The benefits of the early initiation of breastfeeding (EIBF) on reducing neonatal mortality, morbidity and infant mortality are well documented. According to the latest estimates in UNICEF’s Capture the Moment Report, 78 million newborns are not breastfed within one hour of birth, increasing their risk of death and illness and reducing their chances of being breastfed. Most of these children are born in low- and middle-income countries. In Francophone ECOWAS countries, EIBF is not practiced in a homogenous manner. Rates vary from 29% in Senegal to 60% in Togo. With a regional average of 40%, fewer than one in two infants are breastfed within one hour of birth in West and Central Africa. Even with increases in the number of institutional deliveries, EIBF has not increased in the same way. Specific strategies at the health system level are therefore urgently needed to engage policy makers, providers and communities to reduce these missed opportunities for improved EIBF. It is with this context that A&T, in collaboration with UNICEF and the WHO, held a workshop in Ouagadougou, Burkina Faso, Sept. 27-28th 2018 entitled “Putting in place health systems conducive to optimal breastfeeding practices in the ECOWAS region.”

Workshop objectives:

1. Share the process, lessons learned, and recommendations for actions around EIBF in the ECOWAS region
2. Have participating country delegations reflect on how to activate progress on strengthening their own systems for breastfeeding and develop agendas for policy change

More than 70 participants from nine countries attended. Delegations included representatives of Ministries of Health and UNICEF, as well as representaives from associations of midwives and pediatricians and members of civil society. Opening speeches were given from the Burkina Faso delegations of UNICEF and the Ministry of Health, along with Dr. Aissa Bouwaye from the West African Health Organization. A&T and UNICEF presented recent evidence for EIBF and what works in terms of scaling up breastfeeding programs, and countries including Burkina Faso, Niger, Togo, and Côte d’Ivoire presented their own success stories. Other sessions included an overview of the BMS Code and the Baby Friendly Hospital Initiative (BFHI), as well as a session on facilitating provider behavior change. On each day of the workshop, participants were split up among country delegations to identify priorities for systems strengthening for EIBF and to develop detailed workplans on implementing these priorities over the next year.

Workshop recommendations:

1. Identify and use national events and advocacy opportunities for the protection, promotion, and support of breastfeeding - especially EIBF
2. Seize the opportunity of early essential newborn care (EENC) strategies to accelerate implementation of actions for early breastfeeding
3. Initiate the operationalization of the new components of the BFHI
4. Integrate the country workplans for EIBF into existing country-level operational planning
5. Focus on situational analysis, including bottlenecks, monitoring-evaluation of key indicators, and documentation

The next steps (post-workshop) are the validation of the country workplans at the national level and periodic meetings between A&T, UNICEF, and countries to facilitate the exchange of experiences and to monitor progress in EIBF. Closing the workshop on behalf of the Minister of Health of Burkina Faso, Dr. Bertine D. Ouaro Dabire, Director of Nutrition, expressed thanks to the participants for their hard work during the two-day meeting and for their commitment to advance their plans of action over the next year. The representative of the UNICFE Regional Office, Dr. Anne-Sophie Le Dain, and the Regional Director of Alive & Thrive, Dr. Aboubacry Thiam, renewed the commitment of their respective organizations to support the countries of the ECOWAS region to implement their plans of action.