The DHS Program User Forum
Discussions regarding The DHS Program data and results
Home » DHS-8 Questionnaire Review - Archived » Core questionnaire: Nutrition » Support for Breastfeeding at Health Facilities - BFHI Monitoring
Support for Breastfeeding at Health Facilities - BFHI Monitoring [message #16771] Fri, 01 March 2019 13:49 Go to next message
DataDENT is currently offline  DataDENT
Messages: 11
Registered: January 2019
Member
Baby-friendly Hospital Initiative (BFHI) implementation guidance updated in 2018 identifies eight indicators for national monitoring of adherence to the BFHI Ten Steps. We propose several simple additions and a small question modification to collect all eight BFHI monitoring indicators.

1. Antenatal counselling
Definition: The percentage of mothers of who received antenatal counselling on breastfeeding.

2. Early skin-to-skin contact
Definition: The percentage of mothers who had skin-to-skin contact with their baby immediately or within 5 minutes after birth that lasted 1 hour or more.
(This indicator is currently in the DHS, but the length of time is not included.)

3. Early initiation of breastfeeding
Definition: The percentage of mothers who put their infant to the breast within 1 hour after birth.

4. Support with breastfeeding
Definition: The percentage of mothers who received support with learning to breastfeed after delivery.
(This indicator is currently in the DHS.)

5. Exclusive breastfeeding in first 3 days
Definition: The percentage of mothers reporting that their infants received only breast milk (either from their own mother or from a human milk bank) in the first 3 days after birth.
(This indicator is currently in the DHS.)

6. Rooming-in
Definition: The percentage of mothers whose babies stayed with them since birth, without separation lasting for more than 1 hour.

7. Referral to community support
Definition: The percentage of mothers who report that they were informed where they can access breastfeeding support in their community.

8. Overall compliance with BFHI standards
Definition: The percentage of mothers answering affirmatively on at least 6 of the above 7 practices.

Attached to this post is a completed submission form with full justification for the recommendation.

----------

This recommendation originated in the September 2018 Technical Consultation on Measuring Nutrition in Population-Based Household Surveys and Associated Facility Assessments a 2-day working meeting convened by the Bill & Melinda Gates Foundation and United States Agency for International Development in collaboration with the World Health Organization (WHO) and UNICEF, and coordinated by Data for Decisions to Expand Nutrition Transformation (DataDENT). The consultation included more than 60 technical experts, survey program representatives from DHS, MICS, LSMS and SMART, country data stakeholders, and donors from the nutrition measurement community.

This recommendation was authored by Laurence Grummer-Strawn (WHO) and reviewed by Maaike Arts (UNICEF), Chika Hayashi (UNICEF), Vrinda Mehra (UNICEF), Melinda Munos (Johns Hopkins Bloomberg School of Public Health (JHSPH)), Purnima Menon (Institute for Food Policy Research Institute (IFPRI)), Sunny Kim (IFPRI), Kate McCarthy (Population Council), Chessa Lutter (RTI), and Monica Kothari (PATH).

This recommendation is endorsed by the WHO-UNICEF Technical Expert Advisory Group on Nutrition Monitoring (TEAM). Out of the 10 sets of recommendations endorsed by TEAM, this recommendation was prioritized as Tier 2 of 3 (high priority data need).

This recommendation is also endorsed by Countdown to 2030, Alive & Thrive, the nutrition team at the Bill & Melinda Gates Foundation, and the Department of International Health at the Johns Hopkins Bloomberg School of Public Health.

[Updated on: Fri, 01 March 2019 14:40]

Report message to a moderator

Re: Support for Breastfeeding at Health Facilities - BFHI Monitoring [message #16842 is a reply to message #16771] Thu, 07 March 2019 17:02 Go to previous messageGo to next message
Marie Ruel is currently offline  Marie Ruel
Messages: 11
Registered: April 2014
Member
I support this set of questions
Re: Support for Breastfeeding at Health Facilities - BFHI Monitoring [message #16907 is a reply to message #16771] Wed, 13 March 2019 21:43 Go to previous messageGo to next message
SUN Movement MEAL Team
Messages: 9
Registered: March 2019
Member
The SUN MEAL Results Framework includes an indicator tracking the percent of births occurring in facilities designated as "baby-friendly." We believe the proposed overall compliance indicator proposed here will be helpful for SUN member countries and the SUN Movement globally in capturing coverage of the practices recommended by the Ten Steps.
Re: Support for Breastfeeding at Health Facilities - BFHI Monitoring [message #16921 is a reply to message #16771] Thu, 14 March 2019 04:52 Go to previous messageGo to next message
Mauro Brero is currently offline  Mauro Brero
Messages: 12
Registered: March 2019
Member
UNICEF Tanzania Nutrition team recommends maintaining all the 8 indicators. Information generated will be used for evidence-based planning and programming.

However, for indicator 7 we recommend that the definition should specify that the breastfeeding support should be from Community Health Workers.

