AppropriatenessThe Breastfeeding Helpline has a high volume of callers that has been sustained since inception of the consolidated national service in October 2008. The service model has all the features of an appropriately constructed helpline seeking to provide an accessible support to the community. The model is especially appropriate to meeting the needs of breastfeeding mothers and their families, a potentially vulnerable target population, wanting information and support at any time of the day or night. The model has been adapted to a volunteer workforce and has sought to meet quality outcomes through competency standards, continuing education, quality surveys, counsellor mentoring and debriefing.
Sustaining an adequate workforce supply to meet demand poses a threat to the viability of the service. However, the caller waiting times are generally acceptable to callers who value the support, the counsellors are supported to manage their workload and there is innovation in counsellor training to attract new volunteers and widen the workforce base.
As for other helplines in the health and parenting sector, the service model struggles to meet the needs of priority population groups. Those strategies that have been introduced to facilitate communication would appear to be underutilised and there is little opportunity for counsellor practical experience of the circumstances and needs of priority population groups.
The Breastfeeding Helpline is receiving calls from all jurisdictions with some making better use of the service than others. The trend towards increasing reliance on mobile telephones poses an equity issue because of the cost of using a telephone support system.
Consistent with good practice in service arrangements, the Breastfeeding Helpline provides an option within the suite of professional, lay and peer support services that are available for mothers and their families. The high rate of caller referrals to other services and the wide range of sources of information about the Breastfeeding Helpline indicate an active emphasis on coordinated service delivery and the ability to meet the wider advice and support needs of callers to the Breastfeeding Helpline. However, there is opportunity for a more systematic approach to service integration especially at state level and through professional associations.
The Breastfeeding Helpline service is cost effective when compared to other modelled scenarios. The costs per call received and per call answered from callers who found the service relevant, compares favourably with the other models both of which involved paid staff and a higher ratio of cost to output/outcome achieved.
EffectivenessThere was a high level of caller satisfaction with the availability of the Breastfeeding Helpline resource and the relevance of information and support provided by the Breastfeeding Helpline. Calls to the Breastfeeding Helpline were predominantly appropriate to the service and the majority of callers would recommend the service to a friend or relative. The information provided by the Breastfeeding Helpline was considered to be relevant and in many instances led to a change in breastfeeding practice.
The issues managed by the Breastfeeding Helpline and the ability to support the caller with strategies for overcoming difficulties or providing reassurance are highly relevant to contributing to duration of breastfeeding and meeting the policy objectives in this area.
TransparencyProviding a national service supported by governments (financially and in kind) requires an appropriate level of transparency to ensure accountability, to facilitate service integration and optimise resources.
The ABA has a high profile and is known for its specialist breastfeeding expertise. This has been built on its long history of advocacy, volunteerism, and peer support and counselling activity, in and amongst the community.
However, there is little understanding outside of the ABA, about the operations, capability and processes of the Breastfeeding Helpline itself. Given the public investment in the Breastfeeding Helpline, a better knowledge of Breastfeeding Helpline operations would assist in appreciating the role of the Breastfeeding Helpline and the way in which it can complement local service arrangements.
Consideration needs to be given to the impact that a growing reliance on government funding for the Breastfeeding Helpline, with accompanying regulatory and reporting requirements, could have on the organisational structure of the ABA, its mission, and its capacity to remain an innovative and responsive, volunteer based organisation.