FRIENDLY

COMMUNITY
REPUBLIC OF KENYA

INITIATIVE
MINISTRY OF HEALTH

TRAINERS GUIDE 2021

BFCI ANNEXES
ANNEX 1: TRAINING CHECKLIST
1.1: EQUIPMENT AND STATIONERY
ITEMS NEEDED NUMBER NEEDED
Laptop 1
LCD 1
Speakers 1
Trainers’ manual All trainers
MIYCN Counseling cards All participants
Participant’s handouts All participants
Mentorship booklet 1 copy
Flip charts 3 rolls
Felt pens Chisel shaped, 1 dozen, all colors
Sticky notes or manila cards Different colors
BMS Act, 2012 1 copy
Mother and child handbook 1 per 2 partcipants
1000 days booklet 1 copy

1.2: DEMONSTRATION ITEMS

ITEM NUMBER NEEDED
Baby dolls 2 soft and big size
Manual Breast pump (optional) 1
Bowls (250mls) 4
Cup with spout 1
Calibrated jugs 2
Ordinary jugs 2 (sourced from venue)
Breast model ( may be made with cotton, thread 1
and a pair of socks)
20 cc syringe 2
Surgical blade 1
Pencils One per participant
Rubbers One per participant
Sharpeners One per participant
MNP powder (sachets) 2
Anthropometric equipment MUAC tapes- each participant or 4 for demo
MUAC tapes (child, Adult) 2 sets
Weighing scale 2 sets
Height/ length board
400mls thick porridge Divided into two portions 200mls each
Variety of cooked food for children 6-23 months For 4 working groups
Logistics for clinical field experience Transport to and from the nearby health
facility
Name tags for all participants and trainers

2 BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES

1.3: FOOD ITEMS
ITEM (10 food groups) QUANTITY NEEDED
(Any 3 items from each food groups)
Grain, grain products and other starchy Whole grains: rice, maize, millet, sorghum,
foods Starchy roots: white fleshed sweet potato, unripe
bananas, arrowroots, cassava, yam among others
Products: wheat flour, maize flour, spaghetti,
Weetabix, cornflakes, porridge flours among others
Legumes /Pulses Dried beans any variety, dried peas, cow peas,
green grams, lentils among others
Nuts and seeds Macadamia, peanuts/ ground nuts, cashew nuts,
baobab seeds,
Simsim, pumpkin seeds, chia seeds, poppy seeds
Flesh foods Red meat variety, white meat varieties, insects,
canned meats,
Eggs Any type available and consumed by community
Dairy and dairy products Fresh milk, processed milk, fermented milk (lala),
yoghurt, cheese
Green leafy vegetables Any green vegetables available and consumed in
the region
Other vitamin A rich fruits and vegetables Fruits: mangoes, pawpaw, purple skin passion fruit,
peaches, loquats, yellow or orange fleshed sweet
potatoes
Vegetables: carrots, pumpkin
Other fruits Ripe bananas, guavas white and red fleshed,
tree tomatoes, water melon red color, oranges,
pineapples, apples among others
Other vegetables Tomatoes, dhania, hoho, onions, cabbage,
cucumber, green peas, green beans, green maize
among others available in the market

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES 3

1.4: ITEMS TO PRINT/PHOTOCOPY
UNIT TITLE NO. OF COPIES SOURCE
DOCUMENT
Participants’ handouts All participants Hand outs
BFCI Training timetable 1 per participant Annex 2
Pre/post- test 2 copies per Annex 3
participant
Demonstration 4: A-I Listening and learning 2 sets Annex 6.1
skills
Demonstration 5: A-D Confidence and 2 sets Annex 6.2
support
Preparing a young child meal 1 copy per two Annex 7
participants
BMS- Notice of violation form-(HCW and All pax Annex 8
Public)
Assess your practices 6 Annex 8
Growth charts boys - weight and height All pax Annex 9.1
Growth charts girls- weight and height All pax Annex 9.2
Documentation of trainings 10 copies Annex 10
Counselling/education topics per BFCI steps All participants Annex 11
M&E tools
1. Individual Mother’s Record (Form 1b) All Pax Annex 12.1
2. Maternal case studies,1,2 and 3 1 copy per group (3-5 Annex 12.2
pax)
3. Infant and Young Child feeding and All pax Annex 12.3
growth monitoring (Form 1a)
4. Form 1a case studies 1,2 and 3 1 copy per group Annex 12.4
5. Individual Mother’s Record tally sheet 1 copy per group Annex 12.5
6. Individual Child feeding and Growth 1 copy per group Annex 12.6
monitoring tally sheet
7. Pre-populated form 1a and 1b (Kathama, 1 copy per group Annex 12.7
Bukolwe and Gatondo)
8. Form 2-Community Health Unit 1 copy per group Annex 12.8
Reporting Tool
9. Answer sheets form 1a, 1b & 2 2 copies per answer Annex 12.9
sheet
Self-assessment tools
1. Health care worker -1A Half number of Mentorship and
participants self-assessment
booklet
2. CHV-1B Half number of
participants
3. Non-clinical staff -1C Half number of
participants

4 BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES

4. PLW-2A Half number of
participants
5. HH member-2B Half number of
participants
6. Health facility tool 3 Half number of
participants
Mentorship tools
1. Health facility/Community health unit Half number of Annex 13.1
mentorship planning form participants
2. Mentee log Half number of Annex 13.2
participants
3. C/SCHMT BFCI Supportive Supervision Half number of Annex 13.3
and Mentorship tool participants
4. Health workers/CHV mentorship tool Half number of Annex 13.4
participants
5. Mentorship case studies Half number of Annex 13.5
participants
Hospital visit guide 6 copies Annex 14
Action plan template 3 copies per planning Annex 15
group

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES 5

ANNEX 2: TRAINING PROGRAM
Date:__________________ Venue: ____________________

Day One
Time Session Description Facilitators
8:00 – 8:30 Registration
(30 minutes)
8:30 – 9:00 Welcoming, Introduction and administration issues
(30 minutes)
9:00 – 9:10 Opening remarks
(10 minutes)
9:10 – 9:30 Pre-test
(20 minutes)
9:30 – 10:20 Unit 1: Session 1:
(45 minutes) Introduction to BFCI Course
10:20 – 10:40 TEA BREAK
10:40 -11.50 Unit 1: Session 2: Global and national initiatives on
(70 minutes) maternal infant and young child nutrition
11:50– 12:40 Session 3: Baby Friendly Hospital Initiative (BFHI)
(50 minutes) and Baby Friendly Community Initiative (BFCI)
12:40 -1.10 Unit 2: Food and Nutrients
(30 minutes) Food, Nutrients and Nutrition
1:10 – 2:00 LUNCH
2.00-3:30 Unit 2: Food and Nutrients cont….
(90 minutes) • Different Nutrients and their Food Sources
based on FAO food groups
• Relationship between Nutrition Health and
Development
3:30 – 5:00 Unit 3: Maternal Nutrition
(80 minutes) • Importance of optimal maternal nutrition during
pregnancy and breastfeeding
• Package of care during pregnancy
• Danger signs in pregnancy
5:00 – 5: 10 Day’s evaluation
(10 minutes)
5:10 TEA BREAK

6 BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES

Day Two
Time Session Description Facilitators
8:00 – 8:30 Day One Recap
(30 minutes)
8:30 – 9:10 Unit 4: feeding infants 0-6 months.
(40 minutes) Session 1: Importance of breast feeding
9:10 – 10:30 Session 2: How Breastfeeding works
(80minutes)
10:30–11:00 TEA BREAK
11:00 – 12:35 Session 3: Breast feeding techniques.
(95 minutes)
12:35 – 1:05 Session 4: Counseling skills - listening and learning
(30 minutes) skills
1:05 – 2:05 LUNCH BREAK
2:05 – 2:45 Session 4: Counseling skills - listening and learning
(40 minutes) skills cont….
2.45 – 3:35 Session5: Building confidence and support skills
(50 minutes)
3:35 – 5:00 Session 6: Common Breastfeeding Difficulties and
(85 minutes) Barriers
5:00 – 5:10 Day’s evaluation
5:10 TEA BREAK

Day Three
Time Session Description Facilitators
8:00 – 8:30 Day two Recap
(30 minutes)
8:30 – 9:30 Unit 4: Feeding infants aged 0 – 6 months cont’
(60 minutes) Session 7: Expressing breastmilk and cup feeding
9:30–10:15 Session 8: Breast conditions related to
(45 minutes) breastfeeding
10:15–10:45 TEA BREAK
10:45 – 11:45 Unit 5: Complementary Feeding
(60 minutes) Session 1: Importance of Complementary Feeding
11:45 – 1:05 Session 2: Foods to Fill Energy, Iron and Vitamin A
(80 minutes) gaps
1:05 – 2:05 LUNCH
2:05 – 2:40 Session 2: Foods to Fill Energy, Iron and Vitamin A
(35 minutes) gaps cont’
2:40 – 4:25 Session 3: Quantity Variety and Frequency of
(105 minutes) Feeding
4:25 – 5:40 Session 4: Food Modification, Fortification, and
(75 minutes) meal preparation
5:40 – 5:50 Day’s evaluation
(10 minutes)
5:50 TEA BREAK

