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University hospitals (UHs) face multiple challenges to achieve Baby friendly Hospital Initiative (BFHI) designation. Recently UNICEF has supported 6 UHs in Egypt to become Baby Friendly using the UNICEF/WHO BFHI monitoring tools. Aim: The aim of this study is to present and compare the monitoring activities that were carried out by 6 UH in Egypt for assessing BFHI after implementation. Methods: The six hospitals included in this study were AinShams UH (AsUH), Alexandria UH (AxUH), AlHussein (Azhar) UH (AzUH), Assiut UH (ATUH), Benha UH (BUH) and Cairo Kasr ElAini UH (KUH) using the monitoring tools of UNICEF/WHO BFHI. Four monitoring visits were conducted by each UH over the period of 3 months and involved interviews with mothers in maternity wards and NICUs, pregnant women in antenatal clinics and clinical staff in the service wards and observations. Data were collected and analyzed quantitatively into the UNICEF/WHO BFHI summary sheets of the tools. Results: Interviews totaled 915. Hospitals meeting BFHI global criteria were AinShams UH for steps 2, 6, 7 and AxUH for steps 1, 2, 3 and the Code. AzUH achieved steps 1 and 8 and the Code; BUH achieved steps 2 and 8; KUH steps 6 and 7. The lowest mean score was step 4 (16.87 ± 8.67) and the highest score was step 2 (61.68 ± 23.89). AxUH had the highest score in administrative activities, while AinShams UH had the highest score for clinical protocols and AzUH had the highest score for educational activities. Conclusions: A monitoring tool can be effective in achieving the global criteria for the Ten steps of BFHI by identifying gaps in program implementation.

A Multicenter Survey for Monitoring the Baby-Friendly Initiative in 6 University Hospitals in Egypt (2017-2018): A Comparative Analysis