Training

Pre-Service Training for Health Care Providers Theme

Description : This benchmark assesses if the curricula of health provider schools (i.e. medical schools, nursing schools, midwifery schools, nutrition programs etc.) and pre-service education programs specific to health care professionals that will care for mothers, infants and young children includes breastfeeding.  This benchmark specifically refers to only those students and residents who are being trained to care for mothers, infants and young children.  The essential breastfeeding topics required for pre-service curriculum are described in Annex 3

Possible data sources :  Consult expert(s) in higher education, who know the content and quality of pre-service health care professional curriculums, should be able to provide a level of assessment on the quality and coverage of the breastfeeding topics within pre-service programs. This assessment(s) should be corroborated against recent surveys that have probed for this information or conduct a review of the training program curricula.

How to score :  The scoring for this benchmark reflects:

a) Existence of breastfeeding pre-service training for health care professionals;
b) Degree of inclusion of essential breastfeeding topics (see Annex 3) in the pre-service curriculum; and
c) Level of coverage across pre-service programs. 

☐ No progress: Breastfeeding curricula do not exist in pre-service programs for health care professionals that will care for mothers, infants and young children. 

☐ Minimal progress:  Breastfeeding curricula exist in pre-service programs but the curricula do not cover all essential breastfeeding topics and they are not integrated within all pre-service programs. 

☐ Partial progress: Breastfeeding curricula exist in pre-service programs and the curricula cover all essential breastfeeding topics or they are integrated within all pre-service programs. 

☐ Major progress: Breastfeeding curricula exist in pre-service programs and the curricula cover all essential breastfeeding topics and are integrated within all pre-service programs.

In-Service Training for Facility-Based Health Care Providers Theme

Description: This benchmark assesses whether facility-based health care professionals, who care for mothers, infants and young children, are receiving instructional in-service training on breastfeeding and, if so, it assesses the quality of the breastfeeding training received by requiring that specific breastfeeding topics be covered in the in-service training curricula.  These essential breastfeeding topics are listed in Annex 3. 

Facility-based health care professionals : Prenatal care, maternity care and pediatric staff based in clinics or hospitals that work with pregnant and postpartum women, infants and young children. 

Possible data source s: Consult expert(s) in higher education, who know the content and quality of in-service health care professional curriculums, including the hands-on trainings, should be able to provide a level of assessment on the quality and coverage of the breastfeeding topics within facility-based in-service programs. This assessment(s) should be corroborated against recent surveys that have probed for this information or conduct a review of the training program curricula.

How to score :  The scoring for this benchmark reflects:

a) Existence of breastfeeding in-service training for facility-based health care professionals who care for mothers, infants and young children;

b) Degree of inclusion of essential breastfeeding topics (see Annex 3) in the facility-based in-service curriculum;

c) Minimum duration of 20 hours of facility-based in-service training for health care professionals


☐ No progress: Breastfeeding training does not exist in in-service programs for facility-based health care professionals who care for mothers, infants and young children. 

☐ Minimal progress: Breastfeeding training exists in in-service programs for facility-based health care professionals but the curricula do not cover all essential breastfeeding topics and does not meet the recommended minimum training hours. 

☐ Partial progress: Breastfeeding training exists in in-service programs for facility-based health care professionals and the curricula cover all essential breastfeeding topics or meet the recommended minimum training hours. 

☐ Major progress: Breastfeeding training exists in in-service programs for facility-based health care professionals and the curricula cover all essential breastfeeding topics and meet the recommended minimal training hours.

Description: This benchmark assesses whether facility-based health care professionals, who care for mothers, infants and young children, are receiving hands-on breastfeeding counseling and support skills training and, if so, assesses the quality of that training by requiring that specific breastfeeding topics be covered in the in-service training curricula.  The essential breastfeeding topics for counseling and support skills are listed in Annex 4. 

Facility-based health care professionals : Prenatal care, maternity care and pediatric staff based in clinics or hospitals that work with pregnant and postpartum women, infants and young children.

