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Breastfeeding Support in Early Emergency Response

UNICEF partnered with the Indonesian Breastfeeding Center to provide breastfeeding support in the aftermath of an earthquake. Trained facilitators worked within affected communities, training community workers and providing counseling to mothers. The program resulted in increased exclusive breastfeeding rates and improved support for breastfeeding mothers.

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Breastfeeding Support in Early Emergency Response

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  1. Breastfeeding Support in Early Emergency Response Utami Roesli & Sri Sukotjo Indonesian Breastfeeding Center / UNICEF

  2. Un-controlled donations of infant formula Higher consumption of infant formula among those who received donations compared to those who did not receive donations Increased of diarrhea rates after the Earthquake and significant association between formula fed in the previous 24 hrs and diarrhea in infants Background

  3. MOTHER NEEDS SUPPORT How to reach large numbers of mothers rapidly?

  4. UNICEF commissioned Indonesian Breastfeeding Center to conduct the training in the most affected district of Klaten & Bantul Worked with the District Health Office to ensure the sustainability of the programme 12 facilitators BFC-C placed inside the communities (at the village level) Participants were Community Workers/Volunteers & village Midwives Managing The Training

  5. One facilitator based inside the community for 6 weeks would bring benefit for up to 360 families I 6 sub-village A B C D E F 1 2 3 4 5 6 Trained 6 BF MOTIVATORS / sub village a a a a a To graduate, each MOTIVATOR need to counsel at least 5 mothers. These mother recruited as peer educators in their communities b b Each PE required to promote BF to at least 2 or 3 families

  6. WHO/UNICEF’s 40 hours Breastfeeding Counseling Course module Flip-Chart is developed to train mothers The Module

  7. Session 1 Why breastfeeding is important • Session 3 How breastfeeding work • Session 4 Assessing a breastfeed • Session 5 Observing a breastfeed • Session 6 Listening and learning • Session 7 Listening and learning exercises • Session 9 Clinical Practice 1 • Additional 1 Food hygiene and feeding techniques • Additional 2 Preparation of milk feeds - practical • Session 11 Building confidence and giving support • Session 12 Building confidence exercises • Session 10 Positioning a baby at the breast • Session 13 Clinical Practice 2 • Session 16 Refusing breastfeeding • Session 20 Expressing breastmilk • Session 21 “ Not enough milk “ • Session 22 Crying • Session 23 “ Not enough milk “ Crying exercises • Session 24 CLINICAL PRACTICE 3 • Session 27 Increasing breastmilk and relactation • Session 28 Sustaining breastfeeding • Session 32 Wonen and work • Session 33 Commercial promotion of breastmilk subtitutes • Session 29 CLINICAL PRACTICES 4

  8. For clinical practices, breastfeeding and pregnant mothers were brought-in into the training session Facilitators meet every evening to evaluate the process of the training on that day.

  9. Every Sundays the Facilitators helped breastfeeding mothers with difficulties

  10. RESULTS Course Director I II III IV X V VI VII VIII IX XI XII A B C D E F 159 sub-village 1 2 3 4 5 6 426 motivator a a a a a 2130 moms Peer educators 2130+ 4260 = 6390 Supporting Mom Communities b b 4260 aware of breastfeeding

  11. Training conducted in a Tent

  12. Training conducting in a Village Center

  13. Clinical practices at the community

  14. IS THE TRAINING DIFFICULT ? 11% YES 89% NO

  15. Challenges • Many community workers and health workers were in the “traumatic” phase • Difficult to find community workers who have commitment to participate in the training • Different level of education also provided challenges in facilitating the training • Facilitators/Trainers need to ensure that they are able to follow the course • Private one-to-one training was conducted if they are not able to come to the training • Minimal support from the local health office– • More focus on building new premises, health system, and other health issues

  16. Result • Of 50 mothers assessed and who gave birth after the Earth Quake, most (63%) are exclusively breastfeed regardless of access to free formula - mainly due to the counseling / support they received from trained health workers and volunteers

  17. Result • Introduction of early initiation to breastfeeding during the training • Early initiation to breastfeeding were successfully conducted by trained village midwives and community health workers.

  18. Lesson Learned-1 • The training reached a large number of mothers • Facilitators placed in the community, provided breastfeeding counseling services to mothers who have difficulties in the affected areas • Sustainability of the breastfeeding services in the community

  19. Lesson Learned-2 • Klaten District, one of the affected areas : • Facilitators : 8 • Counselors : 190 • Motivators : 310 • Next week they plan to add 8 more facilitators, at least 20 more counselors and 350 motivators

  20. Information received by motivators for such an extended period has increased the confidence of the motivators to assist breastfeeding mothers (although most of them did not have any health related background)

  21. THANK YOU CD from the field on the counseling services experiences is on your folder

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