report on wbti - world breastfeeding trends...report on wbti & wbci training europe 2...

Report on WBTi& WBCi Training Europe

Geneva, May 2015

Report on WBTi & WBCi Training Europe

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Introduction

While global rates of exclusive breastfeeding have risen only modestly since 1990, a marked rise has been seen in those countries that have implemented several evidence‐based strategies drawn from the WHO Global Strategy for Infant and Young Child Feeding (the “Global Strategy”) simultaneously. For breastfeeding to be successful, mothers and families need the right support along the entire course of breastfeeding: giving birth in a Baby Friendly hospital, going home to find skilled local support from health professionals and mother support groups throughout their communities, and then maternity protection and breastfeeding breaks when they return to work. This requires information about breastfeeding to be accurate, free from marketing pressure from industry, and available throughout society, from friends, family and the media as well as from health professionals and policy makers.

The Initiative

What is the WBTi? In 2005, the International Baby Food Action Network (IBFAN) launched the World Breastfeeding Trends Initiative (WBTi), a collaborative initiative to assess and monitor ten key breastfeeding policies and programmes, drawn from the World Health Organization’s Global Strategy and the Innocenti Declaration. The WBTi builds on the WHO’s own assessment tool for the Global Strategy, adding a user‐friendly interface, interactivity, and open access on the public WBTi website http://worldbreastfeedingtrends.org.

The WBTi is not a report card by an outside agency but an ongoing collaboration among the partner organisations and agencies involved in infant feeding in each country. A coalition of partner organisations performs the assessment jointly, uncovering gaps in national policy and programmes, and then develops action plans to address them. The process is repeated at regular intervals, revealing progress and trends. Each country’s WBTi report is publicly displayed on the WBTi website, providing further impetus to governments to act.

With this launch in Europe in 2015, the WBTi will reach more than 100 countries in all five continents.

The WBTi was followed in 2014 by the World Breastfeeding Costing Initiative (WBCi), a tool to help planners and governments calculate the costs of implementing the action plans generated by the WBTi process.


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The Global Policy context

Key policy drivers for the WBTi are: • Global Strategy for Infant and Young Child Feeding, 2003

• Global Strategy for Women’s and Children’s Health, 2010

• International Code of Marketing of Breast‐milk Substitutes, 1981,and subsequent WHA resolutions (referred to as “the Code”)

• Baby Friendly Hospital Initiative, 1991

• Innocenti Declaration, 1990 and 2005

• Convention on the Rights of the Child, 1989

• International Labour Organization C‐183

• CEDAW (The Convention on the Elimination of All Forms of Discrimination against Women), 1979

• Protection, Promotion and Support of Breastfeeding in Europe: a Blueprint for Action 2008; http://www.aeped.es/sites/default/files/6‐newblueprintprinter.pdf (see also Infant and Young Child Feeding: standard recommendations for the European Union; https://www.ihan.es/cd/documentos/Rec_UE_en.pdf)

• WHO European Food and Nutrition Action Plan 2015‐2020 (which includes the Code and BFHI): http://www.euro.who.int/__data/assets/pdf_file/0008/253727/64wd14e_FoodNutAP_140426.pdf

Influence of the WBTi The WBTi process has been associated with significant improvement in breastfeeding rates in a number of countries, and on a global scale. The WBTi has become a key indicator for global policies and research.

WBTi is been one of the sources used by WHO to compile the GINA index of nutrition (Global Database on the Implementation of Nutrition Action), it has been cited in the British Medical Journal, BMJ (2011), and used in the WHO Status of the Code report (2011). It has been published in peer‐reviewed journals and used to track the effects of Global Strategy policies on breastfeeding rates (Lutter and Morrow: 2013).

It was included in the UNICEF 2013 Landscape of Breastfeeding report, has formed the basis of public health research (Smith 2011) and was used by the New Zealand government as a key underlying instrument in formulating national breastfeeding policy.


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Publications mentioning WBTi

• The Ethical Basis for Evidence‐based Practice in Support of the Baby (2008) by Marianne Knapp Ward

• Reproductive Justice: A Global Concern (2012) Edited by Joan C. Chrisler

• Global Obligations for the Right to Food (2008) Edited by George Kent USA: Rowman & Littelfield Publishers, Rotary International, June 2011

The effectiveness of the WBTi process A number of the countries engaging in the WBTi process have seen notable progress in breastfeeding rates as they improve performance in the various WBTi indicators, as shown below.

