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Baby Friendly Hospital Initiative
 
Introduction:
 
The Baby Friendly Hospital Initiative (BFHI) is a global accreditation program launched in 1991 by the World health organization (WHO) and United Nations International Children's Emergency Fund (UNICEF). 
In Lebanon, the BFHI is led by the Ministry of Public Health (MOPH), particularly the unit of Mother, Child and School health.
 
The BFHI is part of the National Infant and Young Child Feeding (IYCF) policy supported by UNICEF developed in March 2018.
 


The BFHI goal is to improve healthcare for babies, their mothers and families in Lebanon. The BFHI enables health care services to better support mothers and families to ensure that all newborns and infants get the best possible start in life.
 
 
Mission: 
 
The BFHI aims to protect, promote and support breastfeeding practices in healthcare facilities providing maternity and newborn services, while enabling timely and appropriate care and feeding of newborns who are not breastfed.
 
Objectives:

The Six main objectives of the BFHI are to:
  1. Enable mothers to make an informed choice about how to feed their newborns.
  2. Support early initiation of breastfeeding.
  3. Promote exclusive breastfeeding for the first 6 months of life, and introduce nutritionally-adequate and safe complementary (solid) foods at 6 months while continuing breastfeeding up to 2 years of age or beyond.
  4. End distribution of free and low-cost supplies of breast-milk substitutes to maternity wards and hospitals.
  5. Help reduce the levels of infant morbidity and mortality in Lebanon. 
  6. Increase the breastfeeding rates in Lebanon. 
Certification Process:
 
To become a designated Baby Friendly Hospital, hospitals must ensure compliance with the Lebanese law 47/2008 for “organizing the marketing of infant and young child feeding products and tools .
In addition, they should fulfill the requirements of the BFHI 10 steps that have been outlined by the WHO and UNICEF which were reviewed in 2018 and adapted by the Ministry of Public Health in Lebanon.
 
Appendix 1: Law 47/2008
Appendix 2: BFHI 10 steps

The baby friendly hospital (BFH) certification process includes several stages:

First stage:
 
  • Registration: 
The CEO of the hospital working towards baby friendly certification has to fill the BFHI registration form and send it to the unit of Mother, Child and School health at the MOPH via the following e-mail: motherchild@moph.gov.lb
 
Appendix 3: BFHI registration form
     
  • Self-appraisal process:

The hospital undergoes self-appraisal using the WHO self-appraisal tool
This tool is used to evaluate the hospital’s current application and practices of the ten steps to successful breastfeeding. This in turn will help in developing an action plan based on the results of the latter evaluation.
 
Appendix 4: WHO self-appraisal tool
 
  • Orientation visit:
Once the self-appraisal process is completed, an orientation visit to the candidate hospital is performed by the BFHI monitoring team to address the 10 steps criteria requiring additional work for the hospital to become baby friendly.
 
  • Application of commitment: 
The CEO of the hospital or an equivalent hospital staff will fill and sign an application of commitment if the candidate hospital has fulfilled the following requirements:
  • Forming a multidisciplinary breastfeeding committee
  • Assigning a breastfeeding coordinator.
  • Developing a breastfeeding policy that covers all the BFHI steps ( Hospital policy checklist and National Policy sample).
  • Developing the procedures needed for the BFHI 10 steps program.
  • Developing a BFHI work plan to ensure the implementation of 10 steps and the law 47/2008.
  • Developing a training plan for the clinical and non-clinical staff.
  • Developing a prenatal, perinatal and postnatal education plan.
  • Developing a data collection plan for documentation, auditing and evaluation of standards. 
All developed policies, plans and educational materials will be reviewed and approved by The BFHI monitoring team.
 
Appendix 5:  Application of commitment
Appendix 6: WHO policy checklist
Appendix 7: National Policy sample
 
Second stage:
 
  • Implementation stage: 
During this stage the hospital should:
  • Train the clinical staff providing clinical care for pregnant women, mothers and their babies, in addition to training the non-clinical staff providing non-clinical care for pregnant women, mothers and their babies or having contact with them in some aspect of their work.
  • Implement the hospital’s BFHI policy, action plans, and law 47/2008.
  • Collect pertinent data relevant to the 10 steps. Follow up evaluation visits and technical support will be provided by the BFHI monitoring team during the implementation phase.

Appendix 8: Baby Hospital Initiative Implementation Guidance -2018
 
 Third Stage:
 
  • Certification: 
Request for external assessment:
 
Once the evaluation report is completed by the BFHI monitoring team, the CEO of the hospital or an equivalent hospital staff should report to the MOPH (Mother, Child and School health unit) via the following email: motherchild@moph.gov.lb requesting an external assessment.

To note: The report of the national BFHI monitoring team should document the accomplishment of all steps and the hospital documentation and internal audits should be consistent with this report, to facilitate the external auditing process.
 
External assessment:
 
The external assessment is a two-step process:
  1. A verification of the hospital’s policies, educational material, action plans, staff training, and competency verification.
  2. On-site interviews with the staff and patients.
The assessment will be conducted by a certified BFHI assessor, assigned by the IYCF National Committee.
 
