bfhi

1. BABY FRIENDLY
HOSPITAL INITIATIVE
Bandana Yadav
M.Sc. Nursing,1st Year (B-2023)
B. P. Koirala Institute of Health Sciences,
Dharan

3. INTRODUCTION
• Baby Friendly Hospital Initiative (BFHI)
was launched in 1992 in India,
• As a part of 'Innocenti declaration' on
breastfeeding

4. INTRODUCTION (CONTD…)
• The historic Innocent Declaration on the
promotion, protection and support of
breastfeeding was produced and adapted
by participants at the WHO/UNICEF
• policy makers' meeting on breastfeeding
in the 1990s, held at the Spedale degli
Innocenti, Florence, Italy, on July 30 to
August 1st, 1990.

5. INTRODUCTION (CONTD…)
• The global initiative was cosponsored by
the USAID and SIDA.
• The baby friendly hospital campaign was
launched by the WHO/UNICEF, in mid-
1991 in Ankara to boost the breastfeeding
practices and to counter the trends of
bottle feeding.

6. INTRODUCTION (CONTD…)
• The goals of the declaration included a
call to the various governments in the
word to act and create an environment for
exclusive breastfeeding
• from birth of the baby till she/he is 6
months old and to continue breastfeeding
with adequate complementary foods for
up to two years.

7. INTRODUCTION (CONTD…)
• Baby friendly hospitals are required to
adopt breast- feeding policy and to follow
the "Ten steps of successful
breastfeeding' as recommended by code
of practice of WHO/ UNICEF.
•

9. TEN STEPS OF SUCCESSFUL
BREASTFEEDING
1. Have a written breastfeeding policy
that is routinely communicated to all
health care staff
2. Train all health care staff in skills
necessary to implement this policy.
3. Inform all pregnant women about the
benefits and management of
breastfeeding.

10. TEN STEPS OF SUCCESSFUL
BREASTFEEDING
 4. Help mothers to initiate breastfeeding
within half an hour of birth.
5. Show mothers how to breastfeed and
how to maintain lactation even if they
should be separated from their infants.
 6. Give newborn infants no food or drink
other than breast milk, unless medically
indicated.

11. TEN STEPS OF SUCCESSFUL
BREASTFEEDING (CONTD…)
7. Practice rooming-in. Allow mothers
and infants to remain together 24 hours a
day.
9. Give no artificial teats or pacifiers
(also called dummies or soothers) to
breastfeeding infants.

12. TEN STEPS OF SUCCESSFUL
BREASTFEEDING (CONTD…)
10. Foster the establishment of
breastfeeding support groups and refer
mothers to them on discharge from
the hospital or clinic.

13. STEPS (CONTD…)
 Indian hospitals are still in early stages
of joining this movement.
The National BPHI task force was
formed in 1992, towards the efforts to
improve the breastfeeding practices

14. STEPS (CONTD…)
The task force comprising of
Government of India, UNICEF WHO
 And professional organizations (TNAI,
BPNI, NNE, IMA, FOGSI, IAP CMAL
CHAI, IBFAN, ACASH) is working for
evaluation of breastfeeding practices in
the hospitals and appropriate certification
as 'Baby Friendly Hospital.

15. STEPS (CONTD…)
The certificate needs re-recognition on
every two years to ensure the standard
and quality for successful breastfeeding.
Besides promotion of breastfeeding, baby
friendly hospital initiative in India also
proposes to provide:

16. STEPS (CONTD…)
• Improved antenatal care
• Mother friendly delivery services
• Standardized institutional support of
immunization

17. STEPS (CONTD…)
• Diarrhea management
• Promotion of healthy growth and good
nutrition
• Widespread availability and adoption of
family planning.

18. STEPS (CONTD…)
• Government of India has made
significant efforts to promote and protect
breastfeeding by enacting a law
• "The Infant Milk Substitutes, Feeding
Bottles and Infant Food Act, 1992:

19. STEPS (CONTD…)
• The act prohibits advertising of infant
milk substitutes (IMS) and feeding
bottles to public
• Free sampling, hospital promotion and
gifts of samples of IMS to health
workers. Violation of the act can lead to
fine or imprisonment.

21. INTEGRATED CHILD
DEVELOPMENT SERVICES
• At present, the most important scheme in
the field of child welfare is the Integrated
Child Development Services (ICDS)
scheme.