Lutter and Morrow (2013) found strong correlation between increasing WBTi scores over time and increasing breastfeeding rates, indicating that improved implementation of the Global Policy results in improved breastfeeding rates.

Annual change in EBF (%) by adjusted WBTi score. EBF, exclusive breastfeeding; WBTi, World Breastfeeding Trends Initiative. Lutter and Morrow © 2013 American Society for Nutrition


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Median breastfeeding duration (mo) and global and Brazilian breastfeeding actions in 1974–2006; global actions are above the line showing median duration, and Brazilian actions are shown below line. The figure was translated from Portuguese, extended to 2006, and used with permission from Cadernos de Saúde Pública (20). Lutter and Morrow © 2013 American Society for Nutrition

Countries Impact of WBTi tool

Gambia • Validated a new Nutrition Policy

Uganda •Led to development of National Policy guideline for IYCF and a district specific 5 year strategic plan

Kenya • The new WHO guidelines on HIV and Infant Feeding was adapted and included in the MIYCN policy, startegy and guidelines

• Also used WBTi Score card to involve media houses in broadcasting breastfeeding information

Impact of the WBTi assessment tool


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Countries Impact of WBTi tool

Costa Rica •Developed a new breastfeeding policy with clear institutional guidelines for Infant Feeding in Emergencies •National standards on Human Milk Banking

Dominican Republic

•Developed a comprehensive policy on Infant Feeding and Emergencies•National Breastfeeding Committee has started functioning

Colombia • Developed a comprehensive strategy on early childhood care in people affected by displaced by violence and included infant feeding in disaster situations

El Salvador • MOH officially established the National Breastfeeding Commission• National Congress declared the whole month of August as month of breastfeeding• A law on breastfeeding submitted to the congress using WBTi assessmnet as supporting document to lobby

Uruguay • Enacted the National Breastfeeding Policy as Minister order in 2009 as recommended by WBTi assessment

Guatemala • Moved the National Breastfeeding Committee to develop 5 year strategic plan for enhancing breastfeeding rates

Impact of the WBTi assessment tool

The Multiplier effect: the “gear” model The multiplier effect of the WBTi method of addressing several – at least 7 –coordinated key strategies simultaneously is clearly seen in the relative success of Brazil compared to Mexico.

In Brazil, there is an integrated model with several Infant and Young Child Feeding (IYCF) strategies working together under effective national coordination, like a set of interlocking gears, to produce valid change.

In Mexico, however, fewer IYCF strategies and a lack of coordination meant that the various “gears” were in fact isolated and much less productive at effecting change.


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Program Coordinationand Advisory Committee

IHACCode + Maternal Benefitis

Brazilian Breastfeeding PolicyBreastfeeding and

Complimentary Brazil Network

Legal Protection

Brazilian Human Milk Bank Network

Innovating Component

Kangaroo Method

Monitoring and Evaluation

Education

Broadcasting, Social Mobilization

and AwardsWBW

Baby and Mother Friendly Hospital

Initiative

The breastfeeding gear model for scaling up and sustainability of breastfeeding programs.

The WBTi process uses UNICEF’s AAA approach: Assessment, Analysis, Action, with the WBTi assessment process repeated periodically, once every several years.

Each time, the partner organisations meet and collaborate to assess where the omissions in IYCF policies and programs occur in order to develop an action plan to target those gaps. This is particularly useful when economic resources are limited and must be focused on the areas where they will have most effect.


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WBTi in practice and effecting action A coalition of partner organisations is built and they work together to improve infant feeding.

WBTi Country Coordinator/s The Country Coordinator facilitates the Core Group and the entire WBTi process. The IBFAN office liaises with the WBTi team via the Country Coordinator, who is responsible for submitting the assessment report and for signing off on the final report.

WBTi Core Group and Partners The core group comprises 5‐12 people who have no commercial conflicts of interest .

Partners are key organizations responsible for the various indicators and they complete the data collection.

Possible partners: • Ministries of Health, Women’s Affairs, Labour Ministry, Information Systems • Chair of national breastfeeding committee • BFHI/BFI • IBFAN • NGOs such as mother support organizations • Health professional organizations: midwives, nurses, community nurses/health

visitors, doctors, GPs, paediatricians, IBCLCs

Where to start? Translate the Global Strategy for Infant and Young Child Feeding into local languages. Use the European Blueprint.

Data Collection Even if the answer to a WBTi assessment question is “No,” it needs a documentary reference, which could be interview notes with names and date.

