breastfeeding curricula are not integrated within all programs. curricula are integrated within all programs. curricula are integrated within all programs. case study, role play, question-answer, group work, group discussion etc. CHWs also undergo 1-3 days of field practice, supervised by a trainer who observes the trainees counseling a mother on breastfeeding, negotiating with mothers around 2-3 key practices, and demonstrating recommended practices. This training covers all the essential breastfeeding topics in Annex 5 (including Code implementation) except contraception and maternal absence. Score: Partial Progress Existence: Yes Quality: Course covers most of the essential breastfeeding topics in Annex 5, with the exception of contraception and maternal absence. Effective: Not enough information to assess the of integration of breastfeeding training into the curricula of all facility-based in-service programs. TPDG8: There exist national/subnational master trainers in breastfeeding There are no master trainers in breastfeeding in the country. There are master trainers in breastfeeding, only at the national level. are master trainers in breastfeeding at the national and subnational level throughout the country. There are master trainers in breastfeeding at the national, subnational, and local levels throughout the country. In Mexico, all the states have at least one qualified person to replicate training with other health professionals. Score: Partial Progress Existence: yes Coverage: national and subnational level but not local level TPDG9: Breastfeeding training programs that are delivered by different entities (e.g. on-line learning) through different There is no evidence of coordination. There is some coordination but the majority of breastfeeding training programs are not included. Between half and 75% of breastfeeding training programs are coordinated. The majority (> 75%) of breastfeeding training programs are coordinated.
modalities are coordinated. TPDG10: Breastfeeding information and skills are integrated into related training programs (e.g. maternal and child health, IMCI). Breastfeeding information/ topics and skills are not integrated into related training programs. Breastfeeding information/ topics and skills are integrated into some (i.e. less than 50%) related training programs. Breastfeeding information/ topics and skills are integrated into most (i.e. between 50% and 99%) related training programs. Breastfeeding information/ topics and skills are integrated into all related training programs. In Ghana, interviews with Program Managers in Reproductive Health and Child Health, Nutrition and reviewing the Ghana Health Service’s training courses and manuals (e.g. Safe Motherhood Protocol, Essential Care for Every Newborn, Helping Babies Breath, IMNCI, Essential Nutrition Actions, Community Management of Acute Malnutrition) demonstrated that breastfeeding is integrated into all the relevant training programs. Score: Major Progress Existence: Yes Coverage: Breastfeeding skills and topics integrated into all related training programs. TPDG11: National standards and guidelines for breastfeeding promotion and support have been developed and disseminated to all facilities and personnel providing maternity and newborn care. Standards and guidelines for breastfeeding promotion and support have not been developed. Standards and guidelines have been developed but they have not been disseminated to any facilities and personnel providing maternity care. Standards and guidelines have been developed and disseminated to some facilities and personnel providing maternity care. Standards and guidelines have been developed and disseminated to all facilities and personnel providing maternity care. The Brazilian Ministry of Health has issued and disseminated a series of guidelines to standardize and ensure high-quality breastfeeding care. This series includes: • Newborn health care: a guide for health professionals (4 volumes) • health: growth and development (Primary Healthcare Book 33) • health: breastfeeding and complementary feeding (Primary Healthcare Book 23) • Ten Steps for a Healthy Feeding: feeding guide for child under two years - a guide for the Professional in the Primary Health Care • Breastfeeding and the use of medicines and substances • Legislation and marketing of products that interfere with breastfeeding: a health professionals • Breastfeeding. Distribution of Milk and Infant Formulas in Health Establishments and Legislation • Essentials of breastfeeding for working woman
• Humanized Care Low Birth Weight: Kangaroo Method: technical manual • Manual for Kangaroo Method: shared follow-up between Hospital Care and Primary Care. These materials are the standard national guidelines to promote, protect and support breastfeeding and complementary food and are disseminated within all facilities providing maternity and newborn care (including hospitals, clinics, and primary health care/community services). Score: Major Progress Existence: Yes Coverage: Standards and guidelines for breastfeeding promotion and support have been developed and disseminated nationally to all facilities and personnel providing maternity care. TPDG12: Assessment systems are in place for designating BFHI/Ten Steps facilities. No assessment systems exist for designating BFHI/Ten Steps facilities. Assessment systems exist for designating BFHI/Ten Steps facilities but they are not on the BFHI UNICEF/WHO