Teddy Nakyanzi - Nutritionist IBFAN Uganda

INTRODUCTION Infant Young Child Feeding has the single greatest potential impact on child survival. Breast feeding indicators in Uganda: 52.5%-initiation of breast feeding 63%-Exclusive breast feeding for first 6 months 19 months-Median Duration of Breast feeding BFHI – Global initiative of the WHO and UNICEF that aims to give every baby the best start in life by creating a health care environment that protects, promotes and supports breastfeeding as a norm BFHI was launched in response to declining breastfeeding rates worldwide – Uganda adopted the BFHI Strategy

BACKGROUND BFHI Implementation process in Kiryandongo district was supported by implementing partners (ACF, IBFAN Uganda) Target beneficiary – 4 major health facilities that support refugees Overall project objective: Build the capacity of health workers in BFHI order to promote optimal Infant and Young Child feeding practices. Baseline assessment was conducted in 4 health facilities 1 hospital (Kiryandongo Hospital) 1 health center III (Panyadole H/C III) 2 Health center II (Nyakadot H/C II, Panyadole H/C II) Workshop Training of health workers in the BFHI Signing of certificate of commitment by health facilities On job mentorship exercise

AIM and OBJECTIVES Aim  Showcase the quality improvement aspect of health workers’ BFHI capacity building on health facility practices that foster breastfeeding. Objectives  To show change in proportion of pregnant women informed about the benefits and management of breastfeeding within implementation period  To highlight change in proportion of newborn babies initiated on breast feeding within one hour after birth within implementation period  To show change in percentage of infants exclusively breast feeding at health facility level before discharge within implementation period

Method and Materials Focus area: 4 health facilities implementing BFHI Quarter 1 of implementation period Desk Review of secondary data Activity reports Health facility records (Integrated ANC/Maternity/PNC registers and health education documentations) Health education schedules and topics at health facilities Observation of Current health workers practices Indicating key activity findings (baseline & post training findings)

Results - Key findings Key findings from baseline  25%-80% of pregnant women informed about the benefits and management of breastfeeding  43% -100% of live newborn babies reported initiated on breast feeding within ½ hour after birth  30% -75% of live new born infants exclusively breast fed at health facility level before discharge

Observed Practices fostering breast feeding

Discussion Quality improvement opportunities to foster breast feeding : Health education of mothers on benefits and management of breast feeding (Requirement 3) is vital Health education schedules that incorporate breast feeding benefits and management and documentation of health education session Initiation of breast feeding of with ½ hour of life (requirement 4) BFHI policy under maternity Creating awareness on breast feeding benefits especially early initiation of breast feeding Exclusive breast feeding practices (requirement 5,6) Preventing use of pre lacteal feeds and maintaining breast feeding

Conclusion  Capacity building of health workers in BFHI provides quick visible changes that improve Breast feeding practices  Informing mothers on benefits and management of breast feeding  Initiation of breast feeding with in ½ hour of birth  Encouraging exclusive breast feeding  Health workers adoption and ownership of project implementation is vital in quality improvement of health and nutrition care systems  Prioritizing the protection, promotion and support of breastfeeding is life-saving measure for babies everywhere, and especially in emergencies (BFHI relevance)

References Advances in Experimental Medicine and Biology 2004: 554: Kiryandongo Health workers baby friendly health facility initiative capacity building training workshop report Kiryandongo Health workers baby friendly health facility initiative on job mentorship workshop report Kramer MS, Kakuma R. The optimal duration of exclusive breastfeeding: a systematic review. Ministry of Health The World Breastfeeding Trends Initiative (WBTi) Uganda assessment Report