Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh.
Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands.
Matern Child Nutr. 2022 May;18 Suppl 3(Suppl 3):e13351. doi: 10.1111/mcn.13351. Epub 2022 Mar 21.
The International Code of Marketing of Breast-milk Substitutes (BMS) instituted to protect breastfeeding against unethical marketing, has been adopted by many countries, including Bangladesh. Despite national adoption, evidence suggests violations occur and inadequate BMS Code implementation is an issue. The study aimed to assess violations of the International BMS Code and the national 'Breast-milk Substitutes, Infant Foods, Commercially Manufactured Complementary Foods and the Accessories Thereof (Regulation of Marketing) Act, 2013' of Bangladesh in commercial settings (retail outlets and media) in Bangladesh, for different types of milk, bottles, and teats using a standardized Network for Global Monitoring and Support for Implementation of the Code and Subsequent relevant World Health Assembly Resolutions (NetCode) protocol. This cross-sectional quantitative study was conducted in Bangladesh from January to September 2018 in Dhaka, Chattogram, and Sylhet cities. Descriptive statistics were reported and χ tests were conducted to assess differences between categorical variables of interest. Data were analysed using SPSS version 20. In retail outlets, there were higher proportion of violations observed in Dhaka than in Sylhet and Chattogram (p < 0.001). Significantly greater proportion of violations in product labels occurred among products sold without local distributors compared to others (p < 0.05); violations were higher among "other milk" for children aged 0 to <36 months compared to formulas and growing-up milk (p < 0.05). Among media channels, internet clips had significantly higher proportions of violations compared to television, radio and newspaper (p < 0.001). BMS Code violations were prevalent in product labels and promotion of products through retail outlets. The study findings highlight the need for specific multisectoral strategies for better enforcement of BMS Code and points to the need for periodic assessment of Code violations.
《国际母乳代用品销售守则》旨在保护母乳喂养免受不道德营销的影响，已被包括孟加拉国在内的许多国家采用。尽管国家已经采用，但有证据表明仍存在违规行为，而且《国际母乳代用品销售守则》执行不力是一个问题。本研究旨在评估孟加拉国在商业环境（零售店和媒体）中违反《国际母乳代用品销售守则》和国家《母乳代用品、婴儿食品、商业制造的补充食品及其附件（营销管制）法，2013》的情况，涉及不同类型的牛奶、奶瓶和奶嘴，使用标准化的全球监测网络和支持实施《守则》及随后的相关世界卫生大会决议的网络（NetCode）协议。这项横断面定量研究于 2018 年 1 月至 9 月在孟加拉国的达卡、吉大港和锡尔赫特市进行。报告了描述性统计数据，并进行了 χ 检验，以评估感兴趣的分类变量之间的差异。使用 SPSS 版本 20 进行数据分析。在零售店中，达卡的违规行为比例高于锡尔赫特和吉大港（p<0.001）。与其他产品相比，没有当地分销商销售的产品标签上的违规行为比例更高（p<0.05）；对于 0 至<36 个月的儿童，与配方奶和成长奶相比，其他“牛奶”的违规行为更多（p<0.05）。在媒体渠道中，互联网视频的违规行为比例明显高于电视、广播和报纸（p<0.001）。产品标签和通过零售店促销母乳代用品的行为存在《守则》违规行为。研究结果表明，需要制定具体的多部门战略，以更好地执行《守则》，并指出需要定期评估《守则》的违规情况。
