Discussion of resultsThe National Breastfeeding Helpline is an appropriate, efficient and effective service that forms a core activity of the ABA. However, as with all services there is both an opportunity and imperative for continuous improvement to remain a dynamic and relevant program.
An immediate priority for the Breastfeeding Helpline is to secure a sufficient workforce to ensure the efficient operation of its service. There are a number of initiatives in place to support workforce retention and improve workforce recruitment. A clearly articulated strategic approach is required assessing the options for staffing the Breastfeeding Helpline in the context of the role it plays in the service landscape and the philosophy of the ABA. This approach would take into account the changing nature of volunteering and its practical implications for staffing of the Breastfeeding Helpline.
Similarly, there is a requirement especially with the use of public monies for the service, to better address the needs of priority population groups. The extent to which this can be achieved through the Helpline, the learnings of jurisdictions and organisations in tackling similar challenges and making better use of current Breastfeeding Helpline facility to provide access to priority groups, should be assessed and the earlier work of the ABA in this area refreshed with wider input. A further consideration is the need to enable a focus on priority groups without neglecting the current and appropriate demand for the Breastfeeding Helpline service.
There are a growing number of support services for the health and wellbeing of mothers and infants. It is timely for the role of the Breastfeeding Helpline to be more systematically promoted amongst consumers, governments and service providers. There would appear to be scope for increased clarity about the service provided by the Breastfeeding Helpline to avoid confusion, improve consumer choices and better integrate the Breastfeeding Helpline into mainstream services.
The increased interest and commitment of governments in Australia to improved breastfeeding practices has implications for the training of health professionals. This current development presents an opportunity to promote consistent practice across Australia and to draw on the expertise of the ABA in that endeavour.
Across the public sector there is a growing expectation and trend for higher levels of governance, accountability and service responsiveness (Commonwealth of Australia 2010 & Holmes 2011). Services delivered by the not for profit sector but funded by public monies are not exempt from this trend.
Reform of the not for profit sector is a key focus of the Council of Australian Governments, with a range of initiatives underway, encompassing improvements in transparency and governance, whilst at the same time reducing the administrative burden on not for profit agencies.
These reforms are driven by the growth in government funded services delivered by not-for-profit organisations, particularly in the health and community services sectors. This growing reliance on government funding does present significant challenges for not for profit organisations. These challenges have been identified as:
- an undermining and confusing of the not for profit’s advocacy role or mission and purpose;
- an increased regulatory and administrative burden; and
- a stifling of innovation through the adoption of prescriptive reporting regimes (PC 2010)
Governments have a clear responsibility to ensure that public expenditure on service delivery provided by not-for-profit organisations is of a high quality, is monitored and is accountable. The dilemma is to ensure that such performance management measures do not undermine the very features of the not for profit organisation in delivering the service.
The role of the Breastfeeding Helpline in supporting breastfeeding practices and its place in the service system requires processes in place to share information about the operation and performance of the Breastfeeding Helpline and to ensure that any changes to the operation of the service are communicated to key stakeholders to ensure currency of information and promotional material.
A strategic set of performance indicators that are aligned to agreed Breastfeeding Helpline outcomes would enhance current reporting arrangements. These arrangements could include a brief annual report on activity and experiences of the Breastfeeding Helpline made relevant to jurisdictional level.