Sunday, November 15, 2009

Cameroon Gets WBTi Orientation Training

By Doualla Etongo Priscille
Cameroon Link Group
14 trainers have been oriented on the new WBTi in Cameroon. The orientation training preparation team received IBFAN Africa Consultant and Director of UniNutri Services, Pauline Kisanga, from Swaziland at the Douala International Airport on the 10th November at 19h30 from a timely South Africa Airlines Flight.
Pauline Kisanga, IBFAN Consultant designated as the principal facilitator and James Achanyi-Fontem, National Coordinator of IBFAN Cameroon Link Group acted as the country facilitator of the trainer of trainers WBTi workshop. Participants came from the government, public and private key nutrition NGO advocacy organisations. The selection of participants considered gender aspects with target groups involving men, women and youths in the learning process.
Training Package
The training package presentations on Power Point tackled all the relevant issues related to the starting of a WBTi in a country and the content included the following:
• The Global Strategy and objectives of the workshop
• Status of IYCF in Cameroon and the national perspective
• WBTI – A successful Initiative
• Tracking, Assessing and Monitoring of GSIYCF – South Asia/Africa ExperienceReading Exercise of the Green Book
• Interactive Discussions with Questions and Answers
• How to conduct a national assessment
• Understanding the indicators (1 – 15)
• Work in groups and presentation of work group reports
• Analysis of data, report writing and presentation (exploiting the samples of Asia country reports)
• How to develop recommendations for actions to bridge the gaps
• Work in groups on developing recommendations and presentation of work in groups
• Utilizing WBTi Information
• What is the web action in WBTi
• How to avoid conflict of interest at national level
• Action Plan for Cameroon and Way Forward
• Executive Budget Estimate

Welcome Address
The welcome address on the occasion of the opening of the 2-day orientation training workshop on the World Breastfeeding Trends Initiative in Cameroon on the 12th and 13th November 2009 was made by the National Coordinator of Cameroon Link, James Achanyi-Fontem, who doubles as the Focal Point for IBFAN Cameroon Group and the President of the Federation of Cameroon Breastfeeding Promotion Associations, FECABPA.
Mr. Achanyi-Fontem said, Cameroon was honoured to have the opportunity to welcome the orientation training workshop on the World Breastfeeding Trends Initiative (WBTi) in Douala. He thanked Mrs. Joyce Chanetsa, the Regional Coordinator of IBFAN Africa who included Cameroon on the list of countries to benefit from the orientation training on the World Breastfeeding Trends Initiatiive (WBTi) and Mrs. Pauline Kisanga, Director of UniNutri , IBFAN RC Emeritus for accepting to come to Cameroon to capacitate and share her experiences with the Infant and Young Child Feeding advocates.
Under the guidance of the Ministry of Public Health secondary data was reached for preparation of the workshop using WHO/ UNICEF data and information to analysis the 15 key indicators of Cameroon’s trends so far documented. IBFAN Cameroon Group coordinator acknowledged that the training will assist in the expansion of breastfeeding protection, promotion and support work throughout Cameroon.
Presenting Pauline Kisanga, the former Regional Coordinator of IBFAN Africa, Mr. Achanyi-Fontem described her as an advocate ambassador of breastfeeding of Africa region. She has published several works including, “The Process for Successful Implementation of ILO Maternity Protection Convention 183 of 2000 at National Level: Africa Regional Experience of Step by Step Action” and “The Protection, Support, and Promotion of Breastfeeding in HIV: Policy Guidelines by IBFAN Africa”.
Pauline is special to Cameroon Link, because in her capacity as the former Regional Coordinator of IBFAN Africa and with the support of Baby Milk Action UK, Cameroon was co-opted and affiliated into the Anglophone and Lusophone IBFAN Africa Group in 2000. With her coaching and constant support, Cameroon Link grew from strength to strength and was recipient of the IBFAN Africa distinction in 2007 in Maputo, Mozambique during the 7th Regional Conference for its commitment and engaging support for the protection and promotion of breastfeeding in the continent as a whole and Cameroon in particular.
Cameroon Link today pilots the Federation of Cameroon Breastfeeding Promotion Associations, FECABPA, and the Men’s Initiative of the World Alliance for Breastfeeding Action, WABA, while remaining the Focal Point for the International Baby Food Action Network (IBFAN Africa) in the country. At Cameroon Link, the slogan is, “Babies can’t wait”. Breastfeeding is a baby’s right and it should be on demand and exclusive for the first six months after delivery with complimentary feeding and continued breastfeeding up to 24 months and beyond. Cameroon Link remains more committed than before, especially as the 23rd November 2009 makes its 20th Anniversary.
This means that Cameroon Link celebrates its 20th anniversary with the new initiative, “The World Breastfeeding Trends Initiative (WBTi).” The data and information presented during the WBTi orientation training workshop were based on information collected from the Demographic Health Survey (DHS) in Cameroon, statistics from the ministry of public health, ministry of planning, programming and territorial development in Yaoundé, WHO, UNICEF and ILO sources.
It should be noted that comprehensive survey results are published in the DHS final reports approximately 8 – 12 months after the completion of fieldwork while standard reports are approximately 200 pages in length and include topics on household and respondent characteristics, fertility and family planning, maternal and child health, nutrition and HIV/AIDS.
The department for health promotion in the ministry of public health contributed through researched data as the policy and decision making channel within the frame work of its partnership with Cameroon Link Group that reports regularly on all its activities.
Cameroon’s key indicators collection is on-going for revision and publication in April 2010 after the survey on the rights of the child to food. As Cameroon joins the WBTi, it is observed by IBFAN Cameroon Link that there is net progress made already as it scores well in 12 of the 15 key indicator areas. The WBTi training brought to light the gaps and recommendations which will be published in the final report by December 15.

