DATA COLLECTION – WHAT
IS NEEDED FOR BFI
DESIGNATION:
ARE WE THERE YET?
MARINA GREEN RN MSN
BREASTFEEDING COMMITTEE FOR CANADA
APRIL, 2015
1
Data collection and surveillance of key
breastfeeding statistics are both
requirements for Baby-Friendly designation
and strategies for program implementation
and evaluation. During this panel
discussion the presenter will outline and
address questions about the required
breastfeeding data collection necessary for
Baby-Friendly designation in Canada.
2
BFI DESIGNATION
ASSESSMENT
What it is
• recognition of good
practice (minimal
standard)
• based on outcomes
What it is not
• forensic audit!
• research
• destination
• reliant on mothers and
families
• qualitative
• quantitative
• aware that nothing is
perfect!
3
ARE WE THERE YET?
What is the purpose of data
collection?
• Meet BFI criteria
• Meet International Child
Health Targets
• Measure progress
• Assess program
effectiveness
• Determine areas of focus
(e.g. caesarean rate)
4
DATA COLLECTION
• Valid Process
• Initiation
• Exclusivity
• Duration
5
OVERVIEW OF BFI DATA
INDICATORS
HOSPITAL
COMMUNITY
6
BFI
HOSPITAL INDICATORS
“it’s in the book”
Step 6
Support mothers to exclusively breastfeed
for the first six months, unless
supplements are medically indicated.
7
FOR HOSPITALS AND BIRTHING CENTRES,
THE MANAGER PROVIDES ANNUAL DATA
FOR THE FACILITY SHOWING :
• breastfeeding initiation rates
P. 9 BFI Indicators
• exclusive breastfeeding rates of babies from birth to discharge
(minimum 75%)
• supplementation rates (medically-indicated and non-medically
indicated)
• describes a reliable system of data collection
8
APPENDIX 6.1: DATA COLLECTION OF
BREASTFEEDING RATES
9
Page 28
APPENDIX 6.3: CALCULATION OF BREASTFEEDING
RATES – HOSPITALS
Page 32
10
APPENDIX 6.3: CALCULATION OF BREASTFEEDING
p.32
RATES – HOSPITALS
11
DOING THE MATH (WHAT IS THE DENOMINATOR?)
100
A/T= 80%
80
80
7
5
3
3
12
DOING THE MATH EXAMPLE 2
A/T = 73%
A+B= 79% (73+6=79%)
T
73
6
7
13
QUESTIONS
• What: initiation rates
• what is the mother’s intent?
• other indicators may require more details (e.g. Step 4)
• Who: applies to all live babies born in the facility
• How: reliable method
• where is the data recorded
• who records the data
14
COMMUNITY FACILITIES: STEP 6 INDICATORS
p.9
AND
15
APPENDIX 6.1 DATA COLLECTION
*
16
p28
APPENDIX 6.4: CALCULATION OF EXCLUSIVE
BREASTFEEDING
17
IF NO
18
What’s wrong with this picture?
BREASTFEEDING AT DISCHARGE
Exclusive Breastfeeding
Some
None
BREASTFEEDING AT 2 MONTHS
Exclusive breastfeeding
5%
Some
None
7%
6%
20%
75%
87%
Babies = 100
Exclusive = 75
Percentage = 75%
Babies = 75
Exclusive = 65
Percentage = 87%
19
BREASTFEEDING AT 2 MONTHS
Exclusive Breastfeeding
Some
None
BREASTFEEDING AT 2 MONTHS
Exclusive = 65
Percent = 65%
15%
Exclusive breastfeeding
Some
None
7%
6%
20%
65%
87%
20
6.2 MEDICAL INDICATIONS FOR SUPPLEMENTS
21
Page 30
SURVEILLANCE
THE WHO GLOBAL STRATEGY FOR INFANT AND
YOUNG CHILD FEEDING
•A Strategy to promote, protect and support
appropriate infant and young child feeding
•Baby-friendly Hospital Initiative (1991),
•International Code of Marketing of Breast-milk
Substitutes (1981)
•Innocenti Declaration on the Protection, Promotion
and Support of Breastfeeding (1990, 2005)
22
ROLES OF CRITICAL PARTNERS
• governments, organizations and other concerned
parties
• specific responsibilities for each to ensure that the
sum of their collective action will contribute to the
full attainment of the strategy’s aim and
objectives.
23
SURVEILLANCE
“to develop, implement, monitor and
evaluate a comprehensive policy on infant
and young child feeding, in the context of
national policies and programmes for
nutrition, child and reproductive health,
and poverty reduction”
24
Perinatal Health Indicators for Canada 2013
25
Perinatal Health Indicators for Canada 2013
26
INNOCENTI 2005
• Establish sustainable systems for monitoring infant and
young child feeding patterns and trends and use this
information for advocacy and programming.
• Monitor progress in appropriate infant and young child
feeding practices and report periodically, including as
provided in the Convention on the Rights of the Child.
27
28
29
BREASTFEEDING DEFINITIONS
*what happened to ‘total’
breastfeeding
30
31
32
33
34
35
36
QUESTIONS
37
STRATEGIES ACROSS CANADA
• How to collect data after the initial contact
• How are people working to align the data definition and collection periods
between hospitals and community health services?
• Any unique suggestions on how to collect the data (software programs, places
to pull the data from)?
• What time intervals are other health units using to collect infant feeding
surveillance.
38
HAND OUTS
Please print (and read)
• pages 9-10 and 28-33 BCC Integrated Ten Steps Practice Outcome Indicators
May 2012 http://www.breastfeedingcanada.ca/documents/2012-0514_BCC_BFI_Ten_Steps_Integrated_Indicators.pdf
• Breastfeeding Definitions and Data Collection Periods
http://www.breastfeedingcanada.ca/documents/BCC_BFI_Breastfeeding_Defi
nitions_and_Data_Collection_English.pdf
• Questions and Answers (attached)
39