PAHO/WHO continues to support the Ministry of Health’s Baby Friendly Hospital Initiative (BFHI) Programme through Training of Trainers Course for maternity staff.


Georgetown, Guyana 6 November 2023- The Baby Friendly Hospital Initiative (BFHI) which  has been recognized as an important medium for breastfeeding action was launched by WHO and UNICEF in 1991.  It sought to help motivate facilities providing maternity and newborn services worldwide to implement the Ten Steps to Successful Breastfeeding - a package of policies and procedures to support breastfeeding and ensure that mothers and newborns receive timely and appropriate care before and during their stay in the facility to enable the establishment of optimal feeding of newborns, which promotes their health and development. Specifically, the BFHI aims to provide a health-care environment that supports mothers/parents/caregivers  to acquire skills necessary to exclusively breastfeed for six months, and to continue breastfeeding for two years or beyond.

Guyana is among more than 150  countries, which adopted the BFHI programme through the Ministry of Health with eleven (11) hospitals being accredited with the BFHI status in the 2015/2016 period. Globally, based on the evidence for each of the Ten Steps, an updated implementation  guidance for countries implementing the BFHI was published with emphasis on strategies to scale up universal coverage and ensure sustainability over time to help to  reduce infant mortality and ill health. Aligned to WHO recommendations that that mothers begin breastfeeding their infants within one hour of birth – referred to as “early initiation of breastfeeding”. This will ensure that the infant receives the colostrum (“first milk”), which is rich in protective and regulatory factors. Infants should also be exclusively breastfed for the first six months of life to achieve optimal growth, development and health, with continued breastfeeding up to two years of age or beyond.

The Regional PAHO Programme on nutrition supports the Ministry of Health’s ongoing National BFHI programme. Aligned to the implementation of the updated guidelines, a cadre of nine (9) trainers including the Food Policy Director(ag), a Community Nutrition Officer, a Medex, the Former Principal Nursing Tutor, three (3) retired midwives  and the former BFHI Coordinator have participated in the newly established “Baby Friendly Initiative training course for maternity staff” Training of Trainers course facilitated by the National PAHO Consultant – Nutrition.  

Overall, this course provided opportunities to strengthen skills to 
•    Implement the Ten Steps to Successful Breastfeeding-  which continue to be valid throughout the world as the basis for BFHI.
•    Improve communication skills to counsel mothers and caregivers - to carry out their own feeding decisions through consistent messages  
•    Refer mothers to the appropriate community resources for ongoing support once she returns home - to effectively support and help mothers and caregivers
•    Abide by the International Code of Marketing of Breast-milk Substitutes and relevant WHA Resolutions- to implement standards to protect, promote and support breastfeeding   in keeping with the Ten Steps

Dr. Woolford
Dr. Janice Woolford,  encouraged participants to embrace the goals of the training programme.

 Trainees participated in role plays to demonstrate ways of communicating the mother to seek information on the feeding of the child and the mother’s well-being.  Clinical practice sessions were conducted at the Pre and Post natal wards at the Georgetown Hospital. The trainers will be expected to replicate the training to other healthcare workers in all the regions, especially the hinterland regions commencing with the main referral  hospital – GPHC.

Role play
Trainees during a role play interacting with mother and baby.

Trainees engrossed with the updated information provided by the training programme- reinforced by the facilitator




PAHO/WHO through the Canada project (IHWAG) will continue to collaborate with the Ministry of Health to support the implementation of specific strategies to strengthen the BFHI programme  through continued capacity building and supportive mentoring and monitoring aimed to implement practices that protect, promote and support breastfeeding to ensure that all maternity facilities become Centres of breastfeeding support.