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Roger Mathisen - One of the best experts on this subject based on the ideXlab platform.

  • The financing need for expanding paid Maternity leave to support breastfeeding in the informal sector in the Philippines.
    Maternal & child nutrition, 2020
    Co-Authors: Valerie Gilbert T Ulep, Mireya Vilar-compte, Grace Carroll, Rafael Pérez-escamilla, Paul Zambrano, Janice Datu‐sanguyo, Graciela Ma Teruel Belismelis, Roger Mathisen
    Abstract:

    In low- and middle-income countries, almost three-fourths of women in the labour force lack Maternity Protection. In the Philippines, current laws do not guarantee paid Maternity leave to workers in the informal economy. A non-contributory Maternity cash transfer to informal sector workers could be used to promote social equity and economic productivity and could provide health benefits by helping mothers meet their breastfeeding goals. The objective of the study is to provide a realistic cost estimate and to assess the financial feasibility of implementing a publicly financed, non-contributory Maternity cash transfer programme to the informal sector in the Philippines. Using a costing framework developed in Mexico, the study estimated the annual cost of a Maternity cash transfer programme. The methodology estimated the unit cost of the programme, the incremental coverage of Maternity leave and expected number of enrollees. Different unit and incremental costs assumptions were used to provide a range of scenarios. Administrative costs for running the programme were included in the analysis. The annual financing need of implementing Maternity cash transfer programme in the Philippines ranges from a minimum scenario of USD42 million (14-week Maternity cash transfer) to a more ideal scenario of USD309 million (26-week Maternity cash transfer). The latter is financially feasible as it is equivalent to less than 0.1% of the country's gross domestic product substantially lower than the share cost of not breastfeeding (0.7%). The annual cost of the programme is only 10% of the total cost of the largest conditional cash transfer programme.

  • Assessing the Effectiveness of Policies Relating to Breastfeeding Promotion, Protection, and Support in Southeast Asia: Protocol for a Mixed Methods Study.
    JMIR research protocols, 2020
    Co-Authors: Tuan T. Nguyen, Amy Weissman, Jennifer Cashin, Paul Zambrano, Roger Mathisen
    Abstract:

    BACKGROUND Despite its well-known benefits, breastfeeding practices remain suboptimal worldwide, including in Southeast Asia. Many countries in the region have thus enacted policies, such as Maternity Protection and the World Health Assembly International Code of Marketing of Breast-milk Substitutes (the Code), that protect, promote, and support breastfeeding. Yet the impact of such national legislation on breastfeeding practices is not well understood. OBJECTIVE This study aims to review the content, implementation, and potential impact of policies relating to Maternity Protection and the Code in Myanmar, the Philippines, Thailand, and Vietnam. METHODS This mixed methods study includes a desk review, trend and secondary data analyses, and quantitative and qualitative data collection. Desk reviews will examine and compare the contents, implementation strategies, coverage, monitoring, and enforcement of national policies focusing on Maternity Protection and the Code in each country with global standards. Trend and secondary data analyses will examine the potential impact of these policies on relevant variables such as breast milk substitute (BMS) sales and women's workforce participation. Quantitative data collection and analysis will be conducted to examine relevant stakeholders' and beneficiaries' perceptions about these policies. In each country, we will conduct up to 24 in-depth interviews (IDI) with stakeholders at national and provincial levels and 12 employers or 12 health workers. Per country, we will survey approximately 930 women who are pregnant or have a child aged 0-11 months, of whom approximately 36 will be invited for an IDI; 12 partners of the interviewed mothers or fathers of children from 0-11 months will also be interviewed. RESULTS This study, funded in June 2018, was approved by the Institutional Review Boards of the relevant organizations (FHI 360: April 16, 2019 and May 18, 2020; and Hanoi University of Public Health: December 6, 2019). The dates of data collection are as follows: Vietnam: November and December 2019, May and June 2020; the Philippines: projected August 2020; Myanmar and Thailand: pending based on permissions and funding. Results are expected to be published in January 2021. As of July 2020, we had enrolled 1150 participants. We will present a comparison of key contents of the policies across countries and against international standards and recommendations and a comparison of implementation strategies, coverage, monitoring, and enforcement across countries. We will also present findings from secondary data and trend data analyses to propose the potential impact of a new or amended policy. For the surveys with women, we will present associations between exposure to Maternity Protection or BMS promotion on infant and young child feeding practices and their determinants. Findings from IDIs will highlight relevant stakeholders' and beneficiaries' perceptions. CONCLUSIONS This study will increase the understanding of the effectiveness of policy interventions to improve breastfeeding, which will be used to advocate for stronger policy adoption and enforcement in study countries and beyond. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/21286.

