Coordination, Goals and Monitoring

Scaling-up of breastfeeding programs and initiatives cannot be effective without having a strong, evidence-informed and decentralized coordinating system, i.e. one that effectively coordinates activities from the local to the national level.  The Breastfeeding Gear Model (BFGM) posits that this coordinating system serves as the master gear, which sets and monitors overall goals and ensures all gears receive timely feedback, thereby enabling the breastfeeding program machine to function properly.  Thus, goal setting and feedback are the key tools of the coordination gear. 

It is expected that a “National Breastfeeding Committee” or equivalent entity will be responsible for overall coordination and monitoring.  This is the only theme within this gear.   All benchmarks are referenced to “the past year” unless otherwise noted.

Breastfeeding Committee

Description:  Not all countries have a National Breastfeeding Committee, but they may have an Infant and Young Child Feeding (IYCF) Committee that oversees breastfeeding.  It is crucial that this committee strives for overall coordination of the scaling up and sustainability of the national breastfeeding program. 

Possible Data Sources:  Interviews with government officials from the MOH, or high level staff from UNICEF and WHO should reveal the presence of a National Breastfeeding Committee/IYCF Committee.  Interviews with committee members, as well as reviewing meeting minutes and resulting reports, should provide the details needed for the scoring criteria. 

How to score:  The scoring for this benchmark includes the presence of a National Breastfeeding Committee/IYCF Committee and the following criteria:

a) Meets regularly;

b) Includes strong representation from civil organizations;

c) Includes representation of sectors beyond health and nutrition; and

d) Set specific time bound breastfeeding objectives.

  No progress: There is no National Breastfeeding Committee/ IYCF Committee. 

  Minimal progress: The National Breastfeeding Committee/ IYCF Committee does not meet any or only one of the above criteria.

  Partial progress: The National Breastfeeding Committee/ IYCF Committee meets two to three of the above criteria.

  Major progress: The National Breastfeeding Committee/ IYCF Committee meets all of the above criteria.

Description:  If a National Breastfeeding Committee/IYCF Committee exists, then its activities must be overseen to ensure they are fulfilling their duties.  Therefore, they must have a work plan in place, it must be reviewed regularly, and the progress of the work plan must be monitored regularly so that it is clear how well the it is implemented. 

Possible Data Sources: Interviews with committee members should identify the presence of a work plan, reviewing and monitoring responsibilities, and how often these occur. The work plan must be reviewed to corroborate the information provided by the key informants. 

How to score: The scoring for this benchmark includes a specific time frame for reviewing and monitoring of the work plan. If a country does not have a National Breastfeeding Committee/IYCF Committee, this benchmark must be scored as No Progress.

  No progress: There is no National Breastfeeding Committee/IYCI Committee work plan.

  Minimal progress: The National Breastfeeding Committee/IYCI Committee work plan is not reviewed at least once every two years nor monitored once every year. 

  Partial progress: The National Breastfeeding Committee/IYCI Committee work plan is reviewed at least once every two years or monitored once every year. 

  Major progress: The National Breastfeeding Committee/IYCI Committee work plan is reviewed at least once every two years and monitored once every year.

Description: Data that is gathered about the progress of breastfeeding programs by the National Breastfeeding/IYCF Committee should be used for decision-making and advocacy.  This data provides decision makers and advocates with the evidence they need to push for change within breastfeeding legislation/policy, funding, training and program delivery, research and evaluation, and promotion to support scaling up of breastfeeding. This data is central to the ability of the coordinating gear to provide timely feedback to the rest of the gears and facilitates communications across them.

Possible Data Sources: Interviews with high level government officials within MOH, UNICEF and WHO should help identify if data about breastfeeding program progress are being used for decision-making and advocacy.  Media reports may also be useful. If available, protocols which have the following data should be reviewed:
a) How data about breastfeeding program progress is used for decision-making and advocacy
b) How data about breastfeeding programs is used to provide feedback to policy makers.

How to score:  The scoring for this benchmark reflects the frequency at which data/information is used by the National Breastfeeding Committee/IYCF Committee for decision-making and advocacy. 

  No progress: Data/information related to breastfeeding program progress are not being used for decision-making and advocacy. 

  Minimal progress: Data/information related to breastfeeding program progress are used rarely (i.e. infrequently-) for decision-making and advocacy. 

  Partial progress: Data/information related to breastfeeding program progress are used sometimes (i.e. somewhat frequently) for decision-making and advocacy. 

  Major progress: Data/information related to breastfeeding program progress are used often (i.e. almost always/always) for decision-making and advocacy.


 

India

Sima Naik discusses breastfeeding and the importance of good nutrition in the first 1000 days with Rebati Naik, Accredited Social Health Activist (ASHA), in Badamahuladhia village, Odisha, India.© 2014 John Nicholson, SPRING Project, Courtesy of Photoshare