Funding Approach potential donors early in the process. Even if no funding is given at this stage this raises the profile of WBTi so that, once the WBTi assessment is complete, potential donors can be approached again for funding for the proposed action plans.

Deliverables (WBTi report, Report Card) are essential for funders!


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Possible funding source ideas: • Mothers’ rights groups, information support organizations, special interest groups • Utility companies such as EDF or a state electricity company have community funds

available • National Culture funding (Portugal) • Scholarship/ research grants available • Information/ data grants (Gulbenkian in Portugal) • Printers might donate a print run.

Finalising the WBTi report The IBFAN Asia office, as secretariat of WBTi, will verify the data submitted. After the assessment information has been verified, all scoring is completed by computer at IBFAN Asia and the final report is sent back to the country coordinator. Once the country coordinator signs it off, the report is published and appears on the WBTi website.

The country WBTi team can then have the full country WBTi report and the Report Card printed and launched, perhaps at a national conference such as may be held by the Baby Friendly Initiative, an organization of professionals such as nurses , or a mother‐support organization such as La Leche League.

The WBTi team could provide each conference delegate with a copy of the single sheet Report Card and a summary of the Code.

The final report can be shared with donors to begin the action plans.

If the government does not engage with the WBTi process, then the coalition of partner organizations can undertake a national assessment and produce a WBTi report which invites the government to join in discussions and proposed actions.

Indicators additional sources of information Additional possible sources of information (see also the Assessment questionnaire) for each of the fifteen indicators:

1. National Health Service Department/ Ministry of Health, National Breastfeeding Committee minutes

2. BFHI guidelines, published research in journals, community health records 3. IBFAN groups, Baby Feeding Law Group, State of the Code by country, WHO review of

Code 4. Civil society groups, labour unions, Department of Labour, formal vs informal work

sector (migrants, illegal immigrants data, which may be difficult to obtain, grassroots organisations, women’s rights organisations, environmental organisations which advocate on effects of toxins/ pesticides on workers may have data on maternity protection), and the WBA task force.

5. Health and Nutrition Care system


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a. Health Professional schools IYCF curriculum and NGO training, Department of Education

b. Birth NGOs, BFHI c. Professional organisations of paediatricians, midwives, Department of Health d. IYCF in other training (HIV/ women’s health), civil society NGOs, professional

organisations, UNICEF country office e. In service training: Dept. of Health, Dept. of Education, NGOs f. Child health policies when mother/child sick: Dept. of Health, paediatricians'

organisation, hospital alliances 6. Mother support and community

a. IT support systems, Ministry of Health, welfare community programs, mother support groups, NGOs, national lactation consultant association, WABA community outreach to mothers, UNICEF country office

7. Usually Department of Health; also NGOs have info campaigns and resources. Evaluating programs: national health service. Conflicts of interest: doctors on industry‐funded TV, YouTube, pamphlets. Is information on artificial feeding in line with WHO?

8. HIV – varies. Is there counselling which supports mother’s choice? Where to get information on policy?

9. Emergencies: May be responsibility of national health service to coordinate response, or armed forces, or UNHCR, ENN, NGOs emergency response team, crisis task force, civil defence. Different in each country. Info should be from each organisation tasked with dealing with emergencies by the government.

10. Data! Different in each country. NGOs, government, Dept. of Agriculture, etc. conflicts of interest. Government data.

11. Dept of Health, government surveys, DHS (Demographic Health Surveys) 12. Mathematical formula; how to obtain the numbers 13. Median 14. Bottle feeding 15. Infant and toddler dietary survey

Preparing the WBTi Country Report

Assessment Facilitated by the Country Coordinator and the Core Group, the partner organisations meet and fill in the assessment. The Core Group prepares the report (report template is on WBTi website), which needs to be succinct and clear.

The draft report can be presented to a wider audience for review, including the wider group of assessment partners – to build a consensus and incorporate comments.


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The finalised assessment is submitted by the Country Coordinator to IBFAN Asia (WBTi secretariat) where it is verified and uploaded onto the web tool, which carries out the grading, colour coding etc.

Verification For each indicator, missing information must have referenced data, i.e. published policy, website, with date/year; meeting/interview notes which can be verified with a named key person. Omissions and recommendations must complement each other.

