Writing and Prioritizing Recommendations

A critical aspect of BBF is identifying the gaps in your country’s breastfeeding environment and making robust, concrete recommendations to address these gaps. Experts in the country may already be aware of some gaps and these may be confirmed or modified by the evidence-based benchmark and gear scores. It is from the BBFI scores and corresponding gaps that recommendations will be developed. The relationship between the scores, gaps and recommendations is a dynamic and iterative one that should be considered throughout the 5-meeting process (Figure 1).

Crafting meaningful recommendations that are understood by key stakeholders, such as policy and decision makers, media sources, funders, and other relevant organizations, is vital to translating these into actions. Well-designed recommendations can also be effectively monitored and evaluated, allowing a country to track its progress.

The BBF recommendation development and prioritization is summarized in 3 steps (Figure 2). The prioritization process has been adapted from The Child Health and Nutrition Research Initiative (CHNRI) research priority-setting methodology for BBF purposes. It is highly recommended that you use specific strategies to reach consensus during this process, similar to those utilized during benchmark scoring.

In-country directors should begin reading the Writing and Prioritizing Recommendations guide before beginning the 5-meeting process. Writing the recommendations begins as gaps are being identified and prioritizing them is conducted after the third meeting.

The Appendices below provide the tools needed to writing and prioritize recommendations during the 5-meeting process.

• Appendix 0. Recommendations Grading Online Survey Set-Up
• Appendix 1. Recommendations development template
• Appendix 2. PowerPoint template for initial recommendations presented in the 3rd meeting by gear teams
  • Advocacy
  • Political Will
  • Legislation & Policy
  • Funding & Resources
  • Training & Program Delivery
  • Promotion
  • Research & Evaluation
  • Coordination, Goals & Monitoring
• Appendix 3. Template for online survey to grade recommendations (See Word Document or Google Forms link)
• Appendix 3a. Letter to committee members requesting recommendation survey completion
• Appendix 4. Excel file to compile survey responses and calculate summary grades for recommendations
  • Recommendations 1-10
  • Recommendations 11-20
  • Recommendations 21-30
• Appendix 4a. Instructions for managing survey and survey responses
• Appendix 4b. Summary grade calculator
  • Recommendations 1-10
  • Recommendations 11-20
  • Recommendations 21-30
• Appendix 5. Template for priority recommendation and development of key actions
• Appendix 6. Methods for prioritization process
  • Guidelines
  • Methods

References

1. Pérez-Escamilla R, Hromi-Fiedler AJ, Gubert MB, Doucet K, Meyers S & Buccini GS. Becoming Breastfeeding Friendly Index: Development and application for scaling-up breastfeeding programmes globally. Matern Child Nutr. doi: 10.1111/mcn.12596. [Epub ahead of print]

2. Rudan I, Gibson JL, Ameratunga S, Arifeen SE, Bhutta ZA, Black M, Black RE, Brown KH, Campbell H, Carneiro I, Chan KY. Setting priorities in global child health research investments: guidelines for implementation of CHNRI method. Croatian medical journal. 2008. 15; 49(6):720-33.

3. Okoli C. & Pawlowski S.D. (2004) The Delphi method as a research tool: an example, design considerations and applications. Information & Management. https://doi.org/10.1016/j.im.2003.11.002