1. MOTHER BABY FRIENDLY WORKPLACE INITIATIVE IN KENYA-ROLES AND RESPONSIBILITIES OF DIFFERENT STAKEHOLDERS Betty Samburu1, Gladys Mugambi1, Laura Kiige2, Grainne Moloney2 , Elizabeth Kimani Murage3, Triza Njoki3, Fredrick Wekesah3, Peter Muriuki3, Milka Wanjohi3, Gloria Ndekei4, Paula Griffiths5,   1 Ministry of Health Nutrition and Dietetics Unit, 2 UNICEF Kenya, 3Africa Population for Health Research center (APHRC), 4KEPSA Trustee. 5Loughborough University, UK

2. Outline Background –work environment in Kenya Breastfeeding indicators
Workplace project goals & partnership
Key outputs
Progress in achieving key output
Recommendations
Conclusion

3. Work environment in Kenya
Women workforce is estimated to be 62% in Kenya
Majority 52% of return to work within 3 months after birth
Despite the WHO recommendation of six months EBF
Most of these working women experience challenges which prevent them complying with the recommendations:
Reduction in the frequency of feeds lowering milk production.
An insufficient milk supply- Most mothers stop breastfeeding.
Kenya allows 90 days paid maternity leave and two weeks paternity leave plus annual leave (Kenya Employment Act 2007).
However studies have shown that women in private sector are offered short term contracts as a way of avoiding maternity leave
Working for long hours

4. Breastfeeding indicators in Kenya
Infant and young child feeding practices
1998 KDHS
2003 KDHS
2008 KDHS
2014
KDHS
Initiation of breastfeeding (% of babies breastfed within 1 hour of birth)
58%
52%
62%
Exclusive breastfeeding
17%
13%
32%
61%
Breastfeeding at age 2
20%
21%
51%
Bottle feeding (% of breastfed babies 1 to 12 months of age fed from bottles in the last 24 hours)
18%
28%
25%
11%

5. Exclusive Breastfeeding and Child Mortality in Kenya- KDHS
Exclusive Breast feeding rates
Child mortality (<5)
2003
13%
115/1000lb
2008
32%
74/1000lb
2014
61%
52/1000lb
As EBF rates increase, there is reduction in child mortality

6. The workplace support Project
The Ministry of Health is partnering with the following organizations to improve working conditions for women especially in private sector
UNICEF-Financial and technical support
African Population for Health Research Centre (APHRC)-research
Kenya Private Sector Alliance (KEPSA)- enabling environment in working with the private sector

7. Overall goal and objectives
Contribute to the reduction of maternal and newborn deaths
OBJECTIVES:
Improve leadership, policies and partnerships to support scale up of maternal and newborn health care including breastfeeding programs in Kenya .
Improving maternal infant and young child feeding through making the workplaces mother and baby friendly
Provision of evidence based research on workplace conditions for mothers working in private sector for scale up

8. Roles of different stakeholders in the workplace project=MOH, UNICEF, APHRC, KEPSA
2015

9. Ministry of Health Provide MIYCN policy environment –guidelines
Coordination of all activities leading to workplace support for breast feeding-national and county
Capacity building
Advocacy
Provision of technical expertise and support to county staff
Regular support supervision and mentorship
Provide the necessary infrastructure for implementation
Lead in county level assessment, external assessments, re-assessments on the status of workplace
Guides and contributes to the dissemination of the study findings to policy makers at the national level. 

10. African Population and Health research Centre (APHRC)
Inform with evidence the design & implementation of a scalable model of workplace support for breastfeeding initiative in a tea plantation and test its operational feasibility, effectiveness and cost-effectiveness
How will they do it?
Baseline survey,
continuous monitoring including real time learning and evidence generation
Final evaluation –endline
Documentation of best practices

11. Kenya Private Sector Alliance (KEPSA)
KEPSA is an umbrella body for all private sector entities in Kenya
Facilitate engagement of companies in the agricultural sector
Technical support and sensitization to partnering agency boards and stakeholders for establishing “Better Business Practices for Children’’
Supporting/profiling “best business practices” and reporting on progress
Advocacy and lobbying efforts through consumer networks, stakeholders and Kenya Human Rights Commission (KHRC) to improve the workplace support for breastfeeding.
Advocacy efforts to have policies passed in parliament.

12. UNICEF
Supporting MOH in championing child rights and better business practices for children
Provide technical expertise in the interventions design and implementation and support policy engagement
Provide financial support to enhance the workplace support

13. What are we aiming to achieve
Compliance ILO.C.NO 183
14 weeks of paid maternity leave
Non discrimination for pregnant & breastfeeding women who are employed & employment protection,
Breastfeeding breaks
Kenya employment Act Part IV section 29 implemented
A female employee shall be entitled to three months maternity leave with full pay.
3. Review work place policies on flex time,
Flexibility for short breaks to express breast milk

14. What are we aiming to achieve?
Promote, protection and support of exclusive breastfeeding through work place sensitization
Providing a designated clean, private area for mothers to express breast-milk or breastfeed their babies
Providing supportive environment including appropriate furniture (chair/table) and access to water and soap to clean storage items
Establishment of cretches in agricultural farms and other sectors to support breastfeeding mothers at workplace
Generate research evidence to inform policy

15. Key outputs
Lobby, Advocacy and Dialogue forums on Best Business Practices in Children held with Government and Other Stakeholders
Development of guidelines on workplace support for breast feeding
Capacity Building of public and private sector member organizations.
Establishment of a model baby friendly facility
Identification of Better Business Practices Private Sector Champions
Evidence on Best Business Practices in the Private Sector documented and disseminated
Mainstreaming BBPC in the private sector.
Generate evidence through research on workplace at a tea estate
Set up monitoring system for workplace support

16. Activity & progress
Establishment of workplace support committee at national
Membership
MOH-divisions and units within the ministry
UNICEF
Central Organization of Trade Union (COTU)
Federation of Kenya Employers (FKE)
Kenya Private Sector Alliance (KEPSA)-Chair
African Population for Health and Research Centre (APHRC)
Children department – Ministry of labour social security and services

17. Development of guidelines on workplace support: Technical committee on workplace during the development of guidelines for workplace support- membership- APHRC, Aghakan Foundation, KEPSA, COTU, FKE, UNICEF, MOH, & county representatives

18. Development and dissemination of guidelines for securing a baby friendly breastfeeding environment

19. Implementation of workplace support research in a tea estate
Visitation to the tea estate to establish rapport and way forward for research at Kericho tea estate (UNICEF, APHRC, MOH-National &County)

20. A photo with the Governor for Kericho county –Prof Chepkwonga (middle) at a tea estate during a reconainces visit to introduce the project –on workplace support

21. Research ongoing Qualitative results ready
Work environment and challenges faced by pregnant and breastfeeding mothers working in the tea estate
An FGD for fathers in session

22. Advocacy forums Certificate of recognition of best practices in workplace support
Recognition of organizations that have set best practices for supporting women to combine work and breastfeeding (6 months maternity leave, cretches, rooms for expression

23. Way forward We hope to generate evidence for policy formulation
More advocacy required
Need for clear guidance and global guidelines on workplace support
More research evidence needed

24. ACKNOWLEDGEMENT
UNICEF
APHRC
KEPSA
COTU
FKE
MOH-UNITS AND DIVISIONS