Challenges

Some African countries struggle with poor health and public-sanitation infrastructure, which endangers the lives of newborn babies and infants. Coupled with such poor conditions, lack of access to food and water are major drivers of child mortality. While human milk banks (HMBs) serve as sustainable solutions for child nutrition in many countries, Africa still lags behind in the adoption of such a public health instrument. Cabo Verde in particular faces a serious food security problem, with a 2.5 per cent infant mortality rate in 2020.

Toward a Solution

The ABC project Technical Support for the Implementation of Human Milk Banks in Cabo Verde was designed and executed as a Brazil-Cabo Verde cooperation framework for the promotion of economic and social development in the African country, focusing on the enhancement of child nutrition and food security. The project was implemented by ABC alongside the Brazilian Ministry of Health and the Oswaldo Cruz Foundation (Fiocruz). Through this cooperation, Brazil transfers knowledge, advice on formulating legislation, support for building information systems, training and technology for pasteurization, management and planning, among other actions.

With regard to the methodology of the project, after a Brazilian technical mission to Cabo Verde to assess local conditions for the implementation of the milk-bank project in 2008, a total of eight steps were followed in the implementation of the project in the country: (a) Cape Verdean technicians went to Rio de Janeiro for a theoretical and practical internship, including workshops and visits to HMBs in 2010; (b) Brazilian experts and technicians from ABC and the Fiocruz HMB Network went to Cabo Verde to establish the technical bases for the continuation of the project and the installation of the first HMB at Hospital Agostinho Neto in Praia in 2010; (c) Brazilian consultants from the Fiocruz HMB Network were sent on a mission to monitor and accompany the installation and preparation of equipment in 2011; (d) Cape Verdean professionals went to Brasilia to learn about the work and performance of the HMBs as well as to exchange experiences; (e) Brazilian experts from the Fiocruz HMB Network were sent to Praia to promote a workshop on processing and quality control of HMBs; (f) Brazilian experts visited Praia to implement the country’s HMB management and information system, with workshops held for local professionals to use the interface; (g) Brazilian experts went to Praia to give a course on promotion of breastfeeding and child nutrition for hospital professionals; and (h) Brazilian officials went to Cabo Verde in 2013 for a final evaluation of the execution and results of the project.

With respect to the outcomes of the ABC project Technical Support for the Implementation of Human Milk Banks in Cabo Verde, there was the transfer of know-how on child nutrition, food security and overall health between Brazilian and Cabo Verdean professionals, which materialized in a myriad of concrete results. For example, in 2012, an HMB unit was implemented at Hospital Agostinho Neto, the first HMB not only in the country but in Africa as a whole. Until 2013, over 90 Cape Verdean professionals were trained in HMB management techniques, with assistance given to over 17,000 women and 2,503 newborn babies in terms of food security. The success of the bilateral initiative incentivized the Government of Cabo Verde to extend its range to the city of Mindelo on the island of São Vicente, arranging for the creation of an HMB at Hospital Batista de Sousa. Finally, the cooperation scheme had significant socioeconomic impacts, reducing the newborn mortality rate by 50 per cent in the country.[1]

The Brazilian Human Milk Bank Network was established in 1998 at the initiative of the Ministry of Health and the Oswaldo Cruz Foundation, with the mission of promoting, protecting and supporting breastfeeding, collecting and distributing human milk of certified quality, and contributing to the decrease in infant mortality.[2] Thus, the ABC cooperation project is aligned with Brazil’s domestic and foreign policy agendas, with long-term goals that ensure its sustainability. Brazil provides “technical cooperation for the implementation of the human milk bank in 24 countries around the world: Angola, Argentina, Belize, Bolivia, Cabo Verde, Colombia, Costa Rica, Cuba, Dominican Republic, Ecuador, El Salvador, Spain, Guatemala, Haiti, Honduras, Mexico, Mozambique, Nicaragua, Panama, Paraguay, Peru, Portugal, Uruguay and Venezuela. Through this cooperation, Brazil transfers knowledge, advice for formulating legislation, support for the construction of information systems, training and technology for pasteurization, management and planning, among other actions.”[3]