Upcoming webinars and other virtual events

Separated by quarantines and travel restrictions, nutrition stakeholders have turned to virtual events to connect, share information and discuss issues. Below is a selection of upcoming webinars and virtual events of interest – a list we will update weekly (so check back regularly!).  The list includes three sections, Webinars, Conferences, and Useful Online Resources.

Please share your webinar or other virtual activities of interest: Send us an email with the details (be sure to include date, time and a link) or share the information on social media using the hashtag #OnlineMIYCN!

Webinars

Food Systems and Nutrition Webinar Series: UCC Centre for Global Development and IFIAD

March 26, April 16 and April 30; times vary

UCC Centre for Global Development and IFIAD will host a three part webinar series on Food Systems and Nutrition. Speakers will include Johan Swinnen, Anna Herforth, Mary Corbett, Sudha Narayanan, Nick Nisbett, Ayako Ebata and Lily Schofield. The webinars will cover the impacts of Covid-19 on food systems (26th March), the affordability of nutritious foods (16th April), and women’s empowerment and nutrition (30th April), presenting the latest evidence and research on these issues. The series aims to highlight work being done by Irish development institutions, and generate discussion on how to move forward, looking toward the UN Food Systems Summit.

Register here.

Mycotoxin Exposure and Nutritional Status in the First 1000 Days: USAID Advancing Nutrition, JSI Research & Training Institute

April 1 @ 9am EDT 

The two-part webinar series focuses on mycotoxin exposure and nutritional status in the first 1000 Days from pregnancy through the first two years of a child’s life. This first webinar will explore the link between nutritional status and mycotoxin toxicity. The second webinar will focus on programmatic and policy implications of this relationship. Please stay tuned for more information on the second webinar set on May 20.

Conferences

iLactation has invited “Rock Stars of Lactation”, including A&T’s own Regional Technical Specialist in Southeast Asia Jenn Cashin, to be speakers at their18th online breastfeeding conference on the theme Feeding the future. Jenn will present on A&T’s recent research covering how our review of global COVID-19 breastfeeding and newborn care guidelines revealed misalignment with World Health Organization recommendations. The conference will be online from IBCLC Day, March 3 until June 3, 2021, with 18+ hours of education. CERPs and other professional development credits will be available.

Register here. 

Useful Online Resources

Investing in Child Nutrition: E-learning Course on Infant and Young Child Feeding from A&T, UNICEF, Global Health Media Project, & Raising Children Network 

Working with UNICEF and a global network of experts, Alive & Thrive developed an e-learning course based on the World Health Organization (WHO) Combined Course on Growth Assessment and IYCF Counselling as a free online resource to address gaps in training for those working in child health and nutrition in developing countries, especially in primary healthcare and community settings. Available in English and French, the self-paced course can be used as a solid introduction or a refresher course; modules include counselling skills, breastfeeding, complementary feeding, and growth assessment. Resources on COVID-19 and breastfeeding have been recently added to the platform.  

Online training courses on nutrition from Tufts University Friedman School of Nutrition Science and Policy

Tufts University Friedman School of Nutrition Science and Policy has created free online certificate courses as part of the Feed the Future Ethiopia Growth through Nutrition Activity. The intended audience for these courses includes those who are engaged in designing, implementing, funding and evaluating multisectoral programs and policies in Ethiopia and other LMIC countries. Each module involves an online lecture and completion of a quiz. Additional courses are added as they become available. Recently added: COVID-19 and Nutrition.

Capitalizing on fears, companies promote breastmilk substitutes during the pandemic

Breastfeeding saves lives and provides antibodies that give all babies a healthy boost and protect them against many infections. Antibodies and bioactive factors in breastmilk may fight against COVID-19 infection, if baby is exposed.

Manufacturers of breastmilk substitutes (BMS) are capitalizing on COVID-19 fears by using health claims and misinformation about breastfeeding to deceive millions of breastfeeding mothers into using breastmilk substitutes, a new review of their promotional materials and activities in major world regions shows. Alive & Thrive programs across the globe collaborated to complete the study.

