Annotation 8_Developing evidence-based advocacy and policy change strategies to protect, promote, and support infant and young child feeding

Hajeebhoy, N. et al. (2013) “Developing Evidence-Based Advocacy and Policy Change Strategies to Protect, Promote, and Support Infant and Young Child Feeding,” Food and Nutrition Bulletin, 34(3_suppl2), pp. S181–S194

Overview: Improved breastfeeding and complementary feeding have significant benefits beyond reducing mortality, including improved intelligence quotient and lower noncommunicable disease risks. Successful breastfeeding promotion strategies are cost-effective and well-documented.The Alive & Thrive project designed three comprehensive IYCF programs in Bangladesh, Ethiopia, and Vietnam to scale up globally. Evidence-based advocacy, alliances, and partnerships were integrated into each country’s program. The paper discusses the design process, examining reasons why decision-makers haven’t prioritized infant and young child feeding (IYCF) and summarizing key lessons learned.

Methodology: The advocacy goal and strategies for each country were based on findings from situational analysis, formative and opinion leader research, and stakeholder consultations. Alive & Thrive conducted a situational analysis in 2009/10 to identify national and subnational priorities and policy barriers for improving IYCF practices and addressing stunting. This led to the development of policy and advocacy goals, potential partners, and understanding of policy windows, barriers, and message frameworks. The advocacy strategies required a systematic yet flexible operational strategy for each action.The research and stakeholder consultations also helped generate an understanding of the potential policy windows, barriers, and the types of internal and external message frameworks, materials, and communication channels to create pathways for change. 

Findings: Child malnutrition is a concern but not a top priority for officials in three different contexts. Nutrition-focused policies do not necessarily make it a top priority, and governments may perceive improvements as less urgent. This, combined with international commitments and interests, results in limited investments in IYCF. Officials are often unaware of policies or misinformed about the benefits of improving IYCF and the consequences of suboptimal practices. In Ethiopia, food scarcity is considered the most important reason for malnutrition, and agricultural and food security policies are rarely formulated or implemented with nutritional considerations. This low visibility, awareness, and prioritization of IYCF highlight the need for strong advocacy and targeted efforts to raise it on the policy agenda.

Conclusion: Malnutrition is often underreported in national governments, leading to limited scope, underutilized strategies, and under-resourced IYCF and nutrition actions. To raise IYCF’s profile, a research-based advocacy strategy is needed, but sufficient time and resources are needed. Evidence-based advocacy frameworks can contribute to policy and advocacy goals, such as strengthening national laws and increasing investments in IYCF.