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Counseling About Breastfeeding at Early Critical Time Points [message #16773] Fri, 01 March 2019 14:01 Go to previous message
DataDENT is currently offline  DataDENT
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Breastfeeding counseling is effective in promoting exclusive breastfeeding and continued breastfeeding after 6 months. In February 2019, the WHO released "Guideline: Counselling of Women to Improve Breastfeeding Practices," which supports breastfeeding counseling at multiple time points. We request five indicators to measure counseling and support coverage at 3 points: during pregnancy, during postnatal care, and around 1 month of age.

1. Breastfeeding counseling during pregnancy
Definition: The percentage of women with a live birth in the last 3 or 5 years* who spoke with a health care provider† 2dabout breastfeeding during her last pregnancy.

2. Breastfeeding counseling during postnatal care
Definition: The percentage of women with a live birth in the last 3 or 5 years* who spoke with a health care provider† about breastfeeding during the first two days after child's birth.
(Note: Already included in DHS, but small modification to question wording is requested.)

3. Breastfeeding counseling during postnatal care with observation
Definition: The percentage of women with a live birth in the last 3 or 5 years* who spoke with a health care provider† about breastfeeding AND was observed breastfeeding the child during the first two days after child's birth.
(Note: Already included in DHS, but small modification to question wording is requested. Currently, postnatal counseling on breastfeeding and observation of breastfeeding are tabulated separately in DHS reports. We recommend an additional tabulation: breastfeeding + observation, which would be an additional column in the "Content of postnatal care for newborns" table.)

4. Breastfeeding counseling during first month
Definition: The percentage of women with a live birth in the last 3 or 5 years* who spoke with a health care provider† about breastfeeding during the first month (but after the first two days) after birth.

5. Breastfeeding counseling during first month with observation
Definition: The percentage of women with a live birth in the last 3 or 5 years* who spoke with a health care provider† about breastfeeding AND was observed breastfeeding the child during the first month (but after the first two days) after birth.

Notes of possible modifications to the above definitions:
*We support the newborn community's recommendation to modify all Section 4. Pregnancy and Postnatal Care to include live births occurring in the previous 2 years. This would be advantageous to reduce data collection burden, align with MICS, and improve data quality. If this recommendation is adopted, the recall period for this proposed recommendation can be changed to 2 years.

†We expect "health care provider" to be contextualized by country based on types of health care providers that provide the described services. This would include community health workers in contexts where lay health workers are providing counseling services, in line with WHO recommendations.

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

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This recommendation originated in a consultation focused on measuring coverage of programs to support breastfeeding and complementary feeding, co-convened by Alive & Thrive, the International Food Policy Research Institute (IFPRI), and Data for Decisions to Expand Nutrition Transformation (DataDENT). It was further discussed and endorsed at 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 United Nations Children's Fund (UNICEF), and coordinated by 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.

The recommendation is also supported by a nutrition metrics working group that was previously anchored by the Countdown to 2030 initiative; this working group has co-authored a paper forthcoming in BMJ Global Health on the global gaps in nutrition coverage measurement, especially highlighting the gaps in measurement of infant feeding counseling and support interventions.

This recommendation was authored by a team from IFPRI and reviewed by Laurence Grummer-Strawn (WHO), Chika Hayashi (UNICEF), 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 1 of 3 (critical 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 14:39]

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