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Nurse holding a newborn, while talking to the mother in a hospital room. Photo Credit: Fridah Bwari, Save the Children
Photo Credit: Fridah Bwari, Save the Children

The Baby-Friendly Hospital Initiative (BFHI) was launched by the World Health Organization and UNICEF over 30 years ago to encourage facilities providing maternity and newborn services to implement the Ten Steps to successful breastfeeding. These evidenced-based practices have been shown to increase breastfeeding initiation and duration. Step 2 of the Ten Steps, staff competency, highlights the importance of ensuring staff have sufficient knowledge, competence, and skill to support breastfeeding. There are several ways to build competencies, ideally through a combination of strategies, since there is no one-size-fits-all approach.

In Kenya, only 60 percent of babies under six months are exclusively breastfed. Skilled breastfeeding counseling can help improve breastfeeding practices and increase exclusive breastfeeding in babies under six months. To address this challenge, USAID Advancing Nutrition and the Kenya Ministry of Health identified key gaps and challenges in breastfeeding counseling in Kenya, held a workshop with stakeholders to identify an approach for strengthening breastfeeding counseling competencies, and, once mentorship was selected, co-created a mentorship program to strengthen skilled breastfeeding counseling competencies of health workers.

The goal of the mentorship program is to reinforce and strengthen the competencies of health workers who regularly counsel pregnant and lactating mothers on breastfeeding. It is intended to serve as a bridge between the BFHI Training Course for Maternity Staff and the Competency Verification Toolkit: Ensuring Competency of Direct Care Providers to Implement the BFHI.

The mentorship program package consists of implementation guidance and a training for mentors in the core concepts of mentorship. The Kenya Ministry of Health and USAID Advancing Nutrition tested the breastfeeding counseling mentorship program at Mbagathi County Referral Hospital in Nairobi County, Kenya, from March–September 2023. A manuscript is forthcoming detailing the findings of our research.

The draft program package is available below. Although this package was specifically designed and piloted in Kenya, many of the concepts and tools can be used in other country contexts with fairly little adaptation. 

Implementation Guidance for a Facility-Based Breastfeeding Counseling Mentorship Program

This document provides guidance for implementation of the facility-based breastfeeding counseling mentorship program. It provides background related to breastfeeding and breastfeeding counseling, the rationale for the breastfeeding counseling mentorship program, its goals and objectives, management structure, implementation process, and monitoring system. This document is for anyone who plays a role in the design, planning, and oversight of program implementation. 
It also includes illustrative slide decks for introducing key stakeholders and participants to the mentorship program as well as job aids and mentorship program tools for mentors and mentees.

The materials are available in editable formats (e.g., Word and PowerPoint) to enable adaptation.

Download the Implementation Guidance (English, Word, 1.23 MB)

Download Annex 2: Illustrative Slides for Sensitisation Meetings (English, PPTX, 11.56 MB)

Download Annex 2: Illustrative Slides for Inception Meetings (English, PPTX, 10.37 MB)

Download Annex 2: Illustrative Slides for Orientation Meeting with Mentors (English, PPTX, 9.34 MB)

Download Annex 2: Illustrative Slides for Orientation Meeting with Mentors and Mentees (English, PPTX, 10 MB)

Core Concepts in Mentorship Training for the Breastfeeding Counseling Mentorship Program

The Core Concepts in Mentorship Training course is required for all mentors participating in the breastfeeding counseling mentorship program. Designed to introduce mentors to basic mentoring skills, it includes sessions on interpersonal communication, clinical teaching, and mentoring in the context of the breastfeeding counseling mentorship program. It includes a variety of participatory exercises and activities to help mentors build the skills required to serve as a mentor and for effective clinical teaching. It consists of a facilitator’s guide, participant’s manual, and slide deck.

Download the Facilitator's Guide (English, Word, 16.91 MB)

Download the Participant’s Manual (English, Word, 15.66 MB)

Download the Slide Deck (English, PPTX, 13.6 MB)