WBTI Training
During the WBTi orientation training workshop organized in Douala by the IBFAN Cameroon Focal Point with the support of IBFAN Africa regional office, it was observed that efforts have been made in the area of Infant and Young Child Feeding with the support of UNICEF. Though there is a net progress in the area of exclusive breastfeeding, statistics have to be collected regularly for up dates starting from the health facilities.

After the presentation of secondary data in Cameroon during the training, IBFAN Africa consultant, Pauline Kisanga spoke about the evolution of the GSIYCF since 2000, emphasizing on the fact that all countries that endorsed the WHO/WHA recommendations were requested to implement the strategy as national policy.
The GSIYCF was put in place to promote good practices and create supportive environment for the promotion of exclusive breastfeeding for the first six months and continued breastfeeding with complimentary feeding thereafter up to 24 months and beyond.
The strategy is based on the Innocenti declaration adopted in 1990 during an international meeting in Italy. One of the recommendations is that countries should put in place a national breastfeeding committee with the appointment of a national coordinator by the ministry of health.
With the frame work of the strategy, the ten steps to successfully breastfeeding is implemented, the international code is implemented, mothers and children are protected. The global strategy added more targets to the innocent declaration.
The Director of UniNutri Services insisted on the fact that exclusive breastfeeding should be recommended to mothers with complimentary feeding after six months to prevent malnutrition. Countries throughout the world are adopting national legislation she emphasized, adding that when WHO and the world Health Assembly (WHA) improves on policies, countries are required to also up grade their national policy with the involvement of all stake holders. According to the IBFAN Africa consultant, nutrition promotion goes with breastfeeding, which occupies 60 per cent on the agenda. For this reason, the government should create a national breastfeeding committee and appoint a national coordinator as recommended by the WHA and WHO.

IYCF Problems
• Many governments believe that breastfeeding is natural and that mothers should automatically breastfeed their children. This is a wrong perception of the issue, because even when the act is natural, the mothers have to be supported. In most cases, it is the man who purchases formula for the baby and not the mother. Fathers should be educated as well on the advantages of breastmilk through the creation of support groups throughout the country.
• Breastfeeding and HIV are not understood. Policy makers need to be informed on the advantages of breastfeeding and WHO recommendation. Data needs to be collected, because it is through the analysis of the data that decisions are made during discussion at meetings.
• Since all countries have endorsed the WHA/WHO policies and resolutions, countries just simply need to implement them, especially as malnutrition of infants has been rated as a public health concern.

What is WBTi ?
The World Breastfeeding Trends Initiative (WBTi) started in Asia. Before the WBTi, countries were using the WHO IYCF monitoring and evaluation tool and the GLOPAR WABA tool. The new WBTi, is a combination of the WHO and GLOPAR tools to fill gaps which were identified in the previous tools. Many countries are already using the WBTi because it is a simple tool to track progress on the implementation of the Global Strategy. It helps for comparing progress in the different countries, considering the fact that all countries have been requested to monitor the progress of child survival regularly.
The trainer of trainers session organised in Cameroon by the regional coordination of the International Baby Food Action network (IBFAN Africa) is expected to help the government to discover gaps in health investment programme activities.
This will promote best practices; improve on child survival and maternal survival. The WHO tool was simplified by combining GLOPAR from WABA to build the WBTi tool. It works by collecting secondary data and analysing it to come out with the trends.
After the analysis of the data, trends are then used for making decisions to fill the gaps. This helps countries and governments to fill gaps in health investment, programmes and activities. WBTi brings people together to discuss results, since the trends demonstrate achievements and gaps to improve on Infant and Young child feeding.

Breastfeeding and HIV
WHO and WHA recommend AFASS. AFASS stands for the following:
A = Accessibility
F= Feasibilty
A= Affordibilty
S= Sustainability
S= Safety
The above is used for counselling mothers to make well informed choices as far as the nutrition of their children is concerned.
The work in groups aimed at verifying the 15 IYCF key indicators used for evaluating countries with the WBTi tool. Within this frame work, the trainers were separated in three different groups and the indicators shared amongst for verification and scoring of Cameroon. Cameroon scored 81/150 by WHO rating analysis standards and this is equivalent to 54 per cent using WBTi tool.

Core Persons & Partners
The WBTi trainers identified core persons and partners who will pilot the initiative in Cameroon and by consensus vote, it was decided that IBFAN Cameroon should coordinate WBTi in Cameroon under the supervision of its national coordinator as team leader.
The WBTi Cameroon core persons identified are: James Achanyi-Fontem (Cameroon Link), Okala Georges (MOH), Tata Japhet (MOH), Mibe Samuel(MOH), Yvonne Bekeny (IBFAN Cam), Florine Nseumi (IBFAN Cam), Annette Efeti (IBFAN Cam)
The WBTI Partners are: WHO, UNICEF, WABA, IBFAN, Plan International, Helen Keller Foundation, Cameroon Link, ACTHU, CAMNAFAW, Fine Forest Foundation, Vine Yard Cameroon, COGESID and Maleo Sante Plus.
Before closing the training of trainers session in Douala, a WBTi action plan with tasks to be accomplished covering the period from November 2009 to March 2010 was put in place. The tasks included preparing a national work plan for collection of WBTi information and writing of a report that will highlight all the 15 indicators used for monitoring and evaluation.
The report needs to be presented to the government (Ministry of Public Health) and a wider audience for validation by November 30. The final WBTi Report on Cameroon will be communicated to IBFAN Africa Regional Coordination by December 15 and the regional coordination of IBFAN Africa will channel will share the report with others in Africa before channelling to IBFAN Asia by December 15 ahead of the Christmas and New Year holiday period.