Breast is Best League evaluation report

Evaluation covered the period 1/85-12/87 and was based on document review and interviews with BIB and Ministry of Health (MOH) officials, breastfeeding counselors (BFC"s), and beneficiaries. BIB has engaged in a wide ranging program which has provided a successful model for the Caribbean region: 45% of mothers in Belize now solely breastfeed their infants for the first four months after birth. This success is largely the result of the door-to-door work of the BFC"s; a nationwide mass media promotional campaign (television ads have been especially successful); and a liaison with the MOH through which breastfeeding is promoted in the hospitals, especially in Belize City, where many of the deliveries take place and where breastfeeding statistics are the lowest. Collaboration with other PVO"s has also been successful. Recommendations are made to expand BIB"s promotional activities and develop its oversight capabilities. Specifically, it is recommended that BIB: (1) produce more promotional material in Spanish and increase its availability to the Spanish speaking community; (2) find permanent office space within the MOH to increase liaison activities, especially at Belize City Hospital; (3) hire a full-time secretary for BIB"s executive director (ED), who is overextended and develop a timetable for following up on district level activities; (4) continue production of promotional T-shirts, calendars, and tote-bags; (5) increase the number of breast pumps available for rent and raise the rental fees; (6) and purchase a bicycle to increase BFC mobility; and (7) coordinate with Project HOPE and others for TA to develop a data collection tool for evaluation of training. In addition BIB and MOH should work together to (1) designate a "Breastfeeding Week" in Fall 1987; (2) develop a physicians" education plan; and (3) increase activities at Belize City Hospital. One of the most surprising aspects of the project was how activities were successful despite potential administrative and supervisory problems. For example, the BFC"s continued to perform their duties and submit regular reports to the ED even though there was a lack of follow up; in another case, the BIB board of directors worked well together despite the potential for factional friction. Despite the project"s success, institutionalization of the BIB is not in the immediate future. Accordingly, the PACD is extended to 5/88, at which time continued support will be provided under a new umbrella child survival project.