  • Assessing the Effectiveness of Policies Relating to Breastfeeding Promotion, Protection, and Support in Southeast Asia: Protocol for a Mixed Methods Study (Preprint)
    2020
    Co-Authors: Tuan T. Nguyen, Amy Weissman, Jennifer Cashin, Paul Zambrano, Roger Mathisen
    Abstract:

    BACKGROUND Despite its well-known benefits, breastfeeding practices remain suboptimal worldwide, including in Southeast Asia. Many countries in the region have thus enacted policies, such as Maternity Protection and the World Health Assembly International Code of Marketing of Breast-milk Substitutes (the Code), that protect, promote, and support breastfeeding. Yet the impact of such national legislation on breastfeeding practices is not well understood. OBJECTIVE This study aims to review the content, implementation, and potential impact of policies relating to Maternity Protection and the Code in Myanmar, the Philippines, Thailand, and Vietnam. METHODS This mixed methods study includes a desk review, trend and secondary data analyses, and quantitative and qualitative data collection. Desk reviews will examine and compare the contents, implementation strategies, coverage, monitoring, and enforcement of national policies focusing on Maternity Protection and the Code in each country with global standards. Trend and secondary data analyses will examine the potential impact of these policies on relevant variables such as breast milk substitute (BMS) sales and women’s workforce participation. Quantitative data collection and analysis will be conducted to examine relevant stakeholders’ and beneficiaries’ perceptions about these policies. In each country, we will conduct up to 24 in-depth interviews (IDI) with stakeholders at national and provincial levels and 12 employers or 12 health workers. Per country, we will survey approximately 930 women who are pregnant or have a child aged 0-11 months, of whom approximately 36 will be invited for an IDI; 12 partners of the interviewed mothers or fathers of children from 0-11 months will also be interviewed. RESULTS This study, funded in June 2018, was approved by the Institutional Review Boards of the relevant organizations (FHI 360: April 16, 2019 and May 18, 2020; and Hanoi University of Public Health: December 6, 2019). The dates of data collection are as follows: Vietnam: November and December 2019, May and June 2020; the Philippines: projected August 2020; Myanmar and Thailand: pending based on permissions and funding. Results are expected to be published in January 2021. As of July 2020, we had enrolled 1150 participants. We will present a comparison of key contents of the policies across countries and against international standards and recommendations and a comparison of implementation strategies, coverage, monitoring, and enforcement across countries. We will also present findings from secondary data and trend data analyses to propose the potential impact of a new or amended policy. For the surveys with women, we will present associations between exposure to Maternity Protection or BMS promotion on infant and young child feeding practices and their determinants. Findings from IDIs will highlight relevant stakeholders’ and beneficiaries’ perceptions. CONCLUSIONS This study will increase the understanding of the effectiveness of policy interventions to improve breastfeeding, which will be used to advocate for stronger policy adoption and enforcement in study countries and beyond. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/21286

  • The financing need for expanded Maternity Protection in Indonesia.
    International breastfeeding journal, 2019
    Co-Authors: Adiatma Y. M. Siregar, Pipit Pitriyan, Dylan Walters, Matthew Brown, Linh Thi Hong Phan, Roger Mathisen
    Abstract:

    Almost half of all Indonesian children under 6 months of age were not exclusive breastfed in 2017. Optimizing Maternity Protection programs may result in increased breastfeeding rates. This study aims to: estimate the potential cost implications of optimizing the current paid Maternity Protection program, estimate budgets needed to increase coverage of lactation rooms in mid and large firms, and explore challenges in its implementation in Indonesia. The potential cost implication of the current and increased Maternity leave length (three and 6 months) as well as the potential budget impact to the government were estimated for 2020 to 2030. The cost of setting up lactation rooms in formal sector companies was estimated using the Alive & Thrive standards. Interviews were conducted in five different provinces to 29 respondents in 2016 to identify current and potential challenges in implementing both existing and improved Maternity Protection policies. The costs of expanding paid Maternity leave from three to 6 months and incorporating standardized lactation rooms in 80% of medium and large size firms in Indonesia was estimated at US$1.0 billion (US$616.4/mother per year) from 2020 to 2030, covering roughly 1.7 million females. The cost of setting up a basic lactation room in 80% of medium and large companies may reach US$18.1 million over 10 years. The three main barriers to increasing breastfeeding rates were: breastmilk substitutes marketing practices, the lack of lactation rooms in workplaces, and local customs that may hamper breastfeeding according to recommendations. The cost of expanding paid Maternity leave is lower than the potential cost savings of US$ 1.5 billion from decreased child mortality and morbidity, maternal cancer rates and cognitive loss. Sharing the cost of paid Maternity leave between government and the private sector may provide a feasible economic solution. The main barriers to increasing breastfeeding need to be overcome to reap the benefits of recommended breastfeeding practices.

