In the fall of 2020, the Demographic and Health Surveys (DHS) Program organized communities of practice to develop recommendations for improving the data collection instruments used in the Service Provision Assessment (SPA). In January 2021, the nutrition working group, coordinated by DataDENT at Johns Hopkins University, provided recommendations to enhance data collection related to the implementation of the Baby-Friendly Hospital Initiative (BFHI).

Some examples include documentation of policies that reflect compliance with the International Code on Marketing of Breast Milk Substitutes, collecting data on the percent of health providers that have recently (within 2 years) received training on early and exclusive breastfeeding, and collecting data from mothers after their post-natal visit to understand whether health providers are adhering to breastfeeding friendly practices around the time of delivery.

These practices include, for example, support for immediate breastfeeding, skin-to-skin contact, and rooming in. In addition, the group has recommended that SPAs be used to calculate the number of facilities that comply with eight of the 10 steps of the BFHI. These BFHI-related recommendations are currently being reviewed by the DHS Program and USAID. The DHS Program will host a series of consultative meetings in April and May to further refine these and other recommendations related to the SPA data collection instruments.