Factors Affecting the Sustainability of the Baby Friendly Hospital Initiative in Khartoum State, Sudan: A Cross-sectional Study

Rahman AA and Alkhatim HS


Background: The Baby Friendly Hospital Initiative (BFHI) is a global initiative aimed at protecting, promoting and supporting breastfeeding. In Sudan there were 25 Baby Friendly Hospitals in 2002, however only three were available in 2013. This study was done to identify the factors affecting the sustainability of the baby friendly hospital initiative in the accredited hospitals in Khartoum state (2013). Methods: The study used qualitative approach to interpret the sustainability issues of the baby friendly hospital initiative in the accredited hospitals; namely: Alsaudi, Albanjadid and Ibrahim Malik hospital in Khartoum state. Three in-depth interviews were conducted with the nutritionists responsible for breastfeeding promotion. Six focus group discussions with the health care providers were also conducted, two in each hospital. Information about the sustainability issues of the BFHI was obtained. The data was analyzed manually using thematic analysis. The analysis revealed six main themes, tackling the sustainability issues of the BFHI. Results: All the three hospitals were baby-friendly at the time of the study. Knowledge about the BFHI was limited. The healthcare providers were few in number and the turnover rate was high. Breastfeeding training was deficient; this negatively affected health education and practical support to the mothers. Monitoring and evaluation was irregular and was not going on as planned. Conclusion: The study concluded that many factors affected sustainability of the BFHI. Paucity of breastfeeding training of the health care providers, especially the doctors at the obstetric and pediatric departments, was an important issue affecting the sustainability of the BFHI. Proper monitoring and evaluation was an important issue for well maintenance of the initiative.

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