Read the abstract and access the full text of the paper here.

“These tactics are not new, but the pandemic has provided a new entry point, helped along by the unprecedented boom in digital marketing,” said Roger Mathisen, director of Alive & Thrive’s program in Southeast Asia, and co-author of the study. “These tactics clearly violate the International Code of Marketing of Breast-Milk Substitutes, and are unconscionable at a time when mothers and families are particularly vulnerable.”

“Breastfeeding and its nutritional and protective health benefits are particularly important in the context of COVID-19, as the pandemic is straining health care systems and increasing food insecurity, especially in low- and middle-income countries,” added Manisha Tharaney, director of Alive & Thrive programs in West Africa.

Breastfeeding is critical to maternal and child health and survival, and its protection persists throughout the lifespan. Inappropriate marketing of BMS, feeding bottles, and teats threatens the enabling environment of breastfeeding, and exacerbates child deaths, diseases, and malnutrition, especially during the COVID-19 pandemic. The costs of not breastfeeding are well known.

Alive & Thrive researchers in the Southeast Asia and West Africa regions and at country offices in the Philippines and Burkina Faso collaborated to review various companies’ promotional activities. They analyzed promotional activities and materials dating from 30 January 2020, when the WHO declared COVID-19 a “public health emergency of international concern.”

The promotional materials, in multiple languages, appeared on the internet (e.g., infant feeding and child nutrition blogs, social media, company websites), in print magazines, in information sent to networks of health officials and professionals, at health facilities, and in shops. Among all the collected data, examples that made direct or indirect references to or coincided with the COVID-19 pandemic were selected for further analysis.

In all, promotional materials and activities from nine companies in 14 countries used various messaging tactics to market breastmilk substitutes. The messages reached millions of mothers and families.

“These tactics show a clear disregard for the health of mothers and children,” Tharaney said. “Companies used strategies such as donations to governments at a time when they are already vulnerable.

“It’s alarming that the companies – fully aware of how important breastfeeding is to the health of mother and child – would promote their products during a public health emergency, precisely when infants need the best nourishment and protection available – breastfeeding.”

The authors propose using the monitoring findings to inform World Health Assembly (WHA) actions, which at its meeting in May will mark the 40th anniversary of the International Code of Marketing of Breast-Milk substitutes. Further, the findings should be used for targeted enforcement and to address misinformation about breastfeeding in the context of COVID-19. Over the longer term, the authors said that more needs to be done to hold social media platforms accountable, raise public awareness on the Code, engage health workers and mobilize community monitoring.

Case studies show how medical colleges in India can improve the quality of MIYCN service delivery

Experiences in nine medical colleges in India have shed light on how the institutions can play a critical role in strengthening maternal, infant, and young child nutrition (MIYCN). The experiences have been summarized in a series of case studies developed by Alive & Thrive.

India medical college case studies
Alive & Thrive worked with multiple stakeholders to integrate MIYCN into the curricula of nine medical colleges. The initiative points to an effective way of filling knowledge gaps among health workers who ultimately serve millions in the nation’s health system.

“In India, medical colleges are strategically placed in the health care delivery system, making them an excellent platform to apply the latest scientific evidence to improve the quality of care,” explained Dr. Sebanti Ghosh, the director of Alive & Thrive’s program in India. “With the right support, these colleges and their attached hospitals can play a critical role in strengthening MIYCN.”

Improving MIYCN practices via medical colleges could potentially reach a significant number of doctors. About 50,000 students graduate every year from Bachelor of Medicine and Bachelor of Surgery programs at 542 government colleges across the country recognized by the Medical Council of India. The schools enroll about 65,000 students annually and place doctors throughout the country.

After a 2017 baseline assessment indicated significant gaps in MIYCN knowledge, A&T forged partnerships with nine government medical colleges in Bihar and Uttar Pradesh states to address the gaps. The goal of the partnerships was to build the capacity of future generations of medical practitioners in evidence-based MIYCN practices  by strengthening the undergraduate medical curriculum and improving the quality of MIYCN service delivery at critical contact points in the attached hospitals and district health facilities.

