Exploring the impact of the Baby-Friendly Hospital Initiative on trends in exclusive breastfeeding
Exploring the impact of the Baby-Friendly Hospital Initiative on trends in exclusive breastfeeding
复制标题
DOI：
10.1186/1746-4358-4-11
复制
发表时间：
2009-01-01
影响因子：
3.5
通讯作者：
Labbok, Miriam H.
中科院分区：
文献类型：
--
作者：
Abrahams, Sheryl W.;Labbok, Miriam H.
背景：爱婴医院倡议（BFHI）旨在支持在产科服务中开展母乳喂养。本研究使用国家一级的数据来检查14个发展中国家的BFHI规划与纯母乳喂养趋势之间的关系。方法：人口与健康调查和联合国儿童基金会BFHI报告提供EBF和BFHI数据。由于国家项目是在不同年份启动的，所以数据点被重新调整为该国首家爱婴医院获得认证的年份。使用固定效应模型对实施前后的时间段进行分析，以解释按国家分组的数据，并进行比较以评估趋势的差异。结果：在2个月和6个月以下，EBF的统计学显著上升趋势（通过拟合趋势的斜率是否显著不同于0来评估）仅在实施BFHI之后观察到，而在实施BFHI之前没有观察到。实施BFHI与两个月以下婴儿EBF率平均每年增加1.54个百分点（p < 0.001）和6个月以下婴儿EBF率平均每年增加1.11个百分点（p < 0.001）相关；然而，这些比率与bfhi之前的趋势没有统计学差异。结论：在研究的国家中，BFHI的实施与EBF率的年统计学显著增加有关；然而，小样本量可能导致结果没有显示出与bfhi之前的趋势有显著差异。需要进一步的研究来考虑趋势，根据婴儿友好设施的百分比，在这些设施中发生的所有分娩的百分比，并继续遵守该计划。
Background: The Baby-Friendly Hospital Initiative (BFHI) seeks to support breastfeeding initiation in maternity services. This study uses country-level data to examine the relationship between BFHI programming and trends in exclusive breastfeeding (EBF) in 14 developing countries.Methods: Demographic and Health Surveys and UNICEF BFHI Reports provided EBF and BFHI data. Because country programs were initiated in different years, data points were realigned to the year that the first Baby-Friendly hospital was certified in that country. Pre-and post-implementation time periods were analyzed using fixed effects models to account for grouping of data by country, and compared to assess differences in trends.Results: Statistically significant upward trends in EBF under two months and under six months, as assessed by whether fitted trends had slopes significantly different from 0, were observed only during the period following BFHI implementation, and not before. BFHI implementation was associated with average annual increases of 1.54 percentage points in the rate of EBF of infants under two months (p < 0.001) and 1.11-percentage points in the rate of EBF of infants under six months (p < 0.001); however, these rates were not statistically different from pre-BFHI trends.Conclusion: BFHI implementation was associated with a statistically significant annual increase in rates of EBF in the countries under study; however, small sample sizes may have contributed to the fact that results do not demonstrate a significant difference from pre-BFHI trends. Further research is needed to consider trends according to the percentages of Baby-Friendly facilities, percent of all births occurring in these facilities, and continued compliance with the program.