Assessment of Status of Infant and Young Child Feeding 2006
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ASSESSMENT OF STATUS OF INFANT AND YOUNG CHILD FEEDING 2006 District: Udhamsingh Nagar (State of Uttarakhand) Written by Dr. Deeksha Sharma Department of Women Empowerment Breastfeeding Promotion Network of and Child Development, Uttarakhand India (BPNI) D-47A, Sector-4, Defence Colony, Dehradun, Uttarakhand BP-33, Pitampura, Delhi – 110034 Tel: 0135-2714104, 2665274 Tel: 011-27343608, 42683059 Tel/Fax: 011-27343606 Fax: 0135-2714389 Email: [email protected] Website: www.bpni.org Contents Page No. Acronyms i Acknowledgements ii District profile iii Executive Summary 1 1. Introduction 3 2. Background 4 3. Objectives of the Study 8 4. Study Design, Data Collection and Analysis 9 5. Findings of the Quantitative Study 12 6. Findings of the Qualitative Data 24 7. Assessment of Infant and Young Child Feeding in the hospitals of 27 Udhamsingh nagar, Uttarakhand 8. Conclusion and Suggested Action Ideas 32 Annexures 1. Quantitative Survey on Infant and Young Child Feeding - I Questionnaires 2. Qualitative Survey on Infant and Young Child Feeding - Questionnaires V 3. Tenth Five Year Plan Goals 2003 – 2007 for Infant Feeding Practices XV 4. Definitions of Infant Feeding Behaviours XVI PUBLISHED BY: Breastfeeding Promotion Network of India (BPNI) BP-33, Pitampura, Delhi – 110034 Tel: 011-27343608, 42683059 Tel/Fax: 011-27343606 Email: [email protected] Website: www.bpni.org ABOUT BPNI The Breastfeeding Promotion Network of India (BPNI) is a registered, independent, non-profit, national organization that works towards protecting, promoting and supporting breastfeeding and appropriate complementary feeding of infants & young children. BPNI believes that breastfeeding is the right of all mothers and children. BPNI works through advocacy, social mobilization, information sharing, education, research, training and monitoring the company compliance with the IMS Act. BPNI does not accept funds or sponsorship of any kind from the companies producing infant milk substitutes, feeding bottles, related equipments, or infant foods (cereal foods). Designed by: Amit Dahiya Acronyms ANM Auxiliary Nurse Midwives AWWs Anganwadi Workers BFHI Baby Friendly Hospital Initiative BPNI Breastfeeding Promotion Network of India CDPOs Child Development Project Officers DPO District Program officers DWCD Department of Women and Child Development EBF Exclusive Breastfeeding IMR Infant Mortality Rate IMS Act The Infant Milk Substitutes, Feeding Bottles and Infant Foods (Regulation of Production, Supply and Distribution) Act, 1992 as amended in 2003 IYCF Infant and Young Child Feeding IEC Information, Education & Communication MPRs Monthly Progress Reports NFHS National Family Health Survey NGOs Non Government Organisations OBC Other Backward Castes SC Schedule Caste ST Schedule Tribes TBAs Trained Birth Attendants UNICEF United Nations Children’s Fund WHA World Health Assembly WHO World Health Organisation i Status of Infant and Young Child Feeding in Udhamsingh nagar, Uttarakhand Acknowledgements t the outset, I would like to offer my heartfelt thanks to Department of Women AEmpowerment & Child Development, who has given BPNI an opportunity to survey 13 districts during 2005-06. Secondly, all the mothers and other respondents are entitled for our thankfulness, who patiently provided answers, and without whom this study could not have happened. We deeply appreciate the role of District Program officers (DPO) of Udhamsingh nagar, who was involved in conducting the study. Dr. B.S. Nagi assisted with data collection, entry, tabulation, and analysis. Mr P K Sudhir, Consultant, BPNI deserve special appreciation because of his keen interest and efforts to make this survey a success. Dr Arun Gupta, Dr J P Dadhich and Dr. Jagdish C. Sobti provided the final comments; I am extremely thankful for their contribution. Sincere thanks to Amit Dahiya for the design and layout - without his help the report would not have come out in this form. Dr. Deeksha Sharma Status of Infant and Young Child Feeding in Udhamsingh nagar, Uttarakhand ii District Profile n the vicinity of the spectular Kumaon lies the district of Udham Singh Nagar which was a part Iof district Nainital before it gained the identity of a separate district in October 1995 The district was named in the memory of Late Shri Udham Singh who was a great freedom fighter and who killed General Dyre after the brutal Jaliyanwala Bagh massacre. The district comprises of three main sub divisions Rudrapur, Kashipur and Khatima and is surrounded by the exotic Himalayan ranges. The tehsils in the district are Kashipur, Kichha, Khatima,Sitarganj. Bajpur and Garadpur are sub-tehsils. Whereas on the one hand, Udham Singh Nagar is basically an industrial district