Possible data sources : Consult expert(s) in higher education, who know the content and quality of in-service health care professional curriculums, including the hands-on trainings, should be able to provide a level of assessment on the quality and coverage of the breastfeeding topics within facility-based in-service programs. This assessment(s) should be corroborated against recent surveys that have probed for this information or conduct a review of the training program curricula.

How to score : The scoring for this benchmark reflects:

a) Existence of hands-on in-service training in breastfeeding counseling and support skills for facility-based health care professionals who care for mothers, infants and young children;
b) Degree of inclusion of the essential breastfeeding counseling and support skill topics (see Annex 4) in the facility-based in-service curriculum; and
c) Minimal duration of hands-on training of at least 20% of the total training hours. 

☐ No progress: Hands-on breastfeeding training does not exist in in-service programs for facility-based health care professionals who care for mothers, infants and young children. 

☐ Minimal progress: Hands-on breastfeeding training exists in in-service programs for facility-based health care professionals but the curricula do not cover all essential breastfeeding counseling and the duration (or length) of hands-on training is not adequate. 

☐ Partial progress: Hands-on breastfeeding training exists in in-service programs for facility-based health care professionals and the curricula cover all essential breastfeeding topics or the duration (or length) of hands-on training is adequate. 

☐Major progress: Hands-on breastfeeding training exists in in-service programs for facility-based health care professionals and the curricula cover all essential breastfeeding topics and the duration (or length) of hands-on training is not adequate.

In-Service Training for Community-Based Health Care Providers Theme

Description: This benchmark assesses whether community-based health care professionals, who care for mothers, infants and young children, are receiving in-service instructional training on breastfeeding and, if so, it assesses the quality of the training by requiring that specific breastfeeding topics be covered in the in-service training curricula.  The essential breastfeeding topics are listed in Annex 3. 

Community-based health care professionals : Staff based in primary health care clinics that work with pregnant and postpartum women, infants and young children. 

Possible data sources : Consult expert(s) in higher education, who know the content and quality of in-service health care professional curriculums, including the hands-on trainings, should be able to provide a level of assessment on the quality and coverage of the breastfeeding topics within community-based in-service programs. This assessment(s) should be corroborated against recent surveys that have probed for this information or conduct a review of the training program curricula.

How to score : The scoring for this benchmark reflects:

a) Existence of breastfeeding in-service training for community-based health care professionals who care for mothers, infants and young children;
b) Degree of inclusion of essential breastfeeding topics (see Annex 3) in the community-based in-service curriculum; and
c) Minimum duration of 20 hours of community-based in-service training for health care professionals. 

☐ No progress: Breastfeeding training does not exist in in-service programs for community-based health care professionals who care for mothers, infants and young children. 

☐ Minimal progress: Breastfeeding training exists in in-service programs for community-based health care professionals but the curricula do not cover all essential breastfeeding topics and does not meet the recommended minimum training hours.

☐ Partial progress: Breastfeeding training exists in in-service programs for community-based health care professionals and the curricula cover all essential breastfeeding topics or meets the recommended minimum training hours.

☐ Major progress: Breastfeeding training exists in in-service programs for community-based health care professionals and the curricula cover all essential breastfeeding topics and meets the recommended minimum training hours.

breastfeeding curricula are integrated within all community-based in-service programs.

Description: This benchmark assesses whether these community-based health care professionals, who care for mothers, infants and young children, are receiving hand-on breastfeeding counseling and support skills training and, if so, assesses the quality of that training by requiring that specific breastfeeding topics be covered in the in-service training curricula.  The essential breastfeeding topics for counseling and support skills are listed in Annex 4.  

Community-based health care professionals: Staff based in primary health care clinics that work with pregnant and postpartum women, infants and young children. 

Possible data sources: Consult expert(s) in higher education, who know the content and quality of in-service health care professional curriculums, including the hands-on trainings, should be able to provide a level of assessment on the quality and coverage of the breastfeeding topics within community-based in-service programs. This assessment(s) should be corroborated against recent surveys that have probed for this information or conduct a review of the training program curricula.

