Assessment of Baby Friendly Hospital Initiative (BFHI) in Thimphu, Bhutan: A cross-sectional study

Abstract

Background: Exclusive breastfeeding immediately after birth up to 6 months shows how healthy, experienced, sick and mentally the baby will develop which means that exclusive breastfeeding is essential for a healthy childhood and adulthood. Bhutan has a prevalence rate of 51.4%, which means almost half of Bhutanese newborn are not exclusively breastfed. Objective: This study aimed to assess the progress of the criteria BFHI hospital and evaluate to propose the intervention to the lacking criteria. To access the knowledge of the mothers regarding the 10 steps to successfully breastfeeding practice and to promote exclusive breastfeeding. Methodology: The cross sectional study was conducted in the Mother and Child Hospital of Jigme Dorji Wangchuck National Referral Hospital in Thimphu. Data were collected from 345 mothers who are visiting the hospitals for their post-natal services using convenience sampling until the calculated sample size was fulfilled. Chi square, frequency distribution and logistic regression were used to find the association and odd ratios. Result: The multivariate regression has found a significant association between the feeding within the first hour of the delivery and Type of Delivery, an odd ratio of 0.34 (CI: 0.15-0.76) p <0.05. Associated between Kangaroo mother care and Type of Delivery odds of 0.02 (CI:0.01-0.04),p<0.05. And birth preparedness and Type of Delivery has a high association, odd of 0.20 CI (0.05-0.76) with p value 0.02. Discussion: The study showed that 7 of the 13 BFHI criteria of breastfeeding scored below 90%. Only 75.1% of the mothers initiated breastfeeding within an hour of the delivery. The findings showed that c-session delivery, not being able to do kangaroo mother care and less knowledge about birth preparedness are potential factors that act as a barrier towards breastfeeding within an hour of delivery. And maternal knowledge score is highly associated with where the lactation room is and baby feeding position. This plays a significant role in continuation of breastfeeding for longer duration. Conclusion: The Baby-Friendly Hospital Initiative (BFHI) was introduced in Bhutan that could potentially help in increasing and improving breastfeeding practice. 7 out of 13 criteria are not up to the set criteria of the Ministry of Health, scoring less than 90%.