BABY FRIENDLY COMMUNITY INITIATIVE PROJECT

PRIME LACTATION CENTER CAMEROON

 

for contacts

Ngala Elvis Mbiydzenyuy MAPS MILCA

Lactation Management Specialist

Director Prime Lactation Center Cameroon

E-mail: elngala@yahoo.co.uk

Prime Lactation Center (the breastfeeding service of Maternal and Child Aid Cameroon) is a not-for-profit clinical, advocacy, educational and research center with a mission to protect, promote and support breastfeeding while helping families breast feed effectively.

Prime Lactation Center Cameroon has been operating for 4 months (since July 2013) and is endearing with innovative activities.

OUR GOALS INCLUDE:

a.       Promote optimal breastfeeding

b.      Increase pregnant and nursing mothers’ access to gain, practice and pass on knowledge of breastfeeding to families, friends and the community

c.       Increase newborn and infant survival rates

d.      Establish, implement and sustain Baby Friendly Hospital (BFHI) and Baby Friendly Community Initiatives (BFCI)

e.      Foster community approach to Integrated Management of Childhood Illnesses

ACTIVITIES:

1. Lactation Management and Support
2. Breastfeeding Counseling
3. HIV and Infant Feeding Counseling and Support
4. Breastfeeding Advocacy
5. Pre-service and In-service training in Infant and Young Child Feeding

STRATEGIES:

1. Behavior change communication through campaigns, advocacy, media and community social marketing
2. Mother-to-mother support group establishment and networking with health agencies, facilities and community leadership
3. Training of community based breastfeeding peer counselors
4. Breastfeeding and Infant feeding counseling, management and support
5. Increased access and utilization of antenatal and postnatal health services by pregnant and nursing mothers
6. Capacity building of health care professionals on basic lactation management skills and on implementation of BFHI Ten steps to successful breastfeeding.
7. Advocate for government to create standard day care centers with expression and storage facilities, around government work areas;
8.  Encourage big corporations and institutions to create breastfeeding corners to promote breastfeeding during nursing breaks    

Re-echoing WABA’s rationale for mother support, Prime Lactation Center Cameroon has taken the assertive initiative as part of her breastfeeding week celebration to create and empower mother-to-mother breastfeeding support groups in the Mezam division of the North West Region of Cameroon.

Many mothers give up breastfeeding exclusively or stop breastfeeding completely in the first few days to six weeks after delivery. This is a time when it may be difficult for mothers to visit a health care provider, support in the community is vital. Traditionally, support has been provided by older women in the family and community especially during the first 40 -42 days postpartum. However as society changes, in particular with urbanization, other family members may be far away and pressures to return to work have caused this period of mother/infant care to disappear.

The center has set-up three (03) mother-to-mother breastfeeding support groups in K-Town, Mile 4 and at Cow Street Bamenda with plans to create others across the division.

AREA LOCALIZATION

Mezam division is one of the seven divisions of the North West region of Cameroon and serves as host to the regional capital, Bamenda. With a population of 465,644 the central city reflects a typical cosmopolitan area with people of all age groups, ethnic, religious cultural and cross-geographical status. Mezam division has a surface area of 1745 km² with the peri-urban areas inhabited mostly by indigenes whose socio-economic statuses fall below the national GDP.  Infant and young child nutritional status in this area is thus a concern. Areas with good agricultural potential represent only about 10% of the surface area supporting 60% of the population. This is more so as wealthy migrants are encroaching with construction works thereby displacing local food sources. 

Mezam division serves host to many higher institutions of learning. This translates to increased youthful sexual activities, pregnancy and HIV rates. It is therefore expected to have higher incidences of postpartum depressions amidst high abortion rates, infant feeding challenges with HIV concerns, teenage mother stigmatization, and increased indiscriminate and inappropriate utilization of breast milk substitutes and lack of infant and young child feeding support.

This project focus area has a district health center and 10 integrated health centers, none of which is baby friendly and with no in-service training in infant and young child feeding within the last 5 years.

The coverage visits during pregnancy includes 50 % (poorest 20%) and 90% (richest 20%) for coverage at least one visit and less than 20% for coverage of at least 4 visits. 63 % births are attended by skilled birth attendants, 60 % of births occur in health facilities.

Share government public expenditures on health have declined in the past decade causing a deterioration of infrastructure and health services. The prevalence of diarrhea and respiratory infections in infants and the progression of the HIV/AIDS epidemic have contributed to the fall in life expectancy and rise in morbidity and mortality rates particularly for infants and under-fives. Population groups most affected are the rural, lesser educated as well as populations living in the peri-urban settlements. Inadequate infant feeding practices combined with low utilization of health services, lack of postnatal breastfeeding and infant feeding support centers, lack of trained health care workers in infant and young child feeding leads to a high prevalence of under-nutrition among infants in the peri-urban areas. While under-nutrition persists in these areas, non-compliance to the code of marketing of breastmilk substitutes and inappropriate feeding practices increase rates of infant hospitalization in the urban areas. 