UNICEF Tanzania Nutrition Team.
Re: Support for Breastfeeding at Health Facilities - BFHI Monitoring [message #16976 is a reply to message #16771] Thu, 14 March 2019 15:35 Go to previous messageGo to next message
jruelbergeron is currently offline  jruelbergeron
Messages: 8
Registered: March 2019
Member
The Global Financing Facility (GFF) Secretariat endorses the recommendations made in this document (DataDENT).
Re: Support for Breastfeeding at Health Facilities - BFHI Monitoring [message #17010 is a reply to message #16976] Fri, 15 March 2019 06:46 Go to previous messageGo to next message
dniyeha is currently offline  dniyeha
Messages: 4
Registered: March 2019
Member
I endorse this recommendation
Re: Support for Breastfeeding at Health Facilities - BFHI Monitoring [message #17012 is a reply to message #16771] Fri, 15 March 2019 06:53 Go to previous messageGo to next message
Nsia is currently offline  Nsia
Messages: 5
Registered: March 2019
Member
From Tanzania, I endorse these questions
Re: Support for Breastfeeding at Health Facilities - BFHI Monitoring [message #17021 is a reply to message #16771] Fri, 15 March 2019 07:03 Go to previous messageGo to next message
Paula Kawiche is currently offline  Paula Kawiche
Messages: 9
Registered: March 2019
Member
I indorse these questions
Re: Support for Breastfeeding at Health Facilities - BFHI Monitoring [message #17069 is a reply to message #16771] Fri, 15 March 2019 10:28 Go to previous messageGo to next message
aperry is currently offline  aperry
Messages: 9
Registered: March 2019
Member
In light of the importance of these actions for improving nutrition and child survival the DFID Nutrition Policy team endorses this proposal
Re: Support for Breastfeeding at Health Facilities - BFHI Monitoring [message #17152 is a reply to message #16771] Fri, 15 March 2019 15:08 Go to previous messageGo to next message
PATH is currently offline  PATH
Messages: 8
Registered: March 2019
Member
Thanks to DataDENT for compiling these indicators. Please consider some of the following:

Indicator #6 We definitely support this rooming-in question can also be a good cross-check question for quality assurance of the answers on early initiation of breastfeeding. Particularly relevant for women who undergo cesarean section
Indicators #4 and #5, suggest to specifically focus on support for mothers to express and store their milk as well as transport of milk to the baby (if in another ward/location) including safe storage and feeding. Additionally, improve indicators tracking feeding of vulnerable neonates including type of feeds (what type of human milk - mother's, shared, donor), support provided to mother, infrastructure for expression/transport/storage/feeding of mother's own milk. We would recommend this content to be added to the SPA questionnaire if there is limited space in the household questionnaire.
Indicator #7 we agree with feedback mentioned above in this thread. If DHS decides to add this question, consider clarifying which health workers e.g. community health workers as the team from UNICEF Tanzania suggested. The "who" in the community is providing support to mothers is relevant.
Re: Support for Breastfeeding at Health Facilities - BFHI Monitoring [message #17168 is a reply to message #16771] Fri, 15 March 2019 15:25 Go to previous messageGo to next message
1000 Days is currently offline  1000 Days
Messages: 10
Registered: March 2019
Member
1,000 Days is the leading non-profit organization working in the U.S. and around the world to improve nutrition and ensure women and children have the healthiest first 1,000 days.
We support the recommendation. Evidence shows that implementing the 10 steps improves early initiation of breastfeeding, exclusive breastfeeding and total duration. Better indicators to assess how well facilities are following the 10 steps will help improve advocacy efforts in support of BFHI and better support women to get a strong start to breastfeeding.
Re: Support for Breastfeeding at Health Facilities - BFHI Monitoring [message #17330 is a reply to message #16771] Fri, 15 March 2019 17:45 Go to previous messageGo to next message
Erin Milner is currently offline  Erin Milner
Messages: 9
Registered: February 2019
Member
USAID supports this recommendation.
Re: Support for Breastfeeding at Health Facilities - BFHI Monitoring [message #17421 is a reply to message #17330] Fri, 15 March 2019 23:32 Go to previous messageGo to next message
Judy Canahuati is currently offline  Judy Canahuati
Messages: 9
Registered: March 2019
Member
La Leche League International supports this recommendation
Re: Support for Breastfeeding at Health Facilities - BFHI Monitoring [message #17424 is a reply to message #16771] Fri, 15 March 2019 23:52 Go to previous message
Olutayo
Messages: 12
Registered: March 2019
Member
This is indeed an important indicator that would allow the assessment of not just coverage of breastfeeding services, but the performance of the health system in delivering crucial nutrition and health information. I completely support the inclusion of the indicator and the associated questions.
Previous Topic: Measuring Household Food Insecurity
Next Topic: Marketing of Breast-milk Substitutes
Goto Forum:
  


Current Time: Thu Jun 4 11:07:35 Eastern Daylight Time 2020