Baby-friendly Hospital Initiative

2003 Estate of Pablo Picasso/Artists Rights Society (ARS), New York

The Baby-friendly Hospital Initiative (BFHI) was launched by WHO and UNICEF in 1991, following the Innocenti Declaration of 1990. The initiative is a global effort to implement practices that protect, promote and support breastfeeding.

To help in the implementation of the initiative, different tools and materials were developed, field-tested and provided, including a course for maternity staff, a self-appraisal tool and an external assessment tool. Additional tools were developed afterwards, such as monitoring and reassessment tools. Since its launching BFHI has grown, with more than 152 countries around the world implementing the initiative. The initiative has measurable and proven impact, increasing the likelihood of babies being exclusively breastfed for the first six months.

Since 1991, the Global Strategy for IYCF was launched with nine operational targets, including BFHI. New evidence became available in the area of infant and young child feeding. Additionally the HIV pandemic raised concerns and queries in relation to feeding recommendations for children of HIV-infected mothers slowing down the process of implementation of BFHI.

In response to the HIV pandemic and other new evidence, WHO and UNICEF collaborated on an effort to update the Baby-friendly Hospital Initiative materials and promote the initiative in the context of the Global Strategy for Infant and young child feeding. The updated materials integrate Code implementation, mother-friendliness, care of pregnant women and mothers in the context of HIV, emergencies as well as expansion towards other type of health facilities and the community. The updated process was also used for strengthening the BFHI-related training courses.

The revised BFHI package includes:

  • Section 1
    Background and implementation, summarizes the background of the initiative and describes the process of implementation
  • Section 2
    Includes all material for training/raising the awareness of policy and decision-makers in relation of BFHI and IYCF in general
  • Section 3
    Corresponds to a 20-hour course for training facility staff (clinical and non-clinical)
  • Section 4
    Includes self-appraisal and monitoring tools
  • Section 5 includes the assessment and re-assessment tools

Section 1-4 are available at WHO and UNICEF websites and Section 5 is available upon request.

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