and Young Child Feeding and how it is linked to the WBTi tool; to impart knowledge and skills on the application of the WBTi tool for monitoring and evaluation as well as for advocacy and action to improve infant and young child feeding; to discuss unique national situations as regards the tool; Identify sources of representative local data and methods of its gathering them. This led to the development of an action plan from the reassessment.
According to the regional coordinator of IBFAN Africa, the workshop achieved its objectives and beyond as it was able to conduct a rough score of Cameroon (95.5/150 or 63.6 %) achievement on implementation of the Global Strategy of Infant and Young Child Feeding (GSIYCF).
The team came up with a concrete plan to utilize the draft assessment results to advocate for further
action using the community radio stations, national TV channels, newspaper publications and internet web sites and blog. The Regional Coordinator of IBFAN Africa appeared on national CRTV after meetings held in Yaounde, capital of Cameroon. During the meetings with top level officials and decision makers, Mrs. Chanetsa made calls for further action on the issue and invited Cameroon to participate in the World Breastfeeding Conference scheduled in New Delhi, India from the 6th – 9th December, 2012.
Cameroon achievements on implementation of Global Strategy
1. Excellent initiation of breastfeeding within one hour of birth (95.6%).
2. Cameroon has a national Code on the Marketing of Breastmilk Substitutes, even though it is not enforced and it has no sanctions.
3. Many health facilities in Cameroon practice kangaroo care to provide care to low birth weight or pre-term infants.
4. Community based support by mother support groups is fairly good, except that there is lack of optimal and correct information for mothers and community workers.
6. The World breastfeeding Week is celebrated nationally annually.
Identified major gaps
1. Too early introduction of other foods and water (26.2%) and too late introduction of appropriate complementary foods (20%).
2. Lack of a National Coordinator for infant and young child feeding in the Ministry of Public Health and a national coordinating committee supported by the Ministry of Public Health and fully responsible for IYCF.
3. The National Code of Marketing is not translated into English so that all can understand and it lacks sanctions.
4. Information, education and communication efforts are only reaching 58% of the population.
5. High bottle feeding practices for infant 0-6 months (26%)
6. No efforts are made to implement BFHI in health facilities.
7. No awareness of infant feeding in emergencies.
8. On Maternity protection, not all provisions of the ILO 183 Convention are addressed and there is no protection of agricultural workers and those in the informal sector.
9. There is need to know more about what is happening to mothers who are HIV positive in terms of infant feeding.
1. Cameroon has over 75 community radio stations that are not fully utilized by the government to disseminate information on infant and young child feeding education.
2. Cameroon boasts of having a good national Federation of Cameroon Breastfeeding Promotion Associations, FECABPA; it is host of the Men’s Initiative of the World Alliance for Breastfeeding Action, (WABA).
3. Good relationships between Cameroon Link, IBFAN Africa, Commonwealth of Learning and the Government.
4. The government was fully supportive of the WBTi workshop and the gathering of preliminary data.
Key recommendations made to the government and local partners
1. Appoint a national Coordinator for infant and young child feeding who is in a senior position and create a national committee answerable to the Ministry of Public Health.
2. The government should have a budget for implementing infant and young child feeding programme.
3. The government should translate the national Code into English so that all can benefit and it should revise the Code so that it includes sanctions.
4. The government, WHO and UNICEF to initiate urgent opportunities to train health workers on BFHI
and implement the BFHI in health facilities and communities.
5. The government needs to integrate guidelines on infant feeding in emergencies within the
5. The Government with the support of WHO and UNICEF to improve monitoring and evaluation of IYCF indicators within existing systems.
Official opening of WBTi Re-assessment
In the welcome address, the national coordinator of IBFAN Cameoon Goup, James Achanyi-Fontem said, Cameroon is honored to have another opportunity for an orientation and reassessment training workshop on the World Breastfeeding Trends Initiative (WBTi). He thanked Mrs. Joyce Chanetsa, the Regional Coordinator of IBFAN Africa who included Cameroon on the list of countries to benefit from the training and reassessment on the World Breastfeeding Trends Initiative (WBTi). He recalled that Cameroon undertook the first assessment in November 2009.
He thanked the government through the ministry of public health for allowing the reassessment to happen and to the patronage it. He acknowledged that since the first assessment, many changes have taken place though the influence and guidance of the Minister of Public Health. The secondary data was reached for preparation of this re-assessment using WHO/UNICEF data and information system for analyzing the 15 key indicators of Cameroon’s trends so far documented.
The data used during the WBTi training and reassessment in Cameroon are based on information collected from the Demographic Health Survey (DHS) in Cameroon, statistics from the Ministry of Public Health, Ministry of Planning, Programming and Territorial Development, WHO, UNICEF and ILO sources in Yaoundé, capital of Cameroon.