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES 7

Day Four
Time Session Description Facilitators
8:00 – 8:30 Recap day three
(30 minutes)
8:30–9:30 Unit 6: BMS (Regulation and Control) Act, 2012
(60 minutes)
9:30 –11:00 Unit 7: Growth Monitoring and Promotion
(90 minutes) Session 1: Introduction to growth monitoring and
promotion
11:00 – 11:30 TEA BREAK
11:30 – 1:15 Session 2: Plotting and Interpretating growth
(105 minutes) trends.
1:15– 2:15 LUNCH
2:15 – 3:25 Session 3: Early Childhood Development and
(70 minutes) Stimulation.
3:25 – 4:25 Unit 8: Nutrition Sensitive Interventions
(60 minutes)
4:25 – 4:55 Unit 9: Establishment of Baby Friendly
(30 minutes) communities
Session 1: Eight (8) steps to successful BFCI
implementation
4:55 – 5:05 Day’s evaluation
(10 minutes)
5:05 TEA BREAK

Day Five
Time Session Description Facilitators
8:00 – 8:30 Recap day four
(30 minutes)
8:30 – 10:00 Session 2: Process of BFCI Establishment
(90 minutes)
(10:00 – 10:15 Field visit – preparation
(15 minutes) Preparation for the field visit and departure
(Group formation and site visit allocation
10:15 – 10:45 TEA BREAK
10:45 –12:45 Field Visit – practice of skills
(120 minutes)
12:45 – 1:05 Field visit report and compilation
(20 minutes)
1:05 – 2:05 LUNCH
2:05 – 2:35 Field visits debrief
(30 minutes)
2:35 – 5:30 Unit 10: Session 1: Monitoring, Evaluation,
(175 minutes) Accountability and Learning (MEAL)
5:30 – 5:40 Day’s evaluation
5:40 TEA BREAK

8 BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES

Day Six
Time Session Description Facilitators
8:00 – 8:30 Recap day five
(30 minutes)
8:30 – 10:30 Unit 10: Session 2
(120 minutes) BFCI Self-Assessment and Accreditation
10:30 – 11:00 TEA BREAK
11:00 – 12:00 Unit 10: Session 2
(60 minutes) BFCI Self-Assessment and Accreditation cont’
12:00 – 1:30 Unit 10: Session 3
(90 minutes) BFCI Supportive Supervision and mentorship
1:30 – 2:30 LUNCH BREAK
2:30 – 3:00 Post-test
(30 minutes)
3:00 – 3:45 Preparation of work plans
(45 minutes)
3:45 – 4:15 Work plan presentation
(30 minutes)
4:15 – 5:00 Closing ceremony
(45 minutes) Pre and Post-test evaluation results
Review of expectations
Workshop evaluation
Closing remarks
5:00 TEA BREAK AND DEPATURE

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES 9

ANNEX 3: BFCI TRAINING PRE/POST TEST
QUESTIONNAIRE
BFCI COURSE FOR SERVICE PROVIDERS- TEST

1. Name two recommendations in the global strategy on Maternal Infant and Young child
nutrition (2 marks)

2. List the 8 steps to successful Baby Friendly Community Initiative (8 marks)

3. List the ten food groups required for women (WRA) dietary diversity (10 marks)

4. List any three interventions during pregnancy (3 marks)

5. List 2 benefits of breast feeding to the mothers (2 marks)

6. List 2 benefits of breastfeeding to the baby (2 marks)

7. List four key points of positioning (4 marks)

8. List four key points of attachment (4 marks)

10 BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES

9. List 2 situations that are useful for mothers to express their breast milk (2 marks)

10. What is the importance of growth monitoring in infant feeding (1 mark)

11. List 3 aspects of developmental milestones to assess in a child (3 marks)

12. Describe the criteria for complementary feeding - FATVAH (3 marks)

13. Explain the meaning of nutrition sensitive interventions (1 mark)

14. List 2 strategies to address household food and nutrition security (2 marks)

15. Name BFCI documentation and reporting tools (2 marks)

16. What is the purpose of BFCI self-assessment (1 mark)

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES 11

ANNEX 4: NATIONAL POLICY MATERNAL, INFANT
AND YOUNG CHILD NUTRITION

12 BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES

ANNEX 5 : 8 STEPS TO BABY FRIENDLY COMMUNITY
INITIATIVE (BFCI)

8 STEPS TO BABY FRIENDLY COMMUNITY INITIATIVE (BFCI)

Step 1 Have a written MIYCN policy summary statement that is routinely communicated to
all health providers, community health volunteers and community
Step 2 Train all health- care providers and community health volunteers in the knowledge
and skills necessary to implement the MIYCN policy
Step 3 Promote optimal maternal nutrition among women and their families
Step 4 Inform all pregnant women and their families about the benefits of breastfeeding
and Risks of artificial feeding
Step 5 Support mothers to initiate breastfeeding within the first one hour of birth, establish
and maintain exclusive breastfeeding for first six months
Step 6 Encourage sustained breastfeeding beyond six months to two years or more
alongside timely introduction of appropriate, adequate and safe complementary
foods
Step 7 Provide a welcoming and conducive environment for breastfeeding families
Step 8 Promote collaboration between healthcare staff, maternal, infant and young child
nutrition support groups and the local community

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES 13

ANNEX 6 : COUNSELLING SKILLS

6.1: LISTENING AND LEARNING SKILLS-DEMONSTRATIONS

14 BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES 15
6.2: BUILDING CONFIDENCE AND GIVING SUPPORT SKILL –
DEMONSTRATIONS

16 BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES

6.3. SUMMARY COUNSELLING SKILLS CHECK LIST
Listening and Learning Skills
□□ Use helpful non-verbal communication
□□ Ask open questions
□□ Use responses and gestures that show interest
□□ Reflect back what the mother/caregiver says
□□ Empathize – show that you understand how she/he feels
□□ Avoid words that sound judging
Building Confidence and Giving Support Skills
□□ Accept what a caregiver thinks and feels
□□ Recognize and praise what a mother/caregiver and child are doing right
□□ Give practical help
□□ Give relevant information
□□ Use simple language
□□ Make one or two suggestions, not commands

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES 17

ANNEX 7: PREPARING A YOUNG CHILD’S MEAL

18 BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES

ANNEX 8: BMS ACT, 2012
8.1 NOTICE OF VIOLATION FOR FORM (HEALTH WORKERS)

REPUBLIC OF KENYA
BMS (REGULATION & CONTROL) ACT, 2012
NOTICE OF VIOLATION FORM (health workers)

If you notice any violation of the BMS Act, 2012, report it to:
i.
Director, Public Health P. O. Box 30016-00100 Nairobi, E-mail: directorphke@gmail.
com and copied to
ii. Director, Nutrition and Dietetics Unit (NDU), Ministry of Health, P.O. Box 43319-
00100 Nairobi, E-mail headnutrition.moh@gmail.com or the nearest public health
or nutrition office.
PART A
The following information is optional. It will enable the Ministry of Health to follow up
with the information you have given. Your identity will be kept confidential.
Name...................................................................................................................................
Address................................................................................................................................
E-mail...................................................................................................................................
PART B
Please provide us with the following information
1. Description of violation ...............................................................................................

2. When was the violation observed? (dd/mm/yyyy).........................................................

3. Where? (Physical place or Geographical

location)..........................................................................................................................
(Note: For newspapers and periodicals, audio media, please indicate the name and date of
publication.)

4. Who is violating the Breast Milk Substitute (Regulation and Control) Act and how?

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES 19

 Person/Organization/Institution/Company/ Type of violation Type of Product
Business that is responsible for Area (please see details (please see details
where there is a Violation below)1 below)2
Type of violation: A. Advertisement, B. Commercial promotion to general public and/or in health
facility,
C. Company contact with mothers, D. Donation of products to health facilities, E. Free sample,
F. Gift to health worker, G. Gift to caregiver, H. Inadequate labeling, I. Promotion in shops, J.
Sponsorship, K. Other (please explain, use another sheet of paper if necessary). L. If sample of
product or picture is attached, tick here: □

Type of product: A. Infant formula, B. Follow-up formula, C. Complementary food, D. Bottle and/
or teat, E. Other (please specify)…..........................................................................................….…

5. Other Relevant Observations ..............................................................................................

................................................................................................................................................
...............
(Please use another sheet of paper if necessary)

NB:
• This form should be returned to Nutrition and Dietetics Unit (NDU) by post or via email.
• An electronic version of this form can be obtained from NDU or can be downloaded
from the NDU website at www.nutritionhealth.or.ke
• Where possible, include actual samples, photographs or images of areas that are not
complying with the Breast Milk Substitute (Regulation and Control) Act identified in
your form.
• Samples should be identified and matched to the correct forms, especially when you do
more than one report.

20 BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES

8.2 NOTICE OF VIOLATION FOR FORM (PUBLIC)

REPUBLIC OF KENYA
BMS (REGULATION & CONTROL) ACT, 2012
NOTICE OF VIOLATION FORM (Public)

If you notice any violation of the BMS Act, 2012, report it to:
i.
Director, Public Health P. O. Box 30016-00100 Nairobi, E-mail: directorphke@gmail.
com and copied to
ii. Director, Nutrition and Dietetics Unit (NDU), Ministry of Health, P.O. Box 43319-
00100 Nairobi, E-mail headnutrition.moh@gmail.com or the nearest public health
or nutrition office.
PART A
The following information is optional. It will enable the Ministry of Health to follow up
with the information you have given. Your identity will be kept confidential.
Name...................................................................................................................................
Address................................................................................................................................
E-mail...................................................................................................................................
PART B
Please provide us with the following information
1. Description of violation ...............................................................................................

