INFANT AND YOUNG CHILD FEEDING PROGRAMMES IN SRI LANKA: THE POLICY LANDSCAPE

Background and objectives: Infant and young child feeding (IYCF) practices play a critical role in growth and development of children. A favourable environment supported by appropriate policies and positive contributions from all stakeholders are prerequisites for achieving optimal IYCF practices. As Sri Lanka has identified childhood malnutrition as a priority issue, this study aimed to assess the IYCF-related policy environment in Sri Lanka. This would help to identify opportunities to strengthen the policy environment to better support appropriate IYCF and reduce childhood malnutrition. Methods: The research team mapped national level policy- related documents on IYCF across four selected domains of best-practice interventions. Mind mapping and causal analysis was used to identify relevant policy sectors and types. Documents were identified by searching government archives and websites, and through officials from Ministry of Health and other relevant Ministries. A matrix was designed to capture data from IYCF policy- related documents using a thematic approach, and a narrative synthesis of data from different documents was conducted. Results: Twenty four policies and policy related documents were identified containing provisions in the areas of global recommendations for best-practice IYCF, marketing of breast milk substitutes, strengthening health and non-health systems, maternity benefits, inter-sectoral collaboration, capacity building, health education and supplementation. Twenty of them belonged to the health sector. Significant policy support for IYCF was evident across the four domains studied, i.e. general policy support, dissemination of evidence based information, capacity building of healthcare workers and enabling mothers/caregivers to engage with best-practice interventions. On the other hand, there is no separate, written policy on IYCF in Sri Lanka, and it is not specifically mentioned in high level policy documents that demonstrates political will and strategic direction. Conclusions: Globally accepted major evidence-based recommendations are covered in the policies and policy documents studied. This is in line with the findings of Gupta et al. (2013) of an assessment conducted in 40 countries, that Sri Lanka generally had good policy support for IYCF programmes. In order to further improve, advocacy should be targeted towards strategic support for IYCF in high-level policy documents, and enhanced involvement of non-health sectors need t