Mary Broadfoot - wonderful to hear that training for BFHI Assessors is
underway in your part of the world.  Fascinating, isn't it?  I just love the
way it works, approximately 12 hospital staff are interviewed and at least
3O mothers  - i e the consumers of the hospital protocols - impossible to
fudge these results.  In Zimbabwe we started off with 8 Assessors and then
trained new Assessors during later Assessments, I believe there are 27 in
all now, but I'm not sure how many are active.  I hear what you say about
the pitfalls ...!  A couple of weeks ago I was one of a team of 4 who
assessed three City Health Polyclinics (the ones who do deliveries) in 3
days.  You will no doubt have the benefit of vast experience in your
training in such a civilized place, but here we've kind of fumbled along and
learnt as we went and it has been chaotic at times!  We have learned to
catch certain categories of mothers - the antenatal mothers you mention, and
the postpartum mothers BEFORE they leave! I can't tell you how many times we
have arrived at a hospital only to be told that a delivery occurred only
half an hour ago!  We also find that we can wait all day and have no
deliveries then there will be four during the night - it takes patience!

But we've had some magic moments - watching a baby wriggle up and attach
herself to the breast while the midwife was busy looking for sutures,
finding that the ENTIRE staff of a small clinic (90 deliveries per month)
have gone through the training, from the matron down to the security guard
(a man!) at the gate - just in case the mothers had breastfeeding questions
on the way in or out of the clinic!!  I can't tell you what a kick it gives
me to interview a male lab technician ("Do you work with breastfeeding
mothers?" - "Oh yes, I do the blood tests!") and have him correctly
demonstrate how to position a baby at the breast and manual expression of
breastmilk.  There are hand-drawn posters of breasts all over the place and
the Breastfeeding Policy has been counted in 23 different places in one
clinic.  In the small hospitals some of the questions are nonsensical, e g
"Are pre-lacteal feeds harmful" - the staff look at you as if you're mad,
because it's unthinkable that anything other than the breast would be given
to the babies.  However, at clinical training sessions at the main Harare
Hospital we have been a bit disconcerted to discover that mothers often give
coke, raspberry cordial or straight tap water to their babies (without the
knowledge of the staff) because they perceive that the babies are thirsty.
So there's no room for complacency.

Best wishes to you - it's hard work doing Assessments - but very rewarding
all the same.  Enjoy!

Pamela, Zimbabwe