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23. ICDS ( Contd…)
• In pursuance of the national policy for
children, Government of India started
ICDS program in 1975, under the
Ministry of Social and Women's Welfare.

24. ICDS (Contd…)
• The ICDS program was initiated for the
welfare of the children and development
of human resources.
• It is designed for both preventive and
development effort through a integrated
package services.

25. ICDS (Contd…)
• The beneficiaries of the program are
children up to 6 years, adolescent girls
(11-18 years),
• pregnant women,
• Nursing mothers and
• women of 15 to 45 years.

26. ICDS (Contd…)
• ICDS scheme is working at village level
in rural areas and also in urban and tribal
areas.
• In 1975, number of ICDS projects was
only 33, which was started on
experimental basis.

27. ICDS (Contd…)
• At present, the ICDS projects are
functioning in 5422 blocks all over the
country.

28. ICDS (Contd…)
The Kishori Shakti Yojna, Adolescent girls
scheme is sanctioned in 2000 ICDS blocks
as special interventions for the benefits of
3.51 lakhs adolescent girls in the age group
of 11 to 18 years.
NGOs are also involved in running Angan
wadi centers in 67 ICDS projects.
World Bank assisted ICDS projects are also
working in some states.

30. Objectives
• The objectives of the ICDS scheme are:
• To improve the nutritional and health
status of children in the age group of 0 to
6 years
• To lay the foundations for proper
psychological, physic and social
development of the child.

31. Objectives (Contd…)
• To reduce mortality, morbidity,
malnutrition and school dropout.
• To achieve an effective coordination of
policy and implementation among the
various departments working for the
promotion of child development.

32. Objectives (Contd…)
• To enhance the capability of the mother
and to provide nutritional needs of the
child through proper nutrition and health
education.

33. Objectives (Contd…)
• To achieve the above objectives the
following package services are provided
to different categories of beneficiaries.
For Children Less than 3 Years
• Supplementary nutrition
• Immunization
• Health checkup
• Referral services.

34. Objectives (Contd…)
• For Children in Age Group 3 to 6 Years
• Supplementary nutrition
• Immunization
• Health checkup
• Referral services
• Non-formal preschool education.

35. Objectives (Contd…)
• For Adolescent Girls 11 to 18 Years
• Supplementary nutrition
• Nutrition and health education.

36. Objectives (Contd…)
• For Pregnant Women
• Health checkup
• Immunization against tetanus
• Supplementary nutrition
• Nutrition and health education

37. Objectives (Contd…)
• For Nursing Mothers
• Health checkup
• Supplementary nutrition
• Nutrition and health education.

38. Objectives (Contd…)
Other Women of 15 to 45 Years Age
Group
• Nutrition and health education.

39. Delivery of Services
• The services are delivered by the
Anganwadi worker (AWW) at the ICDS
center for about 1000 population.
• She is assisted by local women, who are
usually uneducated and unskilled person.

40. Delivery of Services ( Contd…)
• AWW has 4 months training in
fundamentals of child development,
nutrition, immunization, personal
hygiene, environmental sanitation
• Antenatal care, breastfeeding, care and
treatment of common day to day illness
• Identification and management of at-risk
children, preschool education, functional
literacy and record keeping.

41. Delivery of Services ( Contd…)
• The activities of AWW are supervised by
a supervisor or mukhya sevika, who is a
graduate and having special training for
two months.
• Each supervisor is responsible for 20 to
25 AWWS.

42. Delivery of Services ( Contd…)
• The Child Development Project Officer
(CDPO) is the in-charge of ICDS
projects, supervises the activities of four
mukhya sevika or supervisors.

43. Delivery of Services ( Contd…)
• The administrative unit of an ICDS
project is the 'community development
block' in rural areas, the tribal
development block in tribal areas and a
group of slums in urban areas.

44. Delivery of Services ( Contd…)
• ICDS scheme is an important aspect of
child welfare to improve the health,
• Nutrition and
• Education status of the underprivileged
children and mothers. It is much more
than a health program.

45. Delivery of Services ( Contd…)
• The impact of program on the lives of
children is evident in several important
indicators, i.e.
• Increased birth weight,
• Reduced incidence of malnutrition,
• Increased immunization coverage and
• A reduction in infant and child mortality
rate in areas covered by the ICDS.

