Training Benchmark Examples

Example: Little data exists about the presence and quality of breastfeeding within medical pre-service education curriculums in the US. A seminal study in the US in 1995 on residency training for physicians caring for mothers, infants, and young children found that residents within all areas didn’t demonstrate effective breastfeeding management and care. Since then, the studies that have emerged in this area have shown that pre-service breastfeeding training for residents hasn’t significantly improved. The American Academy of Pediatrics (AAP) have developed a Breastfeeding Residency Curriculum and set of curriculum tools for residents (pre-service training) but these have not been adopted by all the institutions providing pre service training for health professionals.
Score: Minimal Progress
Domain- Existence: Yes
Domain- Coverage: Breastfeeding curriculum is not integrated within all pre-service programs.
Domain- Quality: Curriculum does not cover all the essential topics in Annex 4.

Example: The Ministry of Health of Viet Nam developed their IYCF training program based on WHO, UNICEF and Alive & Thrive training material. The 40 sessions, including 25 theory sessions and 15 practicals are focused on breastfeeding and complementary feeding. All the essential topics in Annex 4 are included in this training manual, with the exception of contraception.
Score: Partial Progress
Domain- Existence: Yes
Domain- Quality: All topics in Annex 4 (with the one exception of contraception) are included.
Domain- Effective: Not enough information to assess the level of integration of breastfeeding training into the curricula of all facility-based in-service programs.

Example: The Ministry of Health of Viet Nam developed their IYCF training program based on WHO, UNICEF and Alive & Thrive training material. The 40 sessions, including 25 theory sessions and 15 practicals are focused on breastfeeding and complementary feeding. All the essential topics in Annex 5 are included in this training manual, with the exception of contraception.
Score: Partial Progress
Domain: Existence: Yes
Domain: Quality: All topics in Annex 5 (with the one exception of contraception) are covered.
Domain- Effective: Not enough information to assess the level of integration of breastfeeding training into the curricula of all facility-based in-service programs.

Example: In Sri Lanka, grass-roots level maternal and child health care delivery is done by Public Health Midwives. They provide antenatal education and postnatal counseling, including improving breastfeeding skills, problem identification, intervention and referral. They receive the WHO/UNICEF 40 hour breastfeeding counseling training.
Score: Partial Progress
Domain: Existence: Yes
Domain: Quality: Course follows WHO curriculum, which includes all the essential topics in Annex 4.
Domain- Effective: Not enough information to assess the level of integration of breastfeeding training into the curricula of all facility-based in-service programs.

Example: In Sri Lanka, grass-roots level maternal and child health care delivery is done by Public Health Midwives. They provide antenatal education and postnatal counseling, including improving breastfeeding skills, problem identification, intervention and referral. They receive the WHO/UNICEF 40-hour breastfeeding counseling training.
Score: Partial Progress
Domain- Existence: Yes
Domain- Quality: Course follows WHO curriculum, which includes all the essential topics in Annex 5.
Domain- Effective: Not enough information to assess the level of integration of breastfeeding training into the curricula of all facility-based in-service programs.

Example: The Institute of Public Health Nutrition in Bangladesh developed their IYCF training program in consultation with key NGOs and based it on the results of surveys and formative research undertaken. The course content is also drawn from the WHO/PAHO Guiding Principles for Complementary Feeding of the Breastfed Child (2003), WHO’s Infant and Young Child Feeding Counseling: An Integrated Course (2006), and Academy for Educational Development’s Essential Nutrition Actions training module. The audience is all health workers involved with infant and young child feeding in Bangladesh and it was used to train BRAC’s existing cadre of CHWs - 11,000 frontline workers and supervisors - by integrating into their systems. The language is purposefully easy to understand and accessible to all level of professionals and workers. The training sessions involve brain storming, discussion, demonstration, case study, role play, question-answer, group work, group discussion etc. CHWs also undergo 1-3 days of field practice, supervised by a trainer who observes the trainees counseling a mother on breastfeeding, negotiating with mothers around 2-3 key practices, and demonstrating recommended practices. This training covers all the essential breastfeeding topics in Annex 4 except contraception and maternal absence.

Score: Partial Progress

Domain- Existence: Yes
Domain- Quality: Course covers most of the essential breastfeeding topics in Annex 4, with the exception of contraception and maternal absence.
Domain- Effective: Not enough information to assess the level of integration of breastfeeding training into the curricula of all facility-based in-service programs.

Example: The Institute of Public Health Nutrition in Bangladesh developed their IYCF training program in consultation with key NGOs and based it on the results of surveys and formative research undertaken. The course content is also drawn from the WHO/PAHO Guiding Principles for Complementary Feeding of the Breastfed Child (2003), WHO’s Infant and Young Child Feeding Counseling: An Integrated Course (2006), and Academy for Educational Development’s Essential Nutrition Actions training module. The audience is all health workers involved with infant and young child feeding in Bangladesh and it was used to train BRAC’s existing cadre of CHWs - 11,000 frontline workers and supervisors - by integrating into their systems. The language is purposefully easy to understand and accessible to all level of professionals and workers. The training sessions involve brain storming, discussion, demonstration, case study, role play, question-answer, group work, group discussion etc. CHWs also undergo 1-3 days of field practice, supervised by a trainer who observes the trainees counseling a mother on breastfeeding, negotiating with mothers around 2-3 key practices, and demonstrating recommended practices. This training covers all the essential breastfeeding topics in Annex 5 (including Code implementation) except contraception and maternal absence.

Score: Partial Progress
Domain- Existence: Yes
Domain- Quality: Course covers most of the essential breastfeeding topics in Annex 5, with the exception of contraception and maternal absence.
Domain- Effective: Not enough information to assess the level of integration of breastfeeding training into the curricula of all facility-based in-service programs.

Example: In Mexico, all the states have at least one qualified person to replicate training with other health professionals.
Score: Partial Progress
Domain- Existence: yes
Domain- Coverage: national and subnational level but not local level

Example: In Ghana, there are multiple programs and institutions that conduct training. However, there is no single institution to coordinate breastfeeding training and the situation is fragmented.
Score: Minimal Progress
Domain- Existence: Yes
Domain- Coverage: some level of coordination

Example: In Ghana, interviews with Program Managers in Reproductive Health and Child Health, Nutrition and reviewing the Ghana Health Service’s training courses and manuals (e.g. Safe Motherhood Protocol, Essential Care for Every Newborn, Helping Babies Breath, IMNCI, Essential Nutrition Actions, Community Management of Acute Malnutrition) demonstrated that breastfeeding is integrated into all the relevant training programs.
Score: Major Progress
Domain- Existence: Yes
Domain- Coverage: Breastfeeding skills and topics fully integrated into all related training programs.