USAID Advancing Nutrition, Arlington, Virginia, USA.
John Snow Inc. (JSI) Research & Training Institute Inc., Arlington, Virginia, USA.
Matern Child Nutr. 2023 Oct;19(4):e13506. doi: 10.1111/mcn.13506. Epub 2023 Jul 5.
Health professional competency building is one of nine national responsibilities (to achieve universal coverage and sustainability) described in the 2018 World Health Organization/UNICEF implementation guidance for the Baby-Friendly Hospital Initiative (BFHI). Skilled breastfeeding support as a standard of newborn care is critical to the establishment of lactation and exclusive breastfeeding. This qualitative case study describes the Kyrgyz Republic's experience with health professional competency building related to breastfeeding counselling and support. We interviewed 38 key informants and reviewed national policies and international guidelines related to BFHI. The study found that although the country has a new policy reflecting BFHI global standards and guidance, the policy has not been disseminated nationally. Additionally, the policy lacks guidance on competency monitoring and verification and does not mention preservice training, even though preservice training on breastfeeding support exists. To achieve universal coverage for health professional competencies, the Kyrgyz Republic uses preservice, in-service and refresher training. However, the main limitations to aligning with the new guidance are a lack of preservice BFHI- and breastfeeding-specific curricula, experienced trainers and sufficient time and funding to dedicate to practical skill development. Conducted during the COVID-19 pandemic, this study confirmed disruptions to BFHI training and service delivery but also documents the Kyrgyz Republic's resilient strides to mitigate impacts on breastfeeding support through facility-level individual champions and adjustments to training such as going online. Opportunities exist for strengthening the competencies of service providers through strengthened preservice training, comprehensive and consistent in-service training, solutions for overworked service providers and clear and sufficiently funded monitoring guidance.
卫生专业人员能力建设是 2018 年世界卫生组织/联合国儿童基金会《促进爱婴医院倡议实施指南》中描述的实现全民覆盖和可持续性的九项国家责任之一。作为新生儿护理标准的熟练母乳喂养支持对建立母乳喂养和纯母乳喂养至关重要。本定性案例研究描述了吉尔吉斯斯坦在与母乳喂养咨询和支持相关的卫生专业人员能力建设方面的经验。我们采访了 38 名主要知情者，并审查了与 BFHI 相关的国家政策和国际准则。研究发现，尽管该国出台了一项新政策，反映了 BFHI 的全球标准和准则，但该