2. When was the violation observed? (dd/mm/yyyy).........................................................

3. Where? (Physical place or Geographical

location)..........................................................................................................................
(Note: For newspapers and periodicals, audio media, please indicate the name and date of
publication.)

4. Who is violating the Breast Milk Substitute (Regulation and Control) Act and how?

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES 21

 Person/Organization/Institution/Company/ Type of violation Type of Product
Business that is responsible for Area (please see details (please see details
where there is a Violation below)1 below)2
Type of violation: A. Advertisement, B. Commercial promotion to general public and/or in health
facility,
C. Company contact with mothers, D. Donation of products to health facilities, E. Free sample,
F. Gift to health worker, G. Gift to caregiver, H. Inadequate labeling, I. Promotion in shops, J.
Sponsorship, K. Other (please explain, use another sheet of paper if necessary). L. If sample of
product or picture is attached, tick here: □

Type of product: A. Infant formula, B. Follow-up formula, C. Complementary food, D. Bottle and/
or teat, E. Other (please specify)…..........................................................................................….…

5. Other Relevant Observations ....................................................................................................

.........................................................................................................................................................
(Please use another sheet of paper if necessary)

NB:
• This form should be returned to Nutrition and Dietetics Unit (NDU) by post or via email.
• An electronic version of this form can be obtained from NDU or can be downloaded
from the NDU website at www.nutritionhealth.or.ke
• Where possible, include actual samples, photographs or images of areas that are not
complying with the Breast Milk Substitute (Regulation and Control) Act identified in
your form.
• Samples should be identified and matched to the correct forms, especially when you do
more than one report.

22 BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES

ANNEX 9: GROWTH MONITORING AND PROMOTION

9.1 ASSESS YOUR PRACTICES

Does this practice occur? With all With some Does not Comments
children children occur
Weigh child
Measure child’s length
Look at child’s growth chart
Discuss how the child is feeding
Note on child’s chart that
feeding was discussed
Carry out demonstration
of young children’s food
preparations and feeding
techniques
Make home visits to assess
foods and feeding practices
Other activities
Most frequent nutrition related activities occurring in your health facility

Least frequent nutrition related activities occurring in your health facility

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES 23

9.2 GROWTH CHART BOYS-WEIGHT AND HEIGHT

24 BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES

9.3 GROWTH CHART GIRLS – WEIGHT AND HEIGHT

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES 25

ANNEX 10: DOCUMENTATION OF TRAININGS

TRAINING DOCUMENTATION
County/sub county list of trained community members on BFCI
County………………… Sub county ……………………… Health workers
Name Designation Community Link health Type of Contacts Year month
unit facility training

County/sub county list of trained community members on BFCI

Sub county ……………………………… CHVs/ CMSG

Name of Designation Community Link health Type of Contacts Year month

community member unit facility training

26 BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES

ANNEX 11: COUNSELLING/EDUCATION TOPICS PER
BFCI STEP

STEP TOPICS TO BE COVERED

Step 3: Promote optimal 1. Importance of good maternal nutrition
maternal nutrition among 2. Consequences of malnutrition (underweight and overweight/
women and their families obesity) during pregnancy
3. Promotion of appropriate maternal nutrition through
consumption of diversified diet and extra meals
4. Consumption of iron reach foods and how to increase iron
intake in foods
5. Maternal nutrition assessment (including weight monitoring
for pregnant women) and counseling within the healthcare
system.
6. Importance of gaining adequate weight during pregnancy
7. Effects of anemia in pregnancy
8. Anemia control in pregnancy through
a. dietary diversification and
b. strengthening uptake and utilization of iron folic acid
(IFAS) supplementation
c. Malaria control
d. Deworming
9. Benefits of IFAS during pregnancy
10. IFAS policy
11. Importance of attending Ante Natal Clinic (ANC) in the first
trimester (1st three months)
12. Importance of early HIV testing during ANC visit
13. Importance of tetanus vaccine during pregnancy
14. Importance of male accompaniment to the ANC clinic
15. Family support to pregnant women
16. Family support to HIV positive women
Step 4: Inform all 1. Advantages of breast milk
pregnant women and 2. Advantages of breast feeding to the mother and the baby
their families about the 3. Nutrients in human milk
benefits of breastfeeding 4. Differences in quality of protein and fats in human milk as
and risks of artificial compared to other milks
feeding 5. Duration and importance of exclusive breast feeding for 6
months
6. Importance of early initiation
7. Feeding the baby on colustrum in the first days of birth
8. Benefits of colustrum
9. Risks of not breastfeeding
10. Disadvantages of mixed feeding
11. Dangers of using bottles, teats and pacifiers

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES 27

STEP
Step 5: Support mothers
to initiate breastfeeding
within the first one
hour of birth, establish
and maintain exclusive
breastfeeding for first six
months
28 BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES
TOPICS TO BE COVERED
12. How breastfeeding works (removal and manufacturer of milk
for the next feed to address problem of not enough milk),
attachment and positioning (importance of feeding on demand)
13. Focus on changing negative attitudes and perceptions which
set up barriers to exclusive breastfeeding and continued
breastfeeding Lactation amenorrhoea (LAM)-exclusive breast
feeding as a family planning method)- does it work-3 criteria
that must be met for LAM to be effective as a family planning
method
14. Lactation amenorrhoea (LAM)-exclusive breast feeding as a
family planning method)- does it work-3 criteria that must be
met for LAM to be effective as a family planning method
15. Advantages of family planning
16. Prevention of mother to child transmission during –pregnancy,
labour and delivery, and during breastfeeding
17. Basic facts about HIV-exclusive breast feeding and use of
ARVS for HIV positive mothers
18. Importance of male accompaniment to ANC
19. Birth plan during pregnancy
20. Importance of having a companion during labour and delivery
21. Counselling family members to support a mother during birth
and delivery
22. Importance of Hygiene during pregnancy and delivery
1. Why early initiation of breast feeding
2. How to do early initiation within the first one hour of birth (Skin
to skin contact)
3. Importance of early initiation
4. Breastfeeding on demand-why
5. Signs of recognizing hunger cues from the baby
6. Good attachment-4 key points of good attachment
7. Good positioning-4 key points of good positioning
8. Effective suckling-4 key points of effective suckling
9. Results of poor positioning and attachment
10. Expressing breast milk-in which situation
11. Stimulation of oxytocin
12. How to express breast milk
13. How often to express
14. Storing breast milk-how long
15. How to warm breast milk
16. Common breastfeeding difficulties and how to address them-
a. Not enough milk
b. Baby crying a lot
c. Breast refusal
17. Common breast conditions and how to prevent
18. Importance of attendance to child welfare clinic for
immunization and growth monitoring every month
19. Importance of adequate diet for a breastfeeding mother
20. Referral to health facility incase of a problem
Step 6: Encourage 1. Benefits of continued breastfeeding upto 2 years
sustained breastfeeding 2. Age of introduction of complementary feeds
beyond six months 3. Complementary feeding criteria
to two years or more • Frequency
alongside timely • Amount
introduction of • Texture (Thickness)
appropriate, adequate
• Timely introduction
and safe complementary
• Variety
foods
• Active feeding
• Hygiene
4. Dangers of starting other foods too soon
5. Dangers of starting other foods too late
6. Iron gaps after 6 months and feeding on iron reach foods
7. Vitamin A gaps and feeding on vitamin A rich foods
8. What is the frequency of feeding as per age
9. What is the quantity/amount of food as per age
10. What variety of food to be offered
11. Active and responsive feeding
Step 7: Provide a 1. Establishment of designated breastfeeding rooms/corner for
welcoming and breastfeeding mothers
conducive environment a. running water, sink
for breastfeeding families b. Bench for changing babies
c. IEC materials
d. Friendly colors
2. Advocating for baby friendly workplace
3. Advocating for Family involvement (mother in-law, husbands,
relatives)
4. Companion accompaniment to the facility
Step 8: Provide a 1. Establishment of mother support groups
welcoming and 2. Deciding on activities of the support groups
conducive environment 3. Collaboration with the staff
for breastfeeding families

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES 29

 REPUBLIC OF KENYA
Mother’s Serial No.: ____________

30
Child’s Serial No.: _____________

MINISTRY OF HEALTH

FORM 1B - INDIVIDUAL MOTHER’S RECORD

1. COMMUNITY HEALTH UNIT INFORMATION

Community Health Unit Name: _____________________________________ Village Name: _________________________________________________

Household Number: ______________________________________________ Household Member Contact: _____________________________

MOTHER
2. Mother’s Name: __________________________________________ 4. Parity:__________________________________________

3. Mother’s Age (years): _____________________________________________ 5. Mother expected date of delivery (day/month/year)____/____/____

During Pregnancy After Delivery

M1 or Weeks 1-4
M2 or Weeks 5-8
M 3or Weeks 9-13
M 4 orWeeks 14-17
M 5 or Week 18-22
M 6 or Weeks 23-27
M 7 or Weeks 28-31
M 8 or Weeks 32-35
M 9 or Weeks 36-40
M0
M1
M2
M3
M4
M5
M6
M7
M8
M9
M 10
M 11
M 12
M 13
M 14
M 15
M 16
M 17
M 18
M 19
M 20
M 21
M 22
M 23
6. Month of pregnancy/after delivery Remarks
ANNEX 12: BFCI M&E

____/____/____
____/____/____
____/____/____
____/____/____
____/____/____
____/____/____
____/____/____
____/____/____
____/____/____
____/____/____
____/____/____
____/____/____
____/____/____
____/____/____
____/____/____
____/____/____
____/____/____
____/____/____
____/____/____
____/____/____
____/____/____
____/____/____
____/____/____
____/____/____
____/____/____
____/____/____
____/____/____
____/____/____
____/____/____
____/____/____
____/____/____
____/____/____
____/____/____

7. Date of the visit (day/month/year)

8. Have you received antenatal care during the previous month
(Yes or No)
9a. Mother's MUAC during the visit (Indicate either G, Y, R)
9b. Is the mother malnourished? If Y or R indicate Yes, if any other

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES

colour No
10. Do you have IFAS tablet? (Yes or No)

11a. How many days have you taken IFAS in the past 30 days?

