TRACT 5: MONITORING, EVALUATION AND RESEARCH GAPS

1. TRACT 5: MONITORING, EVALUATION AND RESEARCH GAPS

2. OBJECTIVES • To brainstorm on a core set of indicators that can be used for monitoring breastfeeding strategy • To brainstorm on questions that can be asked in evaluating breastfeeding strategy and practices • To discuss a way forward in developing an implementation plan for monitoring and evaluation of breastfeeding • Where are gaps in research to inform breastfeeding strategy

3. GUIDING QUESTION : MONITORING • What set of national indicators can be collected to monitor breastfeeding strategy? How often? Can breastfeeding indicators fit ion existing routine monitoring system (DHIS)? • Have those indicators been collected? Is there baseline on those indicators? • What data collection methods should be used? Are there existing collection mechanisms (e.g household surveys, routine systems)? • How can community health workers collect and report data on breastfeeding practices at community/household level?

4. GUIDE ON EVALUATION • What are evaluation questions should be asking? • How often should breastfeeding strategy be evaluated? • What type of evaluations should be conducted?

5. M&E STRATEGY • What should be our plan on M&E of breastfeeding • Do we have resources for M&E of breastfeeding?

6. M&E • Monitoring and Evaluation will be informed by the Goals and Objectives of National Breastfeeding Strategy • M&E- done at various levels • Facilities • Communities • District, Provincial and National • Focus on development and use of indicators to be collected using routine DHIS

7. Proposed National Indicators –Routinely collected using DHIS • Early initiation of breastfeeding (within one hour) • Mothers’ feeding practices on discharge (3 – 6 days) • Exclusive breastfeeding at 14 weeks (24 hour recall) • Continued breastfeeding at 9 months (24 hour recall) • Exclusive breastfeeding at 6 months(6months Vit A visit)

8. Proposed Process indicators • Breastfeeding trainings held. • Proportion of doctors, nurses, counsellors trained in breastfeeding counselling • Workshops held/promotion activities

9. Proposed Community level indicator • Need for monitoring child survival –targeting children outside the health facility

10. Research Gaps • Kind of support that stakeholders should offer to the breastfeeding mother • Assessing impacts and effects of programmes in improving child survival • Type of interventions needed to upscale breastmilkbanks • Factors affecting and influences on breastfeeding practices among mothers

11. Surveys • DHS and other 5 yearly surveys • As a source for baseline • Monitoring at population level • Annual SANHANES- inclusion of indicators on nutrition and infant feeding

12. Recommendations • Review of programme indicators in the DHIS including nutrition indicators. retain necessary and used indicators only • Submit inputs for inclusion of feeding practices and childe survival indicators to the SANHANES survey • Assessment of BFHI – all steps are carried • Facility should have dedicated officials to assess compliance by BFH whether hospital is still friendly • Development of Communication strategy and involvement of community based structures and understanding of breastfeeding stance by NGO’s • Breastfeeding promotion initiatives need to be budgeted and financed • Create a conducive environment (legislations ) to breastfeeding • Increase number of accredited Baby friendly PHC health facilities • Train CHWs to collect breastfeeding information and mortality informnation