Strengthened enforcement of a national code for breast milk substitutes can help support and protect breastfeeding practices in Cambodia

Abstract Number Theme Presentation Type Cover Approved
0377 Translating evidence into policy decisions for micronutrient interventions Poster Not Approved


Abstract Content


To assess national and sub-national implementation, monitoring, and enforcement of Sub-Decree 133, the national code regulating the marketing of breast milk substitutes (BMS) in Cambodia.


Interviews were conducted with 45 national and sub-national government officials in Phnom Penh, Battambang, Sihanouk, Kampong Thom, Siem Reap, and Kandal. Officials were purposely selected from the four government ministries responsible for implementing and enforcing Sub-Decree 133 (Health, Commerce, Information, and Industry and Handicraft) and were asked about their knowledge of the Sub-Decree, including key responsibilities, monitoring procedures, and penalties for violations.


Only 12 out of the 45 officials said they were “very knowledgeable” on the content of Sub-Decree 133; 15 respondents, mostly at the sub-national level, reported they were “not knowledgeable.” There was confusion over the roles and responsibilities of each ministry, along with poor inter-ministry communication and coordination: Twenty eight respondents mentioned not receiving any technical support on enforcement of Sub-Decree 133 from other ministries, departments, or partners. Experience of reporting violations on BMS promotions was low, with 40 respondents having never written a violation report; most found the lack of standard reporting mechanisms, a barrier to reporting violations. Violations appear to be handled inconsistently across the ministries, with limited application of fines and increased penalties for repeat violators.


There is a need to strengthen the implementation and enforcement of Sub-Decree 133 to support and protect breastfeeding practices in Cambodia. Clearly designated responsibilities, an accountability structure, and well-articulated guidelines for monitoring and enforcement could lead to improved coordination and regulation of BMS promotions and marketing.

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