11b. Has the mother taken IFAS for 15 days or more? (Yes or No)
Mother consumed food from these food group
1. Grains, grain products and other starchy foods
2. Legumes and pulses
3. Nuts and seeds
12a. What
food did you 4. Flesh foods (meat, fish, poultry and liver/organ meats)
consume 5. Dairy and dairy products (milk, yogurt, cheese)
yesterday
6. Eggs
during the day
and night? 7. Dark green leafy vegetables
8. Vitamin-A rich fruits and vegetables
9. Other fruits
10. Other vegetables
Total
12b. Did the Mother consume food from at least 5 food groups yesterday
12.1 INDIVIDUAL MOTHER’S RECORD (FORM 1B)

during the day and night?

13. How many meals did you have yesterday (day and night)? (includes
snacks)
14a. Expected number of meals per day 6 6 6 6 6 6 6 6 6 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7
14b. Did the mother have the recommended number of meals
yesterday(day and night) (include snacks) Yes or No

15. Feeding recommendations given to the mother (insert the code from
the recommendation list)
16. Indicate the number of nutrition conselling session visits to the mother
during the reporting month.Include only the individual nutrition counseling
sessions done at the household level.

CHV Initials:
CHVs Name:
CHV telephone number:
12.2 FORM 1B STORIES
FORM 1B. STORIES

Case study 1
John Esiyen is a CHV from Kanak community health unit contact 0900123456. Today,
for the first time he has visited Esther Elamach 32 years old from Kapam village
household number 102. She attended her first ANC visit last month. She has 2
older children aged 8 years and 5 years who are alive and well. Her Mid Upper Arm
Circumference is green in color. Her gestation age is estimated at 28- 31 weeks
(7months) and her expected date of delivery is in two months’ time. The nurse at the
clinic gave her IFAS tablets for 30 days during her last visit. She has been consuming
IFAS daily as instructed. Esther reports of consuming 3 meals in a day plus two snacks
and 1 extra meal as advised during her ANC visit. Yesterday, Esther took tea with milk
and bread for breakfast; at 10am she took porridge, then meat, cabbage and ugali for
lunch. She then took a cup of milk at 4pm and a mixture of dried maize and beans
for supper. Before sleeping she took a medium sized ripe mango. Esther’s husbands
contact no is 0900123244. John has recorded Esther’s details in BFCI form 1b serial
no.10.
Case study 2
Grace Zawadi is a CHV from Toghomo community unit contacts 0900765432. She
had visited Nancy Cherop household number 002. Nancy is 27 years old and a single
mother from Chester village. She has 3 older children aged 4 years, 3 years and 25
months who are alive and well. Last month she visited ANC and was given IFAS
for 30 days however she has reported that she only consumed for 2 days only and
was unable to continue due to nausea. Her gestation age was estimated to be 8
weeks (2months) and her MUAC is yellow in color. Yesterday she had two meals
which included green vegetables, rice for lunch and took potatoes, green peas with
carrots for supper. She also took some biscuits in between the day. Nancy lives with
her mother whose contact is 0900876543. According to the mother child hand book
Nancy is expected to deliver in 7 months’ time. Grace counselled her on the health
benefits of taking IFAS, importance of good maternal nutrition and budgeting for meal
planning. Nancy’s BFCI form 1b serial number is 30.
Case study 3
Anita Waceke is a CHV from Waithuku community unit contact 0900765432. She
visited Regina Waruguru from Ruthimiti village, who is already enrolled in BFCI form
1b serial 110. Regina is 28 years old and has two other children 3 and 6 years. Her
household number is 015. She visited the ANC clinic but was not given IFAS as they
were out of stock and she did not buy as recommended by the health care worker.
Her gestation is estimated at 28-31 weeks (7months). Her MUAC reading is green
and reports consuming 3 meals and two snacks. Yesterday day and night she ate:
porridge and Chapati for breakfast, one unripe mango at ten o’clock, rice, beef stew
(carrots, green peas, potatoes) and cabbage for lunch, a glass of milk at 4 o’clock, ugali,
green vegetables and an egg for supper. From the mother child hand book, Regina is
expected to deliver in two months’ time. The household contact is 0900987654.

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES 31

12.3 INFANT AND YOUNG CHILD FEEDING AND GROWTH
MONITORING (FORM 1A)

REPUBLIC OF KENYA
Mother’s Serial No.: ____________
Child’s Serial No.: _____________

MINISTRY OF HEALTH

BFCI FORM 1A - INDIVIDUAL INFANT AND YOUNG CHILD FEEDING AND GROWTH MONITORING RECORD   

1. COMMUNITY HEALTH UNIT INFORMATION

Community Health Unit Name: _________________________________ Village Name: ______________________________________________________

Household Number: __________________________________________ Household Member telephone contact: __________________________________

MOTHER CHILD
2.Mother’s/caregiver Name: __________________________________________ 4a Child Name:__________________________________________

3.Mother’s Age (years): _____________________________________________ 4b. Child’s date of birth (day/month/year) ____/____/____ 4c. Sex of the child: Male Female

5a. Child’s weight at birth (kg) _______ 5b. Low Birth Weight (if < 2,500 g, tick the box)

EARLY INITIATION PRE-LACTEAL FEEDING

6. After how long was your child put to the breast after delivery? 7. In addition to breastmilk, what did you give your child to drink/eat in the first three days of life?

6.1. Within 1hour after delivery 7.1. Water/other liquids; 7.2. Milk (not breastmilk)/infant formula;

6.2. Later than 1 hour after delivery

6.3. Don’t know 7.3. Others specify _________________________ 7.4. None

11 to 11.9  
10 to 10.9

12 to 12.9

13 to 13.9

14 to 14.9

15 to 15.9

16 to 16.9

17 to 17.9

18 to 18.9

19 to 19.9

20 to 20.9

21 to 21.9

22 to 22.9

23 to 23.9
0 to 0.9

1 to 1.9

2 to 2.9

3 to 3.9

4 to 4.9

5 to 5.9

6 to 6.9

7 to 7.9

8 to 8.9

9 to 9.9

8. Child’s age at the moment of the visit (in months) Remarks

____/____/____

____/____/____

____/____/____

____/____/____

____/____/____

____/____/____

____/____/____

____/____/____

____/____/____

____/____/____

____/____/____

____/____/____

____/____/____

____/____/____

____/____/____

____/____/____

____/____/____

____/____/____

____/____/____

____/____/____

____/____/____

____/____/____

____/____/____

____/____/____
9. Date of the visit (day/month/year)

10. Child’s weight during the visit (in kg )

11. Child was breastfed

What did
you feed 12a. Child was given any other form of milk
your child on
12b. Child was given water or any other liquid
yesterday?
(day and 13. Child was given solid or semi-solid foods
night)
14. Child was given meat, poultry, Fish or eggs

15. Was the child exclusive breastfed-based on responses from

11-14(Yes/No)

16a. How many meals (complementary feeding) did your child

have in addition to breastfeeding yesterday(day and night)

16b. Expected number of frequency of feed per day per age

of child 2 3 3 4 4 4 5 5 5 5 5 5 5 5 5 5 5 5

16c. Was the child fed the recommended number of times

yesterday (day and night)? (includes snacks) (Yes/No)

Child consumed food from these food group;

1. Grains, grain products and other starchy foods

2. Legumes and nuts

17.a. What
did you feed 3. Flesh foods (meat, fish, poultry and liver/
your child on organ meats)
yesterday?
4. Dairy products (milk, yogurt, cheese)
(day and
night)? 5. Eggs

6. Vitamin-A rich fruits and vegetables

7. Other fruits and vegetables.

Total

17b. Did the child consume food from at least 4 food groups
yesterday during the day and night?

