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LLLI Strategic Plan Status: April 2008

From: LEAVEN, Vol. 44, No. 3, 2008, pp. 20-22

The LLLI Strategic Plan provides a common direction for Leaders, staff, and the LLLI Board of Directors to focus resources on activities which best position LLL for success in executing the LLLI mission. The Plan outlines core strategic objectives for the organization with measurable target outcomes for each objective.

At the March 2008 meeting the LLLI Board reviewed the Strategic Plan, the measurable outcomes, and the activities for meeting the outcomes. Based on Leaders' comments at the Global Strategic Planning Summit in July 2007, the strategic objectives were slightly reworded to add clarity. (See the LLLI Strategic Plan with strategic objectives and measurable target outcomes in sidebar.)

The LLLI Board recognizes that collecting and analyzing data is the best way to monitor progress in meeting the strategic objectives. Providing data to Board members, LLLI staff and local Leaders will help us all to make better informed decisions in our LLL work. This article highlights recent data collection and other activities addressing the strategic plan target outcomes. Each section details one or more target outcomes and then describes work that LLLI staff and worldwide Leaders are doing to achieve the goals.

Focus on Mother-to-Mother Support/Help More Mothers

  • Improve quality and access to breastfeeding information by updating, digitizing, and modernizing the look of LLLI books, pamphlets, tear-off sheets, and Web site.

The Publications work group conducted a survey to identify the use, needs, and concerns of Leaders and mothers for written breastfeeding information. There was broad international participation with over 35 countries represented in the 947 responses. Based on the respondents' suggestions, there is now a more visible link to tear-off sheets on the Community Network (CN) homepage, which is intended to help Leaders find the tear-off sheets quickly and easily for providing mother-to-mother support.

Providing publications in many languages should help LLL to reach more mothers with our expertise and philosophy while building LLL credibility with the health care community worldwide.

Translations of several books into French, Italian, Chinese, German, Portuguese, and Spanish are in various stages of development. LLL Leaders in Japan, France, and the Netherlands are revising existing translations of The Womanly Art of Breastfeeding. For the first time France will have a Franco-French (versus Quebec French) The Womanly Art of Breastfeeding. The book will be sold in large and small bookstores, and supermarkets.

Leaders in China are translating The Breastfeeding Answer Book, including review by health professionals and then publishing it. It is mind-boggling to think of the number of health professionals this book might influence in China.

Leaders in Italy are translating Adventures in Gentle Discipline and they recently published Mothering Your Nursing Toddler. Peru is translating Whole Foods for Babies and Toddlers and How Weaning Happens.

Several Areas are doing small translation projects to gain experience in the hope of then translating The Womanly Art of Breastfeeding into their language. A team of Leaders in Latin America is translating LLLI pamphlets into Portuguese.

LLL South Africa is translating Breastfeeding Tips (No.1168-27), hoping to publish it as a double-sided tear-off sheet in Afrikaans and Xhosa. They are also putting together a booklet of several pamphlets translated into Afrikaans. Russian-speaking Leaders are working together to translate pages of the LLLI Web site and beginning to think about a Russian The Womanly Art of Breastfeeding.

This sharing of publications resources can help all LLL entities efficiently produce top quality materials. Effort is made to maintain consistency in publications in order to reinforce the LLLI image worldwide.

Build Volunteer Network and Reach Currently Underserved Populations

  • Increase the number of LLL members 25% over two years, to an average of three members per Leader
  • Increase the number of LLL Leaders 20% over two years
  • Document baseline for outreach activities to underserved populations

To know whether the number of Leaders is increasing or decreasing we need to know how many Leaders there are. The LLLI office has introduced new computer systems and more than 70 Area Data Administrators around the world are cleaning up the Leader data -- duplicates removed, addresses updated, names removed and added, etc. -- while maintaining local directories. The "cleaned" LLLI Leader database includes about 3900 Leaders in the United States (US) (3911 as of February 15, 2008) and about 2000 Leaders outside the US. This is a drop from the 6897 Leaders in the April 2005 statistics. Even though we knew the 2005 numbers were not accurate, they were the best numbers available at the time and were therefore used as the baseline for strategic plan measurements. It is impossible to know how much of the decrease reflects a real drop in the number of Leaders or how much is due to cleaning up the database -- most likely a combination of both. This is probably the most accurate database of Leaders that LLLI has ever had. The new systems also provide easy tools for Leaders to renew their dues and commitment to LLL and update their address to receive LLLI publications.

