Hawaii

State Score: 40% (15.50 / 38.5)
Rank: Tied For 14th
 WBTi United States and Territories 2017 Baseline Report   

What does WBTi assessment show us?

The World Breastfeeding Trends Initiative (WBTi) aims to stimulate action, not simply to collect information. Having more information is not helpful unless there are strategies in place for translating the information into tools for change and for taking action to improve the situation. The WBTi aims to stimulate research, investigation, ask questions, and find out why optimal infant and young child feeding (IYCF) does or does not occur. It offers an opportunity for comprehensive analysis to stimulate action for change.

To see the full national report for the United States, please visit:
http://www.worldbreastfeedingtrends.org/GenerateReports/report/WBTi-United-States-2016.pdf

To see the full state report for Hawaii, please visit: https://www.wbtiusa.org

Optimal IYCF is one of the ways to decrease infant and maternal mortality.

CHARTS/NUMBERS

INDICATOR 1

Is there a statewide policy that protects, promotes, and supports optimal IYCF/breastfeeding and if so, is the policy supported by a government program?

Is there a mechanism to coordinate the statewide IYCF committee and a state-employed coordinator for the committee?
Criteria
Results
1.1) A statewide infant and young child feeding (IYCF)/breastfeeding policy has been officially adopted/approved by the government. (1)
0.00
1.2) The policy recommends exclusive breastfeeding for the first six months, complementary feeding to be started after six months and continued breastfeeding up to 2 years and beyond. (1)
0.00
1.3) A statewide plan of action has been developed based on the policy. (2)
0.00
1.4) The plan is adequately funded. (2)
0.00
1.5) There is a Statewide Breastfeeding Committee/ IYCF Committee. (1)
1.00
1.6) The statewide breastfeeding/IYCF committee meets, monitors, and reviews progress on a regular basis. (1.5)
0.00
1.7) The statewide breastfeeding/IYCF committee links effectively with all other sectors like health, nutrition, information etc. (.5)
0.00
1.8) There is a state-employed breastfeeding coordinator with a clearly defined role, including regularly communicating statewide policy. (1) (WIC only .5)
0.50
Total Score
1.5/10

WBTiExpert Panel convened by Healthy Children Project, Inc.

www.centerforbreastfeeding.org



Hawaii
State Score: 40% (15.50 / 38.5)
Rank: Tied For 14th
 WBTi United States and Territories 2017 Baseline Report   
INDICATOR 4

Are there laws or other measures that meet or go beyond the International Labor Organization (ILO) standards for protecting and supporting breastfeeding mothers, including those working mothers in the informal sector?
Criteria
Results
4.1) Women covered by state legislation are allowed the following weeks of paid maternity leave: any leave less than 14 wks (.5), 14-17 wks (1), 18-25 wks (1.5), or 26 wks or more (2).
0.00
4.2) Women covered by state legislation are allowed at least one breastfeeding break or reduction of work hours daily: unpaid break (.5) or paid break (1).
0.50
4.3) State legislation requires private sector employers of women in the state to: give at least 14 wks paid maternity leave (.5) and/or paid nursing breaks (.5)
0.00
4.4) There is provision in state legislation that provides for worksite accommodation for breastfeeding and/or childcare in work places in the formal sector: space for breastfeeding/breastmilk expression (.5) and/or onsite daycare (.5).
1.00
4.5) Women in informal/unorganized and agriculture sector are: accorded some protective measures (.5) or accorded the same protection as women working in the formal sector (1).
0.50
4.6) Information about maternity protection laws, regulations, or policies is made available to workers (.5) and/or there is a system for monitoring compliance and a way for workers to complain if their entitlements are not provided (.5).
1.00
4.7) Paternity leave is granted in public sector for at least 3 days (.5) and/or in the private sector for at least 3 days (.5).
0
Total Score
3/8.5
INDICATOR 9

