Ministère de la Santé et des Services sociaux du Québec, Direction générale de la santé publique, 201 Crémazie, Montréal, Québec H2M 1L2, Canada.
Public Health Nutr. 2012 May;15(5):894-905. doi: 10.1017/S1368980011002394. Epub 2011 Sep 30.
The WHO/UNICEF Baby-Friendly Hospital Initiative (BFHI) is an effective strategy to increase breast-feeding exclusivity and duration but many countries have been slow to implement it. The present paper describes the development of a computer-based instrument that measures policies and practices outlined in the BFHI.
The tool uses clinical staff/managers' and pregnant women/mothers' opinions as well as maternity unit observations to assess compliance with the BFHI's Ten Steps to Successful Breastfeeding (Ten Steps) and the International Code of Marketing of Breastmilk Substitutes (Code) by measuring the extent of implementation of two to fourteen indicators for each step and the Code. Composite scores are used to summarize results.
Examples of results from a 2007 assessment performed in nine hospitals in the province of Québec are presented to illustrate the type of information returned to individual hospitals and health authorities.
Participants included nine to fifteen staff/managers per hospital randomly selected among those present during the interviewer-observer's 12 h hospital visit and nine to forty-five breast-feeding mothers per hospital telephoned at home after being randomly selected from birth certificates.
The Ten Steps Global Compliance Score for the nine hospitals varied between 2.87 and 6.51 (range 0-10, mean 5.06) whereas the Code Global Compliance Score varied between 0.58 and 1 (range 0-1, mean 0.83). Instrument development, examples of assessment results and potential applications are discussed.
A methodology to measure BFHI compliance may help support the implementation of this effective intervention and contribute to improved maternal and child health.
世界卫生组织/联合国儿童基金会促进母乳喂养成功的十项措施（十项措施）是提高母乳喂养率和母乳喂养持续时间的有效策略，但许多国家实施缓慢。本文介绍了一种基于计算机的工具的开发，该工具用于衡量十项措施中概述的政策和实践。
该工具使用临床工作人员/管理人员和孕妇/母亲的意见以及产房观察结果，通过衡量每个步骤的十项措施和国际母乳代用品销售守则（守则）的 14 项指标中的两项到十项的实施程度，来评估对十项措施和守则的遵守情况。使用综合得分来总结结果。
以魁北克省 9 家医院 2007 年评估的结果为例，说明返回给个别医院和卫生当局的信息类型。
每个医院随机选择 9-15 名工作人员/管理人员参加访谈人员观察的 12 小时医院访问，每个医院随机从出生证明中选择 9-45 名母乳喂养母亲在家中进行电话访谈。
9 家医院的十项措施全球合规得分在 2.87 到 6.51 之间（范围 0-10，平均值 5.06），而守则全球合规得分在 0.58 到 1 之间（范围 0-1，平均值 0.83）。讨论了工具的开发、评估结果示例以及潜在的应用。
衡量母乳喂养成功十项措施的遵守情况的方法可能有助于支持这一有效干预措施的实施，并有助于改善母婴健康。