  • The financing need for expanded Maternity Protection in Indonesia
    International Breastfeeding Journal, 2019
    Co-Authors: Adiatma Y. M. Siregar, Pipit Pitriyan, Dylan Walters, Matthew Brown, Linh Thi Hong Phan, Roger Mathisen
    Abstract:

    Background Almost half of all Indonesian children under 6 months of age were not exclusive breastfed in 2017. Optimizing Maternity Protection programs may result in increased breastfeeding rates. This study aims to: estimate the potential cost implications of optimizing the current paid Maternity Protection program, estimate budgets needed to increase coverage of lactation rooms in mid and large firms, and explore challenges in its implementation in Indonesia. Methods The potential cost implication of the current and increased Maternity leave length (three and 6 months) as well as the potential budget impact to the government were estimated for 2020 to 2030. The cost of setting up lactation rooms in formal sector companies was estimated using the Alive & Thrive standards. Interviews were conducted in five different provinces to 29 respondents in 2016 to identify current and potential challenges in implementing both existing and improved Maternity Protection policies. Results The costs of expanding paid Maternity leave from three to 6 months and incorporating standardized lactation rooms in 80% of medium and large size firms in Indonesia was estimated at US$1.0 billion (US$616.4/mother per year) from 2020 to 2030, covering roughly 1.7 million females. The cost of setting up a basic lactation room in 80% of medium and large companies may reach US$18.1 million over 10 years. The three main barriers to increasing breastfeeding rates were: breastmilk substitutes marketing practices, the lack of lactation rooms in workplaces, and local customs that may hamper breastfeeding according to recommendations. Conclusions The cost of expanding paid Maternity leave is lower than the potential cost savings of US$ 1.5 billion from decreased child mortality and morbidity, maternal cancer rates and cognitive loss. Sharing the cost of paid Maternity leave between government and the private sector may provide a feasible economic solution. The main barriers to increasing breastfeeding need to be overcome to reap the benefits of recommended breastfeeding practices.

David L Pelletier - One of the best experts on this subject based on the ideXlab platform.

  • strengthening advocacy and policy change for infant and young child feeding
    Maternal and Child Nutrition, 2019
    Co-Authors: Isabelle Michaudletourneau, Marion Gayard, David L Pelletier
    Abstract:

    : The creation of environments that are more supportive of optimal infant and young child feeding (IYCF) requires countries to enact policies, such as those related to the Maternity Protection Convention, the International Code of Marketing of Breast-milk Substitutes (the Code), and the Baby-Friendly Hospital Initiative. However, challenges are experienced in the translation of international policy standards into national legal measures, and there is an important gap in understanding how countries achieve progress. Policy advocacy is a nearly universal feature, but there are methodological challenges and few studies evaluating strategies and effects. The purpose of this supplement to Maternal & Child Nutrition is to address those gaps. This supplement contains three papers that present findings from a real-time evaluation of the advocacy efforts of Alive & Thrive (AT (b) the creation of a strategic group of actors; and (c) the realization of 15 critical tasks (more specifically for the Code). Each of the critical tasks has been identified as having triggered progress on the Code in those countries. This supplement provides evidence that the advocacy efforts of A&T, UNICEF, and partners contributed to enhanced IYCF policies in SEA and reveals how it helped to achieve progress. The insights contained in this supplement can serve as a guide for policy advocates for enhanced IYCF policies. A short communication puts findings into perspective within global context.