Yes/No

18.   Feeding recommendations given to the mother (insert the

code from the recommendation list)

19. Number of nutrition counselling sessions (fill in this row

during the last household visit conducted during the
reporting month)

CHV Initials: _______________________________________________________

CHV Name: ________________________________________________________

CHV Telephone Number: _____________________________________________

32 BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES

12.4 FORM 1A CASE STUDIES 1,2 AND 3
FORM 1A STUDIES

Exercise 1 (Form 1)
a. John Musyoki is a CHV for Kathama CHU in Kulungu village. He has gone to visit
Jane Nduku aged 29 years from house hold number 102 for the first time, who
has a daughter named Agnes Mbithe 3 weeks old; her birth weight was 2.7 kgs.
Her mother reports that the health worker initiated breastfeeding within 1 hour
of delivery and she has not given her baby anything else other than breast milk
alone. The CHVs contact is 098756432. Agnes Mbithe BFCI form 1a serial no.
is 100 while her mother’s BFCI 1b is serial no. 33.
b. David Wafula is 7 months old from Bukolwe CHU in Mutoma village. His
mother Dorcus Mulamba from household 113, aged 19 years said he was
delivered at home. The mother reports having given glucose water and initiated
breastfeeding after 1 hour. His weight 5 kgs as checked in the mother child
handbook. The mother also reports feeding David on mashed potatoes twice in
a day alongside breastfeeding. Due to cultural beliefs David has not been fed
on animal source foods. The Bukolwe CHV is called Abraham whose contact no
is 034256743. Dorcus was previously enrolled in the program on BFCI form 1b
serial number 244. Her child’s BFCI form 1a serial no. 114.
c. Fatuma Salim is currently two months old, weighing 5.6kg under CHV Abdi
Abdul from Iftin CHU in Bombolulu village contact 02020785643, house number
97. From the mother-child booklet, her birth weight was 3 kgs and she was
initiated to breastfeeding within 1 hr after delivery. Two months after Fatuma
was delivered, the mother died. Baby Fatuma is living with her grandmother
Asha Bakir aged 52 years, On the previous day, Fatuma was fed three times on
liver, mashed pumpkin, and spinach and also fed on cereal porridge in between
meals. The baby BFCI form 1a is serial number 58 while that of her mother was
BFCI form 1b serial no. 85.

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES 33

 REPUBLIC OF KENYA

34
MINISTRY OF HEALTH

BFCI MATERNAL DATA TALLY SHEET(TO BE USED WHEN SUMMARIZING DATA FROM BFCI FORM 1B TO FORM 2)
Indicator 1 Indicator 2 Indicator 3 Indicator 4 Indicator 5 Indicator 6

BFCI Indicator 3: Indicator 4: Indicator 5: Indicator 6:

Indicator 1: Pregnant and
Indicators
lactating women who were
malnourished
Indicator 2:
Pregnant women who Pregnant and lactating Pregnant and lactating women Pregnant and lactating women
Pregnant women who
consumed IFAS for 15 women consuming atleast 5 consuming the recommended receiving nutrition counselling
had IFAS
TALLY SHEETS

days or more food groups in a day number of meals per day during home visit
Questions Form 1b,Q9b Form 1b,Q10 Form 1b,Q11b Form 1b,Q12b Form 1b,Q14b Q16 from Form 1b
Participant Pregnant and lactating
Pregnant women Pregnant women Pregnant women Pregnant and lactating mothers Pregnant women and lactating mothers
group mothers
Don’t
Yes No Total Yes No Total Yes No Total Yes No Total Yes No Total Yes No Total
Know
CHV Name
…………. 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000

00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
Village
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
……….….
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
Subtotal

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES

00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
CHV Name
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
………….
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
Village 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
……….…. 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
Subtotal

00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
CHV Name
…………. 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
Village 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
……….…. 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
Subtotal

00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
CHV Name
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
………….
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
Village 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
12.5 FORM 1B INDIVIDUAL MOTHER’S RECORD TALLY SHEET

……….…. 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
Subtotal

Total
 REPUBLIC OF KENYA

MINISTRY OF HEALTH

FORM 1A: BFCI DATA TALLY SHEET FOR INDIVIDUAL INFANT AND YOUNG CHILD FEEDING & GROWTH MONITORING RECORD
Indicator 1 Indicator 2 Indicator 3 Indicator 4 Indicator 5 Indicator 6 Indicator 7

BFCI child Mother/caregivers

Children 6-23 months Those who received a
Indicators Children 0-5 months Children 6-23 months who received nutrition Early Initiation of breastfeeding
consuming atleast 4 food Pre lacteal feed Gender dissagregation
exclusively breastfed consuming iron-rich foods counselling during home (Children 0-23 months)
groups (Children 0-23 months)
visit

Questions Form 1a,Q15 Form 1a,Q14 Form 1a,Q17b (Form 1a,19) Form 1a,Q 6 Form 1a,Q7 (Form 1a, 4c)
Age cohort 0-5 months 6-23 months 6-23 months 0 to 23 months 0-23 months 0-23 months 0-23 months
Don’t
Yes No Total Yes No Total Yes No Total Yes No Total Yes No Total Yes No Total Male Female Total
Know
CHV Name
…………. 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000

00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
MONITORING TALLY SHEET

00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
Village
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
……….….
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
Subtotal

00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
CHV Name
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
………….
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
Village 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
……….…. 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
Subtotal

00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
CHV Name
…………. 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
Village 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
……….…. 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
Subtotal

00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
CHV Name 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
12.6 FORM 1A INDIVIDUAL CHILD FEEDING AND GROWTH

………….
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
Village 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
……….…. 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES

Subtotal

35
Total
12.7 PRE-POPULATED FORM 1A AND 1B (KATHAMA, BUKOLWE
AND GATONDO)
BUKOLWE PREPOPULATED DATA FOR FORM 1A
Community Name Gender Age Early Pre- EBF Iron 4 food Nutrition
health unit initiation lacteal rich groups counselling
Bukolwe 1 Jane F 7 months Y Y N Y N Y

2 Ambrose M 5 months N Y N N N Y
3 John M 2 months Y N Y N N Y
4 Noah M 8 months Y N N Y Y Y
5 Jim M 3 weeks Y N Y N N N
6 Betty F 10 months Y Y N N Y Y
7 Karimi F 4 months N Y N N N N
8 Joyce F 10 months Y N N Y Y Y
9 Patricia F 7 months Y N N N N Y
10 Monica F 3 months Y N Y N N Y
11 Jack M 6 months N Y N Y N N
12 Noel M 8 months Y N N Y Y N
13 James M 4 weeks Y N Y N N Y
14 Naftali M 10 months Y N N Y N Y
15 Abscondita F 3 months Y N N N N N

36 BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES

 GATONDO PREPOPULATED FOR FORM 1A
Community Name Gender Age Early Pre- EBF Iron 4 food Nutrition
health unit initiation lacteal rich groups counselling
feeds
Gatondo 1 Jane F 2 weeks Y N N N N Y
2 Ambrose M 8 months Y Y N Y N Y
3 John M 11 months Y Y N Y Y Y
4 Noah M 3 days Y N N N N N
5 Jim M 1 month Y N Y N N Y
6 Betty F 11.5 months Y N N Y Y N
7 Karimi F 7.5 months Y Y N N N Y
8 Joyce F 1 week Y N Y N N Y
9 Patricia F 8 months N N N Y Y Y
10 Monica F 9 months N Y N N N N
11 Jack M 2 months Y N Y N N N
12 Noel M 4 months Y N Y N N Y
13 James M 9 months N N N N Y Y
14 Naftali M 5 months Y N N N N Y
15 Abscondita F 3 months Y N Y N N Y
16 Oloo M 7 months Y Y N N N Y
17 Nekesa F 8 months Y N N Y N Y
18 Nzioki M 10 months Y N N N Y Y
19 Kamau M 1 month N Y Y N N Y
20 Wafula M 11 months Y N N Y Y Y
21 Milly F 3 weeks Y N Y N N Y
22 Lydia F 3 months N Y Y N N Y

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES 37

 KATHAMA PREPOPULATED DATA FOR FORM 1A
Community Name Gender Age Early Pre- EBF Iron 4 Food Nutrition
Health Initiation lacteal Rich Groups Counselling
Unit Feeds
Kathama 1 Jane F 6 weeks Y N N N N Y
2 Ambrose M 4 months Y N N N N Y
3 John M 11 months N N N Y Y N
4 Noah M 3 months Y Y Y N N Y
5 Jim M 10 months Y N N Y N Y
6 Betty F 4 weeks Y N Y N N Y
7 Karimi F 8 months Y Y N Y Y Y
8 Joyce F 2 months Y N N N N N
9 Patricia F 9 months Y Y N Y Y N
10 Monica F 7 months N Y N Y N N
11 Jack M 1 month N N Y N N Y
12 Noel M 2 months Y Y Y N N Y
13 James M 6 months Y N N N N Y
14 Naftali M 3 months Y Y Y N N N
15 Abscondita F 5 months Y N Y N N Y
16 Oloo M 11 months N N N Y Y Y

38 BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES

 BUKOLWE PREPOPULATED DATA FOR FORM 1B
BUKOLWE CHU- PRE-POPULATED INFO FOR FORM 1B
Community Name Pregnant Age Attended Malnourished Received Consumed Taken Consumed Offered
Health Unit (P) in ANC IFAS IFAS Daily 5 FOOD ideal NO. Nutrition
Lactating Years GROUPS of meals Counselling
(L)
Bukolwe 1 Jane P 27 N N N N N Y N
2 Ann P 25 N N N N N Y N
3 Janice P 22 Y N Y N N N Y
4 Nelly L 28 N Y N N Y Y N
5 Carol P 23 Y N Y Y N N Y
6 Betty P 20 N N N N Y Y N
7 Karimi P 24 Y N Y N N N Y
8 Joyce L 20 N N N N N Y N
9 Patricia P 27 Y N Y Y N Y Y
10 Monica P 23 Y N Y N N Y Y
11 Angel L 26 N Y N N N N N
12 Schola L 38 N N N N Y N Y
13 Pamela P 34 Y N Y Y N Y Y
14 Joan P 40 N Y Y Y N Y Y
15 Lydia P 33 N N Y N N N N
16 Angela P 22 Y N Y Y N Y Y
17 Carol P 44 Y N Y Y Y Y Y
18 Doris L 38 N N N N Y Y N