Are policies and programs in place to ensure that mothers, infants, and young children will be provided adequate protection for IYCF during emergencies?
Criteria (0-No, 1-Some Degree, 2-Yes)
Results
9.1) The state has a comprehensive policy on infant and young child feeding that includes infant feeding in emergencies (IFE) and contains all basic elements included in the IFE Operational Guidance. (0,1,2)
0.00
9.2) Person(s) tasked with responsibility for statewide coordination with all relevant partners such as the Red Cross, FEMA, state EMA, donors, military and NGOs regarding infant and young child feeding in emergency situations have been appointed. (0,1,2)
1.00
9.3) An emergency preparedness and response plan based on the practical steps listed in the Operational Guidance has been developed and put into effect in most recent emergency situations. (0,1,2)
0.00
9.4) Resources have been allocated for implementation of the emergency preparedness and response plan. (0,1,2)
2.00
9.5) Appropriate orientation and training material on infant and young child feeding in emergencies has been integrated and is taking place in pre-service and in-service training for emergency management and relevant health care personnel. (0,1,2).
0.00
Total Score
3/10
INDICATOR 10

Are monitoring and evaluation systems in place that routinely collect, analyze, and use data to improve IYCF practices?
Criteria (0-No, 1-Some Degree, 2-Yes)
Results
10.1) Monitoring and evaluation components are built into major infant and young child feeding program activities. (0,1,2)
2.00
10.2) Data/information on progress made in implementing the IYCF program are used by program managers to guide planning and investments decisions. (0,1,2)
2.00
10.3) Data on progress made in implementing IYCF program activities routinely collected at statewide levels. (0,1,2)
2.00
10.4) Data/information related to infant and young child feeding program progress are reported to key decision-makers. (0,1,2)
1.00
10.5) Monitoring of key infant and young child feeding practices is integrated into the statewide nutritional surveillance system, and/or health information system or statewide health surveys. (0,1,2)
1.00
Total Score
8/10

WBTiExpert Panel convened by Healthy Children Project, Inc.

