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HIV and Infant feeding Report of 5 Country Rapid Assessment

HIV and Infant feeding Report of 5 Country Rapid Assessment. Dr. Arun Gupta, MD, FIAP Coordinator Dr J.P. Dadhich, MD Co -coordinator IBFAN Asia Pacific Working Group on HIV-Infant feeding . Outline . Need and Relevance Process ♠ Countries ♠ Questionnaire

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HIV and Infant feeding Report of 5 Country Rapid Assessment

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  1. HIV and Infant feedingReport of 5 Country Rapid Assessment Dr. Arun Gupta, MD, FIAP Coordinator Dr J.P. Dadhich, MD Co -coordinator IBFAN Asia Pacific Working Group on HIV-Infant feeding

  2. Outline • Need and Relevance • Process ♠ Countries ♠ Questionnaire ♠ National Consultation • Outcome • Challenges

  3. Need and Relevance To facilitate discussion and find out how HIV and infant feeding is being addressed in the PMTCT programmes as part of HIV AIDS Programmes, specifically to list the processes being followed by a country

  4. Need and Relevance • To raise awareness of the issues and particularly, the latest material on HIV/IF, especially UN materials • To create a solidarity/trusting relationship around each other's concerns • To network for cooperation to initiate some joint actions

  5. Process • Initiated a dialogue with IBFAN Focal points/Contacts in 6 countries,5 responded • Afghanistan • Bangladesh • Indonesia • Malaysia • Nepal

  6. Questionnaire • Shared a common framework of questions for rapid country assessment • Issues covered in the framework included • Policy and Guidelines at national level • PMTCT Strategies in vogue • Utilization of UN Guidelines • National Capacity, Training curriculum • Skills of Counselors

  7. Process • Country Specific Consultations involving stakeholders were held in 5 countries and reports received

  8. Malaysia • 25 participants, both breastfeeding groups and HIV community as well as Govt. UNICEF, WHO, medical association, consumer’s groups. • National MTCT program in place • Govt. policy is to practice replacement feeding for all HIV positive mothers • The mother is provided with free alternative feeding (formula) • Govt. assumes AFASS criteria are fulfilled by the country • A joint task force is proposed • Joint statement to be issued • Several issues were raised including organizing a 3-4 day meeting to think forward.

  9. Nepal • 25 Participants, included govt. and non govt. organizations working in the field of child health and HIV, UNFPA, PSI, Save the children, breastfeeding group NEBPROF, health professionals • Lack of program for PPTCT at national level • Lack of national policy on HIV and Infant feeding • Capacity building of the health workers is required • Plan of action was developed at the meeting; addressing training, of health workers, establishing standards/guidelines, Code implementation, strengthening partnership

  10. Indonesia • 31 Participants,included breastfeeding groups, govt. agencies, UNICEF, WHO, National AIDS Commission, health professional organizations, Save the Children, John Hopkins. • National program on HIV/AIDS in place • Nodal agency on HIV present • Draft policy on PPTCT under consideration(VCT,ARV and Infant feeding counseling) • Recommended first choice is Infant formula • FU Actions :Capacity building of health workers is being planned using WHO 2000 HIV Infant feeding module ; strengthening coordination, awareness programmes

  11. Bangladesh • Participation in consultation widely representative, 23 participants Govt., UNICEF, WHO, Research instt. , Nutrition instt. • National AIDS/STD Program (NASP) supervises AIDS/HIV at national level • No national policy of HIV and Infant feeding • Utilize UN documents • infant feeding and HIV not in curriculum • Capacity building of health workers is a major gap • National policy to promote exclusive breastfeeding for all babies

  12. Afghanistan • 20 participants, included Govt. UNCEF, UNDP, WHO, National Aids Cell, TDh, Pediatrics body. • Issue of HIV as such is not a priority area for the govt. agencies • No national policy on HIV/MTCT/HIV and Infant feeding • No educational program or curriculum to train and orient health workers. • Formation of a working group at the aim to look after different aspects of the program

  13. India : Some fresh news! • We have finished combining BF, CF and HIV courses • Launched in 3 states with UNICEF and State governments • NACO asked BPNI to integrated its PMTCT/PPTCT module with IYCF , accomplished • Future training will be based on this module. • October a TOT is planned in India

  14. Challenges • Lack of national policy, guidelines and initiatives for PPTCT in preventing infant HIV • Lack of educational program or curriculum to train and orient health workers/counselors • Lack of national policy on HIV and Infant feeding • Lack of understanding of AFASS; being used to formulate blanket policies

  15. Lessons Learnt • Feasible activity in a short time • Not very expensive. • Opportunity for various stakeholders to come together to discuss locally relevant action plan • Two sides (BF and HIV) can sit together at national level.

  16. Recommendations • Rapid assessment process may be expanded. • Organize National colloquium on Infant Feeding and HIV to better understand guidelines and prepare a road map for implementation; UNICEF WHO could step up efforts • Revisit AFASS, UN Guidelines and UN Framework ensure clarity.

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