46. NATIONAL HEALTH MISSION
• The National Health Mission (NHM)
encompasses its two submissions, the
National Rural Health Mission (NRHM)
and the newly launched National Urban
Health Mission UHM).
• The main programmatic components
include health system strengthening in
rural and urban areas,

47. NATIONAL HEALTH MISSION
(CONTD…)
Reproductive, Maternal- Neonatal- Child
and Adolescent health(RMNCH+𝐴) and
Communicable and Noncommunicable
Diseases
The NHM envisages achievement
universal access to equitable, affordable
and quality health Services that are
accountable and responsive to people's

48. National Rural Health Mission
• National Rural Health Mission (NRHM)
was launched by the Hon’ble Prime
Minister of Government of India on 12 th
April 2005 for the period of 7 years in
(2005-2012).
• The mission seeks to improve rural
health care delivery system on nutrition,
sanitation, hygiene and safe drinking
water by making necessary changes in
basic health care delivery system.

49. National Rural Health Mission
(CONTD…)
• It also brings the Indian system of
medicine (AYUSH) to the main stream of
health care.

50. National Rural Health Mission
(CONTD…)
• The main aim of NRHM is to provide
accessible,
• Affordable,
• Accountable,
• Effective and
• Reliable primary health care and
bridging the gap in rural health care
through creation of a cadre of ASHA.

51. National Rural Health
Mission(CONTD…)
• Strengthening of sub-centers, primary
health centers (PHCs) and community
health centers (CHCs) are important plan
under NRHM.
• District becomes the core unit of
planning, budgeting and implementation
of programs.

52. National Rural Health Mission
(CONTD…)
• According to NRHM plan all vertical
health and family welfare programs at
district level should be merged into one
common 'District Health Mission' and at
state level into 'State Health Mission!
• There should be provision of mobile
medical unit and public private
partnership (PPP model) under this
program.

53. National Rural Health Mission
(CONTD…)
• Goals to be achieved by NRHM were
formulated clearly. Role and responsibilities
of ASHA, Angan wadi, and ANMS were well
defined under this program.
• Monitoring and evaluation of activities is
planned and done based on process indicators
and outcome indicators of the mission.

54. National Rural Health Mission
(CONTD…)
• Several new initiatives are launched to
boost maternal- neonatal care under
NRHM.
• They include Janani Suraksha Yoyana
(JSY), Facility Based Newborn Care
(FBNC), Home Based Neonatal Care
(HBNC), Navjat Shishu Suraksha
Karyakram (NSSK)

56. National Rural Health Mission
(CONTD…)
• Janani Shishu Suraksha Karyakram
(JSSK) and
• Rashtriya Bal Suraksha Karyakram
(RBSK).

57. National Urban Health Mission
(New Scheme)
• The National Urban Health Mission
(NUHM) as a sub-mission of National
Health Mission (NHM) has been
approved by the Cabinet on 1st May,
2013.

58. National Urban Health Mission (New
Scheme) (CONTD…)
• NUHM envisages to meet health care
needs of the urban population with the
focus on urban poor, by making available
to them essential primary health care
services and reducing their out of pocket
expenses for treatment.

59. National Urban Health Mission (New
Scheme) (CONTD…)
• This will be achieved by strengthening
the existing health care service delivery
system, targeting the people living in
slums and converging with various
schemes relating to wider determinants of
health like drinking water, sanitation,
school education, etc.

60. National Urban Health Mission (New
Scheme) (CONTD…)
• Implemented by the Ministries of Urban
Development,
• Housing and
• Urban Poverty Alleviation, Human
Resource Development and Women and
Child Development.

61. India Newborn Action Plan
(INAP)
• India Newborn Action Plan (INAP) was
launched in September 2014 for
accelerating the reduction of preventable
neonatal death and still births in the
country with the goal of attaining 'Single
Digit Neonatal Mortality Rate (NMR) by
2030' and 'Single Digit Still Birth Rate
(SBR) by 2030

62. India Newborn Action Plan
(INAP)
• The India Newborn Action Plan (INAP)
is India's committed response to the
Global Every Newborn Action Plan
(ENAP) launched in June 2014 to
advance the Global Strategy for Women's
and Children's Health.