Violations of the International Code of Marketing of Breast Milk Substitutes in South African health facilities / Ndugiselo Muravha

• Main Author: Muravha, Ndugiselo
• Language: en
• Published: 2015
• Subjects: Code violations; Breast-milk substitutes; Health facilities
• Online Access: http://hdl.handle.net/10394/15459

INTRODUCTION Exclusive breastfeeding (EBF) for the first six months of an infant‟s life is recognized by the World Health Organisation (WHO) and the United Nations Children‟s Fund (UNICEF) as the most effective and essential strategy for optimal growth and prevention of infant mortality. One of the factors that influences a mothers choice to exclusively breastfeed her child, is the marketing of breast milk substitutes. The International Code of Marketing of Breast-milk Substitutes (ICMBS) was developed to promote, protect and support EBF. Although South Africa (SA) has voluntarily adopted the ICMBS in 1981 to help protect and promote EBF, the exclusive breastfeeding rates in SA remain very low (<8%). In a renewed attempt to protect and promote exclusive breastfeeding in SA, the code has been legislated in December 2012 to ensure compliance. AIM To assess the extent of ICMBS violations in health facilities in four Provinces in SA. DESIGN This was cross-sectional study. A purposive stratified cluster sample of eight to twelve health facilities was drawn in four Provinces (Gauteng, North-West, Free-State and Eastern Cape) in SA. Fixed structured interviews were conducted by trained fieldworkers with three health workers from each of the 40 health facilities to determine the extent of ICMBS violations as well as awareness of the ICMBS. The receipt of free gifts, free/low cost supplies/samples of formula milk, bottles or teats, and free materials or equipment from companies who sell breast-milk substitutes (BMS), infants foods/drinks and bottles or teats (violation of articles 6.2, 6.3, 6.6, 6.8, 7.3 and 7.4 of the ICMBS) were determined. RESULTS A total number of four violations were reported by four health workers from three of the 40 health facilities (7.5%). ICMBS violations were reported only in Gauteng Province with no violations in North West, Free State or Eastern Cape Province. All four violations involved the receipt of free gifts for personal use (including a pen, booklet, calendars and booklet/poster) from a BMS company (Nestlé), violating article 7.3 of the ICMBS. Health workers from four health facilities also reported the receipt of information materials and/or equipment for use in the facility, including leaflets, maternal and infant feeding product booklets and water bags from Nestlé. However, since the brand name of a product within the scope of the ICMBS was not visible on any of the materials or equipment, none of these gifts constituted a violation. In terms of ICMBS awareness, 46 health workers (38%), including the four health workers who received gifts, from 19 health facilities situated mainly in Eastern Cape and Gauteng Province were familiar with the ICMBS. CONCLUSIONS Violations were reported in 7.5% of health facilities, including the health facilities where health workers were aware of the code. Implementation and training of the ICBMS in health facilities is there for warranted. === MSc (Nutrition), North-West University, Potchefstroom Campus, 2015