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A Cross-Sectional Study to Evaluate Adherence to the Ten Steps to Successful Breastfeeding at a Referral Hospital in Rwanda

17 Pages Posted: 14 Feb 2019

See all articles by Janvier Hitayezu

Janvier Hitayezu

The University Teaching Hospital of Kigali - Department of Pediatrics and Child Health

David Ntirushwa

The University Teaching Hospital of Kigali

Jean Claude Ntiyamira

University of Rwanda

Jeannette Kayitesi

The University Teaching Hospital of Kigali

Rose Mary Murungi

The University Teaching Hospital of Kigali

Adeyemi J. Olufolabi

Duke University - Medical Center

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Abstract

Background: Stunting rates during the first two years of life in Rwanda are among the highest worldwide. It is postulated that these may be associated with the quality of care designed to promote infant feeding at a health facility level. The objective was to conduct a baseline assessment of adherence to the Ten Steps to Successful Breastfeeding (the basis of the Baby-Friendly Hospital Initiative) of current hospital practices to identify implementation gaps towards developing strategies for solutions.

Method: In a cross-sectional survey at the University Teaching Hospital of Kigali (CHUK), data were collected on 311 participants using the adjusted hospital self-appraisal tool.

Findings: CHUK has no written breastfeeding policy and 299/311 (96·1%) of women received no education about breastfeeding during their antenatal care. All the 159 mothers who had delivered initiated breastfeeding but 31·4% of infants were also given formula. Admission to the special care unit is a strong predictor of breast milk supplement use with p-value < 0·0001 (adjusted OR: 12·8).

Interpretation: Our study demonstrated poor adherence to most of the Ten Steps in CHUK except for steps 7 & 9, a very likely same situation in many other health facilities across the country. A full Compliance to the Ten Steps can be a good strategy to improve infant nutrition and hence reduce the high incidence of malnutrition.

Funding: CHUK small research grants, 2017 cycle.

Declaration of Interest: The authors declare they have no conflict of interest.

Ethical Approval: The study was approved by the Ethics Committee of CHUK hospital. Approval notice: Ref: EC/CHUK/402/2017.

Keywords: Exclusive breastfeeding, Baby-Friendly Hospital Initiative, CHUK, Rwanda, malnutrition

Suggested Citation

Hitayezu, Janvier and Ntirushwa, David and Ntiyamira, Jean Claude and Kayitesi, Jeannette and Murungi, Rose Mary and Olufolabi, Adeyemi J., A Cross-Sectional Study to Evaluate Adherence to the Ten Steps to Successful Breastfeeding at a Referral Hospital in Rwanda (November 24, 2018). Available at SSRN: https://ssrn.com/abstract=3294101 or http://dx.doi.org/10.2139/ssrn.3294101

Janvier Hitayezu (Contact Author)

The University Teaching Hospital of Kigali - Department of Pediatrics and Child Health ( email )

Kigali
Rwanda

David Ntirushwa

The University Teaching Hospital of Kigali

Kigali
Rwanda

Jean Claude Ntiyamira

University of Rwanda

University of Rwanda, CBE
HUYE, Southern +250
Rwanda

Jeannette Kayitesi

The University Teaching Hospital of Kigali

Kigali
Rwanda

Rose Mary Murungi

The University Teaching Hospital of Kigali

Kigali
Rwanda

Adeyemi J. Olufolabi

Duke University - Medical Center

100 Fuqua Drive
Durham, NC 27715
United States

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