Baby friendly health facility initiative for improved infant and young child feeding practices: Sharing experience and lessons learned from Zambia

The Baby Friendly Health Facility Initiative (BFHFI) is an initiative of the World Health Organization and UNICEF to give every baby the best start in life by strengthening breastfeeding practices. In Zambia, BFHFI was launched in 1991. “Ten Steps to Successful Breastfeeding” and three additional components were developed to determine the extent that BFHFI activities are being implemented. Since the arrival of HIV, BFHFI achievements lost momentum as breastfeeding trends changed in efforts to reduce mother-to-child transmission of HIV. The Ministry of Health (MOH) with the USAID funded Zambia Integrated Systems Strengthening Program conducted focus group discussions with community volunteers and interviews with health facility staff and pregnant women on progress of implementing BFHFI in 25 health facilities in five districts to identify areas requiring strengthening. Six of the 25 health facilities implemented at least 10 of the 13 steps indicating a high commitment to achieving BFHFI status. Ninety-five percent of healthcare workers and 85% of pregnant women had knowledge about the importance of HIV testing in pregnancy demonstrating that messaging on HIV and infant and young child feeding (IYCF) was adequately retained. Seventy-two percent of facilities did not have coordinated community support groups that link with the health facilities hindering the necessary provision of the IYCF continuum of care. MOH and its partners need to take deliberate moves to strengthen BFHFI to improve breastfeeding practices and improve service delivery for IYCF at facility and community levels for the health and well-being of the infant.