Technical consultation on Implementation
of the Global Strategy for Infant and Young Child Feeding

February 10-12, 2003
Geneva, Switzerland
Gisèle Laviolle - LLLI Representative

Introduction

The Global Strategy for Infant and Young Child Feeding (IYCF) was developed jointly by UNICEF and WHO after a two year participatory process involving the governments of all WHO member states, international and intergovernmental agencies, health professionals and nongovernmental organizations. In May 2002, the World Health Assembly (WHA) adopted the Global Strategy as Resolution WHA55.25.

As a nongovernmental organization in official relations with WHO, La Leche League International (LLLI) was invited to send a representative to a technical consultation on the Global Strategy for IYCF, to take place February 10-12, 2003 in Geneva, Switzerland. Due to the current financial situation and as one of two LLLI representatives to WHO and UNICEF in Geneva, I agreed to represent LLLI at this meeting. Lynne Coates (Acting Executive Director and Chairman of the LLLI Board), Rebecca Magalhães (Director, External Relations & Advocacy), Natalia Smith (Special Projects Assistant) and I worked together to prepare for LLLI representation. A number of LLLI materials and documents were sent to Geneva for distribution to the participants, and a summary of LLLI's contributions (in rich text format, viewable by most word processors) to the aims of the Global Strategy was prepared, noting past, present and hopefully future activities.

Technical Consultation - Meeting Process

The meeting objectives were:

to discuss the best ways for achieving progress in the operation areas defined in the Global Strategy
to reach a common understanding on a generic planning framework to facilitate the implementation of the GSIYF in countries
to identify tools available to support implementation as well as those that need to be developed
to agree upon priority developmental and research needs and mechanisms to coordinate future work

Fifty-one (51) persons attended the meeting, with representation from WHO headquarters and regional offices, UNICEF, governments, the World Bank, International Labour Organization and two universities. Other agencies and nongovernmental organizations joined LLLI, with persons attending from BASICS, CARE, CEPREN, IBFAN, IFPRI, ILCA, LINKAGES, Manoff group, and CORE. Outside of the on-site WHO/Geneva personnel, there were 9 persons from Africa, 5 from Asia, 7 from Europe and 13 from the Americas.

Each day there was a succession of 15 minute presentations about the different aspects of the Strategy, its implementation and implications. Following the presentations, participants worked in four different groups. The results of the work groups were presented the next morning or immediately afterward on the last day.

During the afternoon of the last day, time was set aside for each agency or NGO present to talk about what they did and what could be their contribution for the implementation of the Strategy.

Technical Consultation - Discussions

The Global Strategy builds on past and continuing achievements, such as the Baby Friendly Hospital Initiative, the International Code of Marketing of Breastmilk Substitutes, and the Innocenti Declaration. Other texts and actions that are also relevant are the World Declaration and Plan of Action for Nutrition and the ILO Convention.

The Strategy addresses the promotion of appropriate feeding for infants and young children, particularly exclusive breastfeeding for six months and sustained breastfeeding with appropriate complementary food for two years and beyond. Special circumstances and feeding children in exceptionally difficult circumstances (low birth weight babies, emergencies, HIV infected women, women in prison) are also taken into account in the Strategy and were discussed during the meeting.

Complementary feeding is currently a very important topic, as the transition from exclusive breastfeeding to sustained breastfeeding with adequate complementary food is very poorly practised in many parts of the world. Randa Saadeh, Department of Nutrition for Health and Development, WHO, is finalizing a WHO Complementary Feeding Counselling course.

Technical Consultation - Personal Points

There were many very interesting PowerPoint presentations and it is difficult to give too many details in a short report. However, there will be a general report of the consultation produced later. If anyone needs details from one of the presentations, please email me LAVIOLLE.Gisele@wanadoo.fr and I will provide you with what I can.

Being at the meeting provided an opportunity to network with many people who are actively involved in breastfeeding promotion, protection and support. It was also very interesting to talk to people during breaks and lunch.

Another representative from an NGO and I commented together how big agencies and NGOs appear to have funding to carry on their actions and are able to acquire human resources with expertise. They are also able to implement studies and pilot projects and carry out evaluations. NGOs such as LLLI and others can feel inadequate in comparison. On the other hand, these agencies often target a country, carry on a big project and then leave, whereas small grass-root organizations have a lasting and permanent effect on the ground.

There were three LLL Leaders/retired Leaders at the meeting - Margaret Kyenkya, Elizabeth Hormann and myself. It was nice to speak with them about our work and possibilities in LLL.

During the last break, a question was posed to me by a WHO person: is LLL going to get busy in complementary feeding? This happened just before I was going to give the LLL presentation. After discussing this with several people, I realized that the participants needed more from LLL than just the things we had prepared. I made photocopies of the leaflet Becoming a La Leche League Leader and distributed this along with the prepared paper. Thus the participants had the ten concepts of LLL to look at and I was able to show them that complementary feeding has indeed been part of LLL work for a long time. I also spoke of the importance of the LLL Leader who has expertise and experience in helping a mother, and of our members who are passionate about breastfeeding. As I was speaking, I saw a woman raise her hand showing that she had been helped by LLL, and when I had finished, one of the participants mentioned to me that she was an LLL member. In the time allocated, I also went through the different points covered in the paper.

Concluding Thoughts and Recommendations

Overall, the meeting was very interesting and it was valuable for LLLI to be represented at this meeting. Although the time was too short to cover all the meeting objectives, the work on the Global Strategy will continue. The different work groups made suggestions and recommendations that will be included in the final report.

I recommend that LLLI stay in close touch with WHO and UNICEF in order to assist with the implementation of the Strategy in the areas that LLLI knows best. It would also be important for LLLI to create an internal workgroup to study the Strategy in depth, define which tools we can propose that we have already and see if it is possible for us to propose other tools. I also recommend that LLLI be more proactive in relation to the other agencies, as LLLI has the hands-on expertise.

February 19th 2003