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Multi-Indicator Cluster Survey in Macedonia- Breastfeeding Patterns in Children 0-24 Months

Multi-Indicator Cluster Survey in Macedonia- Breastfeeding Patterns in Children 0-24 Months. Some demographic and health indicators*. Total number of the population 2.007.523 Annual number of live births 27.309 Birth rate-14.1%0 Infant mortality rate14.9%0 Perinatal mortality rate18.7%0

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Multi-Indicator Cluster Survey in Macedonia- Breastfeeding Patterns in Children 0-24 Months

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  1. Multi-Indicator Cluster Survey in Macedonia- Breastfeeding Patterns in Children 0-24 Months

  2. Some demographic and health indicators* • Total number of the population 2.007.523 • Annual number of live births 27.309 • Birth rate-14.1%0 • Infant mortality rate14.9%0 • Perinatal mortality rate18.7%0 • * 1999

  3. Health and nutritional survey 1994Breastfeeding rate and nutritional patterns in infants • Exclusive breastfeeding rate (0-4 months) -8.1% • Predominant breasfeeding rate 70.4% • Stop breastfeeding rate 21.6% 59% (first weeks) 26.9% (5-8 weeks) 14.1%(9-13 weeks)

  4. The steps of National Breastfeeding policy development in Macedonia • 1994 -Health and nutritional survey in children under 5 • 1996- Breastfeeding course: London Practice and policy - Ministry of health representatives participation • 1997 -Establishment of National Breastfeeding committee • 1997-1998- Breastfeeding training course for primary health care provider • 1999-Baby friendly hospital initiative • 1999 Multi-indicator cluster survey • 2000- Breastfeeding community support- MtMSG and celebration of WBW • 2000- Implementation of the Code(some articles) in Consumer protection low • Nine months maternity leave

  5. Multi-Indicator cluster survey 1999 • Main objective • achievement of the goals of the World Summit for Children • Specific objective • nutritional status of mother and children • micronutrient deficiencies • evaluation of feeding patterns of infants and small children

  6. The information of infant feeding pattern was collected with • 24 hour recall questionnaire using the following indicators: • Exclusive breast feeding rate (0-4 m) • Exclusive breast feeding rate (0-6 m) • Predominant breast feeding rate (0-4 m) • Predominant breast feeding rate (0-6 m) • Timely complementary feeding (6-9m) • Continued breast feeding at 1 year

  7. Prevalence of breastfeeding in children 0-24 months by population strata Pearson Chi -square :0.9, p=0.34

  8. Feeding pattern of Children 0-4 m and 0-6 m by Population strata Pearson Chi -square :5.24, p=0.15

  9. Prevalence of Exclusive Breastfeeding in Children 0-24 m, by Population strata Age in months

  10. Prevalence of breastfeeding in different ethnic groups in children 0-24 months

  11. Prevalence of exclusive breastfeeding in different ethnic groups in children 0-6 months

  12. Habit of breastfeeding in children 0-24 months by population strata

  13. Median number of suckling during the night in children 0-24 m , per population strata urban rural total 3 2 1 0-6 months 7-12 months 13-24 months A g e

  14. Median number of suckling during the day in children 0-24 m,by population strata urban rural 6 total 5 4 3 2 1 0-6 7-12 13-24 Age in months

  15. Time lapse after birth for breastfeeding children 0-24 months by population strata

  16. Reasons for breastfeedig cessation for children 0-24 by population strata

  17. Progress towards the achievement of the goals for year 2000 of the world summit for children • Year 2000 goal 1994 MIKS 1999 MIKS Progress Year 2000 goal Empowerment of all women to breastfeed their children exclusi- vely for four to six months and to continue breastfeeding, with complementary food, well into the second year Good achievement of the goal that still needs educational efforts 0-4 months Exclusive BF 8% Predominant BF =78% 0-4 months Exclusive BF 45% Predominant BF =34%

  18. NATIONAL REPORT CARD ON BREASTFEEDING* Indicators Score Rate • EBFR at 6 months 4 • National breastfeeding policy 10 • % of BFH 8 • Implementation of ICMBS 9 • Maternity leave 9 m 10 Total 41 GLOPAR - Global Participatory Action Research Project by WABA

  19. SCORE RATING • 41-50 - Excellent • 36-40 - Very Good • 31-35 - Good • 26-30 - Average • 21-25 - Poor • 16-20 - Bad • 11-15 - Vary Bad • 0-10 - Terrible Excellent 41

  20. NUTRITIONAL SURVEY IN REFUGEE CAMPS IN MACEDONIA B.Ancevska MD, N.Janeva MD, K.Venovska MD Collaborative Study : AAA. UNHCR, UNICEF, IMCH

  21. More than 300,000 Kosovar refugees crossed the • Macedonian border from March to June 1999 . • 120.000 - 140.000 were accommodated in 7 camps with • rapid population movement • Health condition was generally good • Food distribution was considered adequate but inconsistent • in nutritional content and frequency of distribution

  22. Goals an objective of the survey • the survey was designed to span several sectors of refugee needs in order to provide recommendations to international organizations serving the refugees in camps in R.M • Specific objective among children under • 5 years of age • determine the nutritional status • estimate the prevalence of breast feeding and infant feeding practice • estimate the prevalence of diarrhea and ARI • estimate the immunization coverage

  23. Sampling methodology and sample size • A systematic random sample of household was taken, a household being defined as a group of persons occupying the some structure and sharing the household resources • The survey population included 1421 households and 1001 children under 5 years • Research tool -questionnaire for interviewing caregivers of young children “ Are you breast feeding your child?” “ Are you feeding your child with infant formula?”

  24. Demographic distribution of children less than 5 years of age among Kosovar refugees in camps in R.M Age group (months) Number % 0- 5 95 9.4 6-17 207 20,7 18-29 210 21.0 30-41 217 21.7 42-53 190 19.0 54-59 82 8.2 Total 1001 100 10.4 % of all population were children under 5

  25. Infant feeding among children < 12 months BF Formula Both Neither Age group N % N % N % N % < 4 months 40 70 3 5 1 1 13 23 4- 7 months 36 51 10 14 4 6 21 30 8-11 months 34 43 11 14 2 3 32 41 All ages 110 53 24 12 7 3 56 32 23

  26. What food those 23% of infants under 4 months received cow’s milk bread and biscuits

  27. BABY FOOD DONATION* • infant formula • baby cereals • dehydrated baby meals • jars of fruits and mix meal for weaning purpose * A calculation of the quantities of formula at the and of July. 99 indicate that there was enough to feed approximately 22% of the infants fin the refugee population for 6 months * Violation of the International Code of Marketing of Breast Milk Substitutes * Source of donation-unknown

  28. Infant feeding intervention in Macedonia during refugee crisis • Mother and baby - station • 5 day training programme to provide PHC training for NGO health workers with one day allocated for breast feeding • On job training for NGO health staff in camps • Availability of training material with appropriate information about breast feeding • UNICEF Initiative to store infant formula donation

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