With Alive & Thrive support, stakeholders developed a roadmap and an implementation plan to address the identified knowledge gaps. Expert committees were formed at the state and national level comprised of the college principals/deans, senior national experts, faculty members from the departments of Paediatrics, Obstetrics and Gynaecology (OBGY), Community Medicine (CFM), and Preventive and Social Medicine (PSM), partner medical colleges, and senior government officials from the Directorate of Medical Education (DGME) and State National Health Mission under the Health Department.

India medical colleges case studies cover

The committees had the ability to revise the undergraduate curriculum and update service delivery protocols at hospitals. A competency-based national curriculum was subsequently developed, which medical colleges can opt to use.

Within the hospitals attached to each college, a coach worked with medical teams to show them how to apply Point of Care Quality Improvement (POCQI) to address MIYCN service delivery gaps (like delayed initiation of breastfeeding). They looked at the processes underlying an identified problem and developed and implemented ways to address it and test and monitor the impact on practices.

“The training and support by Alive & Thrive on MIYCN and quality improvement have enabled the team to ensure early initiation of breastfeeding, even in C-section delivery,” said Dr. Jyoti Bala, Head of Department, Obstetrics and Gynecology, at the Anugraha Narayan Magadh Medical College and Hospital in Gaya, Bihar State. “My team feels proud being a pioneer practicing this in our medical college hospital. Our efforts are giving results, which are being appreciated and replicated in other hospitals.”

The case studies demonstrate the application of the POCQI approach and show some of the specific steps that the nutrition and medical community can take to improve key indicators for MIYCN.

Read the case studies.

COVID-19’s impacts seen in preliminary results of studies in Bangladesh and India

Bangladesh MIYCN service delivery
A clinic in Bangladesh. Research on the impacts of COVID-19 showed significant impacts on MIYCN service delivery.

Social distancing measures implemented to reduce the spread of COVID-19 had widespread impacts on virtually all aspects of life – the delivery of health services was not excepted. Alive & Thrive supported research in India and Bangladesh to evaluate the impacts of measures implemented to reduce the spread of COVID-19.

Read our updated summary of implementation research, including the Bangladesh and India studies.

In India, a recently completed study including a sample of more than 500 women with children under the age of two provided the opportunity to conduct a follow-up phone survey to assess effects of the pandemic on health services and food security. COVID-19 affected the provision and use of health services despite adaptive efforts, and significantly and negatively impacted household food security. The latter, in turn, had implications for child feeding practices and coping strategies.

A&T recommended:

  • Provision of protective equipment
  • Measures that allow for social distancing and appropriate hygiene during service provision
  • Measures to address diminished demand for services and the reality of providers’ role in providing essential services while also responding to emergencies
  • Targeted social protection strategies and safety nets to improve household food security during and after COVID-19

In Bangladesh, an urban nutrition baseline survey, completed in March 2020 immediately before the COVID-19 lockdown, allowed a unique opportunity to contact the recently surveyed sample via phone to conduct a follow up survey and complete a longitudinal analysis of pre- and post-COVID provision and utilization of services and food insecurity, including adaptations and possible solutions to best respond to COVID-19 and other emergencies.

Study findings show that the provision of routine antenatal care services had a modest reduction during the lockdown, anthropometric measurements reduced substantially for pregnant women and for children. Child immunizations fell and counselling on child feeding fell, as well. By September 2020, most services resumed, though provision was still markedly below pre-pandemic levels. Despite key adaptations for service provision that included using phones for counselling and coordinating to arrange immunization visits, drop-offs in service utilization during the lockdown were also large and remained low through September. Household food insecurity increased substantially during COVID-19.

Further investments are needed to improve training and support for providers, ensure availability of personal protective equipment, and continue to increase  availability and demand for routine maternal and child health services. Findings from both studies will be disseminated in early 2021 and through peer-reviewed manuscripts, currently in progress.

