2. Baby-Friendly Hospital Initiative

The Baby Friendly Hospital Initiative (BFHI) was launched by WHO and UNICEF in 1992 in response to declines in breastfeeding rates worldwide.  The Initiative, based on the Ten Steps to Successful Breastfeeding, gives guidelines for optimising support for breastfeeding in any facility providing services for mothers and babies.  The objectives of BFHI (1992) were to increase awareness of the critical role that health services could play and to give guidance on what should be done to provide mothers with appropriate information and support to ensure successful breastfeeding.  The Initiative has had a significant impact on improving service around the world.  There is now considerable interest in both assuring sustainability as well as expanding the Initiative's focus.  In addition, concerns regarding funding and the issue of mother-to-child (MTCT) of HIV pose challenges to this Initiative.

Participants in this series of workshops will join together to review the programme and develop strategies for successfully sustaining and building on BFHI to achieve increased mother-baby friendliness throughout the health care system despite decreased funding from WHO and UNICEF.  Improving maternity and birthing practices, incorporating the needs of the less than full term, healthy infant, achieving appropriate changes in health worker curricula, dealing with MTCT, giving increased attention to the Tenth step and expanding the community-based aspects of the Initiative will also be discussed.  Brief presentations will set the stage in each workshop followed by extensive participant discussion focused on developing results based objectives and a strategic plan for their achievement during the next decade. 

I. BFHI:  Where We Are Now and Lessons Learned from Country
    Experiences  - Dr. Audrey Naylor, Wellstart International, USA,
    Facilitators

BFHI is the first UNICEF-supported strategy to be implemented throughout the world. This workshop will focus on where we are now with BFHI and examine success stories and lessons learned in a number of settings.  After an overview of the current status of BFHI and country examples of what has worked and what has not. Workshop participants will jointly develop an overall list of best practices and pitfalls to assist in future planning.   

Setting the Stage: Margaret Kyenkya-Isabirye, UNICEF New York

• Situation in Bangladesh - Dr. MQ-K Talukder, BBF, Bangladesh

• Situation in Norway - Anne Baerug

• Situation in Madagascar - Dr. Agnes B. Guyon, LINKAGES, Ethiopia

II. BFHI:  Overcoming the Difficulties and Achieving Sustainability
     - Pauline Kisanga, IBFAN Africa, Facilitator

This workshop will examine some of the difficulties that BFHI has confronted, including an array of different constraints in various settings.  Funding, for example, has often been a major challenge.  The impact of HIV is another.  Strategies for sustaining and strengthening the BFHI in the face of these and other challenges will be explored.  

Setting the Stage: - Dr. Elisabet Helsing, WABA, Norway

• Obstacle encountered in the US - Audrey Naylor,  MD, DrPH, FAAP, Wellstart International, USA

• Hospital Administrator's Course - Dr. Ann Brownlee, LINKAGES, USA

• Monitoring and evaluation - Dr. Ann Brownlee, LINKAGES, USA

III. BFHI: Does It Need to Expand? - Helen Armstrong, UNICEF New York,  
       Facilitator

At the start of the Initiative the aim was to implement the Ten Steps to Successful Breastfeeding in maternity services as a minimum standard for all countries to implement.  However, a number of countries implemented BFHI as a broader program nationally. Join us in examining strategies for expanding BFHI, hear what UNICEF and WHO are considering, and discuss what can and should be included in the future.  

IV. BFHI 2002+10: Development of Recommendations and Implementation Strategies - Pauline Kisanga, IBFAN Africa,  Dr. Audrey Naylor, Wellstart International, USA and Helen Armstrong, IBCLC, UNICEF New York,  Facilitators

Based on the feedback from the first three workshops, we will brainstorm together on goals for BFHI 2002+10.  How can/should the BFHI component be strengthened in WHO's new Global Strategy for Infant and Young Child Feeding?  All workshop participants will have an opportunity to contribute to developing the goals and a strategic plan for of the next phase of BFHI. A active participatory effort is planned!  

Brief Session reports I - Rapporteur***
Brief Session reports II - Rapporteur***
Brief Session reports III - Rapporteur***

15. Information, Education, Communication/ IT

I. How to Develop Effective Health Communication Materials - David
    Curtis, Healthlink Worldwide UK, and Dr. Rob Vincent, Exchange               
    Programme, UK, Facilitators

This session was an active participatory workshop that drew on participants' experience in developing resources. It did not follow the format of a traditional presentation. The session looked at the particular problems and challenges faced in the process of developing resources and offered an introduction to the QUEST methodology - a hands-on approach to material development. The group shared ideas and experience and together built an outline of the common challenges experienced in producing resources.

II. People's Media and Breastfeeding Arts - Dr. Rob Vincent, Exchange      
     Programme, UK, Facilitator  

A workshop combining the skills of mobilising popular media such as pop singers (eg. Madagascar) and local songs and lullabies in breastfeeding promotion, and a slide presentation on "Breastfeeding in the Arts" featuring artists of all centuries from the Egyptians to portraits of Holy Mary. Participants were invited to share other examples of how they have successfully utilised alternative media strategies (eg. theatre, songs) and breastfeeding art in their advocacy work.

• A pop-singer as a breastfeeding ambassador: an innovative approach in Madagascar - Dr. Agnes B. Guyon, LINKAGES-AED, Ethiopia

• Nurture baby's natural process of learning through lullabies while breastfeeding  - Amara Peeris, Sarvodaya Women's Movement,  Sri Lanka

• Breastfeeding in the arts - Anne-Marie Kern, IBCLC Austria

III. Using Information Technology in Breastfeeding Promotion - Dr. Rob Vincent, Exchange Programme, UK, Facilitator

This workshop helped participants feel more comfortable working with information technology as part of their day-to-day networking on breastfeeding promotion and advocacy. It also looked at a more creative use of websites and other e-communications to enhance networking nationally and across the globe and provided information on how to set up information resources (such as e-groups and websites) for countries without. 

IV. Props-Making and Acting, the Pantomime Mums - Ines Fernandez,
       ARUGAAN, Philippines, Facilitator

Learn the art of advocacy through a new means of expression and practice your performance skills. This workshop will provide a lesson about how to use props, make-up, music and motion to communicate invaluable messages.