Assessment of baby friendly status of health facilities in Butaleja District

Abstract

Introduction: The Baby Friendly Health Facility Initiative (BFHI) is one of the strategies aimed at enhancing child survival and maternal health at the facility level through protecting, promoting and supporting breastfeeding. However, Limited data exists about the baby friendly status of health facilities in Uganda and specifically Butaleja district. General Objective: The study aimed at assessing the baby friendly status of health facilities in Butaleja district. Methodology: A descriptive cross-sectional study design was used employing both qualitative and quantitative data collection methods. Data was collected from14 health facilities that conduct deliveries in Butaleja district. A total of 82 staff, 196 mothers and 2 key informants were interviewed. Results: Three of the 14 health facilities assessed scored above 90% with the best performing health facility scoring 92.5%. Thirteen health facilities scored above 75% for baby friendly status. Although all the 14 facilities had well baby observation areas, only one of these facilities had a nursery space and a special care unit. The average score for Infrastructural requirements, availability of medicine, supplies and equipment across facilities was 80%, 74%, 80% and 83% respectively. About 49.6% (133/268) of the health workers caring for pregnant women, mothers, and infants in 13 health facilities had been trained in BFHI and only 2 facilities having trained staff on breastfeeding promotion and support within six months of commencing work. Functionality of the BFHI committees and the provision of support supervision to health workers were identified as key facilitators, while the individual attitudes of mothers and health workers as well as cultural beliefs were the barriers to achieving baby friendliness. Conclusion: Overall, Butaleja district had a few health facilities (3) that were baby friendly (overall facility scores of 90% and above). Although majority of the health facilities had basic infrastructure, medicine, equipment and medical supplies, the utilization especially for medicines was not adequate. An area of particular challenge was the lack of adequate staff training. There is need for; the district and other stakeholders in health to provide a quality training covering all sixteen requirements to successful Infant and young child feeding to health workers with a possibility of exploring alternative strategies especially those that address financial constraints. Health workers also need to create awareness to care takers about the need to administer medicines.