Background and purpose
A key priority of the World Health Organization (WHO) is to protect, promote, and support breastfeeding globally through policy guidance and technical assistance to countries.
The Baby-friendly Hospital Initiative (BFHI) is designed to ensure that mothers and newborns receive timely and appropriate care before and during their stay in a facility that provides maternity and newborn services, to enable optimal feeding of the newborn, and thereby protect their health and promote proper development. Since 1991, the BFHI has helped to motivate facilities providing maternity and newborn services worldwide to better support breastfeeding. Based on the Ten Steps, the BFHI focuses on providing optimal clinical care for new mothers and their infants.
In 2018, the WHO and UNICEF revised and updated the implementation guidance for the BFHI (the Revised Baby-friendly Hospital Initiative – BFHI 2018: https://www.who.int/publications/i/item/9789241513807. The revised BFHI implementation guidance focuses on integrating the protection, promotion and support of breastfeeding more fully into the health-care system, including in private and public facilities. It proposes new directions to scale-up BFHI to all facilities and to ensure sustainability of the policies and practices by coordinating strategies for integrated people-centred health services and strengthening the quality-improvement practices already present in the BFHI.
The revised guidance identifies internal monitoring as a key driver of establishing and maintaining continuous quality improvement and ongoing quality assurance. Step 1C of the Ten Steps to Successful Breastfeeding indicates that all maternity facilities should “Establish ongoing monitoring and data-management systems.” The online appendix to the implementation guidance presents the expected indicators to be included within these systems.
The Department of Nutrition and Food Safety is seeking a provider to develop a manual for operationalising these indicators for internal monitoring of the Ten Steps to Successful Breastfeeding (the Ten Steps) in facilities that provide maternity care services. The monitoring manual will provide tools and guidance that can be applied (with modification) for use in a range of national and sub-national health services in both high-income and lower- and middle-income countries.
Work to be performed
Objective: Deliver a manual and tools for monitoring of the BFHI.
- Alternative approaches to data collection (e.g. electronic medical records, patient charts, manual tracking systems, period audit checks, facility discharge surveys, patient satisfaction surveys)
- Pros & cons of the alternatives
- Methods for analyzing data
- Report templates
- Draft questions
Task 1: Provide an outline of the monitoring manual, including tools and procedures, for revision and approval by the WHO and collaborating partners
Task 2: Provide draft text and tools for review and technical feedback from WHO and collaborating partners T
Task 3: Perform required revisions and submit completed Monitoring Manual.
Inputs
Technical assistance on BHFI and review of structure and content will be provided by the World Health Organization and collaborating partners.
WHO will provide proofreading and type-setting.
Concept note and budget
Interested author(s)/teams are invited to submit a concept note (2-3 pages) by sending an email to WHO at nutrition@who.int no later than 9 July 2021. The subject heading of the email should read as, “BFHI Internal Monitoring Manual”.
The concept note should include a proposal containing (in a single pdf document) the following:
- A Statement of Capacity that demonstrates:
- expertise in data collection, analysis, and reporting for health service monitoring;
- extensive experience applying best practice monitoring and evaluation methodologies to designing and implementing monitoring systems that deliver continuous quality improvement and contribute to health system strengthening in more than one country (peer-reviewed publications will be an advantage);
- familiarity with DHIS2 and other health information managements systems, technologies, and software platforms used for health service evaluation, preferably integrated into national or sub-national programme ;
- technical expertise in monitoring facility-based infant and young child feeding programmes;
- capacity to work with multi-disciplinary teams;
- advanced verbal and written English communications skills; and
- excellent time management and organisational skills.
- Description of proposed activities, effort, milestones, and deliverables (Scope of Work).
- Proposed Budget (US $). This should outline the total amount for delivering the BFHI Internal Monitoring Manual, including an approximate breakdown of costs aligned to the Scope of Work.
For the purpose of the concept note, it is not necessary to describe the content of the manual.
Proposed timeline:
- Application deadline: 9 July 2021
- Proposal selection process completed: 23 July 2021
- Draft manual received: 8 October 2021
- Final manual received: 19 November 2021