Developing an Evaluation Plan Implementation of Exclusive breastfeeding within six month of
Using 800-1,000 words, discuss methods to evaluate the effectiveness of your proposed solution
and variables to be assessed when evaluating project outcomes.

Far reaching issues employed in evaluating breastfeeding promotion as well as support
practices are largely analogous with those pertinent to other health schemes (Blyth et al. 2009).
These comprise of scheduling, training, supervision and execution of activities such as target
population and quality of services. The evaluation aims at establishing the process and outcome
aims. Screening and following of program activity in tandem with program objectives is critical
to program managers who use them to evaluate progress in meeting objectives. An alternative
strategy may be opted for in the event that objectives are not met. Monitoring is necessary

especially for managers in determining whether or not the current level of activities has the
nticipated effect on practices (Gibson-Davis & Brooks-Gunn, 2012).
Outcome Indicators: Indicators of Breastfeeding Practices
In the evaluation of outcomes associated with breastfeeding, it entails assessing breasting
practices among the target group. In some instances, outcomes are evaluated to determine
behavior changes among mothers due to a particular intervention (Taveras et al. 2013).
Outcomes can be effects or consequences. Therefore, effects involve short to medium term
changes like 2 to 5 years, in practices fostered by a program such as changes in exclusive
breastfeeding rate and opportune complementation (Gibson-Davis & Brooks-Gunn, 2012). On
the other hand, consequences take place after a long period such as changes in morbidity, dietary
status, mortality and fertility rates. Evaluating these consequences requires a technique as well as
big samle size, which is costly to conduct.
A number of evaluation methods inadequately control all the elements and hence assess
impacts with statistical guarantee. There might be a relationship in a particular breastfeeding
behavior as well as nutritional status and the child’s morbidity (Taveras et al. 2013). This can be
evident if a particular breastfeeding behavior impacted the nutritional status and morbidity of the
child. Nevertheless, alternative view for this relationship might be;
 High morbidity or changes in malnutrition that affect breastfeeding behavior
 Breastfeeding behavior is not related to morbidity or nutritional status though associated
with other confounding factors that are related to morbidity or nutritional condition
 No relationship between breastfeeding behavior and morbidity of nutrition; the evident
relationship is as a result of sampling variation.
Breastfeeding indicators

Exclusive Breastfeeding Rate (EBR)
World Health Organization (WHO) provides that all infants should exclusively be
breastfed from birth up to 6 months. The use of EBR will determine if infants are breastfed based
to these propositions or not (DiGirolamo et al. 2009). Nonetheless, the highest percentage of
EBR is bout 60%, but in many nations the rate is very low about 2%.
Predominant Breastfeeding Rate (PBR)
PBR will evaluate the rate of children who are breastfed however they also take other
food supplements such as water, fruit juice or ORS solutions. Infants receiving milk are not PBR
(DiGirolamo et al. 2009). Furthermore, As such, PBR will evaluate some of the programs that
have attempted to enhance the rate of PBR whereby mothers are encouraged to stop giving
infants milk, but failed to change EBR due to persistence of culture that infants should be given
Never Breastfed Rate
The use of this indicator will show the number of infants that have never been breastfed.
Different factors will be used to evaluate this indicator.
Initiation of Breastfeeding immediately after birth
This indicator will be used to determine the benefits of breastfeeding to both mother and
infant immediately after birth.
Continued Breastfeeding Rate
This indicator will be used to assess constant breastfeeding rate.
Median Duration of Breastfeeding

This aspect will be used to show optimal breastfeeding period. Median Duration of
Breastfeeding will evaluate some of the foods introduced in the early stages must complement
rather than a substitute to breastfeeding (DiGirolamo et al. 2009).
Breastfeeding frequency in 24 Hours
The indicator will evaluate the frequency of breastfeeding during early months of
infancy. Other aspects that will be evaluated using breastfeeding frequency include; milk
production, effect of contraception among others.
Full/Partial/Token Breastfeeding
This indicator will evaluate breastfeeding trend, which has psychological effects.
Duration of Lactational Amenorrhea
The indicator will help in evaluating the intensity of breastfeeding. Additionally, the
evaluation will entail maternal psychological reactions as well as the infant’s ability to maintain
milk supply.
Timely Complementary Feeding Rate
Timely complementary breastfeeding rate will evaluate some of the suitable and
complementary foods for babies. It will also evaluate whether mothers adhere to recommended
foods for infants between 6-10 months.
Family Planning among breastfeeding Mothers
This indicator will evaluate appropriate family planning among breastfeeding women.
This will help in understanding most suitable family planning method for breastfeeding mothers.

