Funding and Resources

Scaling-up breastfeeding programs requires adequate funding and other resources. The Breastfeeding Gear Model (BFGM) posits that, as breastfeeding legislation and policy is adopted, this should generate the allotment of adequate funding and resources to support implementation of those policies.

Funding strategies that demonstrate country-level commitment to scaling up breastfeeding programs can include:

• Specifying line-item funding for breastfeeding policies and programs in national budgets
• Ensuring funding is adequate for breastfeeding programs
• Provision of a formal mechanism to publicly fund maternity entitlements
• Funding human resources to support breastfeeding programs and initiatives

Benchmarks for this gear assess the availability and adequacy of country-level funding and other resources necessary to scale up national breastfeeding programs and initiatives. There is one theme: Government Budgetary Commitment (Benchmarks FRG1, FRG2, FRG3, FRG4).

All benchmarks reference “the past year” unless otherwise noted.

Description: This benchmark examines the presence or absence of a budget line(s) in the national budget specifically designating funds for breastfeeding scaling up activities. Annex 2 describes the items that should be covered in the budget through individual line item designations.

Possible data sources: Interviews with national level government officials, especially within the health sector or infant/young child feeding area, may reveal the existence of a budget line for breastfeeding protection, promotion and support activities. Examining the budget for this budget line as well as additional line items from Annex 2 is essential to being able to score this benchmark.

How to score: The scoring for this benchmark specifies the existence of a budget line item for breastfeeding protection, promotion and support activities in the national budget. If there is a budget line(s) item, the scoring accounts for the inclusion of specific breastfeeding activities funded by the national budget.

☐ No progress: There is no line in the national budget for breastfeeding protection, promotion and support activities.

☐ Minimal progress: There is a national budget line(s) for breastfeeding protection, promotion and support activities but it does not include more than two items in Annex 2.

☐ Partial progress: There is a national budget line(s) for breastfeeding protection, promotion and support activities and it does include most line items in Annex 2.

☐ Major progress: There is a national budget line(s) for breastfeeding protection, promotion and support activities and it includes all items in Annex 2.

Possible data sources: Interviews with national level government officials, especially within the health sector or infant/young child feeding area, may reveal the existence of a budget line for breastfeeding protection, promotion, and support activities. Examining the budget (and the budget items if available) for the amounts set aside for breastfeeding protection, promotion, and support activities will be essential to being able to score this benchmark.

How to score: The scoring for this benchmark reflects existence of a line in the national budget for breastfeeding protection, promotion, and support activities as well as the adequacy and coverage of budget for key breastfeeding scaling up activities.
Adequate means that the funding is sufficient to cover the key components of the breastfeeding protection, promotion and support activities at the national, subnational and local levels.

☐ No progress: There is no line in the national budget for breastfeeding protection, promotion and support activities.
☐ Minimal progress: There is a national budget line(s) for breastfeeding protection, promotion and support activities or there is not a specific budget line but funding is provided for by breastfeeding resources and it is adequate to cover some but not the great majority of the activities in Annex 2 at the national level.
☐ Partial progress: There is a national budget line(s) for breastfeeding protection, promotion and support activities or there is not a specific budget line but funding is provided for breastfeeding resources and it is adequate to cover all of the activities in Annex 2 at the national level.
☐ Major progress: There is a national budget line(s) for breastfeeding protection, promotion and support activities and it is adequate to cover all activities in Annex 2 at the national level.

Description: This benchmark assesses if there is there is at least one fully funded government position to primarily work on breastfeeding protection, promotion and support at the national level.

• This position must be government funded for 100% of a person’s time.
• The job description should specify that at least 75% of that person’s time must be spent working on breastfeeding protection, promotion and support activities specific to each country.
• The person should be at the supervisor or higher level and have the authority/ability to manage the coordination and implementation of substantive breastfeeding protection, promotion and support activities at the national level.

Possible data sources: Interviews with national level government officials, especially within the health sector or infant/young child feeding area, may reveal the existence of a government position dedicated primarily to breastfeeding protection, promotion and support work at the national level. If this position exists, a detailed interview with the person in the position would assess the duties and percent time of this position. Additional resources include the job description used for hiring and examination of the budget to see if and at what level this position is funded.

How to score: The scoring for this benchmark reflects the existence of this position, the level of funding of the position, as well as the level of focus of the position on breastfeeding.

☐ No progress: There is no government funded position to primarily work (i.e. 75% of time) on breastfeeding protection, promotion and support.
☐ Minimal progress: There is at least one government funded position to work on breastfeeding protection, promotion and support but it is not fully funded and the focus is not primarily breastfeeding.
☐ Partial progress: There is at least one government funded position to work on breastfeeding protection, promotion and support and it is fully funded or the focus is primarily breastfeeding.
☐ Major progress: There is at least one government funded position to work on breastfeeding protection, promotion and support and it is fully funded and the focus is primarily breastfeeding.

Description: This benchmark assesses whether there is a formal mechanism that funds maternity entitlements using public funds.
A formal mechanism: a designated entity or process by which funds are earmarked for maternity entitlements.
Maternity entitlements: legislated government programs that provide benefits to pregnant and breastfeeding women.

Possible data sources: Interviews with national level government officials, especially within the health sector or infant/young child feeding area, may reveal the existence of a formal mechanism through which maternity entitlements are funded using public sector funds. Government reports, budgets, and policies should also be key resources to determine if this mechanism exists and the level of coverage it reaches.

How to score: The scoring for this benchmark reflects the existence and coverage of a formal mechanism through which maternity entitlements are funded using public funds.

☐ No progress: There is no formal mechanism through which maternity entitlements are funded using public sector funds.
☐ Minimal progress: There is a formal mechanism through which maternity entitlements are funded using public sector funds but the national coverage is minimal (i.e. less than 50% coverage nationally).
☐ Partial progress: There is a formal mechanism through which maternity entitlements are funded using public sector funds with partial (i.e. 50%) national coverage.
☐ Major progress: There is a formal mechanism through which maternity entitlements are funded using public sector funds with full national coverage.

Save the Children’s Superfood for Babies report has a useful table on pages 50-52 which sets out the scope of maternity legislation, including paid expressing/breastfeeding breaks and whether the ILO Convention 183 requirements are met, and funding mechanisms for maternity leave in a variety of countries in Africa, Latin America and Asia. For example, in Burkina Faso, maternity leave is paid for 14 weeks at 100% of the previous income, and is funded through social security, and the employer pays the difference between social security and wage.

Reference:

1. Save the Children. (2013). Superfood for Babies: How Overcoming Barriers to Breastfeeding Will Save Children's Lives.

• Funding and Resources Gear
• Funding and Resources Scoring Table