Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montreal, Quebec, Canada.
Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Longueuil, Quebec, Canada.
Matern Child Nutr. 2019 Feb;15 Suppl 2(Suppl 2):e12749. doi: 10.1111/mcn.12749.
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 (A&T), United Nations International Children's Emergency Fund (UNICEF), and partners, that sought to support governments in fostering enabling environment for optimal IYCF in Southeast Asia (SEA) and Africa. A combination of two emergent, theory-based evaluation approaches was used: developmental evaluation and contribution analysis. The overall objective of the evaluation was to document the extent to which policy objectives were or were not achieved in each country and to identify the key drivers of policy change. One contribution of the supplement is a distinction between and illustration of triggers and drivers of policy change. Three main drivers of policy change were identified: (a) the use of an explicit advocacy approach; (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.
创建更有利于婴幼儿最佳喂养（IYCF）的环境需要各国制定政策，例如与《产妇保护公约》、《国际母乳代用品销售守则》（《守则》）和《爱婴医院倡议》相关的政策。然而，将国际政策标准转化为国家法律措施存在挑战，并且对于各国如何取得进展存在重要的认识差距。政策倡导几乎是普遍存在的特征，但存在方法学挑战，并且很少有研究评估战略和效果。本《母婴营养》增刊旨在解决这些差距。本增刊包含三篇论文，介绍了 Alive & Thrive（A&T）、联合国儿童基金会（UNICEF）及其合作伙伴实时评估倡导工作的结果，该工作旨在支持政府在东南亚（SEA）和非洲营造有利于最佳 IYCF 的环境。采用了两种新兴的、基于理论的评估方法：发展评估和贡献分析。评估的总体目标是记录在每个国家实现政策目标的程度，并确定政策变革的关键驱动因素。增刊的一个贡献是区分和说明政策变革的触发因素和驱动因素。确定了三个主要的政策变革驱动因素：（a）采用明确的倡导方法；（b）创建一个有影响力的行动者战略群体；和（c）实现 15 项关键任务（更具体地说是《守则》）。每一项关键任务都被确定为触发这些国家《守则》取得进展的因素。本增刊提供的证据表明，A&T、UNICEF 及其合作伙伴的倡导工作有助于加强 SEA 的 IYCF 政策，并揭示了其如何帮助取得进展。本增刊中的见解可以作为增强 IYCF 政策的政策倡导者的指南。一份简短的交流将调查结果置于全球背景下。