Section II
Evaluation Plan and Disseminating Evidence
Data Sources Used in the Monitoring and Evaluation Process
While various forms of data may be employed to attain the required data to monitor and
assess program progress, the study will use existing records, health or management information
systems (HIS/MIS), intermittent surveys, exit interviews and sentinel sites statistical sources.
Existing Records: This will help screen data from standard levels of action, knowledge
and practices. While the approach may be cost-effective, the accuracy of infant data may be

questionable. Such data may present difficulties when it comes to the monitoring process.
Health or Management Information: The availability of management information
systems may make it possible to collect data on process benchmarks.
Sporadic Surveys: In the event that continuing data from MIS are inaccessible owing to
employee illiteracy, it becomes probable to set up a consistent cycle of mini-reviews at definite
time frame. While it’s costly, it is needed in the absence of records (Gibson-Davis & Brooks-
Gunn, 2012).
Sentinel Sites: Identifying few sites for uninterrupted monitoring especially in places that
involve long traveling is critical. Gathering information frequently on practices of breastfeeding
mothers from various small numbers of sites helps diminishing the degree of collected data
which will cut down costs. The methodology will improve the profundity of analysis and clarity
(Johns et al. 2013).
Exit Interviews: The method is significant to a facility-centered project, because of its
capacity to provide a great deal of data
Monitoring and Evaluation Steps
Self-assessment: this is critical particularly before choosing the benchmarks used to
determine stated objectives. You need to start by questioning yourself why you may be
interested in evaluating and monitoring breastfeeding. You also need to determine whether or
not the program requires some improvement or an issue of policy. The availability of data and
standard information as well as the population from which data should be collected and whether
they may be influenced by current scheme target groups may be considered as well (Johns et al.

Priority issues for calculating breastfeeding indicator
No Question 1 st answer: 1=


2 nd answer:

1 Interview date
2 Child’s date of birth
3 Have you ever breastfed “child X” 1 2
4 Have you breastfed “child X” since
yesterday time like this

1 2

5 Has “child X” received any of the
following in last 24 hours

1 2

a Vitamins, mineral enhancements or

1 2
b Water 1 2
c Flavored water 1 2
d Fruit in liquid form 1 2
e Beverage 1 2

f Infant milk 1 2
g Powdered or fresh milk 1 2
h Other fluids 1 2
I Solid foods 1 2
J ORS solution 1 2
k Other (specify) 1 2
L Are your menses back since “child X”
was birthed

1 2

Table 1: Priority issues for calculating breastfeeding indicator


Blyth, R., Creedy, D., Dennis, C.-L., Moyle, W., Pratt, J., & De Vries, S. (2009). Effect of
maternal confidence on breastfeeding duration: An application of breastfeeding self-
efficacy theory. Birth, 29(4), 278-284

Gibson-Davis, C. M., & Brooks-Gunn, J. (2012). The Association of Couples’ Relationship
Status and Quality with Breastfeeding Initiation. Journal of Marriage and Family, 69,
DiGirolamo, A., Thompson, N. Martoel, R., Faden, S., & Grummer-Strawn, L. (2009). Intention
or Experience? Predictors of continued breastfeeding. Health Education and Behavior,
32(2), 208-226.
Johns, H. M., Forster, D. A., Amir, L. H., & McLachlan, H. L. (2013). Prevalence and outcomes
of breast milk expressing in women with healthy term infants: a systematic review. BMC
Pregnancy & Childbirth, 13(1), 1-27.

Taveras, E., Capra, A., Braveman, P., Jensvold, N., Escobar, G., & Lieu, T. (2013). Clinician
support and psychosocial risk factors associated with breastfeeding discontinuation.
Pediatrics, 112(1), 108-115
Webb, K., Marks, K., Lund-Adams, M., & Abraham, B. (2012). Towards a national system for
monitoring breastfeeding in Australia: recommendations for population indicators,
definitions and next steps. Canberra: Australian Food and Nutrition Monitoring Unit,
Commonwealth Department of Health and Aged care

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