Access to Skilled Breastfeeding Counselling

Breastfeeding is a crucial priority for child survival in (not only) emergencies. The indicator therefore measures the proportion of women aware of the available counselling support on preventing and addressing breastfeeding difficulties (such as sore and cracked nipples, engorgement, blocked ducts and mastitis). Such support enables women to provide children with breast milk - the best source of nutrients.

Collect the following data by conducting individual interviews with a representative sample of mothers with children aged 0-23 months:

RECOMMENDED SURVEY QUESTIONS (Q) AND POSSIBLE ANSWERS (A)

Q1: Do you know if anyone in this community/ settlement provides women with counselling on how to address difficulties with breastfeeding their children?

A1: yes, I know / no, I do not know

(the following question verifies whether the respondent really knows a trained counsellor; ask it only if the previous answer is YES)

Q2: Who exactly provides such support?

A2: _

1) the respondent knows the trained counsellor

2) the respondent knows someone other than the trained counsellor - specify whom: ...

3) the respondent cannot specify any counsellor

(the following question is recommended but not mandatory; it is asked to assess whether women might face any obstacles with accessing the counselling)

Q3: Is there any reason why you or other women might not be able to use the counselling services?

A3: no reason / reason provided - specify: ................................

To calculate the indicator's value, divide the number of women aware of the available breastfeeding counselling services by the total number of interviewed women. Multiply the result by 100 to convert it to a percentage. 

Disaggregate the data by wealth and other vulnerability factors (e.g. ethnicity, location). 

1) Breast milk is the best and only food infants up to 6 months of age should receive. Baby formula or other breastmilk substitutes should be provided as a last resort, by health personnel and only after consultations show that breastfeeding is not possible. In a number of emergencies, failing to meet these conditions resulted in severe diarrhoea or other ailments leading to the infants' death. Children between 6 and 24 months of age should be breastfed in addition to receiving (semi)solid food.

2) Consider collecting data for an additional indicator: “% of women with breastfeeding difficulties (now or in the past X months) who used the offered breastfeeding counselling services” - such data will show you the extent to which the services are used by those who need them. To collect the data, first ask whether the woman in the past X months had any breastfeeding difficulties; then ask those who answer YES whether they used the offered counselling support (if not, you might also enquire why they did not use it).

3) This indicator relies on accurate age assessment. Since people often do not remember the exact dates of their children’s birth, the data collectors should always verify the child’s age. This can be done by reviewing the child’s birth certificate, vaccination card or another document; however, since many caregivers do not have such documents (and since they can include mistakes), it is essential that your data collectors are able to verify the child’s age by using local events calendars. Read FAO’s Guidelines (see below) to learn how to prepare local events calendars and how to train data collectors in their correct use.