Ministry of Health, Apia, Samoa.
2Yale School of Public Health, 60 College Street, New Haven, CT USA.
Int Breastfeed J. 2020 Jan 6;15:1. doi: 10.1186/s13006-019-0245-6. eCollection 2020.
Breastfeeding is a critical, evidence-based intervention that addresses malnutrition, improves early childhood development outcomes, and influences long-term maternal and infant health by reducing the non-communicable disease risk. Scaling up breastfeeding is an indisputably strong action countries can take to prevent suboptimal maternal and infant health outcomes. The Becoming Breastfeeding Friendly (BBF) initiative assists countries with scaling up breastfeeding policy and programs. BBF has been successfully implemented within Latin America, Africa, Europe and South-East Asian regions. This study assessed its application in Samoa.
In 2018, BBF was implemented in Samoa by a 20 member committee of breastfeeding experts who participated in collecting and utilizing national level data to score the degree of friendliness of Samoa's breastfeeding environment, identify gaps, and propose policy recommendations to address those gaps. This eight-month process resulted in a public event where priority recommendations were widely disseminated to decision makers and actions agreed upon.
The total BBF Index score for Samoa was 1.6 out of 3.0, indicating a moderate breastfeeding friendly environment for scaling up policies and programs that protect, promote, and support breastfeeding. Gear total scores indicated that seven of the eight gears were moderately strong within Samoa, while the eighth gear, funding and resources, was weakest in strength. Six prioritized recommendations emerged: 1) development and implementation of a National Breastfeeding Policy and Strategic Action Plan; 2) strengthening monitoring and evaluation of all breastfeeding activities; 3) ratifying the International Labour Organization's Maternity Protection Convention 2000 (No 183); 4) identifying high-level advocates to champion and serve as role models for breastfeeding; 5) creation of a national budget line for breastfeeding activities; and 6) hiring of a national breastfeeding coordinator and trainer. Decision makers demonstrated commitment by signing the breastfeeding policy for hospitals ahead of the BBF dissemination meeting and electing to move forward with establishing lactation rooms within government ministries.
Implementation of BBF in Samoa yielded important policy recommendations that will address current gaps in national level breastfeeding support. The BBF consultation process can be successfully applied to other countries within the Western Pacific region in order to strengthen their breastfeeding programs.
母乳喂养是一种关键的循证干预措施，可解决营养不良问题，改善儿童早期发展成果，并通过降低非传染性疾病风险来影响母婴长期健康。扩大母乳喂养规模是各国采取的一项不容置疑的有力行动，可以防止母婴健康结果不理想。“促进母乳喂养友好行动（BBF）”倡议协助各国扩大母乳喂养政策和方案。BBF 已在拉丁美洲、非洲、欧洲和东南亚地区成功实施。本研究评估了其在萨摩亚的应用。
2018 年，由 20 名母乳喂养专家组成的委员会在萨摩亚实施了 BBF，他们参与收集和利用国家一级的数据，对萨摩亚母乳喂养环境的友好程度进行评分，确定差距，并提出解决这些差距的政策建议。这一为期 8 个月的过程导致了一次公开活动，广泛向决策者传播了优先建议，并就这些建议达成了一致。
萨摩亚的 BBF 总指数得分为 3.0 中的 1.6，表明萨摩亚有适度的母乳喂养友好环境，可扩大保护、促进和支持母乳喂养的政策和方案。齿轮总得分表明，萨摩亚的八个齿轮中有七个齿轮的强度中等偏强，而第八个齿轮，即资金和资源，强度最弱。出现了六项优先建议：1. 制定和实施国家母乳喂养政策和战略行动计划；2. 加强对所有母乳喂养活动的监测和评估；3. 批准国际劳工组织 2000 年《产妇保护公约》（第 183 号）；4. 确定高级别倡导者，倡导和树立母乳喂养榜样；5. 为母乳喂养活动设立国家预算项目；6. 招聘国家母乳喂养协调员和培训师。决策者通过在 BBF 传播会议之前签署医院母乳喂养政策，以及选择在政府部门内建立哺乳室，表现出对这些建议的承诺。
在萨摩亚实施 BBF 产生了重要的政策建议，将解决国家一级母乳喂养支持方面的当前差距。BBF 协商进程可以成功应用于西太平洋区域内的其他国家，以加强其母乳喂养方案。
