PG1: There is a national breastfeeding promotion strategy that is grounded in the country’s context.
Example: The Healthy Eating – Healthy Action (HEHA) strategic framework was launched in 2004 by the Ministry of Health in New Zealand as an obesity prevention strategy, which had highlighted breastfeeding as a key message. A multipronged approach was used to implement the HEHA from 2004-2010 and included a breastfeeding promotion campaign that targeted New Zealand women and their families, with specific focus on Māori and Pacific women with the goal of increasing breastfeeding support.
The strategy was fully grounded in the country’s context as it was developed based on the following:
- Review of policy development and existing services and programs in New Zealand and the international literature
- Epidemiological report and study looking at mortality as a result of poor nutrition
- Focus groups held around the country, which included Maori, Pacific peoples, researchers and academics, the public, primary and personal health providers, key interest groups, and food industry groups
- Consultation on draft strategy and publication of the analysis of this feedback
- International peer review of draft strategy
- Implementation plan set in place
Score: Major Progress
Domain- Existence: Yes
Domain- Quality (1): Strategy based on extensive research, pre-tested through focus groups and consultation to ensure the cultural, social, economic, and literacy appropriateness, therefore is considered grounded in the country’s context.
Domain- Quality (2): Strategy supported by the HEHA Implementation Plan for 2004 – 2010.
PG2: The national breastfeeding promotion strategy is implemented.
Example: In 2008, the New Zealand MOH received government funding to implement a national breastfeeding promotion campaign targeted to improve breastfeeding initiation and duration, especially among high risk groups, such as the Māori and Pacific mothers. This campaign was supported by the Healthy Eating-Healthy Action (HEHA) strategic framework and implementation plan, which had highlighted breastfeeding as a key message. The breastfeeding promotion social marketing campaign aimed to improve individual and environmental breastfeeding support among New Zealand women, especially among Māori and Pacific mothers. Since then, another breastfeeding social marketing campaign was launched in 2009 and then expanded to include other social platforms with the goal of increasing communication exchange about breastfeeding.
The Ministry of Health had commissioned an evaluation of the HEHA strategy and early findings showed that there was effective coverage for the targeted subpopulation and that they broadly supported the strategy. The strategy’s implementation was restricted in 2009 and then abandoned in 2011 due to a change in government.
Score: Minimal Progress
Domain- Existence: Yes
Domain- Effective: Due to the strategy not being fully implemented and the evaluations not completed, it is not possible to assess whether breastfeeding awareness and practices were increased as a result of the campaign.
Domain- Coverage: There is anecdotal evidence that the coverage of the target population was high but there was no formal evaluation done to support this.
PG3: Government or civic organizations have raised awareness about breastfeeding.
Example:In 2008, a regional government and a civic organization partnered to launch a breastfeeding promotion campaign targeted to young women, ages 16-25, in England. The Be a Star campaign highlighted local breastfeeding young mothers as “Stars” for breastfeeding. These mothers were featured in ad campaigns that transformed them to look like models, actresses, singers, etc. to emphasize that breastfeeding is glamorous. The goal of the campaign was to “support these women through the breastfeeding process, via peer support and improve understanding and acceptance of breastfeeding within the community”. Within the first few months of the campaign, breastfeeding initiation rates among the target group increased 11% in the region.
Score: Partial Progress
Domain- Coverage: Campaign was run at a regional level and breastfeeding awareness was raised.