A method for the evaluation of primary health care units' practice in the promotion, protection, and support of breastfeeding: results from the state of Rio de Janeiro, Brazil.
A method to assess the effectiveness of primary health care (PHC) units in enabling mothers to breastfeed was developed from the tool used for accreditation of baby-friendly hospitals. A 10-step scoring system assessed the extent to which procedures known to be effective at extending breastfeeding duration were applied within PHC units. Using this method, 13 PHC units showed a fair performance, whereas 11 performed poorly in the state of Rio de Janeiro. More babies younger than 6 months were being exclusively breastfed in fair performance than in poor performance units (38.6% vs 23.6%, respectively, P < .001). Twice as many pregnant women and mothers in fair performance units (61.9%) were satisfied with the support provided for breastfeeding than in poor performance units (31.4%). The differences were not explained by hospital care or working status of the women. The association found between structure, process, and outcomes support the validity of the method.
de Oliveira
Maria Inês Couto
MI
Breastfeeding Program at the Rio de Janeiro State Health Office. RJ, Brazil.
Camacho
Luiz Antonio Bastos
LA
Tedstone
Alison E
AE
D000328:Adult; D001938:Brazil; D001942:Breast Feeding / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006266:Health Education / Q000592:standards; D006293:Health Promotion / Q000592:standards*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009035:Mothers / Q000523:psychology*; D010353:Patient Education as Topic; D018743:Perinatal Care / Q000592:standards*; D011247:Pregnancy; D011320:Primary Health Care / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000379:methods*; D012944:Social Support