Can WHO's New Breastfeeding Competency Toolkit Transform Maternal and Infant Healthcare Worldwide?

The World Health Organization has introduced a competency-based toolkit featuring 11 core competencies, 61 performance indicators, 12 observation tools, and 16 case scenarios to ensure healthcare providers can effectively support breastfeeding through demonstrated skills rather than training hours alone. The framework offers governments, development partners and responsible private-sector stakeholders a standardized roadmap to improve maternal and child health services, strengthen workforce quality and enhance accountability in breastfeeding support.

The World Health Organization (WHO) has introduced a new Competency Verification Toolkit that could reshape how countries train and evaluate professionals providing breastfeeding support. Developed in partnership with the BFHI Network Inc. (Canada) and experts from institutions including the Italian National Institute of Health (Italy), Training and Assistance for Health and Nutrition Foundation (Bangladesh), Fatima Jinnah Medical University (Pakistan), Alive & Thrive East Asia Pacific, Vin University (Vietnam), Baby-Friendly USA, and La Leche League International (Paraguay), the toolkit shifts the focus from counting training hours to measuring real-world competency. The framework includes 11 core competencies, 61 measurable performance indicators, 12 observation checklists, 16 case-based discussion scenarios, and a standardized knowledge assessment. WHO says the approach will help ensure that healthcare workers can consistently deliver evidence-based, ethical and compassionate breastfeeding support rather than simply completing training programmes.

A Shift from Training Hours to Proven Competency

The report highlights that healthcare systems have traditionally measured workforce readiness by the number of hours spent in training rather than by whether providers can apply their knowledge in clinical settings. WHO argues that this model is no longer sufficient. The new toolkit requires providers to demonstrate their skills through workplace observations, simulations and case discussions in addition to written assessments.

The framework covers the entire continuum of breastfeeding care, from pregnancy through childhood to age 2 and beyond. It supports the WHO's recommendation that every woman should receive breastfeeding counselling at least six times, beginning during pregnancy and continuing after childbirth. The toolkit evaluates providers on practical areas such as breastfeeding initiation, skin-to-skin care, counselling mothers, supporting preterm infants, managing breastfeeding challenges, expressing breast milk and identifying maternal or infant danger signs.

Rather than testing only theoretical knowledge, the toolkit measures how providers communicate with mothers, solve problems and make evidence-based decisions in real healthcare situations. WHO considers this integrated approach essential for improving breastfeeding outcomes and ensuring consistent standards of care across hospitals and community health services.

Why the Toolkit Matters for Governments and Health Systems

For governments, the toolkit offers a ready-to-use framework that can strengthen national maternal and child health programmes. It provides measurable standards that can be integrated into nursing, midwifery and medical education, licensing systems, workforce accreditation and continuing professional development.

The 61 performance indicators give policymakers a practical method for assessing healthcare workers across antenatal, maternity and postnatal services. Instead of reporting only the number of personnel trained, ministries of health can monitor whether providers have actually achieved competency.

The toolkit is also designed to be flexible. WHO encourages countries to adapt the assessment tools according to national laws, health system priorities and cultural practices while maintaining the minimum global competency standards. This flexibility makes it suitable for both high-income and resource-constrained settings.

By standardizing competency verification, governments can improve the quality of breastfeeding counselling, reduce inconsistencies in service delivery and strengthen accountability within public health systems. The approach also supports broader universal health coverage goals by improving the quality, not just the availability, of maternal and newborn care services.

New Opportunities for Development Partners and Responsible Businesses

The report offers significant value for development agencies including UNICEF, the World Bank, bilateral donors and international NGOs. Many breastfeeding programmes currently measure success through the number of healthcare workers trained. WHO's framework allows partners to move towards outcome-based monitoring by assessing whether providers have demonstrated competency using standardized tools.

The toolkit's 12 workplace observation checklists and 16 clinical scenarios provide common indicators that can be used across countries, making programme evaluation more consistent and comparable. This could improve accountability for donor-funded maternal and child nutrition initiatives while helping identify gaps that require additional investment.

Private-sector stakeholders also have opportunities, particularly companies involved in digital health, medical education, healthcare technology and workforce training. Digital competency assessment platforms, simulation software, e-learning systems and workforce management tools could all be developed using the standardized framework.

At the same time, WHO reinforces strict compliance with the International Code of Marketing of Breast-milk Substitutes. The report clearly states that providers and examiners should remain free from conflicts of interest involving manufacturers of breast-milk substitutes, feeding bottles and teats. Companies operating in maternal and infant nutrition markets will therefore need to ensure that any engagement with healthcare systems complies fully with national regulations and international standards.

Looking Ahead: Building Stronger Breastfeeding Support Systems

WHO recommends that competency verification become a continuous process rather than a one-time certification. Healthcare workers should undergo repeated assessments throughout their careers, supported by mentoring, workplace observations and professional development. The organization also recommends training qualified examiners who can objectively assess providers and provide constructive feedback.

Future implementation should focus on integrating competency verification into national health workforce policies, expanding examiner capacity and regularly updating assessment tools as new evidence becomes available. Countries may also develop additional competencies to address local healthcare priorities while preserving the toolkit's global standards.

Ultimately, the report represents a significant shift in how breastfeeding support is evaluated worldwide. By replacing attendance-based training with performance-based assessment, the framework aims to improve the quality of care received by mothers and infants. With 11 competencies, 61 measurable indicators, 12 observation tools, and 16 practical assessment scenarios, the toolkit provides governments, development partners and responsible private-sector organizations with a common roadmap to strengthen maternal and child health services and deliver better breastfeeding support at scale.