المعيقات وعوامل التسهيل المؤثرة على تطبيق المبادرة العالمية للمستشفيات صديقة الطفل في بعض المستشفيات الحكومية والخاصة في فلسطين
Date
2016-12-20
Authors
اية مرتجى حسني الفار
AYAH MURTAJA HUSNI ALFAR
Journal Title
Journal ISSN
Volume Title
Publisher
AL-Quds University
جامعة القدس
جامعة القدس
Abstract
Background: The Baby-Friendly Hospital Initiative (BFHI) aims to promote and
support breastfeeding. Globally, around 20,000 facilities have been designated BabyFriendly.
In Palestine, only 6 hospitals have the ‘Baby Friendly’ designation since
2010. Despite the increasing evidence for the positive impact of BFHI on breastfeeding
and health outcomes, few studies have explored the barriers and facilitating factors
influencing to the implementation of Baby-Friendly practices that can be used to
enhance the implementation of this initiative in different healthcare settings.
Study aim and objectives: The aim of this study is to investigate the organizational
factors that hindered or facilitated the implementation of the Baby-Friendly Hospital
Initiative (BFHI) in two selected Palestinian governmental and private hospitals, to
determine the strategies implemented by the participating hospitals to overcome these
barriers and to identify points of convergence and divergence between the explored
governmental and private hospitals.
Methods: Using an interpretive qualitative approach, A purposive sampling technique
was used to conduct in-depth, semi-structured interviews with 15 clinical and nonclinical
staff members from different professional groups and managerial positions.
Data were analyzed using content comparative analysis method.
Results: One of the main organizational facilitators found in this study was the
endorsement of a well-coordinated implementation strategy characterized by autocratic
BFHI adoption and enforcement, strong administrative support, the presence of BFHIor quality coordinator as well as the financial and technical support by external
partners. The designing of mandatory breastfeeding education for all levels of relevant
professional groups was found to be also necessary to improve breastfeeding
knowledge, attitudes, and practices among staff responsible for the implementation of
BFHI tasks. The most frequently reported organizational barriers to implementing the
initiative were inadequate staffing especially in the governmental hospital limiting the
staff ability to implement BFHI related tasks and provide breastfeeding support.
Another commonly reported challenge was hospital structures or routines that interfere
with maternal-infant attachment and breastfeeding practices and lack of comprehensive
auditing and monitoring tools in both hospitals.
Conclusion: findings have indicated that the success of BFHI is achieved by
addressing the integrated sociopolitical, organizational and individual factors. The
organizational barriers and facilitating factors determined by this study provides a
comprehensive model tailored to the Palestinian context which can be adopted to utilize
the most effective strategies for a sustainable implementation of the BFHI in different
health facilities and consequently the attainment of ‘Baby Friendly’ designation.
Description
Keywords
السياسات والاداره الصحية , Policies & Health Management