"Become a Leader" and "Become a Member" links have been added to the LLLI Web site home page. This helps interested mothers get information about membership and leadership. Also, they can indicate their interest in leadership directly to the Leader Accreditation Department (LAD). Alison Parkes, Director of the LAD, reports an increase in interest in becoming a Leader since the link has been given prominent placement on the homepage and all right-hand navigation columns throughout our Web site.

April 2005 statistics indicated 15,939 members; 15,800 members is the best number we have today. The member database has not yet been "scrubbed" by the Area Data Administrators, so it is a very rough number, and mostly reflects US members. The International Division and Affiliates send the names of members only when they subscribe to New Beginnings. The number of memberships has remained fairly constant for the past five years. The planned changes to the online membership system will integrate better with local Leader efforts. The increase in the ratio of Leaders to members is due to a decrease in the number of Leaders rather than increase in membership. The specific goal of an average of three members per Leader has not yet been reached. The ratio of members to Leaders is larger outside the USA. Edie Boxman, LLL Israel, and Carmen Vandenabeele, LLL France, based on years of experience, queried, "Wouldn't you think it reasonable that each active Leader would generate an average of 10-15 memberships a year from her normal mother-to-mother support work?" It looks like that's what happens in Australia: the Australian Breastfeeding Association has a ratio of 10 members per one breastfeeding counselor (10,000 members: 1000 counselors).

A baseline for outreach activities has not yet been determined. If you do outreach to currently underserved populations, please write something about what you do to CN discussion "Underserved populations" or to Micky Jones, moderator of that discussion.

Focus on Mother-to-Mother Support/Help More Mothers

  • Establish mother-to-mother contact baseline, and then increase number of mothers directly served (through Group and online meetings, telephone and email help) by 10% over two years
  • Maintain user satisfaction rating of 3.5 (out of 5) or better among LLL contacts per survey

User surveys will be conducted again in 2009. Thank you for continuing to provide quality service to mothers.

Build LLL Awareness Among Mothers, Mothers-to-Be and the General Public

The LLLI office has rolled out an initial version of LLLIOnline Leader activity reporting in both English and Spanish. This will allow for ongoing reporting and review of the number of Leader "contacts." As we strive to quantify the services La Leche League provides to breastfeeding mothers and babies, we can focus on maximizing the effectiveness and impact that Leaders around the world have when they lead meetings and help mothers on the phone, via email, and face-to-face. In order to determine the number of mothers served, Leaders must submit their statistics. Please complete the LLLIOnline Leader form at http://leaderactivity.llli.org or send to the Leader in your Area who collects your contact numbers. (Editor's Note: If filling out the form online, you will need to log in with your LLLID for access.)

One Leader is contributing a great deal to LLL presence among Spanish-speaking mothers and at the same time, reaching underserved populations. After many years trying to start a Group in her town in Asturias, Northern Spain, Samantha Varas, who not long ago had a very distant relationship with computers, started La Liga de La Leche Virtual, a Google Group that works as an online Series Meeting. Every month she writes about a topic, then mothers, other Leaders, and Leader aspirants*, discuss the topic and exchange information about it. All participating Leaders identify themselves with "LLL," before their names and have moderator privileges. The Group has been going for a year and Samantha is the Leader in Spain who sells the most memberships; she sold 13 last year. She refers mothers to their local Groups and the mothers continue to enjoy the exchange of ideas online. (*Mothers interested in becoming Leaders who may or may not be applicants.)

Transform LLLI into a Global Organization

  • All LLLI (funded/staffed) programs supporting global LLLI community vs. US focus
  • Have LLLI Web portals for major language of all countries where LLLI has a presence by 2009
  • More than 40% of Web visitors are from outside the USA
  • Solidify global agreements by 2008 between Leaders, Area Networks, and Affiliates
  • Increase revenue retained locally to 50% of membership fees by 2009

The LLLI office completed a review of all its programs and has made changes to focus on global programs. Leaders in the USA are now responsible for the LLL Breastfeeding Helpline there. In the past, Areas and LLLI have done education for health care professionals in the USA; Areas and Area Networks may decide to expand their educational offerings. In August 2008, LLLI and the Eastern United States Division co-sponsored the seminar for physicians: "Partnering for Optimal Lactation Management and Support -- Physicians and LLLI Working Together to Keep Breastfeeding The Norm."

Work is progressing to make more Web site pages and the CN accessible for Spanish speakers. Increasingly more breastfeeding and organizational material is being translated into Spanish. Tear-off sheets in other languages are gradually being added to the Web site global publications page. There is a new discussion on the CN, called BABEL, where participants discuss issues about translations in every language; it is a coordination tool. Everybody interested in translations is welcome to join.

Currently there are "Welcome" links along the top of the LLLI Web site in English, Chinese, Italian, Spanish and Russian. Information is being gathered in order to represent all three German-speaking countries (Germany, Austria, Switzerland). Additional links to breastfeeding information in more languages will be added in the near future. If you would like the language of your country included, please contact the IT Network.

To give an example of one week, there were 245,086 visits to the Web site from 153 countries. This included 171,292 visits from the US and 73,794 visits from the nine other countries with the most visits: Canada, United Kingdom, Italy, Spain, Mexico, Russia, Australia, China, and Ireland.

The Leader, Area, and Area Network obligations and privileges are in the Policies and Standing Rules Notebook. There will be meetings and conference calls for Leaders to learn about/clarify decision making and accountability. At the 2008 European Mastery Symposium (EMS), in Assisi, Italy, Leaders met with LLLI Executive Director (ED), Barbara Emanuel, Associate Executive Director LaJuana Oswalt and LLLI Chairman of the Board, Jane Tuttle to discuss the administrative and financial implications of transitioning so that Leaders, Areas and Area Networks can comply with these new policies.

  • Improve awareness of LLL among mothers and mothers-to-be by 4% (to 70%) over two years.
  • Establish a baseline for local media references to LLL, then increase by 5% over two years.

Leaders are sharing the LLL message via print, air, Internet and other media channels. One example of creatively raising public awareness is placing a breastfeeding message, "Grazie Mamma!!!" (Thank you, Mom!), a picture of a breastfeeding baby, and the LLL logo on trucks in Italy (http://www.tognitrasporti.it/info.php?cat=16).

Building upon the helpful data obtained by the North American user surveys conducted in 2006, additional user surveys have been conducted in France, Germany and Spain to assess mothers' breastfeeding support needs and familiarity with LLL. Initial analysis of this data has been completed and more information and recommendations should arise from this work.

Results of the User Survey in France were reported at the EMS. Eighty percent of 504 survey respondents agreed that all babies deserve to breastfeed. More than 60% said that formula feeding is the better choice if a mother plans to go back to work. More than 60% breastfed for one week or more with their youngest child; 25% had heard of LLL France. Respondents expressed satisfaction with the contact they had with LLL. Only nine of 112 women did not contact LLL because they heard negative things about LLL. About 32% considered LLL books and magazines an important influence in deciding whether to breastfeed. The vast majority of the survey respondents consider LLL a well-respected source of breastfeeding information.