and many industry related professions are prevalant here, it is perfect example of 'Unity in Diversity' for which India is so widely known, on the other hand different cultures, religions and life styles are blended in absolute harmony.The fertile land lends itself to different forms of agriculture giving rise to agriculture related activities and industry making this land a green place which has resulted into prosperity all around. Pantnagar university is a leading temple of learning in the fields of agriculture and technology with one of the finest bulit university all around the world. The district is situated at 28-degree southeast, 30-degree north latitude, 78 degree and 81 degree east longitude of Kumaon. Nainital is to the north, Bijnour, Moradabad, Rampur to west, Bareilly, Pilibhit to south and district Champawat is in the east of this district. Southeast lies the border of Nepal. Reserved forest area lies at the borders of district Nainital and Champawat. The total district is Tarai. Water is available at the depth of 10 to 20 meters. Due to its special geographical structure the district is leader in agriculture in the country. The area of the district is 3055 square km. It is divided into three parganas, 4 tehsils,2 sub tehsils. There are 669 revenue villages and 15 forest villages. Out of 669 villages 298 villages are in tehsils Kashipur, 159 in tehsil Kichha, 122 villages are in tehsil Sitarganj and 90 in tehsil Khatima. There are 7 blocks for development work. They are Jaspur, Kashipur, Bajpur, Gadarpur, Rudrapur, Sitarganj and Khatima. These 7 blocks are further divided into 27 Nyaya Panchayat and 326 village Panchayat. Urban area is divided into 8 Palika Parishad Jaspur, Kashipur, Bajpur, Gadarpur,. Rudrapur, Kichha, Sitarganj and Khatima and 7 Nagar Panchayat MahuaDabra, Mahuakheraganj, Kelakhera, Dineshpur, Sultanpur Patti and ShaktiGarh. Population density of this district is 299 per square kilometer. In comparison with Uttarakhand 5.75 percent area is of Udham Singh Nagar. 9.8 percent schedule caste and 40.7 % schedule tribe of Uttarakhand reside in Udham Singh Nagar. According to the census of 1991, 39.3 percent are literate. In literate persons 66.7 % are male and 33.3 % are female. According to the 1991 census 153484 families live here. 102444 families are in rural area and 51040 are in urban area. District At a Glance Item Unit Detail Total geographical Area Sq. Kms. 3055 Population 1. Male Lacks 4.91 2. Female “ 4.24 3. Total “ 9.15 iii Status of Infant and Young Child Feeding in Udhamsingh nagar, Uttarakhand Executive Summary his survey on infant feeding practices in Udhamsingh nagar, district of Uttarakhand was Tassigned to BPNI by Department of Women Empowerment & Child development during the year 2005-06. Assessment of infant and young child feeding practices in the community is the first step to improve the child nutrition and development. The survey helps in documenting the prevalent infant and young child feeding practices and also give insight where actions are required to improve the situation. The findings of this survey are documented under three heads quantitative and qualitative aspect of infant feeding in the community and infant feeding practices in hospitals. The quantitative findings describe the prevalent IYCF practices and qualitative ones describe the reasons behind such practices in Udhamsingh nagar district of Uttarakhand. Quantitative aspect of infant feeding in the community The infant feeding practices were found sub-optimal at every indicator like initiation of breastfeeding within 1 hr was found as low as 32%, Prelacteal feeding that is very harmful for newborn, was highly prevalent (76%) and exclusive breastfeeding for 6 months was found 33% in this district. No 4-6 months old children was found exclusively breastfeeding, this is of serious concern. Qualitative aspect of infant feeding in the community 1. Prelacteal feeding is very much prevalent because the harmful effects of these are not informed to mothers during pregnancy and families. 2. Support and assistance at birth by health care providers was not available for early initiation of Breastfeeding. 3. Skilled-counseling on sufficiency of Exclusive breastfeeding to fulfill all needs of children for first 6 months was not given to these mothers. 4. Counseling on optimal Infant and Young Child feeding, at multiple opportunities, was not available to these families. Infant feeding practices in hospitals 1. There is strong need to encourage hospitals to become baby friendly by practicing ‘ten steps of successful breastfeeding’. 2. There is urgent need to aware all health care staff IMS Act and making them responsible to monitor this Act in their health care facilities. 3. Breastfeeding should be discussed during antenatal visits of all mothers. Proper positioning,