WBTi Training In Cameroon

By Rose Ajonglefac
The President of the Federation of Cameroon Breastfeeding Promotion Association, FECABPA, has lauded efforts of the Cameroon government towards improvement of Infant and Young Child Feeding, IYCF. He was speaking in douala on the occasion of the launching of the orientation training on the World Breastfeeding Trends Initiative, WBTi. He siad, he was honoured to have the opportunity to welcome infant nutrition advocates and the IBFAN Africa consultant, Pauline Kisanga, who arrived Cameroon to capacitate the advocates last November 10. He thanked Mrs. Joyce Chanetsa, current regional coordinator of IBFAN Africa for including Cameroon on the list of countries that have benefited from the training in the Africa region.
The Ministry of Public Health guided the trainer of trainers workshop organisers during the preparation and secondary data was collected from WHO/UNICEF Cameroon websites on child nutiriton trends.
The WBTi orientation workshop was hosted at Royal Palace Hotel Bonaberi-Douala for two days.The 14 participants observed that workshop was alearning and exchange opportunity on the World Breastfeeding Trends Initiative. This training is expected to assist in the expansion of our breastfeeding advocacy for protection and promotion, monitoring and evaluation of mothers' in Cameroon .
Pauline Kisanga was described as the Africa Queen of Infant and Young Child Feeding. WABA had during past ceremonies considered her as Africa’s ambassador of breastfeeding advocacy.
She has published several works including, “The Process for Successful Implementation of ILO Maternity Protection Convention 183 of 2000 at National Level: Africa Regional Experience of Step by Step Action” and “The Protection, Support, and Promotion of Breastfeeding in HIV: Policy Guidelines by IBFAN Africa”.
She is special to Cameroon Link, because in her capacity as the Regional Coordinator of IBFAN Africa and with the support of Baby Milk Action, the organisation was co-opted and affiliated into the Anglophone and Lusophone IBFAN Group in 2000. With her coaching and constant support, Cameroon Link grew from strength to strength and was recipient of the IBFAN Africa distinction in 2007 in Maputo, Mozambique for excellent advocacy strategies during the 7th Regional Conference and its commitment and engaging support for the promotion and protection of breastfeeding in the continent and Cameroon in particular. IBFAN' award was the second distinction after the George Atkins Communication award by the Developing Countries Farm Radio Network in 1996. In 2008, Cameroon Link also received WABA's Gold Medal for the World Breastfeeding Week Marathon events in Cameroon.
Cameroon Link today pilots the Federation of Cameroon Breastfeeding Promotion Associations, FECABPA, the Men’s Initiative of the World Alliance for Breastfeeding Action, WABA, and is the Focal Point for the International Baby Food Action Network (IBFAN)Group in Cameroon. At Cameroon Link, the motto is "Babies can’t wait and it is baby's right to be breastfed on demand and exclusively for the first six months.”
Cameroon Link remains more committed than before, especially as on the 23rd November 2009, the 20th Anniversary, it is involved in a new initiative, “The World Breastfeeding Trends Initiative.” The data and information presented during the World Breastfeeding Trends Initiative orientation trainers' workshop was built on reports and information collected from the Demographic Health Survey, DHS in Cameroon, statistics from the ministry of planning, programming and territorial development in Yaoundé, WHO and UNICEF sources.
It should be noted that comprehensive survey results are published in the DHS final reports approximately 8 – 12 months after the completion of fieldwork while standard reports are approximately 200 pages in length and include topics on household and respondent characteristics, fertility and family planning, maternal and child health, nutrition and HIV/AIDS.
The department for health promotion in the ministry of public health contributed as the policy and decision making channel. The IBFAN Cameroon Link Group collaborates with the Ministry of Public Health and reports regularly on all its activities. Here are key indicators which will be revised and published in April 2010 when the current survey on the rights of the child to food will be validated.
IBFAN Cameroon Link Group observed that much progress has been made to increase the rate of breastfeeding in Cameroon. He presented indicators which have to be validated and published in April 2010.
2009 INDICATORS (1-5)
1. Percentage of babies breastfed within one hour of birth in the last 24
Hours - 95.6%
2. Percentage of babies of 0<6 months of age who are exclusively breastfed - 37%
3. Median duration of Babies breastfed for up to 24 months - 17.5%
4. Percentage of breastfed babies less than 6 months old receiving other foods or drinks from bottles - 26.2%
5. Percentage of breastfed babies receiving complementary foods from 6-9 months of
Age - 79.2%
Indicator 6: National Policy, Programme and Coordination
There is a national policy on infant and young child feeding.
Gaps:
1. Inadequate funding for IYCF activities in Cameroon.
2. Non existence of a National Breastfeeding Committee and Coordinator at the level of Public Health Ministry.

