Breastmilk substitute (BMS) companies routinely violate the International Code of Marketing of Breastmilk Substitutes across West and Central Africa, frequently via national health systems – and more needs to be done to raise awareness of health workers about the Code, participants learned during a regional webinar organized by the regional Stronger With Breastmilk Only initiative in February. The initiative was launched in 2019 by UNICEF, WHO, and Alive & Thrive.

Learn more about the Code

UNICEF and Alive & Thrive have updated a Quick Guide to the Code for Health Workers

“There has not been enough communication about the (BMS) Code in national infant and young child feeding programs and via other platforms,” said Simeon Nananma, UNICEF West and Central Africa’s Regional Nutrition Advisor. “Health workers need to know that there’s an international Code that regulates the marking of  breastmilk substitutes (BMS). They need to know the  the key elements in the Code and the WHA resolutions. 

“We also need to address the way that baby food companies exploit these opportunities and use health education as a way to promote BMS – by doing so they are tampering with the feeding of infants.”

While few studies have been conducted on Code violations in health facilities in the region, the few available make the problem plain: Less than 10 percent of health workers in health facilities in Abidjan said they were aware of the Code, according to an Alive & Thrive study published last year.

That lack of awareness helps to ensure that BMS companies can easily violate the Code: The vast majority of health workers surveyed – 93 percent in Senegal, according to one study – said BMS company representatives regularly contact them to promote BMS products. 

Health workers in Burkina Faso, Cote d’Ivoire, and Niger, whose interviews were shared during the webinar, said the companies offer them a variety of gifts – T-shirts, calendars, pens – and give them posters to advertise the products and free product samples to give to breastfeeding mothers. It is not unusual, either, for the companies to pay travel expenses for health workers to attend various meetings.

“It’s a form of corruption,” one worker said. “It’s hard not to prescribe infant formula to a new mother when you’ve accepted these types of gifts.” 

The webinar, moderated by Ndèye Yaga Sy, the ARCH project manager at Helen Keller International, was organized specifically to support health workers to learn about the Code. It featured speakers addressing key aspects of the Code. 

Click the links below to watch speakers’ respective segments:

• Introduction and overview of health workers' role in supporting, protecting breastfeeding in West and Central Africa (Simeon Nanama, UNICEF West and Central Africa Regional Nutrition Advisor) 
• Introduction to the Code and its importance to protecting, promoting breastfeeding (Ellen Sokol, UNICEF Legal Consultant)
• Main provisions of the Code relevant to health workers (Marina Adrianopoli, WHO AFRO Technical Officer for Nutrition)
• Health workers speak about their experiences in facilities and best practices for reinforcing the Code (Aita Sarr Cisse, Regional Technical Advisor for Alive & Thrive’s West Africa Regional Initiative)
• Closing remarks (Marina Adrianopoli of WHO AFRO)