Upon successful completion of the required 10 steps by the candidate hospital as reported by the certified BFHI assessor, the hospital will be granted the BFHI certification for 5 years by the MOPH (Mother, Child and School health unit).
 
  • Recertification: 
A redesignation process requires the facility to follow the same steps
 
Appendixes:
Appendix 1: Law 4 /2008
Appendix 2: BFHI 10 steps
Appendix 3: BFHI registration form
Appendix 4: WHO self-appraisal tool
Appendix 5: Application of commitment
Appendix 6: WHO policy checklist
Appendix 7: National Policy sample
Appendix 8: Baby Hospital Initiative Implementation Guidance -2018
 
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Name Type Name(ar) Caza Investment Authorization Nb Phone
St Georges Hospital Private Hospitals St Georges Hospital Kesseroune 3407/1, 1/8/1983 09-234201 09-234212
Hospital MGR Cortbawi Private Hospitals Hospital MGR Cortbawi Kesseroune 767/1, 7/6/1996 09/855410/1/2/3/4/5/6
Kesserwan Medical Center Private Hospitals Kesserwan Medical Center Kesseroune
Hospital al Hajj Private Hospitals Hospital al Hajj Kesseroune 207/1,6/7/1977 09/951755
Notre Dame de Liban Hospital Private Hospitals Notre Dame de Liban Hospital Kesseroune 4/2, 4/1/1973 09-644644
Psychiatric Hospital of the Cross Private Hospitals Psychiatric Hospital of the Cross El Meten 693/1-17/12/1971 04/710224
Arz Hospital Private Hospitals Arz Hospital El Meten 2355/10/12/1982 01/876770?4
Eye & Ear Hospital International Private Hospitals Eye & Ear Hospital International El Meten (1/1498)11/9/1995 04/521130
Middle East Institutd Of Health Private Hospitals Middle East Institutd Of Health El Meten قرار رقم 1/476 تاريخ 18/ اب 2003 04/712111
Hopital Abou Jaouke Private Hospitals Hopital Abou Jaouke El Meten 258-7-3----1961 04/718000 – 716000
SACH Medical Co.Bitar Hospital Private Hospitals SACH Medical Co.Bitar Hospital El Meten 404/1---23/6/2004 03-774737 01-682300
Lebanise--Canadian Hospital Private Hospitals Lebanise--Canadian Hospital El Meten 216631-14-9/2001 01/511487?9
Serhal Hospital Private Hospitals Serhal Hospital El Meten 323/1---16/10/82 03-410100 04-405050
Centre Hopital de Behannss Private Hospitals Centre Hopital de Behannss El Meten 203/1---1976 04/984009
Saint Joseph Hospital Private Hospitals Saint Joseph Hospital El Meten 706-29/4/1952 01-240111
Haroun Hospital Private Hospitals Haroun Hospital El Meten 09/12/1985 - n 4/2-1/203 01/897300-1-2-3-4
Belle Vue Hopital Private Hospitals Belle Vue Hopital El Meten 66942--17/6/2009 01/682666
Hopital DAR AL Raheme? Private Hospitals Hopital DAR AL Raheme? El Meten 1/165---21/3/1979 04/872211
Clinique du Levant SM Private Hospitals Clinique du Levant SM El Meten 281/1---2/4/2009 01/501500
Hopital Notre dame pour les Malade Cronique Private Hospitals Hopital Notre dame pour les Malade Cronique El Meten 692/1Dated 17 /12/1971 04/713100
Hopital Hayek Private Hospitals Hopital Hayek El Meten 1/36-19/1/1974 01/499142
Hopital Beit Chabab Private Hospitals Hopital Beit Chabab El Meten 1987/07/09 --قرار رقم 119 04-983393/4 04-981577
Clinique DE Chirugie Estetque Dr Nader Saab Private Hospitals Clinique DE Chirugie Estetque Dr Nader Saab El Meten 517--15/6/2009 04/411111
Hopital Dr Toni Nassar Sal Private Hospitals Hopital Dr Toni Nassar Sal El Meten 233/1--8/3/2010 03/233821
Alhamid Medical Center-Ghandour Hospital Private Hospitals Alhamid Medical Center-Ghandour Hospital El Nabatieh 65/1-22/2/1992 07/760455 – 07/762542
Kalout Hospital Private Hospitals Kalout Hospital El Nabatieh
AlCheick Harb Hospital Private Hospitals AlCheick Harb Hospital El Nabatieh yes 07/766799
Secours Populaire Hospital Private Hospitals Secours Populaire Hospital El Nabatieh 147/1-2/7/1986 07/530970/1/2/3
Al Hikme Hospital Private Hospitals Al Hikme Hospital El Nabatieh 1/31-27/1/2007 07/765362
Ghossein Hospital Private Hospitals Ghossein Hospital El Nabatieh 1/168-1/2/2003 03/224402
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