Funding and Resources

Government Budgetary Commitment Theme

The IYCF Strategic Plan of Action for 2011-2016 has five key strategies and each strategy has corresponding action points and intervention focus and is tied back to the overarching goal of the plan. Annex 1 is a spreadsheet of the five strategies, their corresponding action points, the responsible agency/group and allocated budget. For example, 

Strategy 2: Integration of key IYCF action points in the Maternal Newborn Child Health and Nutrition (MNCHN) Plan of Action 

Action: 2.1 Institutionalize the IYCF monitoring and tracking system for national, regional and
Local Government Unit levels

            a. Institutionalize the collection of Programme Implementation Review (PIR) Data and generate annual performance report
            b. Maximize the use of the unified monitoring tool
            c. Collaborate with the National Epidemiology Center (NEC) and Information Management Service (IMS) regarding IYCF data

Unit/Agency responsible: National Center for Disease Prevention and Control, Centre for Health Development
Budget: 0.5 million Php per year from 2011-2016

Reference:

  1. Republic of Philippines, Department of Health. (2011). Philippine IYCF Strategic Plan of Action 2011-2016

The 2016 Centers for Disease Control and Prevention (CDC) operating budget has a line item for $8 million US dollars for “Hospitals Promoting Breastfeeding” from the Prevention and Public Health Fund (PPHF), which forms part of the implementation of the Affordable Care Act (ACA). The CDC started receiving this funding in 2011 and it allowed them to increase their work in breastfeeding.  PPHF funding is a permanent annual appropriation established in the ACA. The amount available to be spent every year is set in statute; $1 billion through 2017, and thereafter will increase in increments to $2 billion for 2022 and each subsequent fiscal year. Allocation of these funds is decided annually through the Congressional appropriations process, in coordination with the President and the Administration. In years when Congress does not pass a budget, the administration has the authority to direct allocations from the Fund and the Secretary of the Health and Human Services (HHS) Department transfers funds to HHS agencies based on the administration’s budget.

The CDC have four lines of work regarding breastfeeding where funding is allocated:

  • Baby Friendly Hospitals: There is an application process for hospitals to apply for collaborative assistance with improving their maternity services, i.e. achieving Baby Friendly status.  The CDC has focused the funding on areas with populations vulnerable to not breastfeeding, like those with large numbers of Medicare recipients and/or minority populations and geographically in the southern part of the country.
  • Monitoring and collecting data: see the Research and Evaluation Gear for more details.
  • Peer and professional support within communities
  • Worksite initiatives

References:

  1. Trust for America's Health. (2016). Prevention and Public Health Fund (PPHF) Detailed Activities by Agency.
  2. U.S. Department of Health & Human Services, Centers for Disease Control and Prevention (CDC), Office of Financial Resources (OFR). (2016). Centers For Disease Control And Prevention Fy 2016 Operating Plan.
  3. Personal conversation with Nutrition Branch, Centers for Disease Control and Prevention (CDC), U.S. Department of Health & Human Services] (2016).
  4. Redhead, C. Stephen, Dabrowska, Agata (2015). Retrieved from Washington, DC: Public Health Service Agencies: Overview and Funding (FY2010-FY2016)

The IYCF Strategic Plan of Action for 2011-2016 has a budget line for all the items in Annex 2, with the exception of maternity protection.

Budget lines as follows:

  • Partnerships with NGOs and Government Organizations (GOs) in the coordination and implementation of the IYCF Program – 0.2million Php annually
  • Integration of key IYCF action points in the Maternal Newborn Child Health and Nutrition (MNCHN) Plan of Action 0.5 million Php annually
  • Harnessing the executive arm of government to implement and enforce IYCF related legislations and regulations 
  • Consultation mechanism with the IAC* and Department of Justice (DOJ) for the enforcement of the Milk Code and with other relevant GOs for other IYCF related legislations and regulations – 5million Php annually
  • Devise and implement a consultation mechanism to bring together the IAC, DOJ and other relevant GOs for IYCF related legislations and regulations – 1.5million Php annually
  • Modeling the Mother Baby Friendly (MBF) system in the key intervention settings in selected regions – 15million Php annually
  • Set up Models of Mother Baby Friendly Hospital Initiative (MBFHI) and MNCHN implementation in key strategic hospitals and referral networks- 13million Php annually, rising to 14million from 2014
  • Establish protocols/standards on how to set-up and maintain MBF workplaces and integrated in the standards for healthy workplace- 1million Php annuall
  • Enhance the primary, secondary and tertiary education curricula on IYCF - 1million Php annually
  • Creation of a Regional and National incentive and awarding systems for the most outstanding IYCF champions in the different sectors of society – 2.5million annually, rising to 3million in 2013-2016
  • Review and update the existing awarding system – 0.5million Php for 2011-2012Establish a recognition system for health facilities complying with EO 51 (Milk Code), RA 10028** and the MBFHI National Policy -2million annually, rising to 3million in 2013-2016
  • Allocate/Raise /Seek resources for IYCF Research activities that document best practices in the Philippines – 3million Php annually
  • Carry out an inventory of best practices on IYCF – 1million Php annually
  • Allocate resources and conduct IYCF related researches- 0.5million Php annually
  • Setting up of a fund raising mechanism for IYCF with the participation of International Organizations and the Private Sector – 0.5million Php annually
  • Set-up the fund raising mechanism- 0.5million Php annually
  • Capacity Building – 5million Php annually
  • Supportive Supervision -0.5million Php annually
  • Communication Plan -10million Php annually

*Interagency Committee is a body created by EO 51- Milk Code legislation - to establish a clearing house for the promotion and marketing of breastmilk substitutes and related products and to prescribe and promulgate the rules and regulations necessary for the proper implementation of the Milk Code.