global criteria nor are they incorporated into the National Breastfeeding Plan. Assessment systems exist for designating BFHI/Ten Steps facilities and they are on the BFHI UNICEF/WHO global criteria but they are not incorporated into the National Breastfeeding Plan. Assessment systems exist for designating BFHI/Ten Steps facilities; they are on the BFHI UNICEF/ WHO global criteria and they are incorporated into the National Breastfeeding Plan The New Zealand Breastfeeding Alliance (NZBA) is a coalition of 30 breastfeeding stakeholder organisations and is funded by the MOH to manage and assess the BFHI/BBF initiatives. Major Progress Existence: Yes Quality: on the BFHI UNICEF/WHO global criteria Effective:- National Strategic Plan of Action for Breastfeeding 2008–2012 has a goal of all District Health Boards achieving and maintaining Baby Friendly Hospital accreditation. TPDG13: No reassessment Reassessment systems Reassessment systems exist Reassessment systems The New Zealand Breastfeeding Alliance (NZBA), which is a coalition of 30 breastfeeding stakeholder
essential breastfeeding topics as well as their responsibilities under the Code implementation in-service training programs include breastfeeding curricula? See manual for Annex 4. TPDG3: Facility-based health care professionals who care for mothers, infants and young children receive hands-on training in essential topics for counseling and support skills for breastfeeding Domain: Existence: What hands-on, in-service BF counseling and support skills training is available for facility-based health care professionals? Domain: Quality: What topics are covered? Domain: Effective: Which in-service training programs include breastfeeding curricula? See manual for Annex 5. TPDG4: Community-based health care professionals who care for mothers, infants and young children are trained on the essential breastfeeding topics as well as their responsibilities Domain: Existence: What in-service BF training is available for health care professionals? Domain: Quality: What topics are covered? Domain: Effective: Which in-service training programs include breastfeeding curricula?
under the Code implementation See Manual for 4 Community-based health care professionals who care for mothers, infants and young children receive hands-on training in essential topics for counseling and support skills for breastfeeding Domain: Existence: What in-service BF counseling and support skills training is available for community-based health care professionals? Domain: Quality: What topics are covered? Domain: Effective: Which in-service training programs include breastfeeding curricula? See Manual for 5 TPDG6: CHWs and volunteers that work with mothers, infants, and young children are trained on the essential breastfeeding topics as well as their responsibilities under the Code implementation Domain: Existence: What in-service BF training is available for community health workers and volunteers? Domain: Quality: What topics are covered? Domain: Effective: in-service training programs include breastfeeding curricula? See Manual for Annex 4 TPDG7: CHWs and volunteers that work with mothers, infants, and young Domain: Existence: What hands-on, in-service BF counseling and support skills training is available
children receive hands-on training in essential topics for counseling and support skills for breastfeeding for community health workers and volunteers? Domain: Quality: What topics are covered? Domain: Effective: Which in-service training programs include breastfeeding curricula? See Manual for Annex 5 TPDG8: There exist national/subnational master trainers in breastfeeding Domain: Existence: What BF master training programs exist in the country? Domain: Coverage: What facilities and areas of the country are they located in? Are master trainers certified in BF training nationally (or subnationally) or internationally? TPDG9: Breastfeeding training programs that are delivered by different entities (e.g. face-to-face; on-line learning) through different modalities are coordinated. Domain: Existence: What BF training programs are available? Domain: Coverage: Are they national or international? What is the level of coordination between training programs? Are there level agreements, databases, MOUs? TPDG10: Breastfeeding information and skills are integrated Domain: Existence: What training programs for health care providers working in related areas of
into related training programs (e.g. maternal and child health, IMCI maternal and child health are available? Domain: Coverage: What and how much breastfeeding training is part of this curricula? Are there standardized levels of BF integration into the trainings? TPDG11: National standards and guidelines for breastfeeding promotion and support have been developed and disseminated to all facilities and personnel providing maternity and newborn care Domain: Existence: What standards and guidelines for breastfeeding promotion are available? Domain: Coverage: Who developed them? have they been disseminated? What percentage of facilities have received them? TPDG12: Assessment systems are in place for designating BFHI/Ten Steps facilities. Domain: Existence: What is the assessment system for designating BFHI/Ten facilities? Who is the organization responsible for assessing? Domain: Quality: Is certification on BFHI UNICEF/WHO global criteria? Domain: Effective: Is the BFHI assessment system built into National Breastfeeding plan?