How to score: The scoring for this benchmark reflects:

a) Existence of hands-on in-service training in breastfeeding counseling and support skills for community-based health care professionals who care for mothers, infants and young children;
b) Degree of inclusion of the essential breastfeeding counseling and support skill topics (see Annex 4) in the community-based in-service curriculum; and
c) Minimum duration of hand-son training is at least 20% of the total training hours. 

☐ No progress: Hands-on breastfeeding training does not exist in in-service programs for community-based health care professionals who care for mothers, infants and young children. 

☐ Minimal progress: Hands-on breastfeeding training exists in in-service programs for community-based health care professionals but the curricula do not cover all essential breastfeeding counseling and support skills topics and does not meet the recommended minimum training hours. 

☐ Partial progress: Hands-on breastfeeding training exists in in-service programs for community-based health care professionals and the curricula cover all essential breastfeeding topics or meets the recommended minimum training hours.

☐ Major progress: Hands-on breastfeeding training exists in in-service programs for community-based health care professionals and the curricula cover all essential breastfeeding topics and meets the recommended minimum training hours.


In-Service Training for Community Health Workers and Volunteers Theme

Description: This benchmark assesses whether community health workers and volunteers that work with mothers, infants and young children are receiving in-service instructional training on breastfeeding and, if so, it assesses the quality of the training by requiring that specific breastfeeding topics be covered in the in-service training curricula.  The essential breastfeeding topics are listed in Annex 3. 

Community health workers : Para-professionals that are trained to deliver education and provide peer support within the community to mothers, their infants and young children.

Volunteers : People that provide breastfeeding counselling and support but are not paid for providing that service.  

Possible data sources: Consult expert(s) in higher education, who know the content and quality of in-service health care professional curriculums, including the hands-on trainings, should be able to provide a level of assessment on the quality and coverage of the breastfeeding topics within community-based in-service programs. This assessment(s) should be corroborated against recent surveys that have probed for this information or conduct a review of the training program curricula.

How to score: The scoring for this benchmark reflects:

a) Existence of breastfeeding in-service training for community health workers and volunteers who care for mothers, infants and young children;
b) Degree of inclusion of essential breastfeeding topics (see Annex 3) in the community health worker and volunteer in-service curriculum; and
c) Minimum duration of 20 hours of community health worker and volunteer in-service training. 

☐ No progress: Breastfeeding training does not exist in in-service programs for community health workers (or volunteers) who care for mothers, infants and young children. 

☐ Minimal progress: Breastfeeding training exists in in-service programs for community health workers but the curricula do not cover all essential breastfeeding topics and does not meet the recommended minimum training hours.

☐ Partial progress: Breastfeeding training exists in in-service programs for community health workers and the curricula cover all essential breastfeeding topics or meets the recommended minimum training hours.

☐ Major progress: Breastfeeding training exists in in-service programs for community health workers and the curricula cover all essential breastfeeding topics and meets the recommended minimum training hours.

Description: This benchmark assesses whether community health workers and volunteers, who care for mothers, infants and young children, are receiving hands-on breastfeeding counseling and support skills training and, if so, assesses the quality of that training by requiring that specific breastfeeding topics be covered in the in-service training curricula.  The essential breastfeeding topics are listed in Annex 4. 

Community health workers : Para-professionals that are trained to deliver education and provide peer support within the community to mothers, their infants and young children. 

Volunteers: People that provide breastfeeding counselling and support but are not paid for providing that service.  

Possible data sources : Consult expert(s) in higher education, who know the content and quality of in-service health care professional curriculums, including the hands-on trainings, should be able to provide a level of assessment on the quality and coverage of the breastfeeding topics within community-based in-service programs. This assessment(s) should be corroborated against recent surveys that have probed for this information or conduct a review of the training program curricula.

How to score : The scoring for this benchmark reflects:

a) Existence of hands-on in-service training in breastfeeding counseling and support skills for community health workers and volunteers who care for mothers, infants and young children;
b) Degree of inclusion of the essential breastfeeding counseling and support skill topics (see Annex 4) in the community health worker in-service curriculum; and
c) Minimum duration of hands-on training at least 20% of the total training hours. 

☐ No progress: Hands-on breastfeeding training does not exist in in-service programs for community health workers (or volunteers) who care for mothers, infants and young children.

