一项考察澳大利亚推行《爱婴医院健康倡议》的工具性案例研究：参与者的观点。

An instrumental case study examining the introduction and dissemination of the Baby Friendly Health Initiative in Australia: Participants' perspectives.

机构信息

Centre for Midwifery, Child and Family Health, University of Technology Sydney, Ultimo 2007, NSW, Australia.

ACT Health Directorate and University of Canberra, Faculty of Health, University of Canberra, Canberra 2601, ACT, Australia.

出版信息

Women Birth. 2018 Jun;31(3):210-219. doi: 10.1016/j.wombi.2017.08.130. Epub 2017 Sep 14.

DOI:10.1016/j.wombi.2017.08.130

PMID:28923268

Abstract

BACKGROUND

Australia experiences high breastfeeding initiation but low duration rates. UNICEF introduced the global breastfeeding strategy, the Baby-Friendly Hospital Initiative, to Australia in 1992, transferring governance to the Australian College of Midwives (ACM) in 1995. In 2017 23% of facilities were registered as 'baby-friendly' accredited.

AIM

To examine the introduction and dissemination of the Baby-friendly Hospital Initiative into the Australian national setting.

METHODS

An instrumental case study was conducted containing two components: analysis of historical documents pertaining to the Initiative and participant's interviews, reported here. A purposive sampling strategy identified 14 participants from UNICEF, ACM, maternity and community health services, the Australian government and volunteer organisations who took part in in-depth interviews. Thematic analysis explored participants' perceptions of factors influencing the uptake and future of the since renamed Baby Friendly Health Initiative (BFHI) and accreditation programme, BFHI Australia. Two broad categories, enablers and barriers, guided the interviews and analysis.

FINDINGS

Participants revealed a positive perception of the BFHI whilst identifying that its interpretation and expansion in Australia had been negatively influenced by intangible government support and suboptimal capacity building. BFHI's advocacy agenda competed with BFHI Australia's need for financial viability. Widespread stakeholder collaboration and tangible political endorsement was seen as a way to move the strategy forward.

CONCLUSION

Dissemination of BFHI Australia is hampered by multi-level systems issues. Prioritisation, stakeholder collaboration and adequate resourcing of the BFHI is required to create a supportive and enabling environment for Australian women to determine and practice their preferred infant feeding method.

摘要

背景

澳大利亚的母乳喂养初始率较高，但持续时间率较低。联合国儿童基金会于 1992 年向澳大利亚推出了全球母乳喂养战略——婴儿友好医院倡议，并于 1995 年将其管理权限移交给澳大利亚助产士学院。2017 年，有 23%的医疗机构被注册为“婴儿友好”认证机构。

目的

研究婴儿友好医院倡议在澳大利亚国家背景下的引入和传播。

方法

本研究采用了工具案例研究方法，包含两个部分：对倡议相关的历史文件进行分析，以及对参与者进行访谈，这里报告的是访谈内容。采用目的性抽样策略，从联合国儿童基金会、澳大利亚助产士学院、产妇和社区卫生服务机构、澳大利亚政府以及志愿者组织中确定了 14 名参与者，他们参加了深入访谈。主题分析探讨了参与者对影响该倡议（现已更名为婴儿友好健康倡议，简称 BFHI）及其认证项目在澳大利亚的采用和未来发展的因素的看法。访谈和分析的指导原则是两个广泛的类别，即促进因素和障碍因素。