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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
Akkar Rahal Hospital Private Hospitals Akkar Rahal Hospital Akkar رقم 113/1/ تاريخ 13/3/1982 06/690000 -691103
Hopital Notre Dame de la Paix Private Hospitals Hopital Notre Dame de la Paix Akkar رقم 1/476 تاريخ 29/7/1998 06/351670
El Youssef Hospital Center Private Hospitals El Youssef Hospital Center Akkar رقم 1/2038 تاريخ 20/12/1995 26/690455- 26/690537-26/692055- 26/200440
Hopital Albert Haykel sal Private Hospitals Hopital Albert Haykel sal El Koura 948-27/11/1999 06/411411
Hopital Al Koura Private Hospitals Hopital Al Koura El Koura 222/1-28/2/1994 06/ 930981/005
Hopital Al Borgi Private Hospitals Hopital Al Borgi El Koura 64/1-02/04/1986 651025/6 - 06/950030
Al Kheir Hospital- Miniyeh Private Hospitals Al Kheir Hospital- Miniyeh El Minieh-Dennie 261/1 28/4/1998 06/461444-555-666
Miniyeh Hospital Private Hospitals Miniyeh Hospital El Minieh-Dennie غير مرخصة لعدم توافر الشروط الصحية المطلوبة وانتحال صفة طبيب من الطبيب السابق
Dar Al shifa hospital Private Hospitals Dar Al shifa hospital Tripoli 503/1-24/6/2008 06/429595
AL Salam Hospital Private Hospitals AL Salam Hospital Tripoli 701/1-16/4/1997 06/411700/1/2/3/4/5
Social Services Association - Dar Al Ajaza Hospice Private Hospitals Social Services Association - Dar Al Ajaza Hospice Tripoli 244/1-16/5/2003 06/446330
El Bissar Hospital Private Hospitals El Bissar Hospital Tripoli 66/1-3/4/1986 06/432267 430365/430355
Shahin Hospital Private Hospitals Shahin Hospital Tripoli 130/1-18/3/2003 06/625796 06/ 430250
Al Mounla Hospital Private Hospitals Al Mounla Hospital Tripoli 34.8/1-16/11/1982 06/207000
Nine Hospital Private Hospitals Nine Hospital Tripoli 2114/1-17/11/1998 06/431400/1/2
Dar Al Zahraa Hospital Private Hospitals Dar Al Zahraa Hospital Tripoli 4265/2000 06/444529
Islamic Hospital Private Hospitals Islamic Hospital Tripoli 19969 - 22/7/1958 06/210179
Al-Hanan Hospital  Private Hospitals Al-Hanan Hospital  Tripoli 1067/1 - 20/10/1994 06/200526/7
New Mazloum Hospital Private Hospitals New Mazloum Hospital Tripoli 134./1 - 7/3/2006 06/410025
Al Rahma Hospital Private Hospitals Al Rahma Hospital Tripoli 504/1 - 6/8/1998 06/448324
Al Rahban Hospital Private Hospitals Al Rahban Hospital Zgharta 22/9/1998.1101/1 6662871
Hospital Saydet Zgharta Private Hospitals Hospital Saydet Zgharta Zgharta .18/1/1984.16/r 06/660575 06/669300
Centre Hospitalier du Nord Private Hospitals Centre Hospitalier du Nord Zgharta 18/6/1996.854/1 06/555230/1/2/3
Ehden Hospital Private Hospitals Ehden Hospital Zgharta 29/1/2002.7313 6561702
Kharroubi Hospital Private Hospitals Kharroubi Hospital Saida 852/1-7/9/1998 07/443344 – 442224
Alaa-El-Dine Hospital Private Hospitals Alaa-El-Dine Hospital Saida 507/1-14/12/1978 07/443200/1/2
Hammoud Hospital University Medical Center Private Hospitals Hammoud Hospital University Medical Center Saida 756/1-2/1/1967 07/ 723111 - 723888
Dalaa Hospital Private Hospitals Dalaa Hospital Saida 492/1-30/11/1978 03-900404 07-724088/ 07723400
Health Medical Center- Osseiran Hospital Private Hospitals Health Medical Center- Osseiran Hospital Saida 11543-20/5/2011 07726078-79
Alraai Hospital Private Hospitals Alraai Hospital Saida 105/1-21/8/1984 07/222023/4/5/6
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