Determine the feasibility of implementing a facility-based breastfeeding counselling (BFC) mentorship program and its effect on mentee confidence and client perceptions of breastfeeding counselling.

Mbagathi County Referral Hospital in Nairobi, Kenya

Health facility management, health workers (21 mentees and seven mentors), 120 pregnant women in the third trimester who attended an antenatal care appointment at Mbagathi Hospital and reported receiving BFC during a visit in the 2 weeks prior, and 120 postpartum women in the postnatal care ward who delivered a full-term infant and reported receiving breastfeeding counselling.

Mixed methods study incorporating online surveys, client exit interviews, key informant interviews, and focus group discussions. The 4-month intervention involved facility-wide orientations, selection and training of mentors, assigning mentees to mentors, and implementing mentorship activities.

The program successfully maintained 90.5% mentee retention (19/21) over four months. At baseline, mentees demonstrated high knowledge (94% questions answered correctly) which was maintained at endline (92%). Mentees showed significant improvement in confidence counselling on breastfeeding and infant feeding (67% at baseline vs. 95% at endline, p=0.014). The percentage of ANC clients who felt BFC gave them more knowledge increased from 73% to 97% (p<0.001). Among PNC clients, those reporting friendly treatment increased from 89% to 100% (p=0.007), verbal mistreatment declined from 7% to 0% (p=0.044), and those feeling discriminated decreased from 11% to 2% (p=0.03). Key enablers included administrative support, structured mentorship tools, and peer learning communities. Implementation barriers included scheduling conflicts, staff shortages, and high patient volumes.

BFC mentorship was feasible in this setting and was associated with improved health worker confidence in BFC. The program can be successfully implemented with supportive facility leadership, well-matched mentors and mentees, and adaptable mentorship approaches.

This assessment aimed to identify the degree and parameters of demand for support from HTAsiaLink, the Asia regional health technology assessment (HTA) hub, for HTA ecosystem development.

A sequential, exploratory, mixed-method design was implemented, starting with a literature review to define the Asia region’s HTA landscape. Then an online survey was sent to 125 Asia-focused HTA practitioners and support organizations to obtain their thoughts on HTA development needs and how a regional hub could serve them. Finally, fifty purposively selected key informants representing government HTA agencies in Asia, funding partner organizations, philanthropic foundations, global HTA support, and regional HTA hub organizations were invited to participate in semi-structured interviews. Nineteen Asian countries and territories were represented in documents reviewed. Twenty-five recipients from ten Asian countries and territories responded to the survey, and twenty-eight individuals from eight Asian countries and territories plus eight international organizations participated in interviews.

Identified needs include support to fill HTA human resources gaps, strengthen the capacity of the existing HTA workforce, produce HTA public goods, improve harmonization within and across country systems, and strengthen political will. Other important considerations include the need to adapt the hub’s purpose to an expanding role and adopt sustainable financing approaches accordingly.

Demand for an HTA hub in Asia is high, including to support HTA technical, deliberative processes, and institutional capacity strengthening. Findings underscore the importance of both conducting HTAs and fostering demand for HTA output. HTAsiaLink is recognized as well-positioned to play an expanded support role to address these needs.