Verification required: • Maternity Protection: WABA Status of Maternity Protection by Country (via WBTi

portal) • Ratifications of ILO C183 on ILO website • Code: verify using State of the Code (ICDC); can ask Ministry “Where do you think we

stand on the Code” and then confirm against the ICDC document.

Reports requiring clarification will be sent back to the Country Coordinator until finalized.

Summary Comments The Core Group can summarize the “real situation” before making recommendations.

Recommendations Each omission of information must be matched with a recommendation. If there is no gap for a particular indicator, “sustain present programme” can be recommended.

Final report For the final report, the country can add a national sponsor, Department of Health logo, photos, background information on the country etc.

Once approved by IBFAN Asia, the final report is sent back to the Country Coordinator for written approval, then published and launched at a major conference/ event with media invited.

Languages In some countries, the country coordinator may have to vouch for sources which are not available in English or another common language.

The WBTi Guide Book is available in 5 languages and the assessment template is available in English and French.

The recommendation is to produce the WBTi final Report and the Report Card in the local language.


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The WBTi Report Card This consists of one double‐ sided sheet. It includes the scores on individual WBTi indicators, total country score, and KEY recommendations, including the CRC recommendations (see below). There is a Report Card template available.

The Report Card will feature the one or two top priority information omissions alongside the recommendations. It is delivered along with the WBTi report.

The Report Card can be used by • Government officials and policy makers: for a quick overview of issue and key

actions • Government Agencies: to focus on critical areas • Donor agencies • Media: stories, pressure on government

The Convention on the Rights of the Child (CRC) and the WBTi

The CRC is both a convention – the most widely ratified convention on human rights – and a monitoring body. It is an international agreement with a broad scope, incorporating civil, cultural, economic, political and social rights as well as aspects of humanitarian law.

The CRC was ratified by 195 countries but not by the USA or South Sudan. Its monitoring body is the CRC Committee on the Rights of the Child.

The rights related to breastfeeding include: Article 24, which is highly relevant to breastfeeding: '...the right to the enjoyment of the highest attainable standard of health..', and includes specifically:

a). to diminish infant and child mortality

b). the provision of adequate nutritious foods

c). appropriate pre‐natal and post‐natal care for mothers

d). 'all segments of society, in particular parents and children, are informed, have access to education and are supported in the use of basic knowledge of child health and nutrition, the advantages of breastfeeding, …..'

More detail is provided by subsequent CRC General Comments. Number 15 (2013) expands on Article 24 and provides the basis to advocate for full implementation of the Global Strategy by states:


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Paragraph 44. Exclusive breastfeeding to 6 months should be protected, promoted and supported, as defined by the Global Strategy for IYCF from WHA. States are required to enact laws to implement and enforce the Code and WHA resolutions. Private companies shall comply with the Code

• This provision sets a direct obligation for private companies to comply with the Code universally

General Comment number 16 (2013) concerns 'State obligations regarding the impact of the business sector on children’s rights':

Paragraph 57. States are required to implement and enforce international standard of child health including the Code.

2014 OHCHR (Office of the High Commissioner for Human Rights) Technical Guidance on child mortality adopted by the General Assembly:

Paragraph 77. Implement the Code. Paragraph 78. Workplace policies during pregnancy and postnatal period: protect women and support breastfeeding in the workplace.

• This instrument is now used in CRC recommendations for countries with high mortality/morbidity rates

• Instead of formulating long recommendations, the CRC committee can just refer to this document and ask for its implementation.

The CRC reporting cycle At present there is the State party report and the NGO alternative report. IBFAN either submits a pre‐sessional report or written replies to the committee.

In 2016 a new CRC reporting procedure will be introduced, to simplify the procedure for the committee (although not for the NGO report). The State Report will be prepared in reply, with no further written information required from the state until the dialogue with the CRC. However, the NGO submission will be more complicated.

Examples from some European countries of CRC recommendations Armenia 2013: the CRC recommendations included the implementation of BFHI, monitoring, marketing and accelerating adopting the Code into law, and the promotion of proper IYCF, through the health care system.

Portugal 2014: recommendations included the state improving exclusive breastfeeding to 6 months and strengthening the Code. IBFAN Portugal has offered to implement the recommendations but the state has not accepted.

Croatia 2014: recommendations to improve exclusive breastfeeding and to legislate and monitor the Code. The positive outcome included new legislation.


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How to use the CRC report as a lever for the WBTi assessment and vice versa The AAA method is used: Assessment/Analysis/Action.

The Concluding Observations of the CRC report urge the state to take ACTION.

