59TH CRC Committee

Governments to Improve Exclusive Breastfeeding and Enforce the International Code
By Ina Verzivolli, GIFA Geneva, Switzerland
Email: ina.verzivolli@gifa.org
The 59th session of the Committee on the Rights of the Child (CRC Committee) took place from 16 January to 3 February 2012 in Geneva. The Committee reviewed the progress of the implementation of the Convention on the Rights of the Child in 6 countries: Azerbaijan, Cook Islands, Madagascar, Myanmar, Thailand and Togo.
IBFAN presented alternative reports on the situation of infant and young child feeding, for 5 of the countries under review. The report of Madagascar was prepared in coordination with the regional group of IBFAN Africa. The report of Madagascar and Thailand was prepared in coordination with the regional and local IBFAN groups. The reports on Azerbaijan, Cook Islands and Myanmar were written by the Geneva Infant Feeding Association (IBFAN-GIFA). There was no alternative report in the case of Togo.
In its concluding observations, the CRC Committee made observations/recommendations on infant and child feeding in all cases and specifically to breastfeeding to 4 out of the 6 countries.
The rates of exclusive breastfeeding in the group of countries under review are particularly low, e.g. 5% in Thailand, 12 % in Azerbaijan and 15% in Myanmar. Therefore, the CRC Committee stressed, in particular, the necessity for the governments to take all possible efforts to improve exclusive breastfeeding in their countries. Governments were recommended to raise awareness among the public and educate the communities and mothers in particular about the importance of breastfeeding and the risks of artificial feeding. The Committee raised concerns over the very low rates of initiation to breastfeeding in some countries like Azerbaijan and Thailand, and urged these to take the necessary efforts to change this situation.
Almost all governments went home with a recommendation to adopt or strengthen their regulation of the marketing of breastmilk substitutes. Azerbaijan was urged to establish “monitoring and reporting mechanisms” with regards to their law which implements the International Code, and was advised to disseminate information widely about these measures. The government of Madagascar was given a recommendation to effectively enforce its National Code of Marketing of Breastmilk Substitutes and establish monitoring systems to detect cases of violations. Thailand was urged to adopt legal regulation for the marketing activities of breastmilk substitutes in accordance with the International Code and to ensure effective monitoring and compliance.
The Committee paid attention also to the issue of obesity and the marketing of junk, sugary and fatty foods to children. In the case of the Cook Islands, the Committee expressed concern for the increasing obesity rates and recommended the government to adopt regulation to restrict and monitor the marketing of these types of foods.
The Committee considers important the role of the health systems in protecting, promoting and supporting breastfeeding. It urged countries to make their hospitals baby-friendly, to support the Baby-Friendly Hospital Initiative (BFHI) and to sensitize and train of health workers that are involved in maternity work.
On issues related to child nutrition more generally, the Committee expressed its concern with regards to child malnutrition in all countries under review. It focused on the need to improve equal access to health care services and decrease inequalities, increase budget allocations to the health sector, strengthen the primary health care system, improve maternal health care services, etc. These recommendations are an obligation for the governments and a powerful tool for civil society to hold them to account.