The department for health promotion in the ministry of public health contributed through researched data as the policy and decision making channel within the frame work of its collaboration with Cameroon Link, FECABPA and IBFAN Cameroon Group that reports regularly on all its activities.
He concluded by saying, since the government is working on putting in place a national nutrition programme, the opportunity of the training and re-assessment was used to advise the Cameroon government, on the key areas of budgeting for achieving successful breastfeeding in a country.
He explained that in most countries of the world, a national budget for breastfeeding promotion activities is broken down to cover the following key expenditure lines:
• budget for training in IYCF counselling,
• budget for Code implementation and protection of breastfeeding
• budget for promoting maternity benefits,
• budget for policy development of breastfeeding/IYCF promotion,
• budget for developing and promotion of legislation on the Code,
• budget for promotion of the setting up of good crèche systems,
• and a budget for annual operating costs of the nutrition programme.
If the government improves on its policy by taking decisions to make the necessary resources available, breastfeeding rates will increase from the current 20% to 65% by the year 2015, he concluded.
It was highlighted that UNICEF is working with communities and the government to increase access to sanitation from 33 per cent to over 60 per cent by 2015. During the training, paticipants had the opportunity to listen to Mrs. Tamfu Hanson Ghandhi, a Cameroonian UN volunteer on emergencies, who had the opportunity to serve in Rwanda. He addressed the unpreparedness situation of Cameroon in handling emergency situations in flood regions and where there has been an influx of refugees in the north and east regions of Cameroon.
Tamfu Hanson Ghandhi observed that the influx of refugees create silent emergency in some parts of
Cameroon apart from the natural disasters, which have become more and more regular. The participants agreed that additional challenges facing refugee children in Cameroon include the lack of birth registration as well as an increase in child sexual exploitation, early marriages and early pregnancies.
IBFAN Cameroon National Coordinator, James Achanyi-Fontem made a call for aid to Cameroon saying, “unless the Cameroonian Government and host communities receive the support they need to develop long-term solutions, the silent emergencies will continue to grow.
The Regional Coodinator, Mrs. Chanetsa emphasized the fact that over 2.000.000 child deaths is recorded each year due to poor infant feeding practices, and the strategy ensues that mothers feed their babies properly. She explained how the Innocenti Declaration came about with its objective in 2003 and was revised in 2005. The Innocenti Declaration was actually to show young mothers how to breastfeed rightly.
It was within the frame work of the declaration that Cameroon came out in December 2005 with an act of the national code for regulating the marketing of breastmilk substitutes throughout the territory. It was observed that the breastfeeding mothers are not protected after delivering their babies, most especially working mothers. The addition targets aim to remedy some of the IYCF lapses in a way to promote timely, adequate, safe and appropriate complementary feeding with continued breastfeeding by providing guidance on IYCF.
The head of the health plannification service at the regional delegation for public health in the littoral, Mr. Ekoum Joseph (MPH), officially opened the workshop with an acknowledgement to IBFAN Africa and the Commonwealth of Learn9ng for their support and efforts towards improvement of Infant and Young Child Feeding, IYCF, through community education strategies. He thanked Mrs. Joyce Chanetsa, the regional coordinator of IBFAN Africa for including Cameroon on the list of countries that have benefited from the training and reassessment in the Africa region.
In a record card briefing, comments and recommendations were made as follows:
Overall Comments: Cameroon has moved from 79,5% to 95,5% showing slight progress. The red and yellow colour rated areas should be seen as priority for government and stakeholders to act on urgently.
The assessors encouraged the government to enforce the legislation already put in place. The government decisions should ensure that business is done within the respect of laws put in place, as tools for the protection of the mothers and their babies.
The participants strongly recommend that the government should prioritize the following programme areas: Baby Friendly Hospital Initiative (BFHI), Infant feeding during emergencies, Ensure that the median duration of breastfeeding is increased in the community and that bottle feeding should be strongly discouraged.
Government is encouraged to develop an infant and young feeding policy and put in place the necessary structure for implementation.
James Achanyi-Fontem, is a Senior Health Journalist and Communication Consultant. He worked as a health journalist and broadcaster for 30 years with Radio Cameroon and later Cameroon Radio Television, CRTV before retiring in 2005 to engage fully with Cameroon Link (Human Assistance Programme). Cameroon Link is a registered charity, not-for-profit organisation involved in the promotion of community health, humanitarian assistance, promotion of women and child rights through involvement of communities in Cameroon for mother and child health care. Cameroon Link is a partner to Commonwealth of Learning (COL), Farm Radio International (FRI), International Baby Food Action Network (IBFAN Africa), World Alliance for Breastfeeding Action (WABA). As the intermediary of Commonwealth of Learning (COL), Cameroon Link is engaged to implement a Cameroon Rural Radio story design Programming through an investigative research, which aims to discover through interviewing beneficiaries of health programmes on their interests, documenting and disseminating new ideas about how radio stations produce and air Healthy Communities Radio Programs in Cameroon.