Impact case study database

MP and SRH rights are typically portrayed as personal and private concerns within LMICs. Global policy interventions are largely restricted to large businesses in the formal economy, bypassing the majority employed within SMEs and the informal economy, and seen as irrelevant to national policy agendas. Our research achieved impact in this challenging context by: (a) shaping advocacy measures of global organizations on MP and breastfeeding at work; (b) influencing the implementation of national MP and SRH strategies; and (c) improving practice through firm-level responses and building stakeholder capacity.

Engagement with our findings by the ILO, UN, WHO and WABA (World Alliance for Breastfeeding Action), influenced their advocacy on the feasibility of providing MP without harming smaller firms, and the productivity and wider health and social benefits of supporting breastfeeding in the workplace. The MU authored MP report [3.1] remains the only systematic literature review of MP in SMEs and, as an ILO policy specialist observed, “ continues to serve as powerful source of evidence to corroborate the argument of the affordability of low-cost maternity protection measures and potential productivity benefits for employers, including in SMEs” [5.1]. Through shifting perceptions on improved MP at work from business cost to business investment, “MU research has helped to shape ILO’s advocacy messages relating to the need to extend maternity protection to all workplace contexts” [5.1]. WHO [5.2], UNICEF [5.3] and WABA [5.4] have similarly used these findings in their messages and activities to promote MP and breastfeeding support at work.

MU researchers accepted invitations to speak on their findings at global events and policy discussions, subsequently securing contracts as advisors and shaping related advocacy. Stumbitz presented policy recommendations on MP in SMEs and the informal economy at the ILO centenary celebration in 2019. This high-profile event, organised in collaboration with UNICEF, UNWOMEN and WHO, drew a global audience of ILO constituents, EU representatives, senior policy makers, and NGOs, and received global attention through awareness-raising on social media. Stumbitz also represented UNICEF on MP policies and practices globally on its dedicated panel at the 2019 Women Deliver Conference, the world’s largest conference on gender equality.

Through her role as an invited academic advisor to WABA and the Global Breastfeeding Collective (GBC) - the principal global network of MP and breastfeeding advocates, NGOs and international organizations led by WHO/UNICEF - “ Stumbitz’s contributions helped to inform the Collective’s global advocacy focus repositioning breastfeeding as a workplace, gender equality and women’s empowerment issue” [Manager of the GBC: 5.3]. This was reflected in the Collective’s position statement [5.5], which presented case studies from around the world in relation to maternity leave legislation in support of breastfeeding, and included recommendations in relation to the need for context-sensitive implementation and integrated stakeholder working based on MU research findings. Launched at the ILO centenary event in 2019: “the paper initiated discussion on this issue in this global forum and provided it with a heightened profile” [5.3].

Stumbitz contributed to WABA’s work in multiple ways and ensured that: “the challenges of the informal sector are now firmly anchored in WABA’s global breastfeeding agenda” [5.4] and mainstreamed throughout their activities and advocacy messages. Stumbitz was a co-author of WABA’s policy and practice Action Folder in 2019; the key campaigning document for World Breastfeeding Week, organised by WABA. This was published in eight languages, downloaded from the campaign website (which received over 10 million hits) 52,266 times between July-October 2019. It resulted in 788 official pledges for actions to improve breastfeeding support by organizations and government departments from across the world, including from a large proportion of LMICs [5.4].

Workplace MP/SRH policy development within Ghana, Malaysia and South Africa has been influenced by our findings on the need for context sensitivity and multiple stakeholder engagement in its implementation. Our recommendation to address the scarcity of MP research in LMICs [3.1] led directly to ILO commissioned report on MP in SMEs and informal economy businesses in Ghana [5.6]. This identified good practice examples and coping strategies and recommendations of culturally specific solutions to MP provisions at work, particularly those of value to small firms in the informal economy. The MP Steering Committee at the Ministry of Employment and Labour Relations in Accra used our recommendations, along with those of other commissioned studies, in the development of their strategy. These recommendations for progressing MP measures informed the drafting of a MP Bill which extended paid maternity leave in Ghana from 12 to 14 weeks [5.1].

MU research commissioned by UN Women in Malaysia (research project 5) demonstrated the national urgency of SRH related issues. Miles and Endut worked with national stakeholders from government ministries (Health; Home Affairs; Women, Family and Community Development), NGOs, public sector organizations and union representatives to identify a range of SRH-related policies and service. MU subsequently undertook participatory policy-making activities with stakeholder representatives to further clarify and prioritise policy priorities at the level of central government, employers and wider society comprising reforms related to: migration policy; epidemiology to inform SRH service planning and provision; employer obligations for SRH; and reducing the impact of discrimination on women migrant workers’ SRH). These recommendations were detailed in a strategy paper [5.7] which informed the drafting of Malaysia’s twelfth national development plan (2021-2025).

In South Africa, where return to work is a major reason for one of the lowest breastfeeding rates at six months in the world, findings from Stumbitz and Jaga (University of Cape Town) have raised public awareness on the issue of breastfeeding in the workplace through widespread media attention, including national radio and television coverage [5.8]. Collaboration of Stumbitz and Jaga with the Western Cape Government (WCG) has led to the co-development of a more context-specific Department of Health policy strategy. As stated by a senior WCG staff member, this now: “recognises breastfeeding as a multidisciplinary challenge which integrates breastfeeding within the Province’s broader […] gender mainstreaming agenda”. Joint efforts have further included the development of a framework for workplace breastfeeding support and testing of potential workplace interventions within Western Cape Government itself [5.9].

Development and implementation of improved MP and SRH workplace practices in South Africa and Malaysia have actively built capacity through multiple local stakeholder engagement. Alongside employers and women workers, action research in South Africa involved Western Cape government, the South African Clothing and Textiles Workers Union (SACTWU), the South African Medical Research Council. In Malaysia, service development and implementation involved Tenaganita, Reproductive Rights Advocacy Malaysia (RAAM) and the Penang Family Health Development Association (FHDA). Both research streams include train-the-trainer provisions. In Malaysia, for example, 40 women migrant workers were trained as SRH advocates under the ongoing British Council funded research project, to provide guidance and support on SRH practice and further cascade training.

Findings on the affordability of context-sensitive workplace breastfeeding supports have led to the piloting of interventions for low-paid workers in clothing factories in South Africa and the provincial Western Cape Government [5.9]. Initial changes introduced have included the introduction of lactation spaces for staff and the provision of fridges for safe breastmilk storage in all case study factories. In Malaysia, in order to improve institutional responses on the SRH of women migrant workers, Miles worked with NGOs engaged in SRH advocacy to develop the first ‘toolkit’ identifying a range of potential workplace interventions [5.10]. The BC funded project (6) is currently investigating the translation of the toolkit into practice, through evaluation of a number of pilot SRH workplace interventions for women migrant workers, designed and delivered by local NGO actors in a number of factories in Penang.