Recommendations
1. We advocate for increased funding of programmes to improve infant feeding practices.
2. We advocate for the establishment of a National Breastfeeding Committee and that the government should appoint a national coordinator of Infant and Young child Feeding.

Indicator 7: Baby Friendly Hospital Initiative (Ten steps to successful breastfeeding in the maternity services)
Some work was done on the Baby Friendly Hospital Initiative, but not enough evaluation was done for certification in the Adamaoua Region, which was area of concentration.
Gaps:
1. The frequent redeployment and high attrition rate of trained health workers.
2. Infrequent monitoring at national and regional levels.
Recommendations:
1. Train Auxiliary Nurses on the ten steps to successful breastfeeding because these nurses do not change health facilities very frequently.
2. Increase monitoring and supervision.

Indicator 8: Implementation of the International Code
All aspects of the code have been adopted and domesticated in Cameroon and are being implemented, though monitoring needs to be enforced more regularly. IYCF promotion advocates from many works of life have been trained to monitor implementation and violations of the Cameroon National Code put into circulation on the 1st December 2005. There will be greater outreach if the national code is translated into the English language. Repressive measures need to be included in the code for the enforcement of its articles in case of violation.

Indicator 9: Maternity Protection
Gap
1. Maternity leave does not meet the minimum ILO recommendations and does not cover all working women especially those in the informal/unorganized or agricultural sectors.

Recommendations:
1. Advocate for ensuring maternity protection to reach at least the minimum recommended by ILO (ILO MPC 183) while at the same time increasing its scope to include all women of child bearing age who may be in one form of employment or the other.

Indicator 10: Health and Nutrition Care Systems
Gaps
1. Inadequate coverage of IYCF issues in Pre-service health training schools.
Recommendations
1. Support health training institutions to include IYCF issues in their curricula.
2. Train the teachers on IYCF issues.

Indicator 11: Mother Support and Community Outreach – Community based Support for the pregnant and breastfeeding mother.
There is an extensive community based support system that provides up to date information to pregnant women and mothers, though there is inadequate staff in health facilities.
Recommendation
More community outreach staff should be trained for all regions and health districts to be covered.
Activities need to be reinforced within the communities with seedgrants and Ministry of Public health subventions.

Indicator 12: Information Support
The existence of a national IEC strategy for improving IYCF practices in Cameroon helps to raise the status from where it was in the latter part of the 1990’s to where it is now. It has become a tradition to celebrate the National IYCF Nutrition Week (January) and World Breastfeeding Week (August) in Cameroon nation wide.

Indicator 13: Infant Feeding and HIV
The government is commitment to the prevention of paediatric HIV in all regions and health districts.
Gap:
1. Inability to ascertain the actual proportion of babies of HIV positive mothers that are protected from infection due to appropriate feeding options.
2. The high attrition rate and frequent redeployment of health workers hampers the implementation of activities. Many health workers retire without replacements in the health facilities. The number of nutrition counseling specialists in health facilities throughout Cameroon remains low.

Recommendations
Conduct operational research to determine the proportion of babies of HIV positive mothers who become infected through breastfeeding.
Train more staff and reactivate dormant peer education activities for HIV prevention to promote behavior change communication.

Indicator 14: Infant Feeding during Emergencies
Very little is done in the area of emergencies. Emergencies are not well documented and this infringes on preparedness.
Gaps:
Infant feeding in emergencies is not addressed enough in existing policies. Interventions are sporadic and not on permanent basis, especially as rural communities outreach remains limited.
Recommendation
Ensure that the Nutrition Policy is reviewed to capture infant feeding in emergencies and the strategic plans be developed to adequately address IEC on IYCF.

Indicator 15: Mechanisms of Monitoring and Evaluation System
Monitoring, evaluation and follow up is done with the organization of frequent meetings involving NGOs.
Gaps:
1. Paucity of data especially median duration of breastfeeding and bottle feeding rates. Data varies from rural, to semi urban and urban areas.
2. Information on IYCF not routinely collected through the health systems on breastfeeding trends in all districts and regions.
Recommendations
1. Surveys to consider collecting more comprehensive information on Infant and Young Child Feeding practices including bottle feeding and duration of breastfeeding.
2. Incorporate IYCF in the routine health maternity counseling services of both public and private facilities.
For more information, contact the WBTi training organisers at camlink99@gmail.com