Mother-Baby Friendly Philippines: Using Citizen Reporting to Improve Compliance to the International Code of Marketing of Breastmilk Substitutes

INTRODUCTION: In 1986, the Philippines was one of the first countries to pass national legislation on the International Code of Marketing of Breastmilk Substitutes in the form of Executive Order (EO) 51 and Republic Act (RA) 10028. While violations against the legislation and corresponding sanctions are clearly defined, infractions remain unreported or go unpunished. Enforcement of the laws remains a significant challenge as government capacities suffer from inadequate resources to regularly monitor breastfeeding-related law violations. To address these gaps, The Department of Health (Philippines) and the World Vision Development Foundation developed a reporting platform to enable citizen reporting of EO 51 and RA 10028 violations as part of the Mother-Baby Friendly Philippines (MBFP) initiative. METHODS: Upon completion of the project, the Alliance for Improving Health Outcomes Inc. conducted 68 surveys and 24 key informant interviews and focus group discussions with individuals who participated in trainings on EO 51 and RA 10028, community health workers, representatives of local government units and hospitals involved in breastfeeding programs, and city health officials to document benefits, challenges, and lessons learned. RESULTS: The intention and interest of consulted stakeholders to uphold the law by reporting violations through the platform indicate that citizen reporting can be harnessed as an effective tool for reporting violations. Nevertheless, multiple challenges remain in reporting and following up on Code violations. DISCUSSION: The platform provided citizens with an opportunity to report violations, but, in reality, the status of action and feedback did not change. There is a need to strengthen implementation and enforcement at all levels of relevant national government agencies and improve feedback loops on reported violations.