The Baby Friendly Hospital Initiative (BFHI) is a global initiative, with over 20,000 health facilities accredited worldwide. Few studies have investigated the factors that facilitate or hinder implementation of BFHI, but it is acknowledged this is a major undertaking requiring strategic planning and change management throughout an institution, although each country's programme varies in its approach to implementing and accrediting the Ten Steps to Successful Breastfeeding to work with that country's health-care system.
A study of the perceptions of BFHI implementation of midwives and nurses working in one Area Health Service in New South Wales, Australia was carried out (Australia has 77 accredited hospitals, 23% of the total). A total of 132 health professionals, working across four maternity units, two neonatal intensive care units and related community services, participated in 10 focus groups. Data was analysed using thematic analysis.
The researchers identified three main themes: 'Belief and Commitment'; 'Interpreting BFHI' and 'Climbing a Mountain'. Participants considered BFHI implementation a high priority, an essential and innovative set of practices that would have positive benefits for babies and mothers both locally and globally as well as for health professionals. It was considered achievable but would take commitment and hard work to overcome the numerous challenges including a number of organisational constraints. It was also recognised that without a lead person/group, implementation would be very difficult. There were, however, differing interpretations of what was required to attain BFHI accreditation with the potential that misinterpretation could hinder implementation.
The researchers conclude that, in this area of Australia, despite strong support for BFHI, the principles of this global strategy are interpreted differently by health professionals and further education and accurate information is required.
Schmied V, Gribble K, Sheehan A, et al (2011) Ten Steps or climbing a mountain: A study of Australian health professionals' perceptions of implementing the Baby Friendly Health Initiative to protect, promote and support breastfeeding. BMC Health Services Research 2011, 11:208doi:10.1186/1472-6963-11-208