As the CRC template is consistent with the WBTi Indicators and the CRC report can input the WBTi information, the WBTi report card can be used directly to inform the CRC committee.

Or the other hand, the CRC could be used as a basis to start a WBTi assessment.

Is the Convention legally binding? The countries that have signed up to the CRC have to implement the convention and they are also bound by the General Comments. However, there is no enforcement mechanism. A monitoring mechanism exists by the review of the committee.

The lack of sanctions means it is not legally binding on states; private companies are not bound at all except by national legislation.

Call to endorse a Second Treaty Alliance Statement This call is for the adoption of a binding instrument on corporations and their human rights' obligations.

The scope of the CRC is broader than the Global Strategy so it is an additional international instrument. For instance, the CRC report on France can hold French companies responsible for their activities abroad (such as Danone’s violations of the Code in other countries).

World Breastfeeding Costing Initiative (WBCi)

What is the WBCi? Previous attempts to estimate the cost of globally scaling up breastfeeding interventions have not included all aspects of protecting, promoting and supporting breastfeeding. WBCi represents the first attempt to estimate the minimum cost of implementing the Global Strategy for IYCF throughout the entire world.

Estimated one‐off costs: $2.08 billion USD, including: • Policy • Drafting the Code into law • Training


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Estimated annual costs (the principal cost is maternity entitlements): $15.48 billion, including:

• BFHI • Media • Monitoring • Maternity entitlements (World Bank figure of $2 below the poverty line)

Total cost: $17.56 billion IBFAN has developed an advocacy document, The Need to Invest in Babies, along with the WBCi. The WBCi indicators mirror the WBTi indicators except that:

• The HIV and Emergencies are merged into one category • Monitoring and evaluation is contained within EACH indicator rather than as a

separate indicator.

Using the WBCi The tool can be used by WBTi teams to formulate action plans and also by government and policy planners.

The WBCi lists many possible components for action on each indicator so it can be used as a template to plan activities. It is also possible to add other elements.

The country profile page must be fully completed so that data can be exported to other pages.

Difference between recommendations and an Action Plan

Recommendations are usually advisory and made to others, such as Governments.

Action plans map a course of action, establish time lines, assign ownership, identify human resources, and link to government operating plans.

Examples of some indicator recommendations and actions: Indicator 1. Countries can choose to develop a national committee, appoint a coordinator and produce a policy that takes into consideration the WHO IYCF recommendations in full.

Indicator 2. Creation or resumption of the BFHI.

Indicator 3. Work to make the International Code law instead of voluntary recommendation.

Indicator 4. Improve maternity protection with legislation.

Indicator 5. Concentrate on health professional education including the medical professionals. Enhance family‐friendly childbirth procedures.


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Indicator 6. Include and integrate IYCF strategy into community outreach policies.

Indicator 7. Resolve common conflict of interest issues and create effective data collection sets.

Indicator 8. Co‐ordinate international reports and guidelines to comply with IYCF guidelines.

Indicator 9. Contact national organisations responsible for emergency‐preparedness and staff designated in health and nutrition programmes for information on the criteria necessary to protect, promote and support IYCF practices in emergencies.

Indicator 10. Create uniform data collection with scientifically valid definitions of WHO and IYFC criteria.

Where do we go from here? Each country’s WBTi Coordinators to sign an agreement with IBFAN Asia as the WBTi secretariat. Each WBTi country report should be completed by the end of 2015.

Everyone could use World Breastfeeding Week (WBW) as a tool.

A grant of $2000 is available from IBFAN Asia (donors are Norway and Sweden, through NORAD, the Norwegian Agency for Development Co‐operation and SIDA, Swedish International Development Cooperation Agency)

• 80% will be released at time of signing contract for actually doing the work, organising translations, materials, organising the meeting,

• Each WBTi group should maintain a budget and accounts, with an expense report with copies of receipts etc for submission.

• WBTi expenses: IBFAN will supply expense report template. Only one final accounting is needed.

• 20% coordination and communication costs for the use of the coordinators. • Contract should be with each country’s IBFAN group, if in existence, by the end of

May.

Call to Action • 20 countries worldwide can apply for funding for a Call to Action in 2015 and again

in 2016 • A country which does an assessment of WBTi would then do a Call To Action • WBTi report identifies gaps and makes recommendations; local IBFAN uses the

WBTi Report with Recommendations to call upon its government through a Call to Action and an Event; the aim is to hold the government accountable.