www.centerforbreastfeeding.org   



Hawaii
Sources and Comments    
 WBTi United States and Territories 2017 Baseline Report   
Indicator
1.1
Source(s)
1.
Comment(s)
1. No policy found
2. Hawaii has breastfeeding laws that protect time to pump and ? breastfeeding in public ? (http://health.hawaii.gov/wic/files/2013/04/WorkplaceBreastfeedin? g_02_2014.pdf)
3. Hawaii Department of Health has a policy to "support[] maternity ? care hospitals statewide through the Baby-Friendly Hawaii Project? (BFHP)*. BFHP aims to increase the rate of women who ? exclusively breastfeed throughout their hospital stay and at ? discharge, by supporting hospitals to implement best practices in? infant feeding using the "10 Steps to Successful Breastfeeding".? The ultimate goal for hospitals is Baby-Friendly designation, ? as defined by the Baby-Friendly Hospital Initiative (BFHI) ? standards, an international set of guidelines developed by the ? World Health Organization and the United Nations Children's ? Fund." http://health.hawaii.gov/physical-activity-nutrition/home/breastf? eeding-baby-friendly-hawaii-project/
1.2
Source(s)
1.
Comment(s)
1. No policy found
1.3
Source(s)
1.
Comment(s)
1. No policy found
1.4
Source(s)
1.
Comment(s)
1. No policy found
1.5
Source(s)
1. http://breastfeedinghawaii.org/home
Comment(s)
1. Breastfeeding Hawaii is the breastfeeding coalition in Hawaii
1.6
Source(s)
1. http://breastfeedinghawaii.org/Events
Comment(s)
1. Meets regularly. "There is no plan for us to monitor. We do ? participate in the Hawaii Maternal Infant Health Collaborative - ? Infant Health Safety committee to discuss breastfeeding with ? stakeholders" (from Holly excel) No record of regular meetings found on website
1.7
Source(s)
1. http://breastfeedinghawaii.org/about-us
Comment(s)
1. Mission: "To promote, protect and support breastfeeding within ? the State of Hawaii through collaboration and organization of ? community efforts, outreach, legislation, policy change, ? education and advocacy." Excel from Holly says yes. Not able to find evidence on web.
2. Board listed is from 2014. Not clear if there are multiple ? agencies or sectors represented
1.8
Source(s)
1. https://www.nwica.org/states/hawaii
Comment(s)
1. No state breastfeeding coordinator. There is a WIC breastfeeding ? coordinator
4.1
Source(s)
1. http://www.ncsl.org/research/labor-and-employment/state-family-and-medical-leave-laws.aspx
Comment(s)
1.
4.2
Source(s)
1. https://www.dol.gov/wb/maps/
2. http://law.justia.com/codes/hawaii/2013/title-21/chapter-378/section-378-92
Comment(s)
1. An employer may not fire, refuse to hire, withhold pay from, ? demote, or penalize an employee for breastfeeding or expressing ? milk at the workplace. Haw. Rev. Stat.  378-2(7). An employer ? must provide: (1) reasonable break time for a nursing mother to ? express breast milk for one year after the birth of her child and? (2) a private space, other than a bathroom, for an employee to ? express milk, for one year after the birth of her child. ? Employers with less than twenty employees are exempt from these ? requirements if they can show that compliance would impose ? significant difficulty or expense on their business. Haw. Rev. ? Stat.  378-92
2. An employer must provide: (1) reasonable break time for a nursing? mother to express breast milk for one year after the birth of ? her child and (2) a private space, other than a bathroom, for an ? employee to express milk, for one year after the birth of her ? child. Employers with less than twenty employees are exempt from ? these requirements if they can show that compliance would impose ? significant difficulty or expense on their business. Haw. Rev. ? Stat.  378-92.
3. SCORE SHOULD BE 0.5
4.3.a
Source(s)
1. https://www.dol.gov/wb/maps/
Comment(s)
1.
4.3.b
Source(s)
1. https://www.dol.gov/wb/maps/
Comment(s)
1.
4.4.a
Source(s)
1. http://law.justia.com/codes/hawaii/2013/title-21/chapter-378/section-378-92
Comment(s)
1.
4.4.b
Source(s)
1. https://www.cdc.gov/breastfeeding/pdf/2016breastfeedingreportcard.pdf
Comment(s)
1. Data on employer provision of onsite daycare was not found.
4.5
Source(s)
1. See 4.6.a -------
2. http://labor.hawaii.gov/ocs/main/new-hawaii-law-protects-domestic-workers-against-employment-discrimination/
Comment(s)
1. Domestic workers protected under law from discrimination, but can? still be fired
3. SCORE SHOULD BE 0.5
4.6.a
Source(s)
1. http://labor.hawaii.gov/wsd/files/2013/01/12-27.pdf