TPDG13: Reassessment systems are in to reevaluate designated Steps hospitals or maternity services to determine if they continue to adhere to the Baby Steps criteria. Domain: Existence: What is the BFHI reassessment system? Domain: Quality: What is the timeframe for reassessment? Is there a schedule and is it adhered to? Who is the organization responsible for reassessing? Is the BFHI reassessment system built into National Breastfeeding plan? TPDG14: More than 66.6% of deliveries take place in hospitals and clinics designated or reassessed as “Baby- Friendly” in the last 5 years. Domain: Coverage: How many hospitals or delivery facilities exist in the country? How many hospitals have been designated or as Baby-friendly in the past 5 years? What is the total number of births per year in the facilities that were designated or reassessed as Baby-friendly in the past 5 years? TPDG15: Health facility-based community outreach and support activities related to breastfeeding are being implemented Domain: Existence: What health facility-based community outreach and support activities for BF are available? Who is responsible for these activities? Domain: Quality: Are standard guidelines to ensure the Friendly/Ten
quality of the implementation? What is the level of coverage? eg national, regional, local? Domain: Effective: What are the linkages to programs (e.g. breastfeeding/nutrition programs)? TPDG16: Community-based breastfeeding outreach and support activities have national coverage Domain: Existence: What outreach and support activities for BF are available? Who is responsible for these activities? Domain: Coverage: Are programs nationally or locally run? Or are programs targeted to a specific part of the population? TPDG17: are trained and certified lactation management specialists available to provide supportive supervision for breastfeeding program delivery. Domain: Existence: Are there lactation management specialists providing supervision? How are lactation management specialists deployed in facilities and breastfeeding services? Domain: Coverage: Is this organized nationally, regionally or locally? Are there guidelines on the
Data Organization: Please provide as much detail as possible to facilitate accurate scoring of each benchmark and development of recommendations. The relevant Domains are in bold. TPDG2:Facility-based health care professionals who care for mothers, infants and young children are trained on the essential breastfeeding topics as well as their responsibilities under the Code implementation Existence: Brief explanation of BF training Quality: Essential BF topics (Annex 4) covered Effective: Which in-service programs have breastfeeding curricula integrated? References/ Data sources
Data Organization: Please provide as much detail as possible to facilitate accurate scoring of each benchmark and development of recommendations. The relevant Domains are in bold. TPDG3:Facility-based health care professionals who care for mothers, infants and young children receive hands-on training in essential topics for counseling and support skills for breastfeeding Existence: Brief explanation of BF counseling & support skills training Quality: Essential BF topics 5) covered Effective: in-service programs have breastfeeding curricula integrated? References/ Data sources
Scoring Pathway **Insert the final score into the BBFI Calculator** Instructions: Using the pathway, explain below the evolution of the final agreed score, i.e. rationale for any changes to the score, how the score was calculated (domains and criteria met), gaps identified and address any discrepancies of opinion within the Gear Team or Committee on the final score. Date Primary Score Summary of Discussion Scoring Justification Score Gaps identified Between Meeting1 and 2 Date: Meeting 2 Date: Meeting 3 Date:
CHWs and volunteers that work with mothers, infants, and young children are trained on the essential breastfeeding topics as well as their responsibilities under the Code implementation. Existence: Brief explanation of BF training Quality: Essential BF topics (Annex 4) covered Effective: Which in-service programs have breastfeeding curricula integrated? References/ Data sources Scoring Pathway
Meeting 3 Date: Data Organization: Please provide as much detail as possible to facilitate accurate scoring of each benchmark and development of recommendations. The relevant Domains are in bold. TPDG12: Assessment systems are in for designating BFHI/Ten Steps facilities. Existence: Describe the BFHI assessment system Quality: List the BFHI UNICEF/WHO global criteria included in the assessment system Effective: Describe the inclusion of BFHI certification in the National Breastfeeding Plan References/ Data sources
TPDG15: Health facility-based community outreach and support activities related to breastfeeding are being implemented Existence: Describe the activities Existence: Responsible body/ organization Quality: List the areas these activities cover (i.e. local, state, regional or national) Effective: Describe links to community-based activities and quality of implementation References/ Data sources Scoring Pathway
Data Organization: Please provide as much detail as possible to facilitate accurate scoring of each benchmark and development of recommendations. The relevant Domains are in bold. TPDG16: Community-based breastfeeding outreach and support activities have national coverage Existence: Describe the activities Existence: Responsible body/ organization Coverage: List the these activities cover (i.e. local, state, regional or national) Coverage: List the areas the target populations for these activities References/ Data sources