Health leaders from Cambodia and Laos learned about the Centers of Excellence for Breastfeeding initiative in Viet Nam and shared their insights and experiences for improving breastfeeding and newborn care services in hospitals during an exchange visit to Viet Nam in October. The exchange visit was supported and facilitated by Alive & Thrive.

“We are quite impressed with the implementation of Center of Excellence for Breastfeeding,” said Her Excellency Dr. Prak Sophonneary, representative of the Cambodian Ministry of Health. “This result has demonstrated the entire health system’s tremendous efforts to improve maternal and child care services.

“The integration of Center of Excellence for Breastfeeding indicators into hospital quality criteria is a valuable experience for Cambodia to consider for local adaptation based on the updated Early Essential Newborn Care guideline that was launched recently.”

Laos and Cambodia have adapted the Centers of Excellence for Breastfeeding model to their local contexts and are now scaling up. The first two Breastfeeding Model Hospitals in Laos were designated in November 2021, and the next three are expected to receive the designation in 2022. Cambodia is completing a set of breastfeeding and newborn care indicators to be integrated into its national hospital quality standards and routine monitoring systems, which will help to ensure that all hospitals routinely collect and report data on Centers of Excellence for Breastfeeding criteria.

The exchange visit led each of the three countries to identify a variety of follow up actions, at the ministerial and hospital levels, to improve breastfeeding and newborn care in their health facilities. In Cambodia, for example, a national team will be established to implement a Centers of Excellence-type program; in Laos, the Ministry of Health will designate and award hospitals as Breastfeeding Model Hospitals, while at the hospital level, refresher trainings on early essential newborn care and breastfeeding will be held and improvements to human milk banking will be adopted; and in Viet Nam, efforts will be made to increase and improve Centers of Excellence standards. Alive & Thrive will support the three countries to achieve their targets under a new investment by the Government of Ireland to address malnutrition among the furthest behind.

The Centers of Excellence for Breastfeeding initiative was launched in 2019 and now includes more than 80 hospitals in 16 provinces and cities. A hospital can be designated a Center of Excellence if it creates a breastfeeding-friendly environment. This involves promoting immediate and prolonged skin‐to‐skin contact for newborns, ensuring that mothers can successfully initiate early breastfeeding and enabling mothers to breastfeed exclusively, whether giving birth vaginally or via caesarean section. Increasing the prevalence rates of early initiation of breastfeeding and exclusive breastfeeding is critical to the health and wellbeing of both infants and mothers, with myriad benefits for all of society as well.

During the visit, the delegates attended a Center of Excellence for Breastfeeding designation ceremony for Quang Nam Central General Hospital. With the support of the Alive & Thrive Initiative and the Embassy of Ireland since 2019, Quang Nam Provincial Department of Health has successfully established eight Centers for Excellence of Breastfeeding and one satellite human milk bank that provides pasteurized donor human milk to small and sick newborns who cannot access their own mothers’ milk.

From these efforts, together with the establishment of 78 Little Sun counseling clinics and 66 infant and young child feeding support groups in the province, Quang Nam has become one of the country’s role models for promoting breastfeeding and maternal and child healthcare services.

"We have sent the leading hospitals in the field of obstetrics and pediatrics in Laos to Viet Nam, who are looking to scale up this initiative across our country,” said Deputy Director General Souliphone Soudachanh of the Department of Healthcare and Rehabilitation in the Laos Ministry of Health. “The trip included a visit to Quang Nam, a province bordering Laos, and there has been cooperation between the two countries’ hospitals. Thus, we will prioritize the model replication in these localities."

"This occasion is important to create a platform for knowledge sharing among the three countries, which is important given more and more health issues are trans-national in the post COVID-19 pandemic world," said Director General Dinh Anh Tuan, the Department of Maternal Health and Children, Viet Nam's Ministry of Health. "It also contributes to building a network of champion hospitals and health staff towards a breastfeeding-friendly Southeast Asia."

The Government of Ireland supports the Centers of Excellence for Breastfeeding initiative. The Embassy of Ireland’s Deputy Head of Mission, Sean Farrell, said the exchange visit demonstrated the regional impact the initiative has had.

"Ireland is proud to support Cambodia, Laos, and Viet Nam in improving the quality of maternal and child health care, especially for preterm cases or ethnic groups who are left furthest behind in accessing quality health services,” Farrell said.

And the initiative’s impact is now being felt elsewhere in the world, said Nadra Franklin, Managing Director of FHI Solutions, which manages Alive & Thrive. Franklin participated in the exchange visit’s plenary meeting.

"By bringing women’s voices forward, the Centers of Excellence for Breastfeeding model has brought improvements in hospital performance and care practices, which, in turn, generated a culture of excellence and sparked healthy competition,” Franklin said. “I am happy that not only Cambodia, Laos and Viet Nam have committed to scaling up this innovation, but West and Central African countries are also learning about the model and how it could support, protect and promote breastfeeding in their health systems.”

In a webinar presented in partnership with UNICEF in August, stakeholders in the West and Central Africa region discussed the innovations the Centers of Excellence model has developed, expressing interest in adopting a similar approach in countries in the region.