Baby-friendly hospitals promote childbirth revolution

Of Lyailya Bakrayeva's five children, daughter Sof'ya Toktar, now four, is by far the healthiest. "The first child died almost at once, another had diarrhoea and pneumonia, but Sof'ya has never been sick, the others were not like her" she told IRIN in the Kazakh commercial capital, Almaty. The reason Sof'ya has enjoyed a healthy early childhood is simple; she was breastfed for the first six months of her life. Thanks in part to the United Nations Children's Fund (UNICEF), the World Health Organization (WHO) and government programmes promoting breastfeeding and baby-friendly hospitals in Kazakhstan, a whole generation of children are growing up stonger and healthier. For years, health workers in Kazakhstan had been following strict orders in the form of Edict 55, a set of guidelines from the former Soviet Union introduced in 1980 that prescribed strict feeding schedules and discouraged the natural bonding between mother and child. Babies were swaddled and removed from their mothers, while fathers were not allowed to spend time with their infants. Doctors recommended formula as well as other inappropriate foods and drink for babies. Disease and infection were common. This system eroded the traditional breastfeeding culture, health workers told IRIN. The new baby-friendly hospitals, like the Almaty City Perinatal Centre are promoting a completely different model of childbirth and postnatal care. "During Soviet Times a mother was only able to see her new baby after three days, imagine how bad that was!" Doctor Zauresh Amanzholova, director of the hospital, told IRIN from her cramped office off the bustling waiting room. Although the shabby facility has no state-of-the-art equipment it has pioneered a new approach to childbirth in Central Asia. "Here we promote well-being by keeping mother and child together from the moment of birth and also do everything to ensure mother and baby stay healthy afterwards by promoting exclusive breastfeeding and proper nutrition for both," Amanzholova added. Her hospital was the first in Kazakhstan to be internationally certified as 'baby-friendly' in 1998. Today, another 15 hospitals, clinics and maternity departments have won similar recognition. The government's goal is that by 2004, half of all deliveries take place through baby-friendly maternity services. No country in Central Asia has adopted laws regulating the marketing of breast milk substitutes. Yet despite the presence in Almaty of huge billboards advertising powdered milk for infants, UNICEF's advocacy campaigns are working - breastfeeding rates have shot up from their dismal Soviet-era lows. The 1999 Kazakhstan Demographic and Health Survey found that nearly half of all infants were being exclusively breastfed to three months of age - up from one in ten just four years ago. "Kazakhstan is an example of how good policy fully supported by government can produce remarkable results within a short time," UNICEF project assistant Zhanara Bekenova, told IRIN. The baby-friendly concept is being rapidly replicated in other Central Asian Republics - compelled to adopt Soviet-style childbirth and after care. As a result of visits to Almaty, Uzbek health workers have successfully established two baby-friendly hospitals in the capital, Tashkent. Kyrgyzstan And Tajikistan each have one facility with plans for many more.