Wednesday, 28 May 2014

Lack of Adequate Training of Health Professionals in Kyrgyzstan (CRC)

On the 28th of May 2014, the Committee on the Rights of the Child considered the combined 3rd and 4th periodic report of Kyrgyzstan on the implementation of the Convention on the Rights of the Child in the country. 

IBFAN presented an alternative report
 to inform the CRC Committee on the situation on the issue of infant and young child feeding in Kyrgyzstan.

General overview of breastfeeding in Kyrgyzstan

The report noted that in Kyrgyzstan, high rates of infant and neonatal mortality coexist with inadequate infant feeding practices, such as early weaning and early introduction of complementary food, breastmilk substitutes and other liquids. Almost 2 children out of 3 are not breastfed until the age of 6 months and only about 2 children out of 10 are breastfed until the age of 2 years. Moreover, the report pointed out the lack of adequate training of health care workers and health professionals on optimal breastfeeding practices. Besides, even though many provisions of the International Code of Marketing of Breastmilk Substitutes have now been implemented into law, there is still no independent monitoring.  

In Kyrgyzstan, there is neither information on the total amount of maternity yards in the country, nor recent data on the amount of “baby-friendly” hospitals. Besides, the report has highlighted the regional disparities regarding the knowledge on HIV/AIDS. Finally, the lack of emergency preparedness plan to ensure integrated response to protect and support infant and young child feeding in case of emergencies has been noted.

Discussion on infant and young child feeding

The Committee pointed out that a law on the marketing of breastmilk substitutes was adopted in March 2009. However, mothers are still not provided with adequate information on breastfeeding and additionally, they often received free samples of formula. The Committee also emphasized the lack of monitoring mechanism of the new law as well as the poor support to optimal breastfeeding practices, and noted that only one third of the children were exclusively breastfed until 6 months of age.

The Kyrgyz delegation responded that on the contrary, campaigns to promote breastfeeding have been launched. In 2010, an independent demographic medical survey carried out on a large section of the population by international experts found that 56% of infants were exclusively breastfed until the age of six months of age. According to the delegation, breastfeeding is well promoted in the country through many current initiatives led in collaboration with local health committees. The delegation also explained that the government is planning to promote midwifes’ activities at local level. It stated that pre- and post-diploma vocational training is widespread and that breastfeeding classes are included in the programmes. Finally, it explained that teaching and promotion material has been translated to Kyrgyz and Russian languages.

Concluding Observations

In its Concluding Observations, the Committee urged Kyrgyzstan to develop a comprehensive system for collecting disaggregated data (para 7(b). Regarding health issues, it requested the country to tackle the issues of child mortality resulting of preventable and curable diseases and to ensure children's access to adequate and sufficient food (para 48) and take all necessary measures to prevent transmission of HIV/AIDS by raising awareness of the public (para 50).

The Committee also issued direct recommendations related to breastfeeding (para 53-54). After having noted the adoption of the Law on the promotion of breastfeeding of March 2009, regulating the advertisement and promotion of infant formulas, the Committee expressed concern about the poor implementation of the Law and the reported complicity between medical personnel and baby food industries, which has led to inadequate information and free samples of baby food products provided to mothers. Therefore, the Committee recommended Kyrgyzstan to “take all necessary measures to implement its legislation promoting breastfeeding practices and ensure that all mothers receive adequate information on the benefits of their breast-milk”.  It also recommended Kyrgyzstan to adopt the International Code for Marketing of Breast-Milk Substitutes.”