Laos integrates Center of Excellence for Breastfeeding criteria in its national health monitoring system

Laos has integrated the Center of Excellence for Breastfeeding (COE) criteria into the country’s national hospital accreditation quality standards and the national reproductive, maternal, newborn, child, and adolescent health (2021-2025) strategy, laying the  foundation for Laotian hospitals to join the COE initiative. The decision came after the COE initiative was successfully piloted in Viet Nam, where 21 hospitals have been certified under the program over the past two years.

Laos integrate COE
The Centers of Excellence for Breastfeeding initiative is helping hospitals in Southeast Asia implement improvements that increase rates of early initiation of breastfeeding and exclusive breastfeeding, among other benefits.

Read more about the Alive & Thrive COE initiative in Southeast Asia.

COE, a novel implementation model to scale up the “Ten Steps to Successful Breastfeeding,” incorporates WHO’s updated global guidance on early essential newborn care to promote breastfeeding-enabling hospital environments. For the first time, indicators measuring performance to consistently implement breastfeeding counseling, prolonged skin-to-skin contact, early initiation of breastfeeding, rooming-in, and adherence to the International Code of Marketing of Breastmilk Substitutes are included in Laos’s national health monitoring system as the COE monitoring system is integrated.

COE assessment checklists, including for birth observations, maternal exit interviews, and medical record reviews, will now be incorporated into the national Integrated Quality Assessment mechanism. Then, a joint team composed of representatives from the Strategy Secretariat, Department of Healthcare & Rehabilitation, and local health authorities will evaluate whether Laotian hospitals fulfill COE criteria.

New study reveals aggressive marketing techniques by breastmilk substitute companies in China

BMS promotion in China is raising alarms
The aggressive marketing of breastmilk substitutes in China, which is detrimental to the health of both mother and child, is alarming health experts.

Manufacturers of breastmilk substitutes are aggressively marketing the products across China, according to new research supported by Alive & Thrive, the China Development Research Foundation, the Chinese Center for Disease Control and Prevention and Nanjing University of Information Science & Technology.

The companies are advising mothers to use infant formula and providing free samples in efforts that target women from varied socioeconomic groups and places of residence during pregnancy, childbirth, the postnatal period, and beyond. The efforts clearly violate the International Code of Marketing of Breastmilk Substitutes (BMS Code) and undermine breastfeeding.

The analysis underscores the urgent need for stronger regulation and enforcement of the Code to restrict the promotion of BMS in China, especially within health facilities and online, to better protect women and children from the harmful impact of BMS marketing.

Viet Nam adopts mandatory regulations on workplace lactation support

Viet Nam has adopted Decree 145, supporting working mothers to continue breastfeeding. Endorsed by the Prime Minister, the decree mandates 60-minute paid breastfeeding breaks and lactation rooms in companies with over 1,000 female employees.

Viet Nam workplace lactation support
Millions of working women in Viet Nam stand to benefit from a new decree supporting working mothers to continue breastfeeding.

Nearly 40 percent of female workers in Viet Nam’s formal sector are covered by the decree; companies with fewer employees are being encouraged to implement the same practices. Together with a six-month paid maternity leave regulation issued in 2013, Decree 145 demonstrates Viet Nam’s determination to promote an enabling environment for breastfeeding and to reach its target rate for continued breastfeeding for two-year-old’s – 30% by 2030.

Alive & Thrive applied its organizational advocacy strategy to support the passage of Decree 145, partnering with Members of Parliament, the Ministry of Health, the Office of Government, and international organizations including UN Women, UNICEF, the Scaling Up Nutrition Civil Society Alliance, GIZ, and CARE to build support for mothers’ breastfeeding rights. A&T also worked with the General Confederation of Labor, surveying female workers and business representatives to  provide a cost-benefit analysis of workplace lactation to the policy-drafting committee in a policy whitepaper.

An A&T-supported social media campaign brought more than 10,000 women to sign a petition in favor of workplace lactation. In 2021, as the decree was approved, A&T was asked to develop technical guidance by the Ministry of Health, and to develop an online monitoring system for workplace lactation implementation by the Ministry of Labor and Social Affairs and the General Confederation of Labor. A&T’s practical guidance to implement workplace lactation support programs can be found here.

