Breast feeding is the prime source of nutrition for the infants and as per the World Health organization guidelines, breast feeding is the only recommended mode of nutrition for the babies up to 6 months of age. Even 6 months onwards, the breast feeding is recommended to continue for the babies alongside other suitable alternative and complementary food for at least 2 years and beyond (Breastfeeding.asn.au 2018). However, as per the Australian breastfeeding statistical data, the rate of breast feeding in the Australian demographics is short of the expected rates. With respect to the breast feeding policies, first and foremost the WHO recommended policies need to be discussed. WHA Global nutrition targets 2025 Breastfeeding Policy Brief is one international guideline which is followed all over the globe to increase the rate if exclusive breastfeeding in the first 6 months up to at least 50% in the infants. This policy outlines the exclusive breastfeeding to be a cornerstone of child survival and nutrition for the babies, due to the fact that it provides essential and irreplaceable nutrition for the growth and development of the infants (Who.int 2018). The policy has 5 different action areas, the first one is providing hospital and health facilities based capacities involving revitalizing, expanding and institutionalizing the BFHI systems that supports exclusive breastfeeding. The second action area is focussed on providing community based strategies such as implementation of communication campaigns that are tailored to the local context to support exclusive breast feeding. The third action area aims at limiting the aggressive and inappropriate breast-milk substitutes marketing activities via International Code of Marketing of Breast-milk Substitutes. The fourth action area is focussed on empowering the women to exclusively breastfeed with mandatory 6 month maternity leave and related policies that encourage the women to breastfeed in public and in workplaces. The fifth action area is focussed in enhancing the training and capacity building activities to train the women in breastfeeding protection, promotion and support (Health.gov.au. 2018).
Australia has its own sets of policy that emphasize on the breast feeding scenario. First and foremost, the Australian national breastfeeding strategy has to be taken into consideration. The primary aim of this particular strategy had been to improve the health, nutrition and wellbeing of infants and young children and protect the health and wellbeing of the mothers as well. The goal and aim of the strategy is to protect, promote, support and monitor breastfeeding practices. The achievements of this strategy includes breastfeeding friendly environment, support in the hospital environment and outside of the hospital setting as well, community support networks, public awareness and education and training of the staff and extra support and monitoring for the priority groups (Nhmrc.gov.au. 2018). On a more elaborative note, this policy strategy has incorporated complementary resources for the ATSI communities in the year of 2013 which has improved the breast feeding statistics to a large extent. Along with that, the strategy has focussed also on providing translated versions for the traditional Chinese, Vietnamese, Filipino, Korean, Indonesian, Malaysian, Arabic, Turkish and Spanish. The strategy has also encouraged the private and public hospitals to incorporate the ten steps of WHO BFHI initiative as well. The policy also resulted in an annual health professional seminar series by the Australian Breastfeeding Association aiming and better training and educational improvement for the staff. The introduction of National Framework for Universal Child and Family Health Services and Australia-wide 24-hour Pregnancy, Birth & Baby Helpline along with Breastfeeding helpline is also notable initiatives. The priority group identified by this policy initiative is the aboriginals and Torres Strait islanders, for them supportive programs such as the Healthy for Life Program, New Directions Mothers and Babies Services and the Australian Nurse Family Partnership Program have been introduced in the Australia as well. There are also a number of different clinical guidelines such as the Queensland clinical guidelines: Establishing breastfeeding that focuses on disseminating the importance of breastfeeding and how to breastfeed to the staff and the mothers (Health.qld.gov.au. 2018). The children headline indicator and mothers and babies initiative by AIHW also attempts to screen and monitor the breast feeding rates and trends in the Australia and the especially the priority groups as well (aihw.gov.au 2018).
Considering the Australian breastfeeding statistics, 61.6% of the Australian women have been reported to breastfeed. However, as the infants grow to the age of 3 months, the exclusive breast feeding rates start to drop to 39% and as the babies grow up to the age of 5 months and above, the breast feeding rates drop to 15%. Despite the policy initiatives and practice guidelines the breastfeeding rates are short of the expected rates and trends, especially in the priority group which is the Aboriginal and Torres Strait islanders’ community. Hence, inevitably, there is need for better health promotion and advocating the health needs of the patient groups as well. In terms of health promotion, the action areas of the Ottawa charter can be considered. There are 5 principles also known as action areas, including Build Healthy Public Policy, Create Supportive Environments, Strengthen Community Actions, Develop Personal Skills, and Reorient Health Services. Considering the advocacy, Ottawa charter describes three key principles of the health promotion, enable, mediate and advocate which is linked with the principles of the Ottawa charter (who.int 2018).
It has to be mentioned in this context that the lack of awareness literacy and health promotional behaviour in the priority group is the most important contributor to the dropping rates of the breastfeeding scenario. As discussed by Health.gov.au. (2018), the level of awareness among the aboriginal women regarding the need for exclusive breast feeding till the age of 6 months, and the continual need for breastfeeding alongside alternative foods is very low. Many of the women have preconceived notions regarding the need for breastfeeding being limited to only initial 3 to 4 months after birth. Hence, the health promotion activities for the priority group. Considering the principles of primary health care, there are five core elements, accessible, affordable, acceptable, appropriate, and adaptable. In this case, for enhancing the breast feeding behaviour among the priority group, these principles can be incorporated into the care scenario as well by reducing the cost, enhancing the affordability, enhancing the cultural appropriateness, and making the care activities adaptable and sustainable (who.int 2018).
