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Pilot testing of the Becoming Breastfeeding Friendly toolbox in Ghana

BACKGROUND: Ghana has achieved significant progress in breastfeeding practices in the past two decades. Further progress is, however, limited by insufficient government funding and declining donor support for breastfeeding programs. The current study pretested feasibility of the Becoming Breastfeedi...

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Autores principales: Aryeetey, Richmond, Hromi-Fiedler, Amber, Adu-Afarwuah, Seth, Amoaful, Esi, Ampah, Gifty, Gatiba, Marian, Kwakye, Akosua, Otoo, Gloria, Plange-Rhule, Gyikua, Sagoe-Moses, Isabella, Selenje, Lilian, Pérez-Escamilla, Rafael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6042403/
https://www.ncbi.nlm.nih.gov/pubmed/30008793
http://dx.doi.org/10.1186/s13006-018-0172-y
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author Aryeetey, Richmond
Hromi-Fiedler, Amber
Adu-Afarwuah, Seth
Amoaful, Esi
Ampah, Gifty
Gatiba, Marian
Kwakye, Akosua
Otoo, Gloria
Plange-Rhule, Gyikua
Sagoe-Moses, Isabella
Selenje, Lilian
Pérez-Escamilla, Rafael
author_facet Aryeetey, Richmond
Hromi-Fiedler, Amber
Adu-Afarwuah, Seth
Amoaful, Esi
Ampah, Gifty
Gatiba, Marian
Kwakye, Akosua
Otoo, Gloria
Plange-Rhule, Gyikua
Sagoe-Moses, Isabella
Selenje, Lilian
Pérez-Escamilla, Rafael
author_sort Aryeetey, Richmond
collection PubMed
description BACKGROUND: Ghana has achieved significant progress in breastfeeding practices in the past two decades. Further progress is, however, limited by insufficient government funding and declining donor support for breastfeeding programs. The current study pretested feasibility of the Becoming Breastfeeding Friendly (BBF) toolbox in Ghana, to assess the existing enabling environment and gaps for scaling-up effective actions. METHODS: Between June 2016 and April 2017, a 15-person expert country committee drawn from government and non-government agencies was established to implement the BBF toolbox. The committee used the BBF index (BBFI), comprising of 54 benchmarks and eight gears of the Breastfeeding Gear Model (advocacy; political will; legislation and policy; funding and resources; training and program delivery; promotion; research and evaluation; and coordination, goals and monitoring). Available evidence (document reviews, and key informant interviews) was used to arrive at consensus-scoring of benchmarks. Benchmark scores ranged between 0 (no progress) and 3 (major progress). Scores for each gear were averaged to estimate the Gear Total Score (GTS), ranging from 0 (least) to 3.0 (strong). GTS’s were aggregated as a weighted average to estimate the BBFI which ranged from 0 (weak) to 3.0 (outstanding). Gaps in policy and program implementation and recommendations were proposed for decision-making. RESULTS: The BBFI score was 2.0, indicating a moderate scaling-up environment for breastfeeding in Ghana. Four gears recorded strong gear strength: advocacy (2.3); political will (2.3); legislation and policy (2.3); and coordination, goals and monitoring (2.7). The remaining four gears had moderate gear strength: funding and resources (1.3); training and program delivery (1.9); promotion (2.0); and research and evaluation (1.3). Key policy and program gaps identified by the committee included sub-optimal coordination across partners, inadequate coverage and quality of services, insufficient government funding, sub-optimal enforcement of policies, and inadequate monitoring of existing initiatives. Prioritized recommendations from the process were: 1) strengthen advocacy and empower breastfeeding champions, 2) strengthen breastfeeding regulations, including maternity protection, 3) strengthen capacity for providing breastfeeding services, and 4) expand and sustain breastfeeding awareness initiatives. CONCLUSIONS: The moderate environment for scaling-up breastfeeding in Ghana can be further strengthened by addressing identified gaps in policy and programs. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13006-018-0172-y) contains supplementary material, which is available to authorized users.