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES 39

 GATONDO PREPOPULATED FORM 1B
GATONDO PREPOPULATED FORM 1B
Community Name Pregnant Age Attended Malnourished Received Consumed Taken Consumed Offered
Health Unit (P) in ANC IFAS IFAS Daily 5 FOOD ideal NO. Nutrition
Lactating Years GROUPS of meals Counselling
(L)
Gatondo 1 Jane P 22 Y Y Y N N N Y
2 Ann L 18 N Y N N N N N
3 Joan P 14 N Y N N N N N
4 Norah P 30 Y N Y N Y Y Y
5 Jacky L 21 N N N N N N Y
6 Betty P 40 Y N N Y Y Y Y
7 Karimi P 27 Y N Y Y Y N Y
8 Joyce L 18 N Y N N N N N
9 Patricia P 28 Y N Y N Y Y Y
10 Monica P 29 Y N Y N N N Y
11 Joy P 24 Y N Y Y N N Y
12 Nancy P 25 Y N Y N N N Y
13 Juliet P 19 N Y Y N N N N
14 Nataly L 15 N Y N N N N N
15 Abscondita P 30 Y N Y Y N N Y
16 Aloo P 37 Y N Y Y N N Y
17 Nekesa P 38 Y N Y Y Y Y Y
18 Ndanu P 30 Y N Y N Y N Y
19 Karen P 21 Y N Y N N N N
20 Nafula P 21 Y N Y N N Y N
21 Milly P 33 Y N Y N Y Y Y
22 Lydia P 40 Y N Y N Y Y Y

40 BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES

 KATHAMA PRE-POPULATED DATA FOR FORM 1B
KATHAMA PRE-POPULATED DATA FOR FORM 1B
Community Name Pregnant Age Attended Malnourished Received Consumed Taken Consumed Offered
Health Unit (P) in ANC IFAS IFAS Daily 5 FOOD ideal NO. Nutrition
Lactating Years GROUPS of meals Counselling
(L)
Kathama 1 Jane P 26 Y N Y N Y Y Y
2 Alice P 24 Y N Y Y N N Y
3 Jane L 21 N N N N N N N
4 Norah P 33 Y N Y N Y Y Y
5 Juliet P 30 Y Y Y N N N Y
6 Betty L 24 N N N N N N N
7 Karimi P 28 Y N N N Y Y Y
8 Joyce L 22 N N N N N N N
9 Patricia P 29 Y N Y N Y Y Y
10 Monica P 37 Y N Y Y Y Y Y
11 Jacky P 31 Y Y N N N Y Y
12 Ngina L 22 N N N N N Y N
13 June P 26 Y N Y Y Y Y Y
14 Nataly P 23 Y Y N N Y Y Y
15 Abscondita P 25 Y N Y N Y N Y
16 Annet P 21 N N N N Y N N

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES 41

12.8: BFCI FORM 2: COMMUNITY HEALTH UNIT REPORTING TOOL
REPUBLIC OF KENYA

MINISTRY OF HEALTH

BFCI FORM 2: COMMUNITY HEALTH UNIT SUMMARY TOOL

To be completed every month by the CHEW, using Form 1a and 1b. Reporting deadlines: from facility to sub-county is by 5th of the subsequent month, from the sub-county to the county is by 10th of the subse-
quent month, and from county to national is by15th of the subsequent month.

County _________________________________ Sub-county __________________________________________ Ward ________________________________

Health facility Name ______________________ Community health Unit Name ____________________________ Reporting Month __________Year __________

Section 1: Individual Child summary for BFCI Form 1a (to be analysed every month)
Indicator 2: Indicator 3: Indicator 4:
Indicator 1:
Children 6-23 months consuming iron-rich Children 6-23 months consuming atleast 4 Mother/caregivers who received nutrition counselling
Children 0-5 months exclusively breastfed
foods food groups during home visit

Child consuming Children 6-23 Mother/ caregivers

Child exclusively
iron-rich (animal or months consumed received nutrition
breastfed Total Total Total mother/
Total 0-5 fortified) foods atleast 4 food counselling
% 6-23 % children % caregivers in %
months groups
months 6-23 months BFCI
(Form 1a,Q19,all in
(Form 1a,Q15)
(Form 1a,Q14) (Form 1a,Q17b) BFCI)

Y N Y+N % Y N Y+N % Y N Y+N % Y N Y+N %

a b c a/c*100 d e f d/f*100 g h i g/i*100 j k l j/l*100

These two indicators to be analysed at the beginning of BFCI implementation and every six Indicator 7: Gender dissagregation
months there after
Number of males Number of females
Indicator 5: Early Initiation of breastfeeding. Indicator 6: Pre lacteal feeds
(Children 0-23 months) (Children 0-23 months)

Children 0-23
Total Children 0-23 Total
months on early
children months given children Indicator 8: Proxy BFCI coverage for children 0-23 months
initiation to
0-23 % prelacteal feeds 0-23 %
breastfeeding
months in months in Total number of children in
Mother/caregivers with
BFCI (Form 1a,Q7) BFCI this Community health Unit Percentage of children
(Form 1a,Q 6.1I) children aged 0-23 months
age 0-23 months mapped 0-23 months being
who received nutrition
for BFCI, (data from CHS reached with BFCI
Y N DK Y+N+ DK % Y N Y+N % counselling during home visit.
report- ensure the CHS report (coverage)
( From form 1a Q19)
is updated)

m n o p m/p*100 q r s q/s*100 T U T/U*100

Section 2:Maternal summary for BFCI form 1b: (Part B)

Indicator 1: Pregnant and lactating women Indicator 2: Indicator 3:

who were malnourished Pregnant women who had IFAS Pregnant women who consumed IFAS

Pregnant Women
Pregnant and Pregnant women
Total who consumed
lactating women Total PLW who had IFAS Total
number of IFAS for 15 days
malnourished screened for % % Pregnant %
pregnant or more
malnutrition women
women
(Form 1b,Q9b) (Form 1b,Q10)
(Form 1b,Q11b)

Y N Y+N % Y N Y+N Y N Y+N %

a b c a/c*100 d e f d/f*100 g h i g/i*100

Section 1b:Maternal summary for BFCI form 1b: (Part B)

Indicator 4: Indicator 5:
Indicator 6:
Pregnant and lactating women Pregnant and lactating women Indicator 7: Proxy BFCI Coverage for Pregnant and lactating
Pregnant and lactating women receiving
consuming atleast 5 food groups consuming the recommended number women
nutrition counselling during home visit
in a day of meals per day

Pregnant
Pregnant and lactating Total number of
Pregnant and Percentage of
and lactating Pregnant and women pregnant and
lactating women pregnant and
women lactating women Total received lactating women
Total received nutrition lactating women
consuming consuming the pregnant nutrition in this Community
Pregnant counselling & caregivers
≥ 5 food recommended Total and counselling health Unit
and % % % with children
groups in number of meals PLW lactating mapped for BFCI,
lactating (Form 1b,Q16 for less than 2 years
a day per day women in (Form 1b,Q16 (data from CHS
women all pregnant and who received
BFCI for all pregnant report- ensure
lactating women in BFCI services
(Form (Form 1b,Q14b) and lactating the CHS report is
BFCI ) (coverage)
1b,Q12b) women in updated)
BFCI)

Y N Y+N % Y N Y+N Y N Y+N %

j k l j/l*100 m n o m/o*100 p q r p/r*100 s t s/t*100

Name of reporting officer_________________________________ Signature _________________________________

Reporting date _____/_____/_____

42 BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES

12.9 ANSWER SHEET FORM 1A, 1B AND FORM 2

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES 43

44 BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES
 BFCI FORM 2: COMMUNITY HEALTH UNIT REPORTING TOOL
To
To be
be completed
completed every
every month
month by
by the
the CHEW,
CHEW, using
using Form
Form 1a
1a and
and 1b.
1b. Reporting
Reporting deadlines:
deadlines: from
from facility
facility to
to sub-county
sub-county is
is by
by 5th
5th of
of the
the subsequent
subsequent month,
month, from
from the
the sub-county
sub-county to
to the
the county
county is
is by
by 10th
10th of
of the
the subsequent
subsequent month,
month, and
and from
from county
county to
to
County …...........XXXX.................................................... Sub-county ….............................................
XX X
Health facility Name….........BUKOLWE.................... Community health Unit Reporting Month …........1.......Year …2021................
Reporting date .....3......./…..2...../…..2021........