• Currently 20 countries ‐‐ $2000. • Over next couple of weeks: contact IBFAN Asia if interested in doing this after

completing the WBTi assessment.


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• Organise an event in the country; call upon the government using the WBTi report; use the opportunity to launch the WBCi tool.

Each team presented their findings (see below) and the training was concluded with everyone thanking our hosts and appreciating the strength of the WBTi and WBCi tools.

Action Plans for European countries

Action Plan for Armenia

Activity Timeframe

Present the problem in the joint meeting of Mother & Child Health Alliance and MOH authorities

May 25‐26

Review IYCF Policies and Programmes, Health and Nutrition Care Systems (in support of breastfeeding & IYCF), Mother Support and Community Outreach – Community based support for the pregnant and breastfeeding mother, Information Support, National policies on Infant Feeding and HIV, find out gaps for those indicators, score and give recommendations

June 1‐July 15

Find out gaps, score and give recommendations on Baby Friendly Care and Baby‐Friendly Hospital Initiative&Maternity Protection

July 15‐20

Collect information on Mechanisms of Monitoring and Evaluation System, Infant Feeding in Emergencies and Information Support system, find out gaps for those indicators, score and give recommendations

September 1‐20

Follow the developments on Implementation of the International Code of Marketing of Breastmilk Substitutes, score and give recommendations

September 20‐30

Entering data, colour rating, generating report Oct. 1 – Nov.15

Submission of final report Nov. 15‐30


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Action plan for Croatia

Objectives Responsibilities Outcomes Timeframe

Inform NBC & MoH of WBTi

Irena Nomination of Core Group Monday, 18th May, 2015

Face‐to‐face meeting of Core Group to organise assessment

Irena Presentation on WBTi Division of indicators among core group members Identification of partners

Monday, 18th May, 2015

Assessment of indicators

Core Group Indicators assessed using reporting tool downloaded from WBTi website Sources defined

June, 2015

Skype meeting of Core Group to discuss assessment

Core Group Agreement on assessment of indicators and sources

June, 2015

Writing up of WBTi report

Core Group Draft report written in Croatian

July, 2015

Consultation with wider audience

Core Group MoH

Feedback received by key stakeholders (UNICEF, MoH, professional organisations, NGOs)

August/ September, 2015

Produce final report in Croatian and translate into English

Core Group Professional translators Designers

Final WBTi report in Croatian and English

September, 2015

Verification of data

IBFAN Asia Approved report September, 2015

Report uploaded and report card produced

IBFAN Asia Croatian data on WBTi website

October, 2015

Dissemination of report cards

Core group, MoH, media

All relevant stakeholders receive report card

October, 2015

Launch of Call to Action

Core Group, partners

Call to Action launched at major conference, covered by media

October, 2015


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Action Plan for Portugal

May

− Get everything translated. PP, booklet, indicators etc. Translate summary for web page.

− Add a webpage for our website on WBTi so we can link letters and proposals to it.

June

− Request meeting (1st week of June) with IBFAN Portugal board explain/present the WBTi and discuss and decide on possible candidates for Core group and backups in the event the original ones don´t agree to join.

− Contact candidates (email invitations then follow up by phone after 3 days in the event they don´t answer etc)

− Plan meeting for3rd week/end of June .Discuss sponsors (COIs, Code compliance etc)

− June meeting. Need a venue and idea is to present the WBTi and briefly discuss who wants to or should do what.

− Ask candidates to join the initiative and discuss indicators and who should do/wants to do/is best at doing what. Vote on indicators? Vote on IYCF coordinator.

− Give them a week to get back to us. − Follow up possible candidates. − Draft a written agreement so we can be open/public about team. − Get final agreement from final Core group.

July

− 1st week send out a brief description on WBTi to conference providers/planners for breastfeeding week in October so we can launch our plans and explain what the WBTi is and how important it is as a country tool.

− 1st week IBFAN Portugal, research possible information resources (as many options as possible) so you can basically hand it to Core group on a plate. Less work for them/work with them, no excuse for delays.

− Send out research to Core group to who has chosen or has been allocated what.

− Aim for COI and if possible Code complaint sources of information. (what if only resources are Code violations or COI’s)

− Remind Core group to opt for COI sources in the event they do their own thing.

− Ask when Core group are available after holidays. − Ask if Core group need extra support or want a meeting before holidays.

August

− Plan for September with IBFAN Portugal members. − Send out meeting plans for September to Core group. Aim for 1st week of

September for 1st meeting so all are back.