☐ Minimal progress: Hands-on breastfeeding training exists in in-service programs for community health workers but the curricula do not cover all essential breastfeeding counseling and the duration (or length) of hand-on training is not adequate.

☐ Partial progress: Hands-on breastfeeding training exists in in-service programs for community health workers and the curricula cover all essential breastfeeding topics or the duration (or length) of hand-on training is adequate.

☐ Major progress: Hands-on breastfeeding training exists in in-service programs for community health workers and the curricula cover all essential breastfeeding topics and the duration (or length) of hand-on training is adequate.

Train the Trainers Theme

Description : Master trainers in breastfeeding are qualified through national or international certification as breastfeeding specialists or lactation consultants to train and support facility-based and community-based health care professionals and community health workers. They can provide support by:

a) Serving as a primary resource to health care providers and community health workers for breastfeeding-related questions and problems (including those of a clinical nature);
b) Providing breastfeeding related materials as needed; and
c) Maintaining quality and standardization of breastfeeding services through on-site visits.

Possible data sources :  In depth interviews with national level government officials within the area of infant/young child health, NGOs and organizations working on infant nutrition to identify the existence and level of coverage of master trainers within the country.  Expert assessment(s) should be corroborated against specific surveys.

How to score :  The scoring for this benchmark reflects the existence and coverage of master trainers. 

☐ No progress: No master trainers in breastfeeding in the country. 

☐ Minimal progress: Master trainers in breastfeeding- only at national level

☐ Partial progress: Master trainers in breastfeeding- at national and subnational level throughout the country. 

☐ Major progress: Master trainers in breastfeeding- at national, subnational, and local levels through the country.

Coordination and Integration of Breastfeeding Training Programs Theme

Description : Breastfeeding training programs can be delivered through different entities using different modalities, such as face-to-face “classroom” programs or on-line breastfeeding tutorial and courses.   It is essential that the breastfeeding training programs are coordinated to prevent redundancies and ensure the quality of the overall national training for breastfeeding. These courses can be completed by different entities, however, they should be integrated, registered, evaluated and/or certified in order to be coordinated. This benchmark assesses the level of coordination of all breastfeeding training programs within the country.

Possible data sources: In depth interviews with national level government officials within the area of infant/young child health, NGOs and organizations working on infant nutrition identify the level of coordination of breastfeeding trainings within the country. Expert assessment(s) should be corroborated against specific surveys and country-specific documentation.

How to score: The scoring for this benchmark reflects the level of coordination among breastfeeding training programs. 

☐ No progress: No evidence of coordination. 

☐ Minimal progress: Some coordination but the majority of breastfeeding training programs are not included. 

☐ Partial progress: Between half and 75% of breastfeeding training programs are coordinated. 

☐ Major progress: Great majority (> 75%) of breastfeeding training programs are coordinated.

Description : The integration of breastfeeding information and skills into training programs for health care providers working in related areas of maternal and child health is crucial to the scaling up of breastfeeding. This benchmark assesses whether breastfeeding information and skills are integrated into related training programs and, if so, the breadth of coverage of that integration.  

Possible data sources :  In depth interviews with national level government officials and local health service coordinators within the area of infant/young child health, NGOs and organizations working on infant nutrition identify if breastfeeding information and skills are integrated into related training programs and the level of that integration. Expert assessment(s) should be corroborated against specific surveys and country-specific documentation.

How to score : The scoring for this benchmark reflects the level of integration of breastfeeding information and skills into related training programs. 

☐ No progress: Breastfeeding information/topics and skills are not integrated into related training programs. 

☐ Minimal progress: Breastfeeding information/topics and skills are integrated into some - less than 50%- related training programs. 

☐ Partial progress: Breastfeeding information/topics and skills are integrated into most- between 50% and 99%- related training programs. 

☐ Major progress: Breastfeeding information/topics and skills are integrated into all related training programs.

Breastfeeding support, Raichur, India

A technology enhanced campaign uses laptops to support breastfeeding among women in a rural area in Raichur, India. © 2013 Dr Abhay Mane/ Smt. Kashibai Navale Medical College, Courtesy of Photoshare