3245.0 'creating happy synergies': Lessons learnt from lao PDR’s efforts to create an enabling environment to protect breastfeeding and child nutrition

Session: Research on the Ethical, Legal and Social Implications of Human Milk Feeding and Lactation

Program: Breastfeeding

Time: 3:23 - 3:38 PM

Presenter:

Devina Buckshee

Abstract

Despite the large body of evidence, global breastfeeding rates remain below target levels (ENN, 2016), in part because of a weak understanding of the multifactoral determinants of breastfeeding. Nutrition and child health scholars have been advocating for increased investment in multisectoral support, across legal, political, social and structural levels. This paper aims to stitch together the patchwork of actors and ‘gears’ in action to create a conducive, enabling environment to improve child nutrition rates in Lao PDR, a country that is steadily working across sectors to push for breastfeeding protection through the adoption and implementation of the WHO’s International Code of Marketing for Breastfeeding Protections. This paper will tease out the strategies used in Laos to target evidence-based advocacy, multisectoral political will, increased investment, research and evaluation, and stakeholder coordination. After an initial literature review of the existing evidence and grey literature on breastfeeding protection interventions in South-East Asia, a qualitative study design consisting of 7 in-depth interviews were conducted. Key informant interviews were guided by a COM-B (Capability, Opportunity, Motivation) framework, following which qualitative thematic analysis was conducted. The Breastfeeding Gear Model was used to map the factors facilitating or hindering the creation of an overall enabling environment for breastfeeding protection in Laos. Following this, generalizable strategies were teased out, and key recommendations for other countries were developed. The three main themes identified were 1) Multisectoral long-term partnerships 2) Advocacy and 3) Political Will. Key informants identified issues and perceptions of priority improvement areas to be addressed to improve breastfeeding outcomes in Lao PDR. Understanding local contexts and cultures, and leaning into partnerships where the government takes the lead is key to ensuring the sustainability of the BMS Code. Countries with a similar socio-economic makeup may consider Lao PDR’s strategies to support child nutrition along global WHO goals.