INFANT AND YOUNG CHILD FEEDING POLICY PROCESS AND PROGRAMMES IN SRI LANKA: AN ANALYSIS OF STAKEHOLDERS

Background and objectives: Child nutrition indicators have not improved on par with other health indicators in Sri Lanka. Evidence-based interventions to improve infant and young child feeding (IYCF) practices are well documented. Adoption of such interventions, guided by robust polices, and backed by unstinted support from all stakeholders are pre-requisites for successful IYCF programmes, to tackle childhood malnutrition. This study was designed to describe the role of stakeholders in IYCF policies and programmes in Sri Lanka, in order to identify opportunities for improvement. Methods: Technical and funding links of stakeholders involved in IYCF policies and programmes in Sri Lanka were analysed using Net-Map technique. Thirty five experts knowledgeable about IYCF programmes were selected for this purpose, and individually interviewed. Data were analysed using ORA(Organizational Risk Analyzer) software. Relative importance of stakeholders was assessed through 'centrality' measures ('in-degree', 'out-degree', 'closeness' and 'betweenness'). In addition, 'level of influence' and 'support' of each stakeholder were also measured. The ORA software identified 'communities', i.e. groups of stakeholders closely connected. Results: For technical and funding support for IYCF policies and programmes, 56 and 37 stakeholders respectively were identified. Regarding technical support, stakeholders in the government health sector had the highest 'centrality' measures, 'level of influence' and 'support', followed by development partners. The research and academic, non-governmental organization (NGO) and government non-health stakeholders had relatively low 'centrality' and 'level of influence', though most of them were 'supportive'. In the funding support map also government health sector stakeholders were prominent. High 'in-degree' suggested adequacy of funds for this main sector. Generally high 'supportiveness', 'level of influence' and 'centrality' of these stakeholders facilitate favourable distribution and utilization of funds for IYCF activities. Development partners had high 'out-degree' and 'level of influence' measures. Government non-health and NGO sectors had low 'in-degree', 'closeness' and 'level of influence' measures, though 'supportive'. 'Communities' in both technical and funding support maps were diverse, indicating healthy support and collaboration between stakeholders of various sectors. Conclusions: The stakeholder analysis demonstrated that the go