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Compliance of a Baby-Friendly Designated Hospital in Ghana With the WHO/UNICEF Baby and Mother-Friendly Care Practices.
J Hum Lact 2019; :890334419848728JH

Abstract

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.

Authors+Show Affiliations

1 Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana. 2 Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Germany.1 Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana.1 Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana.2 Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31112053

Citation

Agbozo, Faith, et al. "Compliance of a Baby-Friendly Designated Hospital in Ghana With the WHO/UNICEF Baby and Mother-Friendly Care Practices." Journal of Human Lactation : Official Journal of International Lactation Consultant Association, 2019, p. 890334419848728.
Agbozo F, Ocansey D, Atitto P, et al. Compliance of a Baby-Friendly Designated Hospital in Ghana With the WHO/UNICEF Baby and Mother-Friendly Care Practices. J Hum Lact. 2019.
Agbozo, F., Ocansey, D., Atitto, P., & Jahn, A. (2019). Compliance of a Baby-Friendly Designated Hospital in Ghana With the WHO/UNICEF Baby and Mother-Friendly Care Practices. Journal of Human Lactation : Official Journal of International Lactation Consultant Association, p. 890334419848728. doi:10.1177/0890334419848728.
Agbozo F, et al. Compliance of a Baby-Friendly Designated Hospital in Ghana With the WHO/UNICEF Baby and Mother-Friendly Care Practices. J Hum Lact. 2019 May 21;890334419848728. PubMed PMID: 31112053.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Compliance of a Baby-Friendly Designated Hospital in Ghana With the WHO/UNICEF Baby and Mother-Friendly Care Practices. AU - Agbozo,Faith, AU - Ocansey,Doris, AU - Atitto,Prosper, AU - Jahn,Albrecht, Y1 - 2019/05/21/ PY - 2019/5/22/entrez SP - 890334419848728 EP - 890334419848728 JF - Journal of human lactation : official journal of International Lactation Consultant Association JO - J Hum Lact N2 - 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. SN - 1552-5732 UR - https://www.unboundmedicine.com/medline/citation/31112053/Compliance_of_a_Baby-Friendly_Designated_Hospital_in_Ghana_With_the_WHO/UNICEF_Baby_and_Mother-Friendly_Care_Practices L2 - http://journals.sagepub.com/doi/full/10.1177/0890334419848728?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -