A Landscape Analysis of Human Milk Banks in India

Objective: To evaluate the existing status of human milk banks in India with reference toinfrastructure, human resources, funding mechanisms, operating procedures and qualityassurance. Methods: A pretested questionnaire was administered to 16 out of 22 human milkbanks across India, operational for more than one year prior to commencing the study.Results: 11 (69%) milk banks were in government or charitable hospitals; only 2 (12.5%)were established with government funding. 8 (50%) had a dedicated technician and only1(6%) had more than five lactation counsellors. Milk was collected predominantly frommothers of sick babies and in postnatal care wards followed by pediatric outpatientdepartments, camps, satellite centers, and homes. 10 (63%) reported gaps between donormilk demand and supply. 12 (75%) used shaker water bath pasteurizer and cooled the milkmanually without monitoring temperature, and 4 (25%) pooled milk under the laminar airflow.10 (63%) tracked donor to recipient and almost all did not collect data on early initiation,exclusive breastfeeding or human milk feeding. Conclusion: Our study reports the gaps ofmilk banking practices in India, which need to be addressed for strengthening them. Gapsinclude suboptimal financial support from the government, shortage of key human resources,processes and data gaps, and demand supply gap of donor human milk.

Scaling Up Edible Oil Fortification in Madhya Pradesh: Lessons from the Field.

Objectives: Showcasing Soybean oil fortification with Vitamin A and D as a demonstration project in Madhya Pradesh (MP), a state with worst nutritional indicators in India. Methods: A program cycle approach was followed for selection of state, fortifiable vehicle, micronutrient and delivery channel. Results: Soyabean oil was identified as a fortifiable vehicle as MP is soybean oil producing state with 94% household penetration and Industry having necessary infrastructure. Knowledge on fortification process and lack of awareness among consumers/ key stakeholders (KS) were the gap areas. Soybean oil fortification was launched by 12 millers in June in the open market with technical and part financial support from GAIN. With four months of launch, 4 new partners have joined in, increased investment from Industry partners on communication, capacity building was observed. 73% of the branded oil is being fortified and 18.4 million consumers are being reached monthly. 16-20% growth in fortified oil sales was observed. Soyabean oil fortification was found to be cost effective (Vitamin A and D premix: Sale price of oil = 1/1000). Social marketing campaign is creating demand. Advocacy efforts led to state food fortification alliance formation which is advocating for mandatory fortification of oil and usage of proven interventions in public funded programs. The reason for quick scale up is capacity building of industry, KS analysis and management, usage of pretested marketing campaigning, fortification logo, advocacy and monitoring plan. Conclusions: Soya bean oil fortfication was found to be a viable complementary strategy to address vitamin A and D deficiency.