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spelling pubmed-60424032018-07-13 Pilot testing of the Becoming Breastfeeding Friendly toolbox in Ghana Aryeetey, Richmond Hromi-Fiedler, Amber Adu-Afarwuah, Seth Amoaful, Esi Ampah, Gifty Gatiba, Marian Kwakye, Akosua Otoo, Gloria Plange-Rhule, Gyikua Sagoe-Moses, Isabella Selenje, Lilian Pérez-Escamilla, Rafael Int Breastfeed J Research BACKGROUND: Ghana has achieved significant progress in breastfeeding practices in the past two decades. Further progress is, however, limited by insufficient government funding and declining donor support for breastfeeding programs. The current study pretested feasibility of the Becoming Breastfeeding Friendly (BBF) toolbox in Ghana, to assess the existing enabling environment and gaps for scaling-up effective actions. METHODS: Between June 2016 and April 2017, a 15-person expert country committee drawn from government and non-government agencies was established to implement the BBF toolbox. The committee used the BBF index (BBFI), comprising of 54 benchmarks and eight gears of the Breastfeeding Gear Model (advocacy; political will; legislation and policy; funding and resources; training and program delivery; promotion; research and evaluation; and coordination, goals and monitoring). Available evidence (document reviews, and key informant interviews) was used to arrive at consensus-scoring of benchmarks. Benchmark scores ranged between 0 (no progress) and 3 (major progress). Scores for each gear were averaged to estimate the Gear Total Score (GTS), ranging from 0 (least) to 3.0 (strong). GTS’s were aggregated as a weighted average to estimate the BBFI which ranged from 0 (weak) to 3.0 (outstanding). Gaps in policy and program implementation and recommendations were proposed for decision-making. RESULTS: The BBFI score was 2.0, indicating a moderate scaling-up environment for breastfeeding in Ghana. Four gears recorded strong gear strength: advocacy (2.3); political will (2.3); legislation and policy (2.3); and coordination, goals and monitoring (2.7). The remaining four gears had moderate gear strength: funding and resources (1.3); training and program delivery (1.9); promotion (2.0); and research and evaluation (1.3). Key policy and program gaps identified by the committee included sub-optimal coordination across partners, inadequate coverage and quality of services, insufficient government funding, sub-optimal enforcement of policies, and inadequate monitoring of existing initiatives. Prioritized recommendations from the process were: 1) strengthen advocacy and empower breastfeeding champions, 2) strengthen breastfeeding regulations, including maternity protection, 3) strengthen capacity for providing breastfeeding services, and 4) expand and sustain breastfeeding awareness initiatives. CONCLUSIONS: The moderate environment for scaling-up breastfeeding in Ghana can be further strengthened by addressing identified gaps in policy and programs. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13006-018-0172-y) contains supplementary material, which is available to authorized users. BioMed Central 2018-07-11 /pmc/articles/PMC6042403/ /pubmed/30008793 http://dx.doi.org/10.1186/s13006-018-0172-y Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Aryeetey, Richmond
Hromi-Fiedler, Amber
Adu-Afarwuah, Seth
Amoaful, Esi
Ampah, Gifty
Gatiba, Marian
Kwakye, Akosua
Otoo, Gloria
Plange-Rhule, Gyikua
Sagoe-Moses, Isabella
Selenje, Lilian
Pérez-Escamilla, Rafael
Pilot testing of the Becoming Breastfeeding Friendly toolbox in Ghana
title Pilot testing of the Becoming Breastfeeding Friendly toolbox in Ghana
title_full Pilot testing of the Becoming Breastfeeding Friendly toolbox in Ghana
title_fullStr Pilot testing of the Becoming Breastfeeding Friendly toolbox in Ghana
title_full_unstemmed Pilot testing of the Becoming Breastfeeding Friendly toolbox in Ghana
title_short Pilot testing of the Becoming Breastfeeding Friendly toolbox in Ghana
title_sort pilot testing of the becoming breastfeeding friendly toolbox in ghana
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6042403/
https://www.ncbi.nlm.nih.gov/pubmed/30008793
http://dx.doi.org/10.1186/s13006-018-0172-y
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