Mother's Absolute Affection (MAA) program/Baby friendly Hospital initiative (BFHI)

Breastfeeding is an important child survival intervention. Breastfeeding within an hour of birth could prevent 20% of newborn deaths. Infants who are not breastfed are 15 times more likely to die from pneumonia and 11 times more likely to die from diarrhoea than children who are exclusively breastfed.

Given the overwhelming evidence available on the impact of breastfeeding on reduction of neonatal mortality and infant mortality, it is imperative that efforts are intensified to improve optimal breastfeeding practices.

Thus, "MAA – Mother's Absolute Affection" an initiative to improve Infant and young child feeding (IYCF), is being implemented in Tamil Nadu since August 2016.

Goals & Objectives of the Program

The GOAL of the ‘MAA’ Program is to revitalize efforts towards promotion, protection and support of breastfeeding practices and young child feeding practices, through health systems to achieve optimal IYCF and child Nutrition.

The following are the OBJECTIVES of the Program in order to achieve the above mentioned goal:

  1. Build an enabling environment for breastfeeding through awareness generation activities, targeting pregnant and lactating mothers, family members and society in order to promote optimal breastfeeding practices. Breastfeeding to be positioned as an important intervention for child survival and development.
  2. Reinforce lactation support services at all public health facilities through trained healthcare providers and through skilled community health workers
  3. To incentivize and recognize those health facilities that show high rates of breastfeeding along with processes in place for lactation management.

Implementing Units

All health facilities which are providing maternal and child health care

  • DME Hospitals – 24
  • DMS Hospitals – 309
  • Primary Health Centers - 2270

Components of the MAA Programme

The Programme will be implemented at three levels:

  • Macro-level through mass media,
  • Meso-level in all health facilities and
  • Micro-level at communities

An overview of the components of the Programme is as below


Capacity Building

  1. One day sensitization of ASHA – Orientation on benefits of Breastfeeding. Basic concepts of Breastfeeding and Complementary feeding.
  2. IYCF Trainings for VHN/ANMs of all Sub centers in a phased manner - ANMs are oriented in 1 day "MAA" sensitization module and trained in 4 days IYCF training module and provided with IYCF Counseling "MAA" flipchart.
  3. ANMs/Nurses/Doctors at all delivery points /Facilities
    1. Role re-enforcement regarding lactation support services -1 day orientation
    2. 4 day IYCF training package.
  4. Orientation on provisions of IMS ACT for facility and community Health and nutrition workers


Those facilities that perform well will be awarded and recognized at state level, which would act as a motivation for continuing the good work. The nominated and certified facility would be awarded as "MAA- Mother's Absolute Affection award".

A Team Cash award of Rs. 10,000 per facility would be provided after certification following the validated criteria.


ALL the ten steps of BFHI including the adherence to IMS –ACT would be assessed. The assessment by an external assessor would include interviews of Administrators, health care workers involved in mother and child care, mothers themselves and their family apart from assessing the program implementation. If assessor finds any gap, the facility is given time to correct those gaps and reassessment chance will be given to the Institution.

Monitoring and Evaluation

Key Indicators as per MAA guidelines would be collected.



The target will be to get all the facilities converted to awarded units