Open AccessBaby-friendly hospitals in Turkey: evaluation of adherence to the Ten Steps to Successful Breastfeeding
Author(s) -
Nilgün Çaylan,
Melek Kılıc,
Sıddıka Songül Yalçın,
Başak Tezel Fatih Kara
Publication year - 2022
Publication title -
eastern mediterranean health journal/eastern mediterranean health journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.442
H-Index - 47
eISSN - 1687-1634
pISSN - 1020-3397
DOI - 10.26719/emhj.22.021
Subject(s) - breastfeeding , quartile , caesarean section , medicine , sustainability , family medicine , nursing , pediatrics , business , pregnancy , confidence interval , ecology , biology , genetics
Background: The Baby-Friendly Hospital Initiative (BFHI) is a World Health Organization and United Nations Children’s Fund joint global programme to protect, promote and support breastfeeding. Sustainability of the BFHI standards is important for both health facilities and country-level implementation. Aims: To analyse the 2018–2019 external reassessment results of baby-friendly hospitals (BFHs) in Turkey. Methods: We included 414 BFHs. The Ten Steps to Successful Breastfeeding were divided into 2 groups: critical management procedures (Steps 1 and 2) and key clinical practices (Steps 3–10). Results: All 10 steps were fulfilled by 60.1% of the hospitals. Steps 3 and 2 had the lowest compliance rates (81.6% and 85.7%), and Steps 7 and 8 had the highest rates (97.1% and 98.1%). Caesarean section rates in the fourth quartile were associated with significantly lower adherence to Steps 3 and 10. The presence of another external reassessment within 5 years was associated with a significantly higher adherence rate to Step 3, and a significantly higher full implementation rate for the clinical practices. Hospitals that fully implemented management procedures, had a significantly higher fulfilment percentage for all clinical practices. The western region had higher adherence rates for all the clinical practices compared with other regions. Conclusion: Reassessments seem useful for sustainability. Full compliance with Steps 1 and 2 is important for higher adherence to the clinical steps. Regional variations should be taken into account in the implementation of the programme.