Child survival strategy includes promotion of early initiation of breastfeeding, exclusive breastfeeding, and complementary feeding and Vitamin A supplementation. These are poorly communicated and are mostly health facility based with little community involvement. Much attention has been focused on PMTCT although it is mostly focused on voluntary testing and counseling. Confusion has continued to surround the issue of MTCT of HIV through breast milk among health workers as well as in the general public. Inadequate training of health care providers in PMTCT programs and poor information dissemination on this aspect has led to a compromised promotion of breastfeeding among health workers.

The nation is a signatory to the International code of marketing of breast milk substitutes but implementation at the regional and divisional levels have not been evident as we have experienced widespread promotion of breast milk substitutes including in the public health system.

Being the only Lactation Center in the country and located in Mezam division, Prime Lactation center within 3 months of existence has primarily engaged in campaigns, information and education namely: weekly radio-call in programs on infant and young child feeding, free antenatal breastfeeding education and postnatal breastfeeding management and support in health centers in the division.

National NGOs like Plan-Cameroon have had Infant and Young Child Feeding as one of their thematic focus. We belief establishing and engaging mother-to-mother breastfeeding support groups in this area will improve infant survival rates with potentials of scaling up the impact to national levels.

THE ISSUE

45% of women initiate breastfeeding within 1 hour of delivery. By 6 weeks, only 50% of babies are exclusively breastfed with the rates dropping to less than 30% by 3 months of age. At this same time 75% of the women introduce breast milk substitutes by 3 months. MTCT of HIV, perceived milk insufficiency and lack of postpartum infant feeding support and management lead to early cessation of breastfeeding. This accounts for increased infant morbidity and mortality rates with an average of 126 deaths per 1000 live births of infants under the age of 5 due to diarrhea and respiratory infections. These figures indicate clear need for action.

Mezam division peri-urban residents have diverse information needs, including those related to cultural differences, knowledge skills that affect their ability to obtain, process and understand breastfeeding information and services. 

Prime Lactation Center Cameroon in accordance with its mission and goals, seeks to develop, implement and evaluate programs and provide resources to establish a baby friendly community using mother-to-mother support groups in a bid to improve current exclusive breastfeeding/complementary feeding periods and foster community integrated management of childhood illnesses. 

 GOAL

The goal of the project is to reduce infant morbidity and mortality rate arising from inappropriate feeding practices in Mezam division by 30% within 3 years from start of project

OBJECTIVES

1. Breastfeeding counseling contacts with 75% of pregnant women at least twice during each pregnancy
2. Significant increase in sustainable, community specific antenatal and postnatal infant feeding support programs in communities in Mezam division particularly for high need groups
3. Establish, empower and network 50 mother-to-mother support groups to increase access to breastfeeding education and support.
4. Engage mother-to-mother support groups by the second year of the project on community breastfeeding social marketing campaign to promote positive attitudes to breastfeeding in the community and public spaces
5. Follow-up of 50% of breastfeeding mothers in Mezam division to attain exclusive breastfeeding rates at 4 months within the second year of the project

ANTICIPATED OUTCOMES

1. 50% reduction rate in early introduction of breast milk substitutes.
2. 40% exclusive breastfeeding rates at 4 months postpartum
3. Established community monitoring framework for infant and young child feeding practices
4. 30 % reduction in infant morbidity and hospitalization rates
5. Positive breastfeeding perception with complementary feeding and breastfeeding beyond 1 year
6. Increased rates of utilization of reproductive health services by pregnant women
7. Increased family planning outcomes

  

PROJECT WORK SCOPE

This plan addresses 4 action areas

1.       Promoting healthy community policy

2.       Developing peer counseling skills

3.       Strengthening community action

4.       Creating supportive environments

GUIDING PRINCIPLES

This plan is underpinned by guiding principles which apply to all outcomes and objectives

1.       The mother-child relationship is central to the plan

2.       Fathers, partners, family and the community play an important role in supporting a woman’s decision to breastfeed

3.       There will be measurable improvements in the rate and duration of breastfeeding

4.       All members of a community will have access to appropriate information and mother-to-mother support for protection, promotion and support of breastfeeding

5.       Communication, collaboration and effective joint planning between mother-to-mother support groups, health centers with roles and responsibilities that affect breastfeeding

6.       Clear mother-to-mother support group leadership on breastfeeding protection, promotion and support at the community level.

The plan focuses on 3 settings

1.       Family

2.       Community

3.       Health services