India scores poorly when it comes to infant care and feeding

India's latest health indicators paint a very poor picture indeed of the state of infant and young child feeding (IYCF), with India scoring just 78 out of a score of 150. This score is given according to global standards World Breastfeeding Trends Initiative (WBTi) that seeks to monitor infant care across countries. India's score comes from the 2015 assessment, the fourth such assessment, which shows that the country has made bare minimum improvement from a score of 74/150 from the 2012 assessment.

India's indicators are lower than its more impoverished neighbours, Afghanistan with a score of 99, Bangladesh 107.5 and Sri Lanka 129. While Bangladesh and Sri Lanka have long left India eating dust when it comes to public health care, Afghanistan scoring higher should serve as an alarm bell to look into potential gaps the country's programmes and policies.

Dr Vandana Prasad, of the Public Health Resource Network, while releasing the WBTi report, said that these countries had cultural practices and traditions similar to those in India, however, their high score reflected stronger political will. "We need an overall full time national body to coordinate efforts by the Women and Child Development Ministry, the health ministry, the labour and rural ministries," she said. "Our pace needs to pick up more, and political will is very important."

India's score is low largely due to poor performance in national policy, programme and coordination, baby friendly hospital initiatives, maternity protection that entails paid maternity leave, as of yet only available to central government employees, and national legislation encouraging work site accommodation for breastfeeding and/or childcare. Another dismal score was on enabling breastfeeding or young child feeding during emergencies, for which there are no provisions.

Where India performed relatively better was on providing skilled counseling services to all women concerning ICYF, in providing counselling and creative outreach on child feeding in the context of HIV. Dr Prasad noted that only the health ministry's efforts were pulling up India's scores. Efforts have to be made by other wings of the government, such as labour and women and child development to improve on essential factors such as maternity leave and informing women about benefits of breastfeeding. Additionally there needs to be clear policies on the training of health workers to spread this information.

Dr Arun Gupta, regional coordinator for International Baby Food Action Network Asia (IBFAN), raised a question based of the Prime Minister's speech at the recently concluded Global Call to Action Summit, asking "only 44% women are able to begin breastfeeding within one hour when more than 75% deliver in institutions as claimed by our Prime Minister".

This focus on maternal and child care is bound to step up as they are integral to the Sustainable Development Goals of the United Nations. For now, as the report on the WBTi indicator points out India is at an interesting juncture where the government has enacted the significant National Food Security Act that assures "maternity protection and food security for children", yet its rules have to be finalised. There have been important reforms but "failure to convert the national guidelines (relating to ICYF) into policy remains an overarching handicap", as is the slash in India's annual health budget that will negatively impact existing government schemes.