Build LLL Credibility to be First Referral from Health Care Professionals and Health Agencies

  • Leaders hearing referrals from health care professionals 50% more than today.
  • Conduct 100 Community-based Discussion Groups, building relationships with at least 500 health care professionals worldwide.

When a mother calls, do you find out how she found your number? Do you know how a mother gets information to attend your Group meeting? It is wonderful that breastfeeding initiation rates at hospital discharge are rising. Are the doctors, nurses and lactation consultants in your community referring breastfeeding mothers to LLL for continued support? Currently these statistics are not recorded throughout the organization; it might be helpful for Leaders to record their referrals and note the trend. This basic information can be helpful for increasing outreach to more mothers.

Leaders have conducted six Community Discussion Groups (CDG) with health care professionals in five US states; 125 lactation consultants, Women, Infants and Children (WIC*) counselors, nurses, dieticians, and physicians participated in the sessions. Based on the data obtained in the initial CDGs, we have determined that 25-50 CDGs will provide sufficient input on the challenges that women face regarding breastfeeding and suggestions for LLL Leaders for working collaboratively with health care providers. Micky Jones, Leader in Tennessee, US organized a CDG, noting that the overall atmosphere was very productive, light and engaged. One participant told Micky that it was a GREAT meeting, calling Micky a "great spokesperson for LLL" -- just the reason we want Leaders talking with health care professionals. For more information about conducting a CDG, go to CN discussion "SP - HCP Community Discussions" or write directly to Marcia Lutostanski, moderator of that discussion. (*WIC is a US Government program for Women, Infant and Children that provides breastfeeding education and support.)

One recent example of a successful program that demonstrates LLL France's good relationship with health care professionals was the LLL of France Health Care Professional Seminar (also known as the LLL International Breastfeeding Seminar), where the venue was filled with 488 registrants; 150 registration requests had to be turned down. The attendees were: 23% midwives who do the vast majority of birth preparation and postpartum follow-up and assist at a majority of deliveries even when a physician is present, 27% baby nurses/assistant baby nurses; 13% nurses and aides and 10% physicians. (27% were "other" participants, including Leaders).

Of 160 evaluations turned in, most were "very satisfied" or "satisfied." Only three were not satisfied. LLL France made a profit of approximately 20,000 euro (nearly US $31,000!).

The III Breastfeeding Symposium, 19-20 October 2007, in Bilbao, Spain, was attended by nearly 200 health care professionals. LLL Italy held their 11th annual two-day health care professional seminar in May 2008. Thank you for keeping the strategic plan objectives in the forefront as you, your Group, and your Area set goals and plans for your community during 2008-2009. Through our combined efforts Leaders and staff will increase the impact of LLLI philosophy throughout the world.

Translating LLLI breastfeeding and Leader resources so Leaders around the world are informed and connected to each other and making LLL information available to all mothers requires teams of Leaders. The Spanish translators are:
Cathy Urroz de Arce, Mexico
Violeta Farfåan de Oliva, Guatemala
Veronique Lesoine de Potes, Mexico
Ana Charfén Norma, Mexico
Maria Castells, Guatemala
Norma Escobar, North Carolina, USA
Verónica Garea, Argentina
Mayra R. Giovannetti (also known as Mayra Bonilla), Chile
Margarita Hord de Méndez, Mexico
Eva Marsal Miralles, Spain
Eider Pacheco, Spain
Verónica Garea, Argentina
Waleska Porras, Costa Rica
Patricia Ronis, Argentina
Celia Sanchidrián, Spain
Gabriela Carrasco, Peru
Yolanda Ruiz Luque and Lucero de León from Mexico help a lot, although they are not mothers yet.
Mónica Tesone revises/edits the translations.
New Leader Gabriela Carrasco from Perú has agreed to translate all the messages on LLLI News and make them available to Spanish-speaking Leaders.
And of course, Maria del Mar Mazza, our Hispanic Liaison, who has been instrumental in all their work.

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