The health disparities are the most fundamental challenge that is prevalent in the health care delivery scenario, especially the primary health care scenario. The lack of equity, health care rights and accessibility in the health care services and the attitude of the health care staff based on the racial and cultural discrimination does not just reduce the help seeking behaviour among the aboriginal and Torres Strait Islander communities and also reduces their trust, inclination and choice of following the local and national health guidelines regarding maternal and child health and breastfeeding. Along with that, as per Sieder and Vivero (2017), the cultural and traditional superstitions and conventions also limit the health literacy of the aboriginal women regarding the need for breastfeeding and the benefits of breast feeding on the growth and development of the child. Hence, the health promotion in this case will have to take into consideration enhancing and improving the equity and accessibility of the care services and helping the community understand their rights and need for self-determination.
The principles of equity refers to the addressing the disparities and inequities and be able to address the inequities so that the health care scenario of the target group can be improved. In this case, it has to be mentioned that the importance of addressing the lack of equity has imperative importance in improving the health promotional behaviour among the target population. Education and training of the health care staff to reduce disparity and in corporate equity in promotional campaigning and workshop activities. Secondly, it has to be mentioned that there are various rights and privileges that are pertinent for the aboriginal communities especially in the maternal and child health sectors. However, most women do not access the services due to the lack of knowledge regarding their rights to certain health care services. There is need for advocating by the care staff to help the target population understand the rights and privileges they are accessible to so that they can fearlessly avail the services and supportive assistance from the care staff. Lastly, the principles of self-determination is also needed to be discussed in this context. Self-determination had been the revolutionary movement that helped the aboriginal communities with restoration of their land and rights (Victora et al. 2016). The care providers in this case will also have to address their rights to self-determination so that they understand the benefits of breast feeding for their own health and their children and adhere to the national guidelines for better and healthy future.
References:
Australian Breastfeeding Association. (2018). Breastfeeding rates in Australia. [online] Available at: https://www.breastfeeding.asn.au/bf-info/general-breastfeeding-information/breastfeeding-rates-australia [Accessed 21 Oct. 2018].
Australian Institute of Health and Welfare. (2018). Children’s Headline Indicators, 4. Breastfeeding – Australian Institute of Health and Welfare. [online] Available at: https://www.aihw.gov.au/reports/children-youth/childrens-headline-indicators/contents/4-breastfeeding [Accessed 21 Oct. 2018].
Australian Institute of Health and Welfare. (2018). Children’s Headline Indicators, 4. Breastfeeding – Australian Institute of Health and Welfare. [online] Available at: https://www.aihw.gov.au/reports/children-youth/childrens-headline-indicators/contents/4-breastfeeding [Accessed 21 Oct. 2018].
Health.gov.au. (2018). Department of Health | Australian National Breastfeeding Strategy 2010-2015. [online] Available at: https://www.health.gov.au/internet/main/publishing.nsf/content/aust-breastfeeding-strategy-2010-2015 [Accessed 21 Oct. 2018].
Health.qld.gov.au. (2018). Breastfeeding | Queensland Health. [online] Available at: https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/clinical-staff/maternity/nutrition/breastfeeding [Accessed 21 Oct. 2018].
Health.qld.gov.au. (2018). Establishing breastfeeding. [online] Available at: https://www.health.qld.gov.au/__data/assets/pdf_file/0033/139965/g-bf.pdf [Accessed 21 Oct. 2018].
Nhmrc.gov.au. (2018). Infant Feeding Guidelines: information for health workers | NHMRC. [online] Available at: https://nhmrc.gov.au/about-us/publications/infant-feeding-guidelines-information-health-workers [Accessed 21 Oct. 2018].
Sieder, R. and Vivero, A.B., 2017. Legalizing Indigenous Self?Determination: Autonomy and Buen Vivir in Latin America. The Journal of Latin American and Caribbean Anthropology, 22(1), pp.9-26.
Victora, C.G., Bahl, R., Barros, A.J., França, G.V., Horton, S., Krasevec, J., Murch, S., Sankar, M.J., Walker, N., Rollins, N.C. and Group, T.L.B.S., 2016. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. The Lancet, 387(10017), pp.475-490.
Who.int. (2018). WHA Global Nutrition Targets 2025: Breastfeeding Policy Brief. [online] Available at: https://www.who.int/nutrition/topics/globaltargets_breastfeeding_policybrief.pdf [Accessed 21 Oct. 2018].
World Health Organization. (2018). Baby-friendly Hospital Initiative. [online] Available at: https://www.who.int/nutrition/topics/bfhi/en/ [Accessed 21 Oct. 2018].
World Health Organization. (2018). The Ottawa Charter for Health Promotion. [online] Available at: https://www.who.int/healthpromotion/conferences/previous/ottawa/en/index1.html [Accessed 21 Oct. 2018]
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