Abstract
BackgroundIntegrated care is defined as concerted action of healthcare providers ensuring continuity of care within a patient-centered approach, thus contributing to healthcare efficiency and quality. Apart from the WHO/UNICEF Baby-Friendly Initiatives, integrated care has been poorly explored within the context of breastfeeding support. The aim of this study was to investigate the experience of breastfeeding support practitioners, identifying barriers and facilitators towards integrated care.MethodsA 62-item survey was conducted among 900 participants at 3 international breastfeeding conferences. Analysis included uni-and bivariate descriptive statistics, categorizing of mutually exclusive response groups and thematic networks analysis of responses to 18 open-ended items.ResultsThree-hundred-and-one participants (33 % response), from 34 predominantly industrialized countries (98 %) on nearly all continents, responded to the survey. Norwegian residents alone, felt sufficiently supported in providing breastfeeding support by other healthcare providers, the work environment, society, the media and their National Breastfeeding Committee (P < 0.05). Out of 11 suggested measures for effective breastfeeding promotion, 96 % of respondents ranked integrated care as the most important. The largest response group identified in open-ended items, as a major barrier to integrated care in breastfeeding support, was “lacking or failing health promotion strategies” (n = 454), followed by “a lack of vertically integrated care” (n =268), described mainly as unsatisfactory cooperation within healthcare. This inconsistency of care also impairs “shared decision-making” on infant feeding for parents, including accessibility of information and support (n = 265). Among other measures, 29 % of respondents recommended incentivizing integrated breastfeeding support within healthcare. Two figures, based on open-ended response evaluations, illustrate participants’ ideas of the National Breastfeeding Committees’ role in coordinating policies and protagonists towards integrated breastfeeding support, and a family-centered model of integrated care to facilitate successful breastfeeding.ConclusionsAccording to practitioners in breastfeeding support, integrated care is essential for successful breastfeeding. Quality and accessibility of breastfeeding support should be motivated by healthcare system incentives, to counter the reported lack of consistency of care within and beyond healthcare. To effectively integrate a continuum of breastfeeding support into healthcare and society, a policy consensus and strong political action are indispensable, with coordination by an empowered National Breastfeeding Committee.Electronic supplementary materialThe online version of this article (doi:10.1186/s13006-016-0072-y) contains supplementary material, which is available to authorized users.
Highlights
Integrated care is defined as concerted action of healthcare providers ensuring continuity of care within a patient-centered approach, contributing to healthcare efficiency and quality
This study investigates the integrated care concept within breastfeeding support, by analyzing and describing from the perspective of practitioners, how breastfeeding support functions within the following integrated care fields, and how it can be improved [35]:
To further explore the importance respondents ascribed to “integrated care” for effective breastfeeding support, we evaluated open-ended responses using qualitative methods
Summary
Integrated care is defined as concerted action of healthcare providers ensuring continuity of care within a patient-centered approach, contributing to healthcare efficiency and quality. Integrated care can be described as a collaborative approach among healthcare professionals. The World Health Organization (WHO) defines integrated care as [1]:. Integrated care has become increasingly important for healthcare systems to optimize continuity, consistency and quality of care, while ensuring interdisciplinary cooperation and cost-efficiency. Integrated care requires consistency of treatment and advice from multi-professional healthcare providers, independent of setting, otherwise:. “Without integration at various levels, all aspects of health care performance suffer. Exchange between healthcare providers and respect of different healthcare disciplines are indispensable for integrating care toward a patientcentered focus, optimizing cost-efficiency, patient satisfaction and health outcomes
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