Global IYCF e-learning course reaching health workers around the world

IYCF e-learning users mapMore than 2,000 health workers around the world have enrolled in Alive & Thrive’s e-learning course, “Investing in Child Nutrition,” with enrollments of five or more from people in more than 100 countries. The overwhelming majority of those enrolling came from low- and middle-income countries. Compared to 2019 when it was launched, overall enrollments increased by 53% in 2020, from 998 to 1,531 in English; French enrollment reached 211.

Though users report a high degree of satisfaction (E-learning course provides global access to valuable nutrition information), only 73 have fully completed the course. A&T is surveying users to gain further insight into the issue, which could be due to the course’s length (completing it requires several hours), its difficulty, and/or internet accessibility.

In July, Alive & Thrive updated the course with new COVID-19 IYCF guidance issued by WHO. The course’s popularity has drawn interest from UNICEF, which has proposed incorporating the course into its Agora global learning platform.

Partners in other countries have also inquired about integrating aspects of the course into e-learning initiatives for health workers. This interest reflects the high quality of the course, which was developed in collaboration with UNICEF, a global network of IYCF experts, e-learning specialists, and established IYCF media content creators.

The free course is based on WHO’s IYCF training modules, adapting the face-to-face course content into an immersive, interactive e-learning format, and supplementing technical content with a wide range of multimedia material, including expert interviews, instructional videos, and digital animation. It also offers substantial content focusing on counselling skills.

Stronger With Breastmilk Only initiative providing resources, support to reach exclusive breastfeeding goal

More than 200 stakeholders from across West Africa learned how the Stronger With Breastmilk Only initiative is supporting health officials to increase rates of exclusive breastfeeding during webinars in French and English in early December.

The webinar presented the regional initiative, including its objectives, tools and resources, and support for national programs. During a question and answer session of the webinar, participants sought more background on the key messages, the initiative’s design, monitoring and evaluation and sustainability. The discussion is summarized here and includes links to a variety of resources and further information.

The webinar also highlighted the initiative’s new WhatsApp group and invited stakeholders to join.

Watch the full webinar here.

The slide deck is available here.

Speakers included:

  • Anne-Sophie Le Dain, Regional Nutrition Specialist, UNICEF West & Central Africa
  • Nathalie Likhite, Regional SBC Advisor, Alive & Thrive, West Africa
  • Simeon Nanema, Regional Nutrition Advisor, UNICEF West & Central Africa
  • Emilie Buttarelli, C4D Specialist, UNICEF West & Central Africa
  • Emily Dierdre Tarisayi Mbanga, Technical Officer, Nutrition & Food Safety in Emergencies, WHO Africa
  • Manisha Tharaney, Program Director, Alive & Thrive, West Africa
  • Juan Andres Gil, C4D Specialist, UNICEF West & Central Africa
  • Adelheid Onyango, Nutrition and Health Expert, WHO Africa

“Business as usual” will not suffice to improve exclusive breastfeeding in West Africa

Addressing the problem of exclusive breastfeeding in West and Central Africa called for a new approach – “business as usual” would not suffice, UNICEF West and Central Africa Nutrition Advisor Simeon Nanama told participants at the 11th Africa Food and Nutrition Security Day global webinar event in October. The new approach is Stronger With Breastmilk Only.

“Thirty per cent of babies are exclusively breastfed (in the West and Central Africa region),” Nanama said. “That is 20 percentage points away from the 50 per cent World Health Assembly 2025 target. And doing business as usual will not get us to meeting that goal.

“So, because of that, we decided to be very systematic trying to understand how we can reimagine the breastfeeding programming…. Building on these these two analyses of quantitative and qualitative data, a regional programme was designed (Stronger With Breastmilk Only).

“The objective is really to focus on advocacy to change social norms and behaviors. It is a large regional campaign and right now 19 countries have subscribed to the campaign.”

Watch Mr. Nanama’s presentation below.

