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Indicators for assessing health facility practices that affect breastfeeding. Report of the Joint WHO / UNICEF Informal Interagency Meeting, 9-10 June 1992, WHO, Geneva.
Geneva, Switzerland, WHO, 1993. , 32 p. (WHO/CDR/93.1; UNICEF/SM/93.1)In March and June 1992, WHO and UNICEF held a joint informal interagency meeting on breast feeding at WHO headquarters in Geneva. The goal of the meeting was to reach consensus on the definitions of key breast feeding indicators which would allow one to assess whether health care facilities' procedures support, protect, and promote breast feeding practices. Section 2 of the meeting's summary report covers these indicators and their potential users. Identified potential users are maternity services, postnatal outpatient clinics including maternal and child health care services, pediatric inpatient services, and family planning services. Section 3 provides precise definitions of the indicators and the rational for their selection. Representatives from participating activities were asked to propose data collection methodologies to measure these indicators. The participating agencies included UNICEF, the WHO Working Group on Infant Feeding, The Population Council, World Alliance for Breastfeeding Action, Wellstart, the Institute for Reproductive Health at Georgetown University, USAID, the Swedish International Development Agency, and WHO. They agreed on health facility-based indicators of breast feeding. Section 4 discusses mainly indicators based on interviews with mothers at the time of infants' discharge or at the time of attending a clinic. It briefly covers those based on information collected from health facility staff or observation at the facility. The interviews with mothers were the basis for all the indicators agreed upon at the meeting, except for maternity services indicator 2 (breast milk substitutes and supplies receipt rate). Section 5 addresses methodological issues to be developed and sampling considerations. The annexes include a list of participants in the March and June meetings, sample data collection instruments (i.e., questionnaires), and breast feeding indicators for health facilities.