Point‐of‐sale promotion of breastmilk substitutes and commercially produced complementary foods in Cambodia, Nepal, Senegal and Tanzania

Abstract

In order to assess the prevalence of point‐of‐sale promotions of infant and young child feeding products in Phnom Penh, Cambodia; Kathmandu Valley, Nepal; Dakar Department, Senegal; and Dar es Salaam, Tanzania, approximately 30 retail stores per site, 121 in total, were visited. Promotional activity for breastmilk substitutes (BMS) and commercially produced complementary foods in each site were recorded. Point‐of‐sale promotion of BMS occurred in approximately one‐third of sampled stores in Phnom Penh and Dakar Department but in 3.2% and 6.7% of stores in Kathmandu Valley and Dar es Salaam, respectively. Promotion of commercially produced complementary foods was highly prevalent in Dakar Department with half of stores having at least one promotion, while promotions for these products occurred in 10% or less of stores in the other three sites. While promotion of BMS in stores is legal in Senegal, it is prohibited in Cambodia without prior permission of the Ministry of Health/Ministry of Information and prohibited in both Nepal and Tanzania. Strengthening legislation in Senegal and enforcing regulations in Cambodia could help to prevent such promotion that can negatively affect breastfeeding practices. Key messages Even in countries such as Cambodia, Nepal and Tanzania where point‐of‐sale promotion is restricted, promotions of BMS were observed (in nearly one‐third of stores in Phnom Penh and less than 10% in Dar es Salaam and Kathmandu).Limited promotion of commercially produced complementary foods was evident (less than 10% of stores had a promotion for such foods), except in Dakar Department, where promotions were found in half of stores.Efforts are needed to strengthen monitoring, regulation and enforcement of restrictions on the promotion of BMS.Manufacturers and distributors should take responsibility for compliance with national regulations and global policies pertaining to the promotion of breastmilk substitutes.

Violations of the International Code of Marketing of Breast‐milk Substitutes in Mexico

“…Despite Mexican regulations stating that BMS manufacturers are not allowed to contact health providers, 15.5% of providers reported having contact with BMS manufacturers. Such contact with providers has also been reported in Bangladesh, Poland, South Africa, and Thailand (Coriolis, ), as well as in Togo and Burkina Faso (Champeny et al, ). In addition, an important and disturbing finding is the lack of knowledge of the Code among health providers in Mexico, similar to health professionals in Togo and Burkina Faso (Champeny et al, ).…”

“…Such contact with providers has also been reported in Bangladesh, Poland, South Africa, and Thailand (Coriolis, ), as well as in Togo and Burkina Faso (Champeny et al, ). In addition, an important and disturbing finding is the lack of knowledge of the Code among health providers in Mexico, similar to health professionals in Togo and Burkina Faso (Champeny et al, ). It is urgent to establish actions at a national level to disseminate the Code and develop government strategies to implement it.…”

“…Other studies have identified that promotion of BMS outside of health facilities is a common practice in Cambodia (Pries et al, ) and Senegal (Feeley et al, ), as is promotion within health facilities (Coriolis, ; Pries et al, ). BMS promotion at POS has been identified in Senegal, Cambodia, Nepal, and Tanzania (Champeny et al, ). Violations of labelling standards of the Code have also been identified in other countries (Ergin et al, ; Parrilla‐Rodriguez & Gorrín‐Peralta, ).…”

“…The effect of a health provider's recommendation for the use of BMS on a mother's decisions about feeding practices is well known. Health providers have unparalleled credibility in terms of infant health and feeding recommendations (Champeny et al, ; Piwoz & Huffman, ). Thus, it is of paramount importance to ensure that health providers have the knowledge to adequately support breastfeeding (or know where to refer mothers who require support) and understand their ethical responsibility not to recommend the use of infant formula when there is no medical reason to do so.…”

Promotions of breastmilk substitutes, commercial complementary foods and commercial snack products commonly fed to young children are frequently found in points‐of‐sale in Bandung City, Indonesia

“…Once all information on product availability was recorded, enumerators captured information on each promotion observed throughout the store. A promotion was defined as an individual occurrence of promotional activity in a store for one or more BMS, CPCF or commercial snack product, such as a shelf display, price discount or an informational brochure (Champeny et al, ). The types of promotions assessed were: price‐related, such as coupons, discounts or buy‐one‐get‐one; displays, including brand shelves/counters/tables, special shop windows, posters/banners or shelf tags/talkers/wobblers; information materials, like leaflets, pamphlets/brochures or catalogues; free gifts to customers, such as toys, baby items or plastic food‐storage containers; product samples; company representatives in store; store banners/signs with store name/logo and product logo/brand; and any other promotions, such as contests, store bonus‐points or holiday baskets. …”