September − During September country coordinator keeps in touch with each member


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of the Core group to see how if they have progressed and do they need help.

− Meeting end of 1st week to discuss report and findings. − First draft of answers to indicators in by 3rd week/end of September. − Meeting at the end of September either as a group or one on one with

Country Coordinator. − Plan for final meetings in the 3rd week of October. Debate/discuss final

answers. Agree as a group. Plan and brainstorm for launch of report and call for Action at the end of November. Venue, date, length etc.

− Send out invitation to meeting to present final report to the government. − Book/plan presentation to Government for 3rd week of October. − Plan presentation on WBTi for conferences which run 1st 2 weeks of

October. − Contact press release centre to start discussions/send background date

etc.

October

− 1st week, meeting with Core group to finalise report. − Prepare small booklet (for government) with international

resources/guidelines in case we get questioned at the meeting. Include Portuguese legislations etc.

− Translate report. − Present report to government 3rd week of October. Allow for discussion. − Keep everyone happy. − Finalise report and send off to IBFAN Asia.

November

− Final planning etc. for the ‘Call for Action’ − Launch report 1st week of November and coincide it with ‘Call for Action’

December − Take a few days off !!!!!!!!!!!!

Core Group

− Country Coordinator: Jacqueline de Montaigne − Dra Ana Jorge − Dr António Gomes − Dra Mariana Hancock − Dra Marta Stilwell − Dr Pedro Graça − Enf Teresa Felix − Enf Barbara Menezes − Enf Adelaide Orfão − Dra Isabel M Loureiro − Dra Andreia Pereira?


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Action Plan for WBTi in UK

Objectives Responsibilities Outcomes Timeframe

Inform partners in Core Group

Helen /Clare Finalization of Core Group

June/July 2015

Attend Mainn Conference

Helen Meeting with core members and others

Wed 10th June 2015

Face‐to‐face meeting of Core Group members (Best Beginnings)

Helen/Clare Presentation on WBTiDivision of indicators among core group members Identification of partners

Wed 17th June, 2015

Arrange meetings for other core group members

Helen /Clare Indentify venue and date June/July 2015

Arrange Skype calls for those unable to attend

Helen /Clare June/ July 2015

Assessment of indicators

Core Group Indicators assessed using reporting tool downloaded from WBTi website Sources defined

June, 2015

Skype meeting of Core Group to discuss assessment

Core Group Agreement on assessment of indicators and sources

June, 2015

Writing up of WBTi report

Core Group Draft report written July, 2015

Consultation with wider audience

Core GroupDoH

Feedback received by key stakeholders (UNICEF, DoH, professional organisations, NGOs)

August/September, 2015

Produce final report Core Group Final WBTi report October , 2015

Verification of data IBFAN Asia Approved report October, 2015

Report uploaded and report card produced

IBFAN Asia data on WBTiwebsite November, 2015

Dissemination of report cards

Core group, MoH, media

All relevant stakeholders receive report card

November,2015

Launch of Call to Action

Core Group, partners

Call to Action launched at major conference, covered by media

November, 2015


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Action Plan for WBTi in Switzerland

JunDec 2015

− Explore interest by government (OSAV, OFSP), Swiss Foundation for the Promotion of Breastfeeding, and other key partners (Swiss Society of Paediatrics, Swiss Federation of Midwives, Swiss Association of Lactation Consultants, La Leche League Switzerland, HUG Contrepoids Genève, DEAS Genève, UNICEF Switzerland and other identified partners) in participating in a WBTi assessment in 2016. (Note : the OSAV and the Swiss Foundation have already given us a negative response).

JanMar 2016

− Organize a WBTi meeting with identified partners, to introduce the process and identify responsibilities and put in place an action plan

MayJune 2016

− GIFA finalize WBTi report based on inputs provided by key partners, and the IBFAN CRC alternative report (2014)

June 2016 − Organize second WBTi meeting to finalize and validate report

SeptOct 2016

− Dissemination of the WBTi report for Switzerland and uploading on the WBTi website


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Country Action Plan

Malaysia − June‐meeting of core group − July‐collect data/assessment − August‐develop work plan/report − September‐identify other partners for larger meeting − October‐November‐WBTi finalize

Belgium − May last week‐WBTi to be reported in BF Committee meeting − Develop WG on plan/policy − June to September‐Assessment − October to November‐WBTi Report & Report Card