  • Strengthening advocacy and policy change for infant and young child feeding.
    Maternal & Child Nutrition, 2019
    Co-Authors: Isabelle Michaud-létourneau, Marion Gayard, David L Pelletier
    Abstract:

    The creation of environments that are more supportive of optimal infant and young child feeding (IYCF) requires countries to enact policies, such as those related to the Maternity Protection Convention, the International Code of Marketing of Breast-milk Substitutes (the Code), and the Baby-Friendly Hospital Initiative. However, challenges are experienced in the translation of international policy standards into national legal measures, and there is an important gap in understanding how countries achieve progress. Policy advocacy is a nearly universal feature, but there are methodological challenges and few studies evaluating strategies and effects. The purpose of this supplement to Maternal & Child Nutrition is to address those gaps. This supplement contains three papers that present findings from a real-time evaluation of the advocacy efforts of Alive & Thrive (AT (b) the creation of a strategic group of actors; and (c) the realization of 15 critical tasks (more specifically for the Code). Each of the critical tasks has been identified as having triggered progress on the Code in those countries. This supplement provides evidence that the advocacy efforts of A&T, UNICEF, and partners contributed to enhanced IYCF policies in SEA and reveals how it helped to achieve progress. The insights contained in this supplement can serve as a guide for policy advocates for enhanced IYCF policies. A short communication puts findings into perspective within global context.

Isabelle Michaudletourneau - One of the best experts on this subject based on the ideXlab platform.

  • strengthening advocacy and policy change for infant and young child feeding
    Maternal and Child Nutrition, 2019
    Co-Authors: Isabelle Michaudletourneau, Marion Gayard, David L Pelletier
    Abstract:

    : The creation of environments that are more supportive of optimal infant and young child feeding (IYCF) requires countries to enact policies, such as those related to the Maternity Protection Convention, the International Code of Marketing of Breast-milk Substitutes (the Code), and the Baby-Friendly Hospital Initiative. However, challenges are experienced in the translation of international policy standards into national legal measures, and there is an important gap in understanding how countries achieve progress. Policy advocacy is a nearly universal feature, but there are methodological challenges and few studies evaluating strategies and effects. The purpose of this supplement to Maternal & Child Nutrition is to address those gaps. This supplement contains three papers that present findings from a real-time evaluation of the advocacy efforts of Alive & Thrive (AT (b) the creation of a strategic group of actors; and (c) the realization of 15 critical tasks (more specifically for the Code). Each of the critical tasks has been identified as having triggered progress on the Code in those countries. This supplement provides evidence that the advocacy efforts of A&T, UNICEF, and partners contributed to enhanced IYCF policies in SEA and reveals how it helped to achieve progress. The insights contained in this supplement can serve as a guide for policy advocates for enhanced IYCF policies. A short communication puts findings into perspective within global context.

Seema Puri - One of the best experts on this subject based on the ideXlab platform.

  • Opportunities for strengthening infant and young child feeding policies in South Asia: Insights from the SAIFRN policy analysis project
    BMC Public Health, 2017
    Co-Authors: Anne Marie Thow, Sumit Karn, Madhu Dixit Devkota, Sabrina Rasheed, Sk Roy, Yasmeen Suleman, Tabish Hazir, Archana Patel, Abhay Gaidhane, Seema Puri
    Abstract:

    Background South Asian countries experience some of the highest levels of child undernutrition in the world, strongly linked to poor infant and young child feeding (IYCF) practices. Strong and responsive policy support is essential for effective interventions to improve IYCF. This study aimed to identify opportunities for strengthening the policy environment in the region to better support appropriate infant and young child feeding. Methods We mapped policies relevant to infant and young child feeding in India, Pakistan, Bangladesh, Sri Lanka and Nepal, based on a common matrix. The matrix described potentially relevant policies ranging from high-level strategic policy documents to implementation-level guidelines. We analyzed the data based on themes focused on caregiver interactions with IYCF interventions: provision of correct information to mothers, training of frontline workers, enabling mothers to engage with service providers and strategic support for IYCF. Results Policy support for IYCF was present in relation to each of the themes assessed. In all countries, there was support for nutrition in National Development Plans, and all countries had some level of Maternity Protection and restrictions on marketing of breast milk substitutes. Sectoral and implementation-level policy documents contained provisions for system strengthening for IYCF and for training of frontline workers. Conclusions The key opportunities for strengthening IYCF policy support were in relation to translating strategic directives into implementation level documents; improving multi-sectoral support and coordination; and increased clarity regarding roles and responsibilities of frontline workers interacting with mothers. These findings can support efforts to strengthen IYCF policy at the national and regional level.

Isabelle Probst - One of the best experts on this subject based on the ideXlab platform.

