A robust response to HIV/AIDS is a top priority in UNICEF's Medium-Term Strategic Plan for 2002-2005. "Fighting HIV/AIDS" is one of UNICEF's five organisational priorities over the next four years. One of the specific strategies mentioned in the MTSP is "to provide counselling and advice for the appropriate feeding of infants born to HIV-positive mothers".
UNICEF has identified 5 priority areas for UNICEF's support in the area of HIV and infant feeding:
1. Support governments with developing comprehensive national infant and young child feeding policies and guidance, which include guidelines on HIV and infant feeding.
2. Intensify efforts to support governments to implement and enforce the International Code of Marketing of Breast-milk Substitutes and subsequent World Health Assembly resolutions through effective national legislation, regulation and monitoring.
3. Intensify efforts to protect, promote and support optimal infant and young child feeding practices through capacity development of health workers, counselors, communities, families and parents including strengthening the Baby Friendly Hospital Initiative
4. Support governments in ensuring that HIV-positive women receive adequate support to select an infant feeding option and enable them to carry out their decision safely and effectively through expanding access to Voluntary Counselling and Testing and informing and training health workers, counsellors and support groups on HIV and infant feeding counselling.
5. Support country level learning, monitoring and evaluation and operational research. Key areas include assessing the feasibility, acceptability, affordability, safety and sustainability of different infant feeding options in different circumstances and evaluating infant feeding practices and the impact of interventions on child health, and survival.
Since April 1999, UNICEF has participated in a United Nations inter-agency programme to prevent mother to child transmission of HIV. Some of the activities that have been undertaken during the last few years include: Formative studies looking at the feasibility, acceptability, affordability, safety and sustainability of different infant feeding options for HIV-infected mothers have been conducted in more than 10 countries including Haiti, Malawi, Namibia, Swaziland and Zambia. The findings of these studies help with the development of national policies and guidelines.
UNICEF provided support to several counties including Botswana, India, Kenya and Uganda for the development of national policies and guidelines on HIV and infant feeding. Since 1998, 13 countries have adopted (some or all provisions of) the International Code of Marketing of Breastmilk Substitutes. At the moment 16 other countries have drafted measures awaiting final approval while another 26 are studying how best to implement the Code.
UNICEF in collaboration with WHO has supported the training of more than 100 trainers on breastfeeding and on HIV and infant feeding counselling. These in turn have trained more than 1000 counsellors and these have counselled thousands of mothers with regards to HIV and infant feeding. UNICEF supported countries like Botswana, Uganda, India and Guyana with developing a communication strategy on PMTCT including HIV and infant feeding. A communication tool on HIV and infant feeding is presently being finalised.
At the end of 2001, around 15,000 health facilities around the world have been declared baby friendly as part of the Baby Friendly Hospital Initiative. Every year additional facilities become baby friendly.
With UNICEF support, assessments of HIV and infant feeding practices by HIV-infected mothers have been conducted or are planned in India, South Africa, Botswana, Rwanda, Malawi, Kenya and Uganda. In South Africa a study is conducted on a simple method for pasteurisation of breastmilk and the feasibility of use of milkbanks. A study in Uganda looked at the experiences with early cessation of breastfeeding by HIV-positive mothers. Such type of studies will help getting a better understanding of the issues around HIV and infant feeding and assist with improved counselling of and support to HIV-infected mothers.
For further information, please contact:
HIV/AIDS Unit, UNICEF, 3 UN Plaza New York NY 10017, USA
Tel: (212) 824-6555