Barriers and Strategies for Successful Implementation of Baby-Friendly Hospital Initiative: A Scoping Review

Abstract

IntroductionImplementation of the Baby-Friendly Hospital Initiative (BFHI) with maternal and/or neonatal services in all health care facilities is valuable to protect, promote and support breastfeeding and the well-being of young children. It is essential to identify challenges that hinder the successful implementation of BFHI and explore strategies to overcome those barriers to promote, protect and support breastfeeding practices of mothers all over the world.MethodsA scoping review of evidence-based literature was undertaken. A total of 44 articles on BFHI published globally between the years 2000 and 2021 were reviewed and analyzed.ResultsThe barriers to the successful implementation of the BFHI include the absence of clearly stated policies on breastfeeding, lack of uniform understanding of BFHI, insufficient support and resources, disagreements/lack of collaboration among health care professionals, maternal circumstances, and hospital routines and practices. The strategies for successful implementation of BFHI include health care providers’ leadership, teamwork/collaboration, adequate staffing and financial resources, education, mentoring and skills training opportunities for healthcare professionals, continuous monitoring of the BFHI steps, compliance with every step of BFHI, mother-centred approach, and regulation on marketing and sale of breastmilk.ConclusionsGThe role of multi-layered interventions, interdisciplinary collaboration and partnership-based approach is critical in minimizing barriers and promoting the successful implementation of BFHI in all healthcare settings.