Assessment of maternity protection policies in the Philippines and their role in creating an enabling environment for breastfeeding

Background and Objectives The Philippines has enacted maternity protection policies, such as the Expanded Maternity Leave Law and the Expanded Breastfeeding Promotion Act, to create a more enabling environment for breastfeeding. Our objective was to review the content and implementation of maternity protection policies in the Philippines, examine their impact on women in the workforce, and determine the role of policy interventions in improving breastfeeding practices in workplaces. Methods Policies, guidelines, and related documents on maternity protection were reviewed and their contents compared with international recommendations. In-depth interviews were conducted with policy makers, employers, employed pregnant women, mothers of infants, and mothers' partners. Data were analyzed with thematic analysis using NVivo software. Results Results indicated that the Philippines' policies on maternity protection are aligned with the majority of International Labor Organization recommendations, except for 1) coverage of maternity leave payments for all, including informal workers, and 2) allocation of public or social funds for paid maternity leave. Although policies are in place, gaps in monitoring and enforcement systems to ensure functionality and uptake of services for breastfeeding were observed. Barriers to uptake of maternity entitlements, especially in the informal sector, exist. The current policies to support breastfeeding in workplaces do not necessarily translate into improved breastfeeding practices. This is due to poor communication of entitlements, and insufficient breastfeeding support and promotion within workplaces. Due to inadequate breastfeeding assistance and advocacy, challenges to continuing breastfeeding while working can overpower mothers' decisions to breastfeed their baby. The Philippine maternity protection policies operate separately from breastfeeding promotion programs, resulting in poor recognition of how maternity entitlements are intended to enable breastfeeding. Conclusion Although maternity protection policies are in place, they are not yet aligned to create an enabling environment to improve and sustain recommended breastfeeding practices. Strengthening enforcement mechanisms and revisitation of entitlements in the workforce are needed. Partnerships with both government and breastfeeding advocates are needed to strengthen breastfeeding advocacy in workplaces, by facilitating the creation of technical assistance and educationa