Transcript

Before I get into how we went systematically on the use of data, I would like to give you an overview of the UNICEF West and Central Africa region. It is a region with 24 countries. Together, those countries are home to 11 percent of the world’s under five children. However they are also home to 20 of the world’s stunted children and 35 percent of the world’s under five death. It means that there is a big discrepancy between population size and all the burden of child-related issues in this particular region.  We all know that breastfeeding is important and adequate child feeding – and breastfeeding in particular – is critical for survival development and growth of children and there is a lot of evidence on that. But when we look at the data in this region only 3 out of 10 children are exclusively breastfed and the remaining seven children who are not exclusively breastfed are not exclusively breastfed for different reasons because they are receiving other food in addition to breastmilk.

Breastfeeding is a priority in the UNICEF regional plan for the period 2018-2021 and we really wanted to make sure that we focus and work on this aspect, which is the first line of defense and the first line of prevention when we are talking about malnutrition. But because the situation has not been improving for many years, we thought that we needed to really be innovative, thinking out of the box and trying to be a bit more focused and going to scale to make sure that we make a difference when it comes to improving breastfeeding. Because 30 percent of the babies who are exclusively breastfed that is 20 percentage point away from the 50 of the world health assembly 2025 targets and doing business as usual will definitely would not get us to meeting that that goal.

So because of that, we decided to be very systematic in looking at the data and trying to understand how we can re-imagine the breastfeeding programming. We started by looking at the first step – looking at quantitative data and this is illustrated by the first graph that you see on the upper side of upper left side of the of the slide where the yellow bars are showing the proportion of babies age less than six months that are exclusively breastfed in a number of countries in the region. And the blue part of the bars are the proportion of the children who are fed breast milk plus water. The blue presents those breastfed with receiving water in addition to breast milk and clearly if we are able to remove or reduce the proportion of babies who have fed water we would bring the rate of exclusive breastfeeding to in most of the countries, except maybe two, to the level of 50 which is the 2025 target. So this analysis, the quantitative data has helped us to identify a critical bottleneck which is really water being the problem in most of the countries of the region.

Then we went ahead in a second step to try to understand what are the social cultural barriers to child feeding in general and to breastfeeding in particular: What are the influences of child feeding in the community in the families and what are the enabling factors that we can leverage on to improve breastfeeding? We did that work together with Alive & Thrive and that has helped us to really understand where are, who are the people in the community we need to target if we need to make a difference in in breastfeeding. We also identified the factors that can enable us to make a difference at the community level and in families. And that qualitative study led also to programmatic recommendations. Now building on these two analyses of quantitative and qualitative data, an original program was designed which is called Stronger With Breast Milk Only and you can see the logo on the right hand side of the slide.

The objective is really to focus on advocacy to change social norms and behaviors. It is a large regional campaign and right now 19 countries have subscribed to the campaign. The campaign was launched in Cote d’Ivoire last year and it is being now rolled out. And the idea through this program is really to support, promote and protect adequate child feeding practices, breastfeeding practices and to support the families to engage the community systems in this initiative, to also strengthen this health care system and improve the norms, and to engage the business sector as well and to improve the perception and the social environment around child feeding and strengthening the national policy and regulation related to breastfeeding especially some regulations like the code of marketing of breast milk substitute.

The overall outcome we are aiming at is really to push most of the countries engaged in this initiative to be able to remove water from the feeding of children and to be able to achieve the 2025 uh world health assembly target for exclusive breastfeeding which is 20 to 50 percent at minimum of the of the children being exclusively breastfed. Now the program was launched and it’s being rolled out now we are in a stage where we are working on the next steps which is really to work on the monitoring framework and be able to monitor the countries and see how they are progressing and see what are the bottlenecks they are facing in the implementation of the campaign and help them readjust the program. We also need to engage in knowledge generation and knowledge management to document best practices in countries that are making progress so that the other countries could use that and also speed up the process toward achieving the objective and do the adjustment of the program as we go. This is an example that we are just taking to share with you on how we use data to design a program aiming to reduce malnutrition. We often hear that we are lacking data in many sectors and this is true but it is also true that we can do a lot with the data that we already have in hand.