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 2019More...
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
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