Section 1: Individual Child summary for BFCI Form 1a

Indicator 1: Indicator 2: Indicator 3: Indicator 4:
Child exclusively Total % Child consuming Total % Children 6-23 Total % Mother/ caregivers Total %
breastfed 0-5 iron-rich (animal 6-23 months children received nutrition mother/
month or fortified) foods months consumed 6-23 counselling caregiv
s atleast 4 food months ers in
(Form 1a,Q15) groups (Form 1a,Q19,all in BFCI
Y N Y+N % (Form
Y 1a,Q14)
N Y+N % Y N Y+N % BFCI)
Y N Y+N %
18 9 27 66.66666667 18 8 26 69.23077 14 12 26 53.84615 39 14 53 73.58491
a b c a/c*100 d e f d/f*100 g h i g/i*100 j k l j/l*100

Total number of children in this

Total number of children, age 0-23 Community health Unit age 0-23 Percentage of children 0-23
months, reached with BFCI in the months mapped for BFCI, (data months being reached by BFCI
reporting month from CHS report- ensure the CHS (coverage)

Gender dissagregation
Number of males Number of
Females
29 24

Section 2:Maternal summary for BFCI form 1b: (Part A)

General information Indicator 1: Indicator 2: Indicator 3: Indicator 4:
Pregnant women Total % Pregnant and Total % Pregnant women Total % Pregnant Women Total %
attending ANC pregnan lactating mothers PLW who received number consuming IFAS Pregnan
Total number of Number of PLW the previous t malnourished screene IFAS of daily in the t
Number of month women d for pregnan reporting month women
women reached reached with BFCI
pregnant and (Form 1b,Q9) malnutri t who
with BFCI this this month
lactating mothers (Form 1b,Q8) tion (Form 1b,Q10) women (Form 1b,Q11) consum
month in the
in NICHE this ed IFAS
Community (Total number of
month previou
Health Unit PLW enrolled in BFCI
(Form 1b,Q6c) s Month
(Data from CHS) Form) 1b)

Y N Y+N % Y N Y+N % Y N Y+N Y N Y+N %

35 21 56 62.5 12 44 56 21.42857143 31 9 40 77.5 13 27 40 32.5
a b c d e f d/f*100 g h i g/i*100 j k l j/l*100 m n o m/o*100
Section 1b:Maternal summary for BFCI form 1b: (Part B)
Indicator 5: Indicator 6: Indicator 7:
Pregnant and Total % Pregnant and Total
Pregnant and % Total %
lactating mother Pregn lactating mother PLW
lactating mothers pregnan
consuming ≥ 5 ant consuming the received nutrition t and
food groups in a and recommended counselling lactatin
day lactati number of meals g
ng per day (Form 1b,Q16 for mother
(Form 1b,Q12b) mothe all pregnant and in BFCI
rs (Form 1b,Q14) lactating mothers

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES

Y N Y+N % Y N Y+N in
Y BFCI ) N Y+N %
22 34 56 39.28571429 28 28 56 50 28 28 56 50
p q r p/r*100 s t u s/u*100 v w x v/x*100

45
ANNEX 13: MENTORSHIP TOOLS
13.1 : HEALTH FACILITY/COMMUNITY HEALTH UNIT MENTORSHIP
PLANNING FORM
(This sheet will be used by the mentor to plan for the mentorship sessions in the health facility and
community health unit after conducting the gap analysis)

Name of Mentor: ________________________ Link facility _________________________________

Community Health unit: _________________ County _____________ Sub County: ___________

Staff requiring Identified Activities Date & Venue Methodology Resource

mentorship gap (demonstration, time (specific (CME, group requirement
(name & discussions) department or individual (references,
designation) and venue) mentorship) equipment, IEC
materials)

46 BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES

13.2: MENTEE LOG
(This sheet will be used to monitor progress of the mentorship sessions with the health worker/CHV). Attach a plain sheet of
paper to document findings on every mentorship session
Name of mentee: ______________________________ Name of mentor: __________________________________
Sub county ___________________________________ Community health unit:____________________________
Health facility: ________________________________

Date
Visit number 0 1 2 3 4 5 6 Comments
BFCI STEPS
1. Promote optimal maternal nutrition
among women and their families
2. Inform all pregnant women and
their families about the benefits of
breastfeeding and Risks of artificial
feeding
3. Support mothers to initiate
breastfeeding within the first one
hour of birth, establish and maintain
exclusive breastfeeding for first six
months
4. Encourage sustained breastfeeding
beyond six months to two years or
more alongside timely introduction
of appropriate, adequate and safe
complementary foods
5. Provide a welcoming and conducive
environment for breastfeeding
families
6. Promote collaboration between
healthcare staff, maternal, infant and
young child nutrition support groups
and the local community.

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES 47

13.3: SCHMT/CHMT BFCI IMPLEMENTATION MONITORING TOOL
Supervision team:
Name Designation
1.
2.
3.
4.
5.
Date of visit (dd/mm/yy):
CRITERIA 1: LINK FACILITY INFORMATION
Name of health facility:
No. of community health unit/s attached to the facility:
No. of community health units implementing BFCI:
No. of Community Mother Support Groups
Target population for BFCI in the catchment area
No. of pregnant women
No. of lactating mothers (total live births)
No. of children 0-23 months
CRITERIA 2: FUNCTIONALITY OF COMMUNITY MOTHER SUPPORT GROUP (CMSG)
Remarks/
Recommendations
Is there a CMSG? Yes () No ()
If yes, what is its composition? Yes () No ()
Core members:
CHEW/CHA [ ]
Nutritionist [ ]
Chief/assistant chief [ ]
CHVS [ ]
CHCs representative [ ]
lead mother [ ]

Others (specify) [ ] ________________________

If No why? ______________________________
Does the CMSG committee meet bi-monthly? Yes () No ()

If yes, check minutes/reports

Is there a plan for bi-monthly baby friendly meetings? Yes () No ()

If yes, check minutes/reports

CRITERIA 3: FUNCTIONALITY OF MOTHER-TO-MOTHER SUPPORT GROUPS (MTMSG)
Are there Mother to Mother Support Groups (MTMSG)? Yes () No ()
If Yes, how many? [_________]

Number of PLWs & caregivers of children 0-23 months in the

MTMSGs? [_________]

If more than one MTMSG, provide membership for each

1.
2.
3.
4.

48 BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES

Does the MTMSG meet monthly? Yes () No ()
If yes, check minutes
Is there a functional (complete) referral system between the facility Yes () No ()
and the MTMSG?

If yes, Check records

CRITERIA 4: TARGETED HOUSEHOLD VISITS
No. of targeted households for BFCI implementation in the CHU;
________
What proportion of the targeted households were visited in the
previous month? ______%

(Check form 2)
Proportion of maternal indicators whose performance is <80%
______%
(Numerator: Total maternal indicators performing <80%
Denominator: 7 maternal indicators *100 )
(Check form 2 for maternal indicators performing <80%)
Proportion of child indicators whose performance <80% ___%
(Numerator: Total No. of child indicators performing <80%
Denominator: 4 child indicators *100)
(check form 2 for child indicators performing <80%)
CRITERIA 5: COMMUNITY BABY FRIENDLY GATHERINGS
No. of community units holding baby friendly gatherings bi-monthly

Check minutes and reports

What was the composition of community members who attended
the last baby friendly gathering?

Indicate the number who attended in the box

Pregnant women [ ]
Lactating mothers [ ]
Caregivers of children 0-23 months [ ]
Older women [ ]
Youth (18-24) [ ]
Men [ ]
Other sector representatives [ ]

Check CMSG meeting report

Was an MIYCN cooking demonstration conducted during the last Yes () No ()
community baby friendly gathering?

Check report
Was there inclusion of other health promotion and nutrition sensitive Yes () No ()
activities during the community baby friendly gathering?

If yes, list the activities

1.__________________________
2.__________________________
3.__________________________
4.__________________________
5.__________________________

Check report

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES 49

CRITERIA 6: COMMUNITY HEALTH VOLUNTEERS (CHVs) MONTHLY REVIEW MEETINGS
Was the CHV review meeting conducted the previous month? Yes () No ()
Check minutes
What proportion of CHVs attended the meeting?
Total in attendance/Total CHVs in CHU×100% _______

Check minutes
Was BFCI agenda included in the CHVs review meeting in the Yes () No ()
previous month?

Check minutes
Were follow-up actions from the previous meeting accomplished? Yes () No ()
Check minutes
CRITERIA 7: CAPACITY BUILDING ON BFCI
What proportion of CHVs/Health Care Workers (HCW) implementing
BFCI have been trained?
Total No. of Community Health Volunteers ______
No. trained ______
Proportion [___%]
Total No. of health care workers in the facility ______
No. trained ______
Proportion [___%]

Check training records

What ongoing actions are taken to bridge the training gap?

Tick as appropriate
Orientation of new staff [ ]
Handing over of BFCI activities by outgoing staff [ ]
Refresher training [ ]
Sensitization [ ]
CMEs [ ]
Mentorship [ ]
On Job Training [ ]
Others (specify) __________________________

Check training records

CRITERIA 8: BABY FRIENDLY COMMUNITY RESOURCE CENTRE
Is there a BFCI resource centre in the facility or community? Yes () No ()
Ask & Observe
What IEC materials are available in the resource centre? Tick as
appropriate
MIYCN counselling card [ ]
MIYCN policy summary statement [ ]
MIYCN Brochures [ ]
Others (Specify) _________________________

Observe
Is there evidence of use of the resource centre? Yes () No ()
Check visitor’s book/user log (register)
Are there breastfeeding spaces in the facility and community? Yes () No ()
If yes, observe
Is there evidence of use of the breastfeeding space? Yes () No ()
Observe

50 BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES

CRITERIA 9: MONITORING AND SUPERVISION OF CHEW/CHV
Did the CHEW monitor/supervise CHV activities in the previous Yes () No ()
month?

If yes, Check supervision/monitoring report

Proportion of CHVs monitored/supervised in the last quarter. __/___
[__%]

Check supervision/monitoring report

What proportion of CHVs submitted form 1 A & B? _______%

Check CHV review meeting report

Has the CHEW summarised form 1 A & B into form 2? Yes () No ()
If yes, Check form 2 report
Is there an action plan based on analysis of form 2? Yes () No ()
If yes, check records

CRITERIA 10: FACILITY OBSERVATION

Does the facility have a written MIYCN policy - summary statement Yes () No ()
present and displayed in all relevant areas of the health facility?
If yes, tick as appropriate.

