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Baby-friendly hospitals in Turkey: evaluation of adherence to the Ten Steps to Successful Breastfeeding

Nilgün Çaylan1, Melek Kiliç1, Sıddıka Yalçin2

  • 1Ministry of Health, Department of Child and Adolescents Health, Ankara, Turkey.

Eastern Mediterranean Health Journal = La Revue De Sante De La Mediterranee Orientale = Al-Majallah Al-Sihhiyah Li-Sharq Al-Mutawassit
|June 7, 2022
PubMed

Insights

Baby-Friendly Hospital Initiative (BFHI) reassessments in Turkey show that full compliance with critical management steps (1 and 2) is key for adherence to clinical practices. Regular reassessments improve overall sustainability and implementation success.

Area of Science:

  • Public Health
  • Healthcare Management
  • Maternal and Child Health

Background:

  • The Baby-Friendly Hospital Initiative (BFHI) is a global program by WHO and UNICEF to support breastfeeding.
  • Ensuring the sustainability of BFHI standards is crucial for healthcare facilities and national health programs.

Purpose of the Study:

  • To analyze the 2018-2019 external reassessment findings for Baby-Friendly Hospitals (BFHs) in Turkey.
  • To identify factors influencing adherence to BFHI standards and assess the impact of reassessments on program sustainability.

Main Methods:

  • A total of 414 Baby-Friendly Hospitals (BFHs) in Turkey were included in the analysis.
  • The Ten Steps to Successful Breastfeeding were categorized into critical management procedures (Steps 1-2) and key clinical practices (Steps 3-10).
  • Compliance rates were analyzed, along with associations between Caesarean section rates, reassessment frequency, and adherence to specific steps.

Main Results:

  • Overall, 60.1% of hospitals achieved full compliance with all 10 steps.
  • Lowest compliance was observed for Step 3 (81.6%) and Step 2 (85.7%), while Steps 7 and 8 showed the highest compliance (97.1% and 98.1%).
  • Higher Caesarean section rates correlated with lower adherence to Steps 3 and 10. Hospitals with recent reassessments and those fully implementing management procedures demonstrated significantly higher adherence to clinical practices. The western region showed higher adherence rates for clinical practices.

Conclusions:

  • External reassessments appear to enhance the sustainability of BFHI standards.
  • Full compliance with critical management steps (1 and 2) is essential for improving adherence to clinical practices.
  • Regional disparities in adherence should be considered during BFHI program implementation.
Abstract

Keywords:
Baby-Friendly Hospital InitiativeInternational Code of Marketing of Breastmilk SubstitutesTen Steps to Successful BreastfeedingTurkeyadherence ratereassessment

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