Tipat Halav

Tipat Halav (Hebrew: טיפת חלב, literally "a drop of milk") is a network of primary healthcare centers in Israel that provide post-natal well baby and early childhood care to children across the county through the age of six. The centers provide children with well-baby checkups and vaccinations. The centers monitor children for developmental issues and public health concerns, as part of an effort to prevent childhood disease and mortality. New and prospective parents are also given assistance in learning about breastfeeding and child care, as well as to detect post-partum depression and domestic violence.^[1][2] The efforts of Tipat Halav resulted in a more than 50% decline in infant mortality in pre-state Israel to some of the world's lowest levels.

History

In 1909, Henrietta Szold came to Jerusalem, where she encountered extremely high levels of disease and infant mortality in the Yishuv, which was then under the control of the Ottoman Empire.^[3] Szold's encounter with the squalor and disease she saw, including mothers who were too weak to shoo away flies swarming over the eyes of their children, drove her to establish what became the Hadassah Women's Zionist Organization of America.^[4][5] Szold realized that the best way to deal with conditions was to provide preventive care, bringing public health workers from the United States to serve the residents.^[6]

Building on models that had been developed by other organizations, American nurse Bertha Landsman helped establish the first Tipat Halav center in the Old City of Jerusalem in 1921.^[6][4] Contaminated milk was a common cause of infant mortality, so the centers taught mothers to breastfeed and distributed healthy milk and taught parents how to pasteurize milk on their own.^[6] Physician Helena Kagan created Baby Welfare Clinics that provided milk and medical care, that became part of Tipat Halav, serving Jewish and Arab children in Jerusalem.^[7][8]

Tipat Halav was named for La Goutte de lait [fr], a network of similar centers established in France in 1894 whose name also translates as "a drop of milk".^[9]

Many mothers were reluctant to come to Tipat Halav, so outreach efforts were made to provide diapers as an incentive to have their babies cared for at the center.^[6] As the program expanded, centers were constructed to serve the Arab population.^[6] Early deliveries of pasteurized milk were made using donkey carts.^[5] Mothers were handed flyers emphasizing that "It is easier to maintain a healthy baby than cure a sick one."^[10]

In 1924, the American businessman and philanthropist Nathan Straus contributed $10,000 which was used by Hadassah to create a nationwide network of infant care centers. Strauss had been an advocate for pasteurized milk in New York City.^[11] A center funded by Straus, described as a "friend of the children all over the world" was targeted at Arab neighborhoods in Jerusalem and was "dedicated to meet the needs of Moslem women in particular, for all babies are dear to Mr. Straus' heart."^[12]

By the early 1940s, the efforts of Tipat Halav had brought infant mortality rates to levels that were comparable to Europe.^[10] Infant mortality rates that were cut from 108 per 1,000 live births in 1927 to 48 per 1,000 by 1948, one of the lowest in the world.^[13] After the establishment of the State of Israel in 1948, Tipat Halav centers run by Hadassah were switched over to the government.^[4]

Around 2010, the Israel Ministry of Health, as part of an effort to improve efficiency in the provision of child care, divided up control of the 900 Tipat Halav centers nationwide, so that half were run by the four state-mandated health service organizations, more than 40% by the government and about 5% by the cities of Jerusalem (with 34 clinics) and Tel Aviv (with 15).^[14]