On January 15th,
2015, the Committee on the Rights of the Child considered
the combined second and third periodic report of the Gambia on the situation of
the implementation of the Convention on the Rights of the Child in the country. The
delegation of The Gambia was led by Ms. Fanta Bai Secka, Director of Social Welfare, Mr. Baba Samateh,
Director of Social Statistics at the Gambia Bureau of Statistics, and Ms. Bafou
Jeng, State Counsel at the Ministry of Justice, Child’s Rights Unit.
On this occasion,
IBFAN presented an alternative report to inform the CRC
Committee on the situation of infant and young child feeding in the Gambia.
General overview of
breastfeeding in the Gambia
The Gambia is characterized by high neonatal, infant, under-five and
maternal mortality rates, associated to little delivery care coverage and low
breastfeeding rates. Almost one baby out of two is born without the assistance
of a skilled attendant and a same proportion of newborns are not breastfed
within one hour from birth, while seven children out of ten are not exclusively
breastfed until 6 months of age. Additionally, the most recent data on
breastfeeding in the Gambia date back to 2010, showing an irregular and
insufficient data collection system regarding breastfeeding. The UNICEF
highlighted the existence of cultural beliefs against exclusive breastfeeding
among the population, with a general traditional mindset asserting that colostrum
is not good for the baby.
Although National Nutrition Policy 2010-2020 dedicates a
full section to the promotion of optimal infant and child feeding practices,
including a list of specific strategies, there is no clarity on their
implementation. In addition, there is neither National Breastfeeding Committee
and Coordinator nor information available on future plans of creating one.
On a positive note, the Gambia adopted a strong law on the marketing of
breastmilk substitutes, implementing most of the International Code of Marketing of Breastmilk Substitutes. In 2008, the Baby-Friendly Hospitals Initiative criteria were respected in over 20 health care
facilities, but there are no recent data on its current implementation and
monitoring mechanism.
Finally, the legislation on maternity protection does not cover all
women working in all sectors. There are no figures on the exact number of
children under 15 living with HIV in the Gambia and no strategic action plan on
infant and child feeding in emergencies.
Discussion on infant and young child feeding
The CRC Committee questioned the delegation of the Gambia on the causes
of such a low profile of breastfeeding in the country, mentioning specifically
that the exclusive breastfeeding rate under 6 months could and should be
improved, observing that it is the most natural way of feeding children and
that should be promoted also because of the emotional needs of children. The
Committee asked also what measures are being taken in order to encourage women
to breastfeed and whether these measures are put in place at a prenatal care
level or through the media.
The Gambian delegation stated that breastfeeding was an issue in the
past, and that is does not constitute an issue anymore. Continuous campaigns on
the radio, on TV and in the communities are supporting breastfeeding and
encouraging exclusive breastfeeding until 6 months. Additionally, the
delegation affirmed that since the enactment of an act in 2010, women are
entitled to 6 months of paid maternity leave, as a further proof of the efforts
the government is making to promote and support breastfeeding.
The Committee then addressed the fact that the Gambia’s legislation on
maternity protection does not cover all sectors, and the delegation assured
that it actually does, adding that there is all the political will to promote
and raise the breastfeeding rates, confirmed by a statement made by the
President of the nation. Regarding HIV and breastfeeding, the Committee asked
what support system is provided to the mothers living with HIV, and the
delegation mentioned the existence of a system of monthly food rations
including supplement milk provided to women living with HIV.
Concluding Observations
In its Concluding Observations, the Committee
made both indirect and direct recommendations related with infant and young
child feeding. It first recommended to ensure the allocation of sufficient
resources for the health sector and to facilitate a greater and equal access to
quality primary health services by mothers and children in all areas (§ 61a). Effective
measures were also required to “increase the number of trained medical and other health personnel,
including traditional healers”, and “facilitate cooperation between trained
medical personnel and traditional healers, especially midwives” (§ 61b). The
Committee also urged to improve access to maternal care services through
improved health infrastructure and to increase availability and accessibility
of emergency obstetric and neonatal care and skilled birth attendants at lower-
and district-level health facilities (§ 61c).
With regard to
nutrition, the Committee recommended the Gambia to “strengthen its efforts to
address malnutrition and diseases of children, including by strengthening
educational programmes, campaigns to inform parents about basic child health
and nutrition [...]” (§ 61d), and to “strengthen its efforts to increase
address to safe drinking water and sanitation” (§ 61e).
Finally, specifically
referring to breastfeeding, the Committee urged the State party to “ensure the
effective implementation of the 2010-2020 National Nutrition Policy, strengthen
its awareness-raising efforts on the importance of breastfeeding and promote
exclusive breastfeeding of children up to the age of six months”. It also recommended
to “establish a National Breastfeeding Committee, systematically collect data
on breastfeeding practices, ensure the enforcement of the International Code of
Marketing of Breast-milk Substitutes, include breastfeeding in the training of
nurses, and provide maternity leave to all working mothers, including domestic
workers” (§ 65).
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