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:
- Lactation Management and Support
- Breastfeeding Counseling
- HIV and Infant Feeding Counseling and Support
- Breastfeeding Advocacy
- Pre-service and In-service training in Infant and Young Child Feeding
STRATEGIES:
- Behavior change communication through campaigns, advocacy, media and community social marketing
- Mother-to-mother support group establishment and networking with health agencies, facilities and community leadership
- Training of community based breastfeeding peer counselors
- Breastfeeding and Infant feeding counseling, management and support
- Increased access and utilization of antenatal and postnatal health services by pregnant and nursing mothers
- Capacity building of health care professionals on basic lactation management skills and on implementation of BFHI Ten steps to successful breastfeeding.
- Advocate for government to create standard day care centers with expression and storage facilities, around government work areas;
- 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
- Breastfeeding counseling contacts with 75% of pregnant women at least twice during each pregnancy
- Significant increase in sustainable, community specific antenatal and postnatal infant feeding support programs in communities in Mezam division particularly for high need groups
- Establish, empower and network 50 mother-to-mother support groups to increase access to breastfeeding education and support.
- 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
- 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
- 50% reduction rate in early introduction of breast milk substitutes.
- 40% exclusive breastfeeding rates at 4 months postpartum
- Established community monitoring framework for infant and young child feeding practices
- 30 % reduction in infant morbidity and hospitalization rates
- Positive breastfeeding perception with complementary feeding and breastfeeding beyond 1 year
- Increased rates of utilization of reproductive health services by pregnant women
- 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