Ukraine − Complete data collection‐May‐June − Conduct larger meeting with WHO/UNICEF‐June − Complete WBTi report & submit IBFAN Asia–Sept‐Oct − Publish Article

Italy − Meeting with IBFAN Italy council and briefing on WBTi − Report to the coalition of association on infant feeding − Inform authorities/Italian breastfeeding committee − Government members and representative of paediatric association − Dissemination of work on indicators − Data Collection –June − Complete data collection‐Sept − Send IBFAN Asia‐Oct − Present WBTi results during WBW with official press release and inform

government‐Oct Turkey − Form core group‐June

− Questionnaire clarification on WBTi‐end June − Translation of tool‐June − Collection of data & draft recommendations‐July‐August − Coe group meeting for consensus‐September − Draft report‐end September − Present to larger audience during WBW‐October − Final report‐November − Launch of report‐December − Article publish‐Feb‐March 2016

Georgia − Preliminary meeting with stake holders (MoLHSA, UNICEF, WHO) Initial information on WBTi‐June

− Assessment and collect information WBTi‐July‐August − Elaboration Gaps‐September − Meeting with stake holders (MoLHSA, UNICEF, WHO) discussion collected

data‐September − WBTi Launch ‐October − Preparation of report and send to IBFAN Asia‐November


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List of Participants for WBTi & WBCi training workshop for

European Countries May 13‐15 2015, Geneva

S. No. Country Participant EMail Addresses

1 Armenia Susanna Harutyunyan [email protected]

2 Ukraine Olga Schlemkevch [email protected]

3 Turkey Charlotte Cordon [email protected]

4 Belgium Els Flies [email protected]

5 Georgia Keteven Nemsadze [email protected]

6 Tamar Bakhtadze [email protected]

7 Bosnia& Herzegovina

Aida Fhilipovic [email protected]

8 Dr. Sabaha [email protected]

9 Portugal Jacqueline de Montaigne [email protected]

10 UK Helen Gray [email protected]

11 Clare Meynell [email protected]

12 Croatia Irene Zakarya [email protected]

13 Italy Paola Raffaella Mariotti [email protected]

14 ICDC Constance Ching [email protected]

15 Africa Barbara Nalubanga [email protected]

16 Africa Joyce Chanetsa [email protected]

17 India Dr Shoba Suri [email protected]

18 India Dr Arun Gupta [email protected]

19 Switzerland Rebecca Norton [email protected]

20 Camille Selleger [email protected]


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References

Lutter C, Morrow A (2013) 'Protection, promotion, and support and global trends in breastfeeding' Adv Nutr. 2013 Mar 1;4(2):213‐9. doi: 10.3945/an.112.003111 [Online] Available at: http://www.ncbi.nlm.nih.gov/pubmed/23493537 (Accessed 7/7/15)

UN CRC (2013) General comment No. 15 (2013) on the right of the child to the enjoyment of the highest attainable standard of health (art.24) [Online] Available at: https://www.google.co.uk/search?q=convention+on+rights+of+child+general+comment+15+2013&ie=utf‐8&oe=utf‐8&gws_rd=cr&ei=no‐bVeyxO8ursgGH2JG4Dg (Accessed 7/7/15)

UN CRC (2013) General comment No. 16 (2013) on State obligations regarding the impact of the business sector on children’s rights [Online] Available at: https://www.google.co.uk/search?q=convention+on+rights+of+child+general+comment+16+2013&ie=utf‐8&oe=utf‐8&gws_rd=cr&ei=uZKbVc3YMsixygP0qp7ICg (Accessed 7/7/15)

UN General Assembly (2014) Technical guidance on the application of a human rightsbased approach to the implementation of policies and programmes to reduce and eliminate preventable mortality and morbidity of children under 5 years of age [Online] Available at: http://www.ohchr.org/Documents/Issues/Children/TechnicalGuidance/TechnicalGuidancereport.pdf (Accessed 7/7/15)

UNICEF (2013) Breastfeeding on the worldwide agenda [Online] Available at: http://www.unicef.org/eapro/breastfeeding_on_worldwide_agenda.pdf (Accessed 7/7/15)

WHO (2011) Country implementation of the International Code of Marketing of Breastmilk Substitutes, Status Report 2011 [Online] Available at: http://www.who.int/nutrition/publications/infantfeeding/statusreport2011/en/ (Accessed 7/7/15)


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www.ibfan.org

http://worldbreastfeedingtrends.org/