Compliance with the Baby Friendly Hospital Initiative Programme in Two Hospitals Designated “Baby-Friendly” in Kirkuk City, Iraq, an Evaluation Study Ahmed Fakher Abobaker1,*, Spence Dale2,6, Lynn Finoa3, Tubman Richard4, Sadiq Ziad Mohammad5 1Gli, College of Nursing, Kirkuk University, Iraq 2Senior Lecturer, Queen's University, Belfast, UK 3Lecturer, Queen's University, Belfast, UK 4Consultant Neonatologist, Belfast Trust, UK 5College of Medicine, Kirkuk University, Iraq 6Professor Linda Johnston, University of Toronto, Canada *Corresponding Author: Fakher Abobaker Ahmed, Gli, College of Nursing, Kirkuk University, Iraq, M. Sc. Paediatric Nursing, Hawler Medical University, Iraq, Former PhD student at Queen's University, Belfast e-mails: fgli01@qub.ac.uk, gliahmed@uokirkuk.edu.iq
Online published on 23 December, 2019. Abstract Background Although the Baby Friendly Hospital Initiative (BFHI) was implemented in Iraq since 1992, a remarkable regression in exclusive breastfeeding has been highlighted by UNICEF (2011). Kirkuk province has experienced the lowest rate of breastfeeding initiation in the first hour of life, with higher neonatal and under five years mortality rates. International organizations have recommended a focus on breastfeeding practices and strengthening the implementation and monitoring of BFHI program in Iraqi provinces. Method Two-phase study was carried-out in two-designated Baby-Friendly hospitals (Azadi Teaching Hospital and Kirkuk General Hospital), using a standardized questionnaire. Monitoring BFHI tools utilised to measure the compliance with BFHI. Carolina B-KAP survey questionnaires were used to assess knowledge, attitudes, and practices of clinical and non-clinical staff and to measure the components of Organisational Readiness for Change (ORC) theory through practical and theoretical knowledge of hospitals processes. The Chi-square test of independence was performed to test for group differences in the responses to the Carolina B-KAP questionnaire. Results There was compliance in both hospitals with step 1, 7 and 10 of the Ten Steps to Successful Breastfeeding, and the International Code of Marketing Breastmilk Substitutes (the Code). However, a non-compliance with step 3, 4, 5, 6, 8 and 9 were present. KGH also showed non-compliance with step 2 (training on BFHI). A total of 143 participants (124 clinical and 19 non-clinical) responded to the survey. ATH were more likely to have greater knowledge of infant feeding, than respondents working in KGH (p < 0.05). Responses indicated that (61.7%) of participants reported that healthy full-term newborns within their care had started to breastfeed within 60 minutes after birth. In terms of matching infant feeding with appropriate clinical support plans, the results show that respondents agreed or strongly agreed on the need for additional guidance and training (78.3%). Conclusion Increased compliance with the BFHI programme can have positive impact on breastfeeding initiation, duration and exclusivty. Maternity departments in Kirkuk hospitals must fully implement Baby Friendly Hospital Initiative to support an increase in exclusive breastfeeding rates. Also, implimenttion of Baby Friendly Community Initiative (BFCI) can provide community support for breastfeeding. Top Keywords Baby Friendly Hospital Initiative (BFHI), the Ten Steps to Successful Breastfeeding, International Code of Marketing Breastmilk Substitutes (the Code), Organisational Readiness for Change (ORC). Top |