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Table 2 Summary of policies supporting best practice intervention

From: Policy content and stakeholder network analysis for infant and young child feeding in Nepal

Policy categories

# policy documents

General support for IYCF

Provision of correct information to mothers

Training of health workers to counsel mothers

Support mothers / caregivers to engage

Summary notes on how IYCF is supported in policy document

High level support

 

 Five-Year Development Plans (covering the period from 1965 to 2007 [23, 24, 52,53,54,55]

6

   

• These strategic development plans of the country supports for better nutrition since the Fifth Strategic Development Plan. These plans focussed to provide nutrition education (counselling) through the peripheral health facilities on breastfeeding, raising public awareness and utilisation of nutritious foods to improve the nutritional status.

 Three Year Interim Development Plan [56]

1

   

• The recent interim development plan has given emphasis to focus to the pregnant and lactating women and mothers with children under 2 years of age through multi-sector nutrition plan, which covers comprehensive interventions on Infant and Young Child Feeding.

 Multi-Sector Nutrition Plan 2013–2017 [27]

1

• This is the guiding plan for each sector to implement nutrition interventions and the major component of the plan is on implementation and scaling up of comprehensive maternal, infant and young child feeding program through BCC.

Sector specific support

 

 National Health Policy 1991, 2014 [30, 34]

2

   

• The Health Policy of 1991 focused in the promotion of breast-feeding, growth monitoring, prevention of iodine deficiency disorders, iron and vitamin A deficiency, and health education to enable mothers to meet the daily requirements of children through locally available resources. The recently endorsed national health policy has given emphasis to food based approach (promotion of dietary diversity in complementary feeding) along with promotion for breastfeeding. Growth monitoring has been identified as a key delivery point for nutrition education.

 Second Long Term Health Plan 1997–2017 [31]

1

 

• Implementation of programmes to control micronutrient deficiencies (anaemia, vitamin A and iodine deficiency) in order to improve the nutritional status of women and children was emphasized. Nutrition supplementation, Nutrition education and rehabilitation were identified as major interventions under the essential health care services but there was no mention about infant and young child feeding.

 Nepal Health Sector Program 2004–09, 2010–15 [32, 37]

2

 

• These health sector reform strategies strongly put nutrition as one of the priority programmes in which nutrition counselling was given an emphasis to be provided during growth monitoring both at the health facility and community level. A strong priority is given to the promotion of improved feeding and health practices via the network of community-based health volunteers and health workers, as well as using media-based campaigns.

 National Nutrition Policy and Strategy 2004 [35]

1

• This is the first guiding document for health sector in nutrition and protection, promotion and support for the optimal feeding practice for infants and young children was identified as one of the strategic objective of the document. Almost all aspects of IYCF has been included in the document.

 National Health Communication Policy 2012 [33]

1

    

• Nothing has been mentioned on nutrition and IYCF in the policy.

 National Safe Motherhood Policy 1998 [38]

1

 

• Maternity care especially during ANC has emphasized counselling on breastfeeding and family planning. Promotion for early initiation of breastfeeding during delivery care is included.

 National Policy on Skilled Birth Attendants 2006 [39]

1

 

 

• Assist women and their new-borns in initiating and establishing early and exclusive breastfeeding, including educating women and their families and other helpers in maintaining successful breastfeeding has been included as one of the core skills and abilities of Skilled Birth Attendants in the policy document.

 Food and Nutrition Security Plan of Action 2013 [48]

1

  

• This plan document is a part of Agriculture Development Strategy which has broader support for improving the nutrition security and it has prioritized nutrition education and counselling on complementary feeding practices through promotion of dietary diversity.

Implementation level support

 

 National IYCF Strategy 2014 [13]

1

• The term “counseling’ has been emphasised in the document, however, lacks in actionable term. Strongly recommends to establish and roll out a national integrated community and harmonized counselling package for behaviour change on IYCF, hygiene and sanitation practices, stimulation and responsive feeding, care of the sick child and maternal nutrition and to strengthen IYCF counselling into key maternal and child health contact points. Gives priority to scale up of community based IYCF integrated with key health and nutrition community based programs and has clearly outlined for identification of effective approaches for harmonising IYCF components across health sector and beyond.

 National Communication Strategy for MNCH 2012–16 [29]

1

 

• Recognises the importance to protection, promotion and support for optimal feeding practice for infants and young children for action against protein energy malnutrition by building capacity on infant and young child feeding (IYCF) counselling. Behaviour change communication for changing dietary practices and raising awareness, on appropriate feeding practices has also been emphasised. The document has explicit objectives both for caretakers as well as service providers to influence the appropriate IYCF care and practices

 National MIYCN Communication Plan 2016 [36]

1

• Use of all possible channels for raising awareness and emphasised the importance of interpersonal counselling at health facilities and outreach clinics.

Other relevant policies

 

 Breast Milk Substitute Act 1992 [28]

1

 

• Has instructed to form a high-level Breast Feeding protection and promotion Committee under the chairmanship of Secretary of MoHP to supervise the compliance of this act and to protect and promote breast-feeding and regulate the sale and distribution of products. Provisions like following points are some of the highlights of the act- During the promotion and information about the complementary food/BM substitute, the benefits of BF and risks of substitutes must be included, the manufacturer or the distributor shouldn’t make contact with the general public in the premises of health care agency in order to enhance their business or such objectives, the label on any substitute products must include its method of use and must not discourage BF.

 Nepal Labour Act 1992 [46]

1

   

• A pregnant woman worker or employee shall be granted maternity leave with full pay for a total of 52 days before or after delivery. Such leave may be obtained not more than two times during the entire period of service, provided that in the event two children of a woman who has already utilized maternity leave twice do not survive and in the event that she becomes pregnant again, she may obtain maternity leave under this section upon the birth of two more children