Brandão Danusa S, Venancio Sonia I, Giugliani Elsa R J
Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Municipal Health Secretariat of Caxias do Sul, Caxias do Sul, RS, Brazil.
Instituto de Saúde, State Health Secretariat, São Paulo, SP, Brazil.
J Pediatr (Rio J). 2015 Mar-Apr;91(2):143-51. doi: 10.1016/j.jped.2014.06.009. Epub 2014 Nov 6.
To estimate the association between the implementation of the Brazilian Breastfeeding Network and prevalence of breastfeeding in a medium-size city in southern Brazil.
This was a cross-sectional study involving 405 children under 1 year who participated in the second phase of the multivaccination campaign in 2012. Children's consumption of food on the day before the interview was obtained through interviews with mothers or guardians. The manager and one health professional from every health facility that joined the Network were interviewed in order to investigate the process of implementation of this initiative. The association between prevalence of breastfeeding and exclusive breastfeeding and adherence to the Network implementation process was tested using Poisson regression with robust variance.
Multivariate analysis revealed that among the children assisted by health facilities who joined the Network and those attending services that did not adhere to this strategy, the prevalence of breastfeeding (74% and 70.4% among children under 1 year, respectively) and exclusive breastfeeding (43.3% and 38.1% among children under 6 months, respectively) did not differ significantly. Difficulties in implementing the Network, such as high turnover of professionals, not meeting the criteria for accreditation, and insufficient participation of tutors in the process were identified.
Contrary to the hypothesis of this study, there was no significant association between the implementation of the Brazilian Breastfeeding Network and prevalence of breastfeeding and exclusive breastfeeding in the studied city. It is possible that the difficulties found in implementing the Network in this city have influenced this result.
评估巴西母乳喂养网络的实施与巴西南部一个中等规模城市母乳喂养率之间的关联。
这是一项横断面研究，纳入了405名1岁以下儿童，他们参与了2012年多疫苗接种活动的第二阶段。通过与母亲或监护人访谈获取儿童在访谈前一天的食物摄入情况。对加入该网络的每个卫生机构的管理人员和一名卫生专业人员进行访谈，以调查该倡议的实施过程。使用稳健方差的泊松回归检验母乳喂养率和纯母乳喂养率与网络实施过程依从性之间的关联。
多变量分析显示，在由加入网络的卫生机构提供服务的儿童和那些接受未遵循该策略服务的儿童中，母乳喂养率（1岁以下儿童分别为74%和70.4%）和纯母乳喂养率（6个月以下儿童分别为43.3%和38.1%）没有显著差异。确定了实施网络存在的困难，如专业人员流动率高、不符合认证标准以及导师在该过程中的参与不足。
与本研究的假设相反，在所研究的城市中，巴西母乳喂养网络的实施与母乳喂养率和纯母乳喂养率之间没有显著关联。在该城市实施网络过程中发现的困难可能影响了这一结果。
