BFHI is an important element of breastfeeding promotion and support and an approach that reached, trained, and energized a critical audience: professional and para-professional groups. In 1991 UNICEF and WHO launched the Baby-friendly Hospital Initiative with its Ten Steps to Successful Breastfeeding. A year later eight hospitals were designated baby friendly in Bangladesh. In 1994 the Director General of Health Services approved and initiated implementation of the new hospital policy developed by BBF that included the Ten Steps along with five additional steps.3 This policy was distributed to all hospitals.

Today 498 out of 670 government maternity services4 (74 percent) are designated “baby friendly.” At one point baby-friendly certified hospitals represented more than one-third of all government and private hospitals, but the number of registered private hospitals continues to grow rapidly. The exact number of functioning private hospitals is unknown, and the percentage of all hospital births that take place in baby friendly hospitals is not available.

BBF achievement of BFHI

• 498 out of 650 health facilities have been declared as Baby Friendly Hospitals;
• Conducted BFHI training course on maternity service facilities and trained 14,670 doctors and nurses;
• Conducted TOT on the management of breastfeeding for 518 trainers of nutrition programs
• Conducted training on the management of Breastfeeding for 715 paramedics from 74 NGOs.
• Breastfeeding management centres have been established in 20 Medical College Hospitals and other hospitals;
• Developed Curriculum and trained internee doctors and nurses of Rangpur Medical College Hospitals;
• Conducted 40-hours counseling course of 40 trainees;
• Baby Friendly Hospitals have been monitored and assessed and continuous activity;
• Arranged BFHI conference (1st conference in the Asia Pacific)

Goals of BFHI:

1. To transform facilities providing maternity services to baby friendly hospitals through implementation of the Ten Steps to Successful Breastfeeding.
2. Stricter implementation of Breast Milk Substitute (BMS) marketing regulation ordinance in the hospitals by hospital administration as well as by ALL its staff members.

Steps for converting to Baby-Friendly hospital:

1. BFHI training of the maternity staff of the hospital: The Trainer will be conducted 4 days log 20 hour BFHI training on Breastfeeding Promotion and Support for the maternity doctors and nurses of the respective hospitals.

2. Half day orientation session: The core trainers will also conduct a half day orientation session for doctors of other discipline and well as orientation for the other staff members (pharmacists, messengers, ward boys, ayahs, cleaners etc)

3. Practices 10 steps: Once all the staff members have received training on breastfeeding, IYCF and maternal nutrition, it is expected all the hospital staff members, auxiliary/ancillary staff will start practicing the 10 steps of successful breastfeeding in their hospitals.

4. Self assessment appraisal: After starting of practice of 10 steps (15 steps for Bangladesh) hospital will conduct a self assessment and inform their status to BBF and will ask for assessment.

5. External assessment: After completion of self assessment, the external assessment will be conducted by one International assessor and 2 national assessors with “Global standard External Hospital assessment tool” which will examine the fulfillment of the ten steps. The two day long assessment will be performed which will include interview with maternity staff, pregnant mothers, post natal mothers.

6. BFHI committee: A BFHI committee consisting of 7 members will be formed headed by Hospital authority. They will meet three monthly to review and internal monitoring of the BFH status and also send report to BBF secretariat.

7. Certification: Finally BBF will be declare & certified the hospital into BFHI.