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Alive & Thrive reports dramatic improvements in nutrition practices in Viet Nam


Alive & Thrive reports dramatic improvements in nutrition practices in Viet Nam

Exclusive breastfeeding rates tripled

HANOI—December 9, 2014—More than 150 participants gathered today for the final dissemination workshop of Alive & Thrive—a six-year initiative to reduce child undernutrition in Viet Nam by improving infant and young child feeding (IYCF) practices. Optimal IYCF practices are critical to reducing stunting, a key measure of malnutrition that has irreversible impacts on an individual’s health, social, and economic development outcomes—and when multiplied across an entire nation, is estimated to reduce a nation’s Gross Domestic Product by at least eight percent. Results showed that the program’s two central interpersonal counseling models, the Mat Troi Be Tho social franchises and IYCF support groups, contributed to dramatic increases in exclusive breastfeeding rates and additional improvements in complementary feeding. Results from the initiative’s mass media campaign and workplace lactation support program were also shared at the workshop.

The Vice Minister of Health, Dr. Nguyen Viet Tien, delivered opening remarks at the workshop. “Over the past six years, the Alive & Thrive program has helped position Viet Nam as a global leader in the fight against malnutrition,” said Vice Minister Tien. “I would like to congratulate Alive & Thrive, and all the partners who contributed to these remarkable results, on their hard work and innovation. These successes truly show how much can be achieved through collaboration and partnership between stakeholders.”

The initiative established a goal of doubling rates of exclusive breastfeeding—which means feeding infants only breastmilk during their first six months of life, even excluding water. From 2010 to 2014, exclusive breastfeeding rates increased from 19 percent to 58 percent—almost tripling in areas that, in addition to a mass media campaign, had Mat Troi Be Tho social franchises, where mothers received high-quality IYCF counseling services.

“The most important result of all is the impact that these improved feeding practices will have on the health and well-being of Viet Nam’s most precious resource—its children,” said Ellen Piwoz, Senior Program Officer at the Bill & Melinda Gates Foundation, which funded the Alive & Thrive initiative. “By creating a new social norm for breastfeeding, new generations of well-nourished children will be able to achieve their full potential in life.”

IYCF support groups were established for remote areas that fall outside the mainstream health system, which was particularly important for reaching ethnic minority communities. In IYCF support group communities, infants are about five times as likely to be exclusively breastfed as those living in communities without an IYCF support group.

“It has been an honor for the National Institute of Nutrition (NIN) to implement these interpersonal counseling models in partnership with Alive & Thrive over the past six years,” said Dr. Le Bach Mai, Vice Director, National Institute of Nutrition. “Because the program demonstrated incredible impact, NIN has committed to sustaining this important work after Alive & Thrive has completed activities. We will continue to manage more than 1,100 social franchise locations, 700 IYCF support groups, and will launch IYCF training in more provinces using a standard manual developed with Alive & Thrive technical expertise and approved by the Ministry of Health.”

The initiative’s mass media campaign included TV spots, loudspeaker announcements, print materials, billboards, and bus wraps. The evaluation demonstrated that mothers who recalled more messages from the TV spots were much more likely to practice exclusive breastfeeding.

The workshop also celebrated recent shifts in Viet Nam’s national policy environment related to infant and young child feeding practices. Many of the stakeholders present were actively involved in providing support to the National Assembly in their 2012 vote to extend paid maternity leave to six months for all salaried female employees, and to tighten restrictions on the marketing of breastmilk substitutes for children up to 24 months of age. Early results show that working mothers who take maternity leave in Viet Nam are more likely to continue exclusive breastfeeding.

The initiative’s workplace lactation support program, implemented in partnership with the General Confederation for Labor and private enterprises throughout Viet Nam, was credited with establishing more than 70 lactation rooms in workplaces spanning government, the garment industry, electronics, and beyond. The outcomes show that workplaces can become much more breastfeeding friendly with simple and affordable actions, which in turn support mothers in their dual roles as income earners and caregivers. In the workshop, a toolkit was launched to guide the implementation of workplace lactation support programs in more Viet Nam businesses and to be shared with other institutions and countries interested in replicating the intervention throughout the Association of Southeast Asian Nations region.

“Viet Nam has now led the way in implementing numerous successful interventions to improve child nutrition that will be replicated in countries around the world,” said Jean Baker, Alive & Thrive Global Project Director. “But the work is not complete. It is our sincere hope that the government of Viet Nam and stakeholders will sustain and expand these interventions so they can reach more mothers and young children throughout Viet Nam, well into the future—which is our ultimate measure of success.”

Despite significant progress, more work remains to be done to improve child nutrition in Viet Nam. Workshop presenters highlighted that the successful interventions need to be sustained and scaled up to reach more people in more provinces throughout Viet Nam. Health financing is still needed to ensure that all families receive proper IYCF and nutrition counseling. And rates of early initiation of breastfeeding, and continued breastfeeding with complementary feeding until a child is 24 months old, still need improvement.

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Alive & Thrive (A&T) is an initiative to improve infant and young child feeding (IYCF) practices by increasing rates of exclusive breastfeeding and improving complementary feeding practices. A&T aims to reach more than 16 million children under two years old in Bangladesh, Ethiopia and Viet Nam, and to create program models that can be replicated worldwide. In Viet Nam, A&T worked with the Ministry of Health, the National Institute of Nutrition (NIN), the Women’s Union, the Viet Nam General Confederation of Labor (VGCL) and provincial authorities to double the rate of exclusive breastfeeding, improve the quality and quantity of complementary foods, and reduce stunting by two percentage points each year. These objectives were attained through different strategies including policy engagement, interpersonal counseling delivered through two distinct service delivery platforms, use of mass media, and the strategic use of data.