Transcript Infant & Young Child Feeding Assessment & Scoring Tool

Infant & Young Child Feeding
Assessment & Scoring Tool:
Practices, Policies & Programs
Mother-friendly Aspects
What is the Tool?
• It is an assessment tool designed to assist
countries in assessing the strengths &
weaknesses of their policies & programs to
promote, protect, & support optimal feeding
practices.
• It can help in determining where
improvements may be needed to meet the
aims & objectives of the new WHO Global
Strategy for Infant & Young Child Feeding.
Who can use the Tool and when?
• It can be used by a team of key national policymakers, program managers and staff, and local
NGOs to undertake a “self-assessment” as a
first step in formulating a plan for strengthening
I&YCF policies and programs.
• A country planning to implement the Global
Strategy for I&YCF can use the Tool for needs
assessment and planning purposes.
What is included in the Tool?
Part One: Infant & Young Child Feeding Practices, &
Background Data
assesses how well countries are doing on key feeding
practices by reviewing practice indicators and
background data.
Practice Indicators:
 Time of initiation of breastfeeding
 Exclusive breastfeeding
 Duration of breastfeeding
 Bottle feeding
 Complementary feeding
Background Data:
Key health, nutrition & economic indicators, including
some related to maternal health such as:
 HIV prevalence among women 15-49 yrs of age
 Mothers with low body mass index
 Maternal mortality rate (per 100,000)
 Births attended by trained health personnel
 etc.
Part Two: National Infant &Young Child Feeding Policies
and Targets focuses on the key actions and targets
identified by the Innocenti Declaration and explores what
steps countries are taking to implement the new Global
Strategy.
Part Two Indicators:
• National Infant & Young Child Feeding Policies
• National Coordinators and Committees
• “Baby-Friendly Hospital Initiative” Achievements
• International Code of Marketing of BM Substitutes
• Legislation Protecting BF among Working Women
• Operational Targets in the New Global Strategy
Part Three: National Infant and Young Child Feeding
Program focuses on other important aspects of a
comprehensive national program.
Part Three Indicators:
• National infant & young child feeding program
• An active & sustainable BFHI
• Mother-friendly childbirth strategies
• Health provider (pre-service) education
• In-service training for health providers
• Community outreach and support
Part Three Indicators (continued):
• Information, education and
communication
• Contraceptive support for
BF women
• HIV and infant feeding
• Infant & young child
feeding in emergencies
• Research for decisionmaking
• Monitoring and evaluation
Why is a “mother-friendly childbirth”
component included?
• The 1989 Joint Statement by WHO/UNICEF on “The
Special Role of Maternity Services” [10] includes a
section on care of the mother during labor, delivery,
and immediate post partum and discusses the
routines and procedures (support in labor, minimizing
invasive routines and medications) which best
support breastfeeding.
• In 2001 WABA, through its Global Initiative on Mother
Support (GIMS), called for “support to mothers during
pregnancy, labor and delivery”.and “...transformation
of birthing practices that affect breastfeeding into
those that are more human and gender sensitive...”
Criteria
Score
Circle all that apply
• A national mother friendly childbirth strategy
has been developed.
2
• There is a program that promotes appropriate
mother friendly birth procedures that are supportive
of breastfeeding. (See Annex 4)
2
• There is a national coordinator or other official
responsible for promoting birth procedures
that are supportive of breastfeeding.
2
Criteria
Score
Circle all that apply
• Standards and guidelines for mother-friendly child birth
procedures and support have been developed and
disseminated to all facilities and personnel providing
maternity care.
2
• Both health personnel involved in facility births and
homebirth attendants are trained in
“mother friendly” practices.
2
Total Score:
_____
ADDITIONAL INFORMATION (NOT RATED)
(Use multiple sheets or adapt the form, as necessary.)
• Name of national coordinator for mother friendly initiative (or
equivalent):
• Describe the key components of the mother friendly initiative
(or equivalent):
• Describe who receives training on mother-friendly practices,
who provides it, & what type of training is given:
GUIDELINES FOR RATING
Score on criteria for “mother friendly”
childbirth strategies:
____ points
Score
Rating
0–3
4–6
7–8
9 – 10
Poor
Fair
Good
Very Good
Rating:
___________
CONCLUSIONS & RECOMMENDATIONS
(To be completed by the assessment team.)
Annex 4: Example of criteria for motherfriendly care
(Adapted with permission from the Mother-Friendly
Childbirth Initiative (CIMS) and from the ten priorities
for perinatal care developed by the WHO-Euro Child
Health & Dev Unit for the Bologna meeting, 2000.)
A woman in labor, regardless of birth
setting, should have:
 Access to care that is sensitive and responsive to the
specific beliefs, values, and customs of the mother's
culture, ethnicity and religion.
 Access to birth companions of her choice who
provide emotional and physical support throughout
labor and delivery.
 Freedom to walk, move about, and assume the
positions of her choice during labor and birth (unless
restriction is specifically required to correct a
complication). The use of the lithotomy position (flat
on back with legs elevated) is discouraged.
 Care that minimizes routine practices and procedures
that are not supported by scientific evidence (e.g.,
withholding nourishment; early rupture of membranes,
IVs (intravenous drip); routine electronic fetal
monitoring; enemas; shaving).
 Care that minimizes invasive procedures, such as
rupture of membranes or episiotomy.
 Care by staff trained in non-drug methods of pain relief
and who do not promote the use of analgesic or
anesthetic drugs unless required by a medical
condition.
A health facility that provides
delivery services should have:
• Supportive policies that encourage mothers and
families, including those with sick or premature
newborns or infants with congenital problems, to
touch, hold, breastfeed, and care for their babies to
the extent compatible with their conditions.
 Clearly defined policies and procedures for:
collaborating and consulting throughout the peri-natal
period with other maternity services, including
communicating with the original caregiver when
transfer from one birth site to another is necessary;
linking the mother and baby to appropriate
community resources, including prenatal and postdischarge follow-up and breastfeeding support.
 A policy on mother-baby friendly
services (as outlined above) and
staff who are trained to
understand that the health and
well-being of the mother, her
fetus, her newborn, and the
successful initiation of
breastfeeding, are all part of a
continuum of care.
How can results from the Tool be used?
• The results, including recommendations for action,
should be presented to national decision-makers and, if
desired, to potential donors.
• Decision-makers will need to decide which areas for
improvement are of highest priority in light of the new
Global Strategy and set into motion the process of
planning and implementation.
• The “mother-friendly” component will hopefully sensitize
decision-makers to the importance of a comprehensive
approach, supporting both mother and child.