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Compliance of a Baby-Friendly Designated Hospital in Ghana With the WHO/UNICEF Baby and Mother-Friendly Care Practices

Agbozo, Faith ; Ocansey, Doris ; Atitto, Prosper ; Jahn, Albrecht

In: Journal of Human Lactation, 36 (2020), Nr. 1. pp. 175-186. ISSN 0890-3344 (Druck-Ausg.), 1552-5732 (Online-Ausg.)

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Background: Although the Baby-Friendly Hospital Initiative has improved breastfeeding rates globally, weak monitoring still affects hospital-level implementation.

Research aim: To reassess compliance of a Baby-Friendly Hospital with the Ten Steps to Successful Breastfeeding, International Code of Marketing of Breast-milk Substitutes, HIV and Infant Feeding, and Mother-Friendly Care following the WHO/UNICEF global criteria.

Methods: In this cross-sectional, prospective, mixed-methods study (N = 180), clinical staff (n = 60), pregnant women (n = 40), postpartum mothers (n = 60), and mothers of babies in intensive care (n = 20) were randomly selected from one urban secondary-level public hospital in Ghana designated as Baby-Friendly in 2004 but never reassessed. Data were collected through interviews, document reviews, and observations using the revised WHO/UNICEF external reassessment tool and analyzed quantitatively using the Baby-Friendly Hospital Initiative computer tool. Scores higher than 80% signified a pass (high compliance). Scores rated as low (< 50%) and moderate (50–80%) signified noncompliance.

Results: The facility passed the criteria for full compliance with the International Code (86%) but failed other components. Compliance with the Ten Steps was moderate (55%). Step 7 about rooming-in (84%) and Step 9 about human milk substitutes (100%) were passed, whereas Step 1 about written breastfeeding policies (0%), Step 2 about staff training (7%), and Step 4 about early breastfeeding initiation (31%) were met the least. Compliance with Mother-Friendly Care (34%) and HIV and Infant Feeding (47%) were low. Main implementation gaps were unavailability of policies and staff’s inadequate knowledge about Baby-Friendly practices.

Conclusions: Improving staff training and maternal counseling, routinely reassessing designated facilities, and providing technical support in problematic areas might sustain implementation.

Item Type: Article
Journal or Publication Title: Journal of Human Lactation
Volume: 36
Number: 1
Publisher: Sage Science Press
Place of Publication: Thousand Oaks, Calif.
Edition: Zweitveröffentlichung
Date Deposited: 27 Nov 2020 12:24
Date: 2020
ISSN: 0890-3344 (Druck-Ausg.), 1552-5732 (Online-Ausg.)
Page Range: pp. 175-186
Faculties / Institutes: Medizinische Fakultät Heidelberg > Institut für Public Health (IPH)
Subjects: 610 Medical sciences Medicine
Additional Information: Dieser Beitrag ist aufgrund einer (DFG-geförderten) Allianz bzw. Nationallizenz frei zugänglich. *** This publication is freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively.
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