Integrated Early Childhood Development at UNICEF: Targeting the Mother-Child Dyad -

Vital to MTSP Success

UNICEFProgramme Division

Nutrition Section

UNICEF

What is Optimal Infant and Young Child Feeding?

Six months exclusive breastfeeding

Continued breastfeeding with appropriate

complementary foods and feeding for 2 years

and beyond

Related maternal nutrition and care

(Birth Interval of 3 years or more)

UNICEF

A World Fit for Children

By 2010: Reduction of child malnutrition among children

under five years of age by at least one-third, with special attention to children under two years of age, and reduction in the rate of low birth weight by at least one third of the current rate.

Other Millenium Goals for <5MR and MMR

UNICEF

Nutrition related MTSP target indicators

Reduction in anemia prevalence among women of reproductive age by 15%

> 60% of pregnant women use adequate antenatal services

> 60% of children receive appropriate home care for prevention and treatment of malnutrition

UNICEF

Focus of I/ECD

Integrated-ECD is based on child’s rights principles and the life-cycle approach, developed to co-ordinate actions at different levels, aiming to improve:– Quality of family care

– Family access to good basic services and adequate livelihoods

– Community & policy environment needed to support the previous points.

General Goals: Survival, Growth and Development

UNICEF

I/ECD: Health, Nutrition, WES, ECD, & Child Protection:

The Importance of the Mother-Child Dyad “A good start on life”

“Children under 3 y.o.”

“Support women’s health, nutrition, and well-being”

“Links to maternal health and survival”

Maternal nutrition for birth weight and maternal survival, early initiation of exclusive breastfeeding (EBF)

EBF, appropriate CF which includes responsive feeding, VitA, Birth spacing

Mother-child vs Child orientation, empowering caretaker to act and interact

If mom survives, the child is 3- 5 times more likely to survive

UNICEF

Other MTSP Strategies

Girl’s Education

Immunisation Plus

HIV/AIDS

Child Protection

Cognitive and psycho-social achievement highly associated with breastfeeding

Breastfeeding provides first immune protection, and Vitamin A, among others, helps fight disease

Strong nutrition link; EBF decreases transmission

Nurtured and breastfed children less likely to be deserted and abused

UNICEF

Current and Planned I/ECD Interventions: The Same Target Audience for All

ANTENATAL CARE

SAFE DELIVERYADEQUATE BIRTH WEIGHT

OPTIMAL AND RESPONSIVEINFANT AND

YOUNG CHILD FEEDING

AT LEAST THREE YEARSBIRTH SPACING VIA

FAMILY PLANNING USE

ANTENATAL CARE

MPSMNI

Malaria Presumptive Tx/Nets

Expanded MPS/SMBFHI

“Expanded Step Ten”CODEMNICF

IMCI/CIMCIIMM WES

FP(UNFPA)ECDLAM

BF/CF

CARE SEEKING

UNICEF

Mother-Child Dyad:The Heart of ECD

Three years birth spacing for mother’s nutritional recovery Three years as youngest child

Three years of stimulation and responsive feedingThree years of health-care seeking and preventive actions

Maternal Protein, Calorie and Micronutrient Stores

UNICEF

Baby Friendly and Beyond

Is it time to expand beyond BFHI? If so, in what direction? How can we support the World Fit for Children goals,

the new UNICEF priorities, the war on HIV, while maintaining support and interest in best start for children: the caring of an empowered mother?

What specific components would extend the effort towards increased empowerment of women while maintaining the focus on the importance of optimal breastfeeding?

Other ideas?

UNICEF

Countries that have adopted the Code into Law

16 countries have measures drafted awaiting final approval, and a further 26 are studying how best to implement the Code.

1994 1998 2002Law (basedon Code asminimumstandard)

11 20 24

Some or mostprovisionsLaw

36 46 55

UNICEF

Infant Feeding and HIV:Draft Action Framework

1. Create comprehensive Infant and Young Child Feeding policies

2. Support the International Code of Marketing of Breastmilk Substitutes

3. Promote, protect and support optimal infant and young child feeding practices, especially in HIV prevalent areas

4. Support HIV-positive women to succeed in their infant feeding choice

5. Support country level learning, monitoring and evaluation, and operational research

UNICEF

Conclusion: Breastfeeding

support is central to the helath of

the mother-child dyad, and central

to I/ECD!

UNICEF

Thank you

Asante-sana

Salamat po

Merci

Gracias

Danke

Spasibo

Abrigato

Barakallaofik

UNICEF

Breastfeeding -> Early Childhood Development

Decreased child desertion in hospitals Best growth in first 6 months Improved elements of neuro-psycho-motor development

at age 1-2, and up to 12 Improved vision from a few months to years Increased independence and parental trust Increased intelligence quotient (IQ) assessed at ages 8

and 9 years; at age 18 years Decreased infectious and chronic illness, and decreased

impact of several metabolic conditions, supporting continued thriving

Increases in breastfeeding are associated with:

UNICEF

Breastfeeding -> Early Childhood Development Increased adolescent perceptions of maternal caring Higher reading comprehension, mathematical ability,

and scholastic ability assessed during the period from 10 to 13 years;

Higher teacher ratings of reading and mathematics assessed at 8 and 12 years;

Higher levels of attainment in school leaving examinations

Contribution to birth intervals, allowing more attention to care and feeding, and maternal nutritional recovery:

Result: children are alive and thrive!

UNICEF

Conclusions Interactive Breastfeeding and Responsive feeding are major

elements in the life of the 0-3 year old

Early, Exclusive and Sustained Breastfeeding are responsive to intervention programs

Survival, growth and development benefit inescapably from the presence of a living, health, and well-informed mother who is supported by her community - breastfeeding is empowering

If optimal infant and young child feeding is programmed, nearly all aspects of ECD are addressed and supported.

Targeting the maternal-child dyad may be a key to cross-sectoral integration