  • Implementation, mechanisms and effects of Maternity Protection legislation: a realist narrative review of the literature
    International Archives of Occupational and Environmental Health, 2018
    Co-Authors: Isabelle Probst, Alessia Zellweger, Maria-pia Politis Mercier, Brigitta Danuser, Peggy Krief
    Abstract:

    PurposeMost industrialized countries have introduced Maternity Protection legislation (MPL) to protect the health of pregnant workers and their unborn children from workplace exposure. This review aimed to assess this legislation’s level of implementation, barriers and facilitators to it, and its expected or unexpected effects.MethodsA realist narrative review was conducted. Keyword searches of the PubMed, CINAHL, PsycINFO, MIDIRS, Sociological abstracts and Google Scholar electronic databases were performed in March 2018.ResultsThe 42 publications included show that the implementation of MPL is deficient in most countries. Allowing pregnant women to withdraw from work on preventive leave or sick leave is favored over workplace adaptations or worker reassignments. The publications highlight mechanisms which encourage or obstruct the enforcement of legislation at the levels of the individual, the physical and social environment, and the macrosocial context. The delay between the conception and implementation of Maternity Protection measures appears to be a major barrier to the efficacy of MPL. The literature also suggests that unexpected adverse effects, such as degradation in working relationships or discrimination can obstruct the implementation of protective measures.ConclusionsThis study showed the need for a better implementation of MPL during pregnancy. Further research and recommendations for improvements in MPL should consider the diverse mechanisms and effects of its implementation. Barriers and adverse effects of this implementation do not only ensure a lack of information or awareness about MPL, but are also linked to contradictions between requirements to protect employment and protect pregnancy.

  • Protection of pregnant women at work in switzerland implementation and experiences of Maternity Protection legislation
    Proceedings of the 20th Congress of the International Ergonomics Association (IEA 2018): Vol. II. Safety and health slips trips and falls, 2018
    Co-Authors: Alessia Zellweger, Brigitta Danuser, Peggy Krief, Maria-pia Politis Mercier, Pascal Wild, Michela Zenoni, Isabelle Probst
    Abstract:

    Objectives. Like most industrialized countries, Switzerland has introduced legislation to protect the health of pregnant workers and their unborn children from workplace hazards. This study aims to assess legislation’s degree of implementation in the French-speaking part of Switzerland and understand the barriers to and resources supporting its implementation.

  • Proceedings of the 20th Congress of the International Ergonomics Association (IEA 2018) - Protection of Pregnant Women at Work in Switzerland: Implementation and Experiences of Maternity Protection Legislation
    Advances in Intelligent Systems and Computing, 2018
    Co-Authors: Alessia Zellweger, Brigitta Danuser, Peggy Krief, Maria-pia Politis Mercier, Pascal Wild, Michela Zenoni, Isabelle Probst
    Abstract:

    Objectives. Like most industrialized countries, Switzerland has introduced legislation to protect the health of pregnant workers and their unborn children from workplace hazards. This study aims to assess legislation’s degree of implementation in the French-speaking part of Switzerland and understand the barriers to and resources supporting its implementation.

  • Implementation, mechanisms and effects of Maternity Protection legislation: a realist narrative review of the literature.
    International archives of occupational and environmental health, 2018
    Co-Authors: Isabelle Probst, Alessia Zellweger, Brigitta Danuser, Maria-pia Politis Mercier, Peggy Krief
    Abstract:

    Most industrialized countries have introduced Maternity Protection legislation (MPL) to protect the health of pregnant workers and their unborn children from workplace exposure. This review aimed to assess this legislation’s level of implementation, barriers and facilitators to it, and its expected or unexpected effects. A realist narrative review was conducted. Keyword searches of the PubMed, CINAHL, PsycINFO, MIDIRS, Sociological abstracts and Google Scholar electronic databases were performed in March 2018. The 42 publications included show that the implementation of MPL is deficient in most countries. Allowing pregnant women to withdraw from work on preventive leave or sick leave is favored over workplace adaptations or worker reassignments. The publications highlight mechanisms which encourage or obstruct the enforcement of legislation at the levels of the individual, the physical and social environment, and the macrosocial context. The delay between the conception and implementation of Maternity Protection measures appears to be a major barrier to the efficacy of MPL. The literature also suggests that unexpected adverse effects, such as degradation in working relationships or discrimination can obstruct the implementation of protective measures. This study showed the need for a better implementation of MPL during pregnancy. Further research and recommendations for improvements in MPL should consider the diverse mechanisms and effects of its implementation. Barriers and adverse effects of this implementation do not only ensure a lack of information or awareness about MPL, but are also linked to contradictions between requirements to protect employment and protect pregnancy.