**RA 10028: An Act Expanding the Promotion of Breastfeeding, Amending for the Purpose RA 7600. It covers: facilities for breastmilk collection, storage and utilization; establishment of lactation stations; nursing breaks; information, education, re-education and training for health workers involved in maternal and health care on current and updated lactation management; teaching, training and supporting women on current and updated lactation management and infant care; integration of breastfeeding education into the curricula in the elementary, high school and college levels; a comprehensive national public education and awareness program to be undertaken during the observance of the Breastfeeding Awareness Month.

Reference:

Female workers in Vietnam are entitled to 6 months paid maternity leave and for each additional child there is an additional 30 days maternity leave, if they have paid compulsory social insurance premiums for at least full six months within the 12 months before giving birth.   The employee is entitled to 100% of salary (equal to the last month's earnings) during maternity leave, funded through compulsory social insurance premiums.  The Law on Social Insurance sets out the provisions and funding mechanism (note - maternity leave is now six months).  The Ministry of Labour, Invalids and Social Affairs administers social insurance.
The mandated contributions to the State Social Insurance Fund:

  • Insured person: 8% of gross monthly earnings (2014 figure)
    • The minimum earnings for contribution calculation purposes are equal to the minimum wage.
    • The maximum earnings for contribution calculation purposes are 20 times the minimum wage.
    • The minimum monthly wage is 650,000 dong as of May 2009.
  • Self-employed person: Not applicable.
  • Employer: 14% of monthly payroll (2014 figure)
    • The minimum earnings for contribution calculation purposes are equal to the minimum wage.
    • The maximum earnings for contribution calculation purposes are 20 times the minimum wage.
    • The minimum monthly wage is 650,000 dong as of May 2009.
  • Government: Subsidies as necessary

The law stipulates that the Government will annually report to the National Assembly on the management and use of the social insurance fund and, once every three years, the state audit will audit the social insurance fund and report on the results to the National Assembly.

References:

  1. Ministry of Justice, Socialist Republic of Viet Nam. (2006).  Law on Social Insurance.  
  2. United States Social Security Administration, Office of Retirement and Disability Policy. (2008). Social Security Programs Throughout the World: Asia and the Pacific, 2008.  
  3. Ministry of Justice, Socialist Republic of Viet Nam. (2014). Law on Social Insurance.

“In New Zealand, the 14 weeks paid parental leave is funded via general taxation and administered by the Inland Revenue Department (IRD). An employee has to have worked continuously with the same employer for at least six months to receive paid parental leave. Eligibility is also subject to a minimum hours test. Self-employed people are eligible for parental leave if they have worked on average at least 10 hours a week over the six or twelve months immediately prior to the expected date of delivery or adoption of a child. 

Under current legislation the eligible parent is entitled to 100 percent of their average weekly earnings up to a maximum payment cap which is adjusted in July each year in relation to changes to average weekly earnings. In 2006-07 it was set at $372.12 per week (before tax) and this increased to $391.28 per week on 1 July 2007. This represents around 83 percent of the adult weekly minimum wage for full time work and 46 percent of average adult weekly full-time earnings.”(National Breastfeeding Advisory Committee, 2008)

Reference:

  1. National Breastfeeding Advisory Committee. (2008). Protecting, Promoting and Supporting Breastfeeding in Aotearoa New Zealand.

During the four weeks before birth and 8 weeks after, Austrian mothers receive a form of maternity pay called Wochengeld, which is a form of health insurance and is the equivalent to their average income during the last 13 weeks before the absolute employment prohibition (starts four weeks before birth), with no ceiling cap. 

  • Freelance workers receive an income-based maternity benefit.
  • Marginally employed self-insured women receive a flat-rate payment.
  • Self-employed women (traders and farmers) are eligible to apply for financial or other support to maintain their businesses as a form of maternity benefits, but if no financial support is granted, they can claim a flat-rate payment.
  • Unemployed women or those receiving Childcare benefit are entitled to 180 per cent of their previous unemployment benefit.

This benefit system is partly funded partly (70%) from Familienlastenausgleichsfond (FLAF - Family Burdens Equalisation Fund), financed by contributions from employers (4.5 per cent of their salary bill) and from general taxes; and partly (30 per cent) from public health insurance. 

Reference:

  1. Rille-Pfeiffer, C. and Dearing, H. (2014) ‘Austria country note’, in: P. Moss (ed.) International Review of Leave Policies and Research 2014. Leave Network: Leave Policies & Research.

Save the Children’s Superfood for Babies report has a useful table on pages 50-52 which sets out the scope of maternity legislation, including paid expressing/breastfeeding breaks and whether the ILO Convention 183 requirements are met, and funding mechanisms for maternity leave in a variety of countries in Africa, Latin America and Asia. For example, in Burkina Faso, maternity leave is paid for 14 weeks at 100% of the previous income, and is funded through social security, and the employer pays the difference between social security and wage.

Reference:

  1. Save the Children. (2013).  Superfood for Babies: How Overcoming Barriers to Breastfeeding Will Save Children's Lives.
Zimbabwe

Village Savings and Lending (VSL) group members in Gwanda, Zimbabwe, demonstrate the process of collecting monthly contributions to their groups. All contributions are made in public and recorded in the group's ledger book. © 2012 David Snyder, Courtesy of Photoshare