KARACHI: The provincial health ministry has failed to devise rules for the past four years to properly implement the Sindh Protection of Breastfeeding and Child Nutrition Act, 2013, despite the low breastfeeding practices across the province, it emerged on Monday.

If implemented in full, the law promises a turnaround in the present situation but the nutrition cell has yet to take any concrete measures to discourage media campaigns of formula milk.

Officials said around 37 per cent children below the age of six months were breastfed in Pakistan, but the ratio in Sindh is even below the national average.

Members of civil society put the blame on baby milk formula companies who they said had managed to delay the law’s implementation, in cahoots with some government officials.

“The rules are being delayed while the formula companies are aggressively campaigning for their products and no one is there to question them,” said an official close to a technical committee that is taking care of the matter.

The health ministry formed the committee with the chief drug inspector as its secretary over two years ago with the mandate to listen to the representatives of baby food manufacturers and marketing association and recommend their suggestions (for necessary amendment to the act) to the health secretary. It asked the representatives of baby food manufacturers and marketing association to appear in person before the committee.

Sources in the health ministry said there were certain clauses in the Sindh Protection of Breast Feeding and Child Nutrition Act 2013, with which the baby food manufacturers had not come to terms. They wanted some amendments to the law, the sources added.

The officials said that for unknown reasons by-laws for the breastfeeding act had not been formulated despite several reminders by the committee.

Infant Feeding Board

Similarly, not a single ‘formal’ meeting of the Infant Feeding Board has been held since its constitution. The board had been formed more than three years ago.

Chairperson of the standing committee on health Dr Sohrab Sarki is heading the board, while its two members, Nasir Hussain Shah and Mehtab Akbar Rashdi, were nominated from the Sindh Assembly by the speaker.

Other members of the board included two paediatricians, two obstetricians, a representative of the baby food manufacturers and marketing association and Dr Durre Samin Akram from civil society nominated by the health department.

The Sindh health secretary is the board’s secretary while programme manager of the Nutrition Support Programme was also nominated as a member.

Penalties

The breastfeeding act has certain explicit restrictions on baby food manufacturers and it envisages penalties as strict as sentence of two years and Rs500,000 fine for violators.

It says no person shall, in any form whatsoever, promote any designated products except as provided for under this act.

Similarly, no person shall in any manner assert that any designated product is a substitute for mother’s milk, or that it is equivalent to or comparable with or superior to mother’s milk.

It restricts all manufacturers and distributors from offering or making gifts or contributions of any kind, or paying to any extent for any reason whatsoever, or giving any kind of benefit, to a health worker or one’s family, or any personnel employed, directly or indirectly, in a healthcare facility, or any member of the board, or the employees thereof.

Published in Dawn, April 25th, 2017