Labour and delivery area  Yes  No  N/A

Antenatal clinic  Yes  No  N/A
Postpartum ward/room  Yes  No  N/A
Well baby clinics/Rooms  Yes  No  N/A
ANC inpatient ward  Yes  No  N/A
Consultation rooms  Yes  No  N/A
Special baby units  Yes  No  N/A
PMTCT clinic  Yes  No  N/A
Waiting Bay  Yes  No  N/A
Paediatric ward  Yes  No  N/A
Is the MIYCN policy simplified through
- Pictorial illustrations  Yes  No
- Video clips  Yes  No
- IEC material  Yes  No
- Other specify ______________________________
that are contextualized and understood by the local population?

Observe
Are pregnant women attending ANC issued with IFAS at the health Yes () No ()
facility?

Check ANC register and MCH handbook

Are health talks on optimal MIYCN practices conducted? Yes () No ()
If yes, check health talk schedule and CME records
Are the health workers complying to the BMS Act, 2012?

Observe
If yes
If No, why

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES 51

Are there hand washing facilities in points accessible to mothers/ Yes () No ()
caregivers?

Observe
FOLLOW UP INFORMATION FOR LINK FACILITY
(To be discussed with the facility in-charge and transferred to the facility supervision book)
KEY FINDINGS
1.
2.
3.
4.
5.
Action points/Recommendations Responsible Timeline
person

1.
2.
3.
4.
5.
Signed by: Signed by:
Facility in charge: Supervision lead:
Name: Name:
Date: Date:
Signature: Signature:

52 BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES

ANNEX 13.4: HEALTH WORKER/CHV MENTORSHIP TOOL
Name of Mentee:_______________________________ Title of Mentee: ________________________
Sub-County: __________________________________ Community Unit: _______________________
Name of Mentor: ______________________________ Title of Mentor: _________________________
Date: _______________________________________

BFCI Step 1: National MIYCN policy

Knowledge and skills. Observations/gaps Mentorship conducted Action points
1. MIYCN policy components.
2. Infant feeding in context of HIV.
3. Awareness of the BMS Act, 2012.

Step 2: Train all health care providers and community health volunteers in the knowledge and skills
necessary to implement the MIYCN Policy
Knowledge and skills. Observations/gaps Mentorship conducted Action points
1. Trained or sensitized on BFCI?
2. Trained or sensitized on MIYCN?
Step 3: Promote optimal maternal nutrition among women and their families
Knowledge and skills. Observations/gaps Mentorship conducted Action points
1. Recommended number of ANC visits and
its importance.
2. 10 food groups for PLW.
3. Extra meals for PLW.
4. Importance of IFAS.
5. Health worker can demonstrate weight,
MUAC taking and documentation.
6. CHV can demonstrate MUAC taking.
7. Recommends a typical day’s menu using
locally available foods.
Step 4: Inform all pregnant women and their families about the benefits of breastfeeding and Risks of
artificial feeding.
Knowledge and skills. Observations/gaps Mentorship conducted Action points
1. Benefits of breastfeeding to child, mother,
family.
2. Dangers of artificial/mixed feeding.
3. Dangers of using bottles, teats, and
pacifiers.
Step 5: Support mothers to initiate breastfeeding within the first one hour of birth, establish and maintain
exclusive breastfeeding for first six months
Knowledge and skills Observations/gaps Mentorship conducted Action points
1. Importance of early initiation of
breastfeeding.
2. Supports early initiation of breastfeeding.
3. Benefits of colostrum.
4. Benefits of exclusive breastfeeding.
5. Dangers of pre-lacteal feeds
6. Identify hunger cues.
7. 4 key points of positioning and
attachment
8. Demonstrates on 4 key points of
positioning and attachment, breast
support.

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES 53

Knowledge and skills Observations/gaps Mentorship conducted Action points
9. Signs of effective suckling
10. Demonstrates and explains breast milk
expression, storage, warming, and cup
feeding techniques.
11. Describes how to resolve breastfeeding
difficulties.
12. Identify common breast conditions and
refer/counsel appropriately.
13. Feeding children 0- 6 months in special
circumstances
Step 6: Encourage sustained breastfeeding beyond six months to two years or more alongside timely
introduction of appropriate, adequate, and safe complementary foods
Knowledge and skills Observations/gaps Mentorship conducted Action points
1. Benefits of continued breastfeeding up to
2 years or beyond.
2. Importance of timely introduction of
complementary foods.
3. 7 recommended food groups for children.
4. Complementary feeding principals
(FATVAH).
5. Age specific FATVAH.
6. Feeding children 6-23 months in special
circumstances
7. Health worker can conduct and
document GMP.
8. CHVs can interpret the growth curve and
take appropriate action.
9. CHVs can establish GMP status.
10. CHVs can screen for malnutrition and
refer appropriately.
Step 7: Provide a welcoming and conducive environment for breastfeeding families
Knowledge and skills Observations/gaps Mentorship conducted Action points
1. Promotes male/family/communities
involvement.
2. Promotes community involvement in
baby friendly fora.
3. Advocate for establishment of breast-
feeding spaces in the facility and
community.
Step 8: Promote collaboration between healthcare staff, maternal, infant, and young child nutrition
support groups and the local community.
Knowledge and skills Observations/gaps Mentorship conducted Action points
1. Health workers/CHVs can link mothers/
caregivers to community health services
and/or other sectors for appropriate
support.
2. Promotes and documents complete
referral process.
BFCI facilitation skills observation
Knowledge and skills Observations/gaps Mentorship conducted Action points
MIYCN Counselling Skills
Can state and apply:
1. Listening and Learning skills
2. Building confidence and giving support
skills

54 BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES

Appropriate use of counselling cards and training aids.
Manage group sessions.
1. Participants sit in circle.
2. Facilitator conducts climate setting
3. Facilitator(s) clearly explain the day’s
agenda.
4. Facilitator(s) asks questions that generate
participation.
5. Facilitator(s) manages group dynamics to
enhance learning
Facilitate group discussions.
1. Encourage mothers/fathers/ caregivers to
share their own experiences.
2. Able to address all questions/issues
arising from members competently.
3. Able to facilitate sessions and answer
questions using the counselling cards
effectively
4. Able to conclude and give a clear way
forward.
Monitoring and reporting
1. Completeness and accuracy of Form 1a
and b.
2. Target population of;
- Pregnant and lactating mothers
- Children 0-23 months
3. CHVs proportion of households visited
during the previous month with;
- pregnant and lactating mothers
- Children 0-23 months

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES 55

13.5 CASE STUDIES FOR MENTORSHIP TOOLS
Tool
Health facility/community Health Unit
Mentorship Planning form
Health worker/CHV Mentorship tool
Mentee log
56 BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES
Methodology
Ann is the SCNO in Matata sub-county and is part of the SCHMT
conducting supportive supervision in Afya Bora Health Center, which
is also the link facility for Matunda community unit.
During supervision, Ann noticed that Jackline, the facility nutritionist
stationed at the MCH, has gaps in demonstrating how to correctly
position and attach an infant to the breast when counseling on
breastfeeding. Ann also noticed that Jackline struggled when
counselling the mother on dietary diversity (10 food groups) even
though she has been trained on BFCI.
As a BFCI mentor, Ann decides to plan for mentorship with Jackline.
Tasks:
1. Participants discuss as a group and develop a plan of
mentorship for Jackline.
2. Facilitator debriefs the session ensuring that participants can
fill in the mentorship planning tool
Role play
Jackline counsels a mother with a 2-month-old baby who has gained
only 300 gms (3.4 kgs) since the previous visit (3.1kgs). The mother is
thinking of introducing animal milk because she thinks her milk is not
adequate.
Instructions
In plenary, facilitator to identify 3 participants and prepare them in
advance for the role-play: 1 as mentor, another as nutritionist and the
other as mother.
The other participants to observe and fill in their health care workers/
CHVs mentorship tool for: -
• Gaps
• Mentorship they would conduct.
• Actions they would take.
Task:
After the mentor has given feedback, ask the rest of the participants
to give their feedback.
After the role-play, the mentor fills in the mentee log based on the
findings from the role-play.
Tasks
1. Ask the rest of the participants to contribute towards filling in
the mentee log.
2. Facilitator debriefs the session ensuring participants are able to
fill the mentee log.
ANNEX 14: HOSPITAL VISIT GUIDE

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES 57

ANNEX 15: ACTION PLAN
PRE-POPULATED ACTION PLAN
Activities Responsible Resources Time Indicators
person(s) to measure
(by when) performance
Multi-sectoral County/Sub county
sensitization
Sensitization for the community
stakeholders
Training of Health care workers
Selection of CMSG
Training of CHV and CMSG
Mapping of households with pregnant
and lactating mothers
Initial BFCI self- assessment (baseline)
Other follow up / continuous activities
Formation of Mother to Mother
support groups
CHV monthly review meetings
Household visits by CHVs
Bi-monthly baby Friendly community
meetings
Education sessions for the mothers at
Maternal and Child Health clinic (MCH)
Continuous medical education for
CHVs
Engagement/ involvement of/in other
existing community groups/activities
Bi- monthly CMSG meetings
Mentorship for health care workers
and CHVs
SCHMT support supervision
Monthly Reporting
Establishment of a facility resource
Centre
Establishment of a community
resource centre
Periodic BFCI assessments
Self-assessments and External
assessment
Accreditation of community units as
baby friendly

58 BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES

BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES 59
 REPUBLIC OF KENYA

MINISTRY OF HEALTH

60 BFCI TRAINING FOR HEALTH CARE WORKERS | ANNEXES