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Establishing the Baby-Friendly Community Initiative in Italy: development, strategy, and implementation
Maria Enrica Bettinelli1, Elise M Chapin, Adriano Cattaneo
1Maternal and Child Health Unit, Milan, Italy. m.bettinelli@unicef.it
Insights
The Baby-Friendly Community Initiative (BFCI) extends the Baby-Friendly Hospital Initiative (BFHI) to communities. Italy has successfully implemented the BFCI, with one community accredited and others in progress.
Area of Science:
- Public Health
- Maternal and Child Health
- Community Health Programs
Background:
- The Baby-Friendly Hospital Initiative (BFHI) promotes breastfeeding globally but requires complementary interventions for sustained success.
- The Baby-Friendly Community Initiative (BFCI) is a multifaceted, community-based program designed to enhance breastfeeding support beyond hospital settings.
- Existing interventions need expansion to meet recommended 6-month breastfeeding targets.
Purpose of the Study:
- To detail the development, strategy, and implementation of the BFCI within the Italian healthcare system.
- To adapt and establish BFCI standards for community health settings in Italy.
- To assess the feasibility and initial outcomes of the BFCI in Italy.
Main Methods:
- A dedicated working group was formed by UNICEF Italy in 2006 to adapt global BFCI models.
- A review of international BFCI approaches informed the adaptation of tools for Italian community health care.
- Standards for Best Practice were launched in 2009, building upon BFHI and UNICEF UK BFCI guidelines.
Main Results:
- The primary outcome focused on promoting BFCI adoption across Italian regional health systems.
- Tools were developed to evaluate adherence to BFCI criteria.
- Currently, one community is fully accredited as Baby-Friendly, with 17 additional communities actively engaged in the accreditation process.
Conclusions:
- The BFCI has been successfully established in Italy as a comprehensive program.
- The initiative requires significant stakeholder participation, training, and ongoing support for health workers and families.
- BFCI implementation involves a continuous cycle of audits, feedback, and resource provision.
Background:
The Baby-Friendly Hospital Initiative (BFHI), developed by the World Health Organization and the United Nations Children's Fund (UNICEF) to promote breastfeeding in maternity facilities worldwide, has had a global impact on breastfeeding outcomes, but other interventions are needed both before and after hospital discharge to meet the recommended targets at 6 months. The Baby-Friendly Community Initiative (BFCI), a multifaceted program for community-based breastfeeding promotion that is complementary to the BFHI, addresses this challenge.
Objective:
To describe the development, strategy, and implementation of the BFCI in Italy.
Methods:
In 2006, UNICEF Italy created a working group to develop the BFCI for the Italian health system. A review of the different BFCI models worldwide was conducted. A preliminary adaptation of tools to Italian community health care settings was developed in 2007, when the Italian BFCI Seven Steps were published. Two years later, UNICEF Italy launched the Standards for Best Practice for both hospitals and communities, based on 2009 BFHI and UNICEF UK BFCI materials.
Outcomes:
The main outcome was to promote this process in Italian regional health systems and develop tools to assess compliance with the BFCI criteria. There is now one fully accredited Baby-Friendly Community in Italy, and 17 other communities are working on the various stages.
Conclusions:
The BFCI, a complex program that involves participation, training, audits, a continuous flow of feedback, and provision of resources for health workers and families, is now a reality in Italy.
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