In Bangladesh since 1992, 74 percent (499 out of 670) of the government maternity services have been designated as “Baby friendly” in phases. Despite that births in the healthcare facilities are being increased, bottle feeding rate has been increasing mostly as well due to aggressive marketing by several BMS Companies which prudently deteriorates the BFHI status in many of our hospitals yet to day. Frequent turnover of trained health professionals, lack of refreshers trainings and weak implementation of BMS Act remains the major challenges & contributing factors for this non baby friendly situation. That is why the BBF in collaboration with IPHN had initiated revaluation of BFHI since 2012. From 2012 to 2015 (pre-phase,1st phase and 2nd phase), 361 health facilities (Medical Colleges Hospitals, District Hospitals and Upazila Health Complex (UHC) out of 499 have been revitalize.
Goal of BFHI:
1. The primary goal of the present project is to transform facilities (n=499) providing maternity services to baby friendly hospitals through implementation of the Ten Steps to Successful Breastfeeding.
2. Stricter implementation of The Breast Milk Substitutes, Infant Foods, Commercially Manufactured Complementary Foods and the Accessories There to (Regulation of Marketing) Act, 2013 in the hospitals by hospital administration as well as by All its staff members.
Objectives of the Project
The objective of 3rd phase of this project is to revitalize BFHI in selected 229 health facilities in Bangladesh.
Following the global wave of making all hospitals Baby Friendly, Baby Friendly Hospital Initiative (BFHI) program started in government and non government health facilities (HFs) in Bangladesh since 1992 with active cooperation and technical assistance by the WHO and funded by UNICEF, Bangladesh. the Honorable Prime Minister of Bangladesh advised to transform all the hospitals, health-complexes and clinics into Baby- Friendly and to revitalize the baby friendly hospitals.
1. BFHI training of the maternity staff of 250 hospital
2. Formation of BFHI committee and establishment of Breastfeeding corner
3. Practice of BFHI 10 steps in health facilities
4. External assessment
Major areas or topics has been covered in 4 days training program:
This training has covered mainly-
1. Breastfeeding: Importance and benefits of timely initiation of breastfeeding (immediately or within one hour after delivery),
Exclusive Breastfeeding (180 days) and no pre/post lacteals such as water, other liquids, and ritual foods.
2. Hazards of Breast Milk substitute: Risk for Formula Feeding for children, Mother and family.
3. Quality of complementary foods and appropriate feeding practices, in addition to continued breastfeeding at least upto 24 months or beyond ensuring amount, frequency, consistency, composition, and preparation.
4. Provide support for optimal Maternal Nutrition during pregnancy and lactation
5. Breast Milk Substitute Act- 2013
- BFHI activities has been successfully accomplished with the objectives of revitalizing BFHI activities in 231 selected healthcare facilities (41 in Dhaka, 63 in Chittagong, 10 in Barisal, 24 in Rajshahi, 40 in Rangpur, 18 in Khulna, 25 in Sylhet and 10 in Mymensingh Divisions).
- Thus around 2780 health service providers have been trained so far by the resource persons (receiving a 4 days TOT in earlier part of the project in 2012).
- Under this 3rd phase, a 4 day long BFHI hospital training was carried out in 6 sadar hospitals, 13 medical college hospitals 28 tertiary/specialized care hospitals, 120 Upazilla health complexes and 64 Mother and child Welfare Center (MCWC) under strict monitoring and stringent supervision. These were based on 3 tire systems 1) by the BBF 100%, 2) by the supervisors -100%, 3) 30% by the high officials from BBF, IPHN and DGHS.
- Findings of these activities showed that the mean score was 17.9 (51%) which increased a few folded more at 27.9 (79.9 %) yielding a significant increase (p<0.001), demonstrating a post training knowledge gain of 55%.
- The findings showed that 231 healthcare facilities have reported that they have existing BFHI committee consists of 16 members in Govt and non-govt medical college hospital, 8 members in sadar hospital and upazilla Health Complex and 6 members in MCWC.
- All of these 231 healthcare facilities, the LMC were found to exist.
- Assessment in 231 health facilities was carried out by a team (n=103) of BFHI expert assessors comprising paediatricians and gynaecologists) from 7 divisions. Before the external assessment, all the 231 hospitals were given enough time to prepare and practice 10 steps of BFHI over the next 6 weeks. Standard evaluation format following WHO 2009 to adapt for using our country context.
- Finally in this phase (out of 231), overall scored evidenced that 53.2% of HFs has been accredited as ‘Baby-Friendly’.
Certification and Dissemination of BFHI:The Certification and Dissemination Seminar of Baby Friendly Hospital Initiative (BFHI) was held on 28th June, 2016 at 11.00 am in BCPS Auditoriu, Mohakhali, Dhaka-1216. The Chief Guest of the meeting was Prof Dr. Deen Mohammad Nurul Haq, Director General, Directorate General of Health Services (DGHS). Prof Dr. Abul Kalam Azad, Additional Director General (Administration), Directorate General of Health Services; Prof. Dr. Md. Samiul Islam, Director (Hospital), Directorate General of Health Services and Dr. Ehteshamul Haque, Director (Administration), Directorate General of Health Services was present in the seminar as special Guest. The seminar was chaired by Dr. A.B.M. Muzharul Islam, Director, IPHN & Line Director, NNS, DGHS, MOH&FW. The key note presentation was given by prof. Dr. S K Roy, senior Scientist and Chairperson, BBF.