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5-meeting Process

The 5-meeting process is the toolbox component that guides countries in how to implement BBF. As illustrated in the timeline above, 5 meetings are held over several months to score the BBFI, identify gaps, and develop recommendations as well as actions. There are several factors that need to be in place before implementing BBF. First, the country needs to have:

  1. a demonstrated need to improve breastfeeding practices and the supporting environment,
  2. a level of country commitment to improve the breastfeeding friendly environment,
  3. a window of opportunity for your country to move forward with recommendations to strengthen the breastfeeding friendly environment,
  4. adequate resources are available to support implementing BBF

When these are in place, it provides a strong foundation for your country to start BBF. Prior to beginning the 5-meeting process, you begin planning and setting BBF up. To do this requires:

  • Generating and ensuring country commitment
  • Identifying an in-country director and support staff
  • Engaging stakeholders
  • Identifying 10-12 experts to form a BBF country committee to implement BBF
  • Developing a workplan

See Implementing BBF for more detail on roles and process.

First Meeting

The first meeting is suggested to be a two-day meeting for the BBF committee to gather and begin BBF. During this meeting, the following is done:

  • Presentation of BBF Index (BBFI) and scoring methodology
  • Committee members are assigned to gear teams (Gear teams are small groups of BBF committee members, around 3, that are assigned to collect data and score benchmarks for specific gears. Committee members can be assigned to more than one gear team. However, it is recommended that committee members assigned to score the 17 benchmarks comprising the training & program delivery gear are not assigned to any other gears)
  • Identify sources of information to score benchmark
  • Teams develop Data Gathering Action Plans to provide a data collection plan. The Data Gathering Action Plans are located within gear packages. They are intended for the in-country BBF director and support staff to use as well as BBF Committee Members. Each gear package is given to the respective gear team for them to use during the rest of the 5 meeting process. Each gear package contains the following sections:
    • General description of the gear
    • Gear benchmark and examples
    • Identification of Available Data template: guide the identification of data (prior to Meeting 1)
    • Data Gathering Action Plan: gear teams set out their strategies to gather the remaining information needed to score each benchmark (Meeting 1)
    • Data Organization template and Benchmark Scoring Pathways: help organize the information collected for each benchmark and the Scoring Pathways are designed to assist with the actual scoring (Meetings 2 & 3)
    • Recommendations for action template: gear teams outline/describe their proposed actions to address the gaps identified for the gear (Meeting 4)

It is essential that minutes of all the meetings are taken to document evidence and changes in the scoring of the benchmarks throughout the 5-meeting process. A template is provided below but countries can use their own version, if desired.

Interim Between First and Second Meeting

It is recommended that the second meeting is scheduled for approximately 2 months after the first meeting. Between the first and second meeting, the BBF committee and the hired staff work to collect the data for each of the 54 benchmarks (each gear team works to collect their own data in collaboration with the staff hired to support BBF implementation). During that time, the gear teams also document their progress and conduct preliminary scoring of the benchmarks using the Gear Packages. The Gear Examples are intended to guide gear teams with scoring the benchmarks and can be used as well. Gear teams may need to meet multiple times to be able to reach consensus on the initial benchmark scores and update their presentations for the second meeting.

Second Meeting

When the second meeting is held, there are several activities that take place during this day-long meeting:

  • Gear teams present their progress with the preliminary benchmark scoring and highlight initial gaps found within their gear. The presentation templates for each gear team are provided below.
  • The BBF Committee works to reach consensus on each of the benchmark scores and begins discussing recommendations and actions to address those gaps. The Gear Packages are important to use during this time to help document the benchmark changes and recommendations.

Interim Between Second and Third Meeting

It is recommended that the third meeting is scheduled two months after the second meeting to allow time for the gear teams to meet in between meetings and finalize individual benchmark scores for their respective gears. At this time, additional data may need to be collected to fully inform the gear teams so that they are able to finalize benchmark scores. At this time, gear teams also develop recommendations based on identified gaps. Gear teams may need to meet multiple times to be able to reach consensus on the final benchmark scores, document preliminary recommendations, and update their Gear Packages and presentations for the third meeting. When developing preliminary recommendations, the Experienced Based Briefs can help guide gear teams.

Third Meeting

When the third meeting is held, there are several activities that take place during this day-long meeting:

  • Gear teams present on final benchmark scores and committee works to reach consensus on them
  • Gear teams present initial recommendations for action and committee discusses them to generate an agreed upon list of recommendations
  • Eight gear scores and the country BBF score is calculated using the BBF Calculator

Interim Between Third and Fourth Meeting

Between the third and fourth meeting, the in-country director and support staff generate a survey containing the full list of recommendations (see Support Tools, Writing and Prioritizing Recommendations). This survey is distributed to all committee members so that the recommendations can be evaluated on the criteria of effectiveness, affordability, and feasibility. Once results have been calculated, a presentation on the scores for each recommendation is developed to present at the 4th meeting.

Fourth Meeting

The fourth meeting is scheduled approximately 1 month after the third meeting and is intended to last approximately 1 day. During this meeting, the scores for each recommendation are presented and the committee discusses and reaches consensus on the prioritized recommendations. The committee also reaches consensus on the proposed actions needed to implement the recommendations.

Interim Between Fourth and Fifth Meeting

Between the fourth and fifth meeting, the in-country director and support staff work with the committee to develop dissemination materials (see Support Tools, Dissemination Tools) that will be shared at the first meeting. Preparations for the fifth meeting need to be undertaken during this time to invite key decision makers and stakeholders, prepare presentation of BBFI results and recommendations, develop agenda, etc.

Fifth Meeting

The fifth meeting is a Call to Action meeting so that key decision makers and stakeholders can come together to learn about BBF findings, hear recommendations as well as proposed plan of actions, and discuss next steps and future commitment. It is essential that there is strong media coverage and a clear articulation of the call to action.