2. http://breastfeedinglaw.com/state-laws/hawaii/
Comment(s)
1. Mandatory for employers to post law regarding pumping breaks
2. Employers must treat women affected by pregnancy, childbirth, or ? related medical conditions the same as other individuals who may ? have a temporary limitation or inability to work. Haw. Rev. Stat.?  378-1. An employer may not terminate or otherwise penalize a ? woman because she requires time away from work for disability ? stemming from pregnancy, childbirth, or related medical ? conditions. Employers must make reasonable accommodations for ? women affected by a disability stemming from pregnancy, ? childbirth or related medical conditions. The law applies to all ? employers. Haw. Code R.  12-46-107.
3. SCORE SHOULD BE 0.5
4.6.b
Source(s)
1. http://labor.hawaii.gov/wsd/files/2012/11/WSD-1.398-rev1-13.pdf
2. http://breastfeedinglaw.com/state-laws/hawaii/
Comment(s)
1. Mandatory for employers to post law regarding pumping breaks
2. Employers must treat women affected by pregnancy, childbirth, or ? related medical conditions the same as other individuals who may ? have a temporary limitation or inability to work. Haw. Rev. Stat.?  378-1. An employer may not terminate or otherwise penalize a ? woman because she requires time away from work for disability ? stemming from pregnancy, childbirth, or related medical ? conditions. Employers must make reasonable accommodations for ? women affected by a disability stemming from pregnancy, ? childbirth or related medical conditions. The law applies to all ? employers. Haw. Code R.  12-46-107.
3. SCORE SHOULD BE 0.5
4.7
Source(s)
1. http://family.findlaw.com/paternity/paternity-leave.html
2. http://www.nationalpartnership.org/research-library/work-family/paid-leave/state-paid-family-leave-laws.pdf
Comment(s)
1. Only federal protections
4.8
Source(s)
1. http://family.findlaw.com/paternity/paternity-leave.html
2. http://www.nationalpartnership.org/research-library/work-family/paid-leave/state-paid-family-leave-laws.pdf
Comment(s)
1. Only federal protections
4.9
Source(s)
1. http://labor.hawaii.gov/wsd/files/2013/01/12-27.pdf
2. https://www.dol.gov/wb/maps/; http://breastfeedinglaw.com/state-laws/hawaii/
Comment(s)
1. Unclear if this applies to breastfeeding as well as pregnancy
3. SCORE SHOULD BE 0.5
4.10
Source(s)
1. http://hr.blr.com/HR-topics/Discrimination/Pregnancy-Maternity/Hawaii
Comment(s)
1. The Hawaii Fair Employment Practice (FEP) Law prohibits ? employment practices that discriminate on the basis of sex, ? including discrimination on the basis of pregnancy, childbirth, ? and related medical conditions. State law also contains special ? provisions for nursing mothers.
2. Unclear whether job protection is included
3. 378-10 Breastfeeding. No employer shall prohibit an employee ? from expressing breastmilk during any meal period or other break ? period required by law to be provided by the employer or required? by collective bargaining agreement. [L 1999, c 172,  2]
9.1
Source(s)
1. http://dod.hawaii.gov/hiema/
Comment(s)
1. No policy found
9.2
Source(s)
1. http://dod.hawaii.gov/hiema/contact-us/about-us/
Comment(s)
1. Met, assuming all citizens of Hawaii includes infants and ? children
9.3.a
Source(s)
1. http://dod.hawaii.gov/hiema/
Comment(s)
1. No evidence found
9.3.b
Source(s)
1. http://dod.hawaii.gov/hiema/
Comment(s)
1. No evidence found
9.4
Source(s)
1. http://dod.hawaii.gov/hiema/
Comment(s)
1. Although budget not found, seems very well funded
9.5.a
Source(s)
1. http://dod.hawaii.gov/hiema/
Comment(s)
1. No evidence found
9.5.b
Source(s)
1. http://dod.hawaii.gov/hiema/
Comment(s)
1. No evidence found
10.1
Source(s)
1. http://health.hawaii.gov/wic/
Comment(s)
1. This state has one major infant and young child feeding program, ? Special Supplemental Nutrition Program for Women, Infants and ? Children (WIC). Into the WIC program are built monitoring and ? evaluation components.
10.2
Source(s)
1. http://health.hawaii.gov/wic/
Comment(s)
1.
10.3
Source(s)
1. http://health.hawaii.gov/wic/
Comment(s)
1.
10.4
Source(s)
1. https://www.fns.usda.gov/pd/wic-program
Comment(s)
1. All states report program data to UDSA office. USDA is ? considered the key-decision maker. The majority of the ? information reported is program data ie client participation and ? program costs.
10.5
Source(s)
1. https://www.cdc.gov/prams/index.htm
Comment(s)
1.

WBTiExpert Panel convened by Healthy Children Project, Inc.

www.centerforbreastfeeding.org