Cameroon Link New Year Wishes 2012

On behalf of Cameroon Link, I would like to wish you all a Happy New Year and I hope your 2012 is off to a great start. The month of January is a time for new beginnings, but it is also a moment when we reflect on the previous year. In 2011, Cameroon Link began exciting new programs with the Commonwealth of Learning, WABA, Farm radio International, Plan Cameroon and the Cameroon Ministry of Public. A review of Cameroon Link's activities sheet was made to meet up with current modern challenges. We lost dear ones, but we also received new faces on board our programmes. At the same time we have reaffirmed our commitment to continue to promote, protect and support mother and child health care advocacy in various ways through community of learning open distance skills training and sharing of experiences.
We are proud of all we achieved in 2011 especially with the reshaping of the Men's Initiative e-newsletter. We could not have done it without the support of all at WABA Secretariat, our partners, national networks, regional networks, donors and people like you, who are passionate about the work we do. In your various countries and regions, there are many ways you can play an active role in changing the world through information, education and support of expectant mothers and lactating mothers. Find out more about SUFI, Community of Learning, Farm Radio and WABA Men’s Initiative campaigns and get creative with your awareness raising activities! Take a chance to inform and engage people on important global infant and young child health issues. Also remember that change doesn't happen on its own. We have to act collectively. When at http://uk.youtube.com/camlink99, click on breastfeeding promotion at the right corner and you will find yourself at"www.waba.org.my" web site.Click on healthy community and you will be at the www.col.org. Know more about Farm Radio International by visiting, www.farmradio.org. Congratulations to our IT specialists for connecting us better every day. We wish that 2012 should open the door for "Peace, Good Health, the achievement of your heart's desires and Happiness!
James Achanyi-Fontem
Coordinator,
WABA Men’s Initiative
Email: camlink99@gmail.com
You Tube: http://uk.youtube.com/camlink99
Online Radio: http://www.spreaker.com/page#!/show/the_camlink_douala_show

CAMEROON LINK SHARES COL ACTIVITIES IN LEBIALEM

By Helen Egbe Ayamba,
Cameroon Link
Email: camlink99@gmail.com
The Regional Director of Cameroon Radio Television, CRTV Littoral, Serge Ngando Ntone, has lauded the opportunity given by the COL Cameroon Link Partnership Liaison to media men and women of the Cameroon Association of English Speaking Journalists, CAMASEJ, to learn about the activities of the Commonwealth of Learning.
Serge Ngando Ntone was speaking during a one day workshop at the conference hall of CRTV Littoral in Douala on the occasion of the World Press Freedom Day 2011.The COL Cameroon Link Partnership Liaison, James Achanyi-Fontem, shared the experiences and content of the on-going Commonwealth of Learning pilot programme in Lebialem, south west region of Cameroon and how it is impacting behavior change and communication with the communities there.
Patricia Oben, National President of CAMASEJ, told the participants at the sharing workshop, that it was a great opportunity to learn and discuss about COL activities, especially as Cameroon is one of the 54 member-states of the Commonwealth. She invited members to make good use of the information relayed by the COL Cameroon Link Liaison person, who he described as a veteran journalist and broadcaster, who remains an example to be copied.
The theme of the workshop was centred on the use of 21st Century communication tools for informing and educating communities within the scope of Open Distance Learning, ODL. The workshop facilitator told media men and women in Cameroon that Commonwealth of Learning is coordinated from Vancouver, Canada and that it provides a wealth of services and collaborative opportunities for policy makers, institutions and distance education practitioners to encourage the development of, and help enhance, the use of open and distance learning (ODL) policies, systems and applications.
He added that COL guides media professionals on how to use modern technology as a means of increasing the scope, scale, quality and impact of member-countries’ education and training systems. The application of technology through ODL techniques has shown its power and value in many countries and for many purposes. Achanyi-Fontem shared the experience of the radio-in-box experiment in Kochi, India during the 6th Pan Commonwealth of Learning Forum in November, 2010 saying that participation, education and development are the key guiding principles for giving equal opportunities to citizens of any community.
COL partnership liaison person described “Community Media” as any form of media that is created and controlled by a community, either a geographic community or a community of identity or interest. He reminded the media professionals that it is increasingly recognized as a crucial element in a vibrant and democratic media system like Cameroon.
Community media is "Community Communication” because it can take so many forms, be applied by so many different groups of people, and be directed at a wide range of issues like the case of Lebialem, where the issue is using Lebialem Community Radio to inform and educate the community on mother and child health care through the story design matrix. He observed that no single individual or organization can change a community. All target groups within the community have to be involved for any results to be achieved. The role of the experts are to guide citizens on decision making and seeking solutions to problems concerning their well being and livelihood.
Achanyi-Fontem told Cameroon journalists that the success of the Commonwealth of Learning lies on the fact that the organization has no axe to grind any where on the planet during its application of “Learning for Development” principles. From experience, it was reveal that community media is a facilitative tool for discussion and engagement of the ordinary citizenry and has some inherent implications, because the key characteristics of community media convey a more clear understanding of its definition as well as its depth and dimension in terms of how it takes shape in the civic landscape.
The community media programme in Lebialem is serving as a means by which to avoid self-marginalization in the health matters while still adhering to the principles of community interests and social objectives within the reproductive health domain and acts as a means by which local news and information is disseminated. This is allowing citizens to inform themselves about the issues taking place around them.
Lebialem Community Radio is said to be becoming a powerful tool for learning for development, especially informal learning for improving health and livelihoods, because it is both a mass medium and a local medium. It is now providing non-formal educational opportunities, especially for non literate communities in the division.
From interactions between the programme producers and the listeners, it has been observed that the radio is a focal point for community driven learning, that allows learners to identify their own priorities based on participatory mechanisms of assessment. Radio Dramas, storytelling, interviews and songs are used as effective and low cost ways of making community voices an integral part of the learning process.
COL Cameroon Link Partnership liaison invited CAMASEJ to get involve because it is a win-win direction. The CRTV Regional director, Serge Ngando Ntone, recommended that COL should create more capacity building opportunities because the community media scope in Cameroon is fast expanding but formal training possibilities are narrowing down.
Participants asked questions on the use of internet links, how to design media community driven projects and where to get funding for execution media projects and the facilitator shared a few links with the journalists and broadcasters. One participant asked why funding agencies focalize in some regions and not others. The liaison person explained that good governance remains a challenge and road block for many Africa countries and sub regions. He added that when funders discover organizations with excellent delivery records, they do not hesitate to make a contribution. He made it known that organizations should work as a network to achieve better results when funding become rare.
He concluded by quoting the on-going Africa Radio Research Programme Analysis taking place in five countries, Cameroon, Malawi, Ghana, Kenya and Tanzania to learn how radio stations go about producing farmers’ interest programmes, the difficulties encountered and how they are overcome. Websites were shared after introducing the persons behind the different Community of Learning initiatives.Sir John Daniels was introduced to the Cameroon journalists as COL President and Chief Executive Office since 2004. Before occupying the position of the chair, Sir John Daniels had gained wide international experience in universities and the United Nations systems.The Vice president, Prof. Asha Kanwar doubles as COL Programme Director and She is responsible for stakeholder engagement and programme direction. Ian Pringle is the Media Education Expert directly monioring the COL Cameroon Link Partnership action taking place in Lebialem, Cameroon and contributing to areas for consolidation of impact. The focal points of the Commonwealth of Learning in Cameroon are Prof. Tambo Leke and Dr. Ndume Ndume, who are both top level government officials in the Cameroon education sector.
CRTV Littoral station manager, Kenneth Asobo, told participants that he is particularly delighted to have had the opportunity of participating in the workshop, especially as he is only two months old in Douala. He wished that several such opportunities be created for fruitful exchanges, since it remains a learning and sharing of experiences process.
Participants at the Commonwealth of Learning Exchange workshop came from Cameroon Radio Television, Spectrum Television, Canal 2 Tv, Cameroon Post, Cameroon Tribune,Radio Veritas, l'Effort Camerounais newspaper and Africa News Agency, just to name a few.Some important web site links shared with the journalist for gathering programming materials include: www.col.org,http://cscuk.dfid.gov.uk/
http://www.cscuk.org.uk/alumni/alumni_general.asp,www.farmradio.org, "IJNet Editor" editor@icfj.org, http://www.gfwc.org,www.awid.org dealing with women's rights issues,http://bit.ly/fq2Ruj,http://bit.ly/4pxeD5,www.waba.org.my

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