International Healthcare Leadership: Breastfeeding Program Implementation in Saudi Arabia

Running head: INTERNATIONAL HEALTHCARE LEADERSHIP
INTERNATIONAL HEALTHCARE LEADERSHIP (SERVICE IMPROVEMENT)
Name of the Student
Name of the University
Author Note

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Introduction:
Breastfeeding is the most natural way by which mothers feed their newborn babies
(Dettwyler 2017). The importance of mother’s breastfeeding their babies have been pointed
out by several authors who suggest that the process can enhance nutrition for babies between
the ages of 0 to 5 years (Borra et al. 2015). Other authors have shown that breast feeding is
crucial for child development and important for the health of both the child as well as its
mother (Pérez‐Escamilla et al. 2016; Sankar et al., 2015; Chowdhury et al., 2015). According
to the World health Organization, the optimal breastfeeding approach towards breastfeeding a
child is an exclusive breastfeeding for the first 6 months after birth, followed by continued
breastfeeding along with complementary feeding until and beyond the age of 2 years (Kramer
and Kakuma 2017). Studies also show that poor breastfeeding of the child can increase the
risks of neonatal deaths by 13% among children below the age of 5 years (Seske et al. 2015).
Moreover, breastfeeding can also reduce the risks of breast cancer among the mothers thereby
preventing thousands of deaths (Islami et al. 2015). Longer duration of breastfeeding have
also been associated with an improved intelligence quotient (IQ) of the child as well as
reduced risks of obesity (Cornish et al. 2015; Luby et al. 2016; Horta et al. 2015). Such
aspects clearly show that breastfeeding is crucial for the health and wellbeing of the child as
well as the mother.
Programs to educate mothers on breastfeeding are therefore an important aspect of
healthcare education that can promote the health and wellbeing of the mother and child
(Wouk et al. 2017). According the World health Organization, breastfeeding is both a natural
act as well as a learnt behavior and mothers as well as the caregivers needs active support in
order to establish and sustain effective breastfeeding practice (Hays 2017). In 1992, WHO

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and UNICEF developed the Baby-Friendly Hospital Initiative (BFHI) that can help to
strengthen maternity practice that can support optimal breastfeeding. The BFHI outlines 10
steps that can help to protect, promote and support effective breastfeeding practices. WHO
and UNICEF also developed a 40 hour counseling course of breastfeeding that can educate
mothers, healthcare providers and healthcare workers to support breastfeeding and help
mothers to overcome problems during breastfeeding (Hawkins et al. 2015).
The aim of this study is to examine the national breastfeeding program implemented
in a maternity hospital in Saudi Arabia following the 10 step model proposed by WHO and
UNICEF under BFH Initiative using the Business Model Canvas framework.
Discussion using Business Model Canvas
Business Model Canvas is a strategic management tool that is used to develop a new
or existing business model (Joyce and Paquin 2016). The model provides visual information
in the form of a chart and identifies or describes the value proposition of a project as well as
the necessary infrastructure, customers and financial aspects (Dudin et al. 2015; Keane et al.
2018). This can help to assess the project and align the activities by identifying the trade-offs.
The model consists of 9 specific aspects such as key partners, key activities, key resources,
value propositions, customer relations, channels, cost structure and revenue streams (Toro-
Jarrín et al. 2016). Through these aspects, the potential of a project can be assessed and thus
understand its performance (Plenter et al. 2017; Martin et al. 2018).
The given program is a breastfeeding program that has been adopted in a maternity
hospital, following 10 step BFHI model. Discussed below is the program using the BMC
model:
1. Customer Segments:

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-1.1.Who are the customers?
Healthcare workers: The healthcare workers are the main customers of the BFHI program as
they would be provided the training to support optimal breastfeeding practice among the
mothers. The providers would get education on 10 steps of effective breastfeeding outlined
the BFHI strategy and therefore are the main customers of the program. It should be noted
that the target group of the program consists of nurses and midwives working in the maternity
ward of the hospital and associated with pre and post natal care of the mothers and their
babies. Training would be provided to them with the aim of protecting, supporting, and
educating and promoting effective breastfeeding practice among the mothers (Amick et al.
2016).
Mothers: The mothers admitted in the maternity ward are the secondary customers of the
program as the program is aimed towards the development of the health and wellbeing of the
mothers and educate them on effective breast feeding practices. The progr4am can help the
healthcare providers to support the mothers in a more effective manner and thus the mothers
are an important part of the program. Since the mothers would benefit from the
implementation of the program, they are the main benefactors of the program (Wouk et al.
2017).
Babies: The program also aims to benefit the health and wellbeing of the babies by
establishing and supporting the maintenance of optimal breast feeding practices among the
mothers. Following the standard practices for breastfeeding, the program helps to ensure
proper nutrition and development of the child and therefore they are also other important
benefactors of the process. Moreover, the program also helps to establish a baby friendly
environment for the hospital suggesting the focus of the program on their wellbeing and
health (Schreck 2015).

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Caregiver: The caregivers in the family would also be benefited by the program as it would
help them to understand how to maintain optimal breastfeeding for the child and how to best
support the mother to maintain optimal breastfeeding (Wouk et al. 2017).
Hospital Administration: They are also an important customer segment who would benefit
from the program, as it would enable the development of the hospital environment, making it
baby friendly and thereby foster the health of the babies as well as the mothers (Amick et al.
2016).
-1.2 What do they think? See? Feel? Do?
The healthcare workers work towards the providence if care for the mothers and their
babies, providing pre and post natal care to the mothers and helping to establish optimal
breastfeeding behavior among the mothers. The healthcare workers at the hospital are often
worried that the mothers do not fully understand the best approaches towards breastfeeding
and that they do not get proper support to maintain effective breastfeeding practices for their
children. Due to this, they have seen several instances of poor health among the babies as
well as the mothers caused by ineffective breastfeeding practices. The healthcare workers
such as nurses and midwives have also shown concerns about their lack of proper knowledge
about effective breastfeeding (La Monica et al. 2018; Esselmont et al. 2018).
The hospital administration also has the belief that by implementing effective
strategies to educate the healthcare workers can help to educate the mothers in a better way
on how to breastfeed their children. The administration aims towards fostering the overall
quality of care provided to the mother and babies and ensure better health outcomes for both.
The administration feels that currently awareness about effective breastfeeding practices is
low among the nursing and midwifery staff. In order to address this, the administration has

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tried to implement programs about educating the healthcare workers to enable them to guide
and educate the mothers in a better way (Schiff et al. 2018).
The mothers often feel a significant stress after childbirth as they feel confused as to
when and how often to breastfeed their children and when to provide nutritional supplements
such as baby food. Moreover, they also feel unsure for how long or how many years the
breastfeeding should be continued. They mostly follow the advice of the family elders in the
absence of support from the healthcare organizations (Schiff et al. 2018).
2. Value Propositions:
-2.1 What’s compelling about the proposition?
The breastfeeding education program for the healthcare workers in the hospital is an
important consideration because of the following reasons:
Promoting the wellbeing of the child: Effective breastfeeding can help to improve the health
of the child and prevent the risks of several health conditions such as obesity, diabetes.
Optimal breastfeeding can help to improve the IQ of the child and improve the life
expectance and thus promote the wellbeing of the child on the long term (Crosnoe 2018).
Promoting the wellbeing of the mother: Studies suggest that regular breastfeeding reduces the
risks of health problems among the mothers and reduces the risks of diseases such as breast
cancer. Therefore the program helps to promote mother’s health as well (Liang et al. 2018).
Helping to improve the experience of the new mothers about the service of the hospital: The
program can also help to increase the experiences of the mothers and their families about the
hospital services. Education from the healthcare providers helps to foster a feeling of being
cared for among the expecting and new mothers and therefore can be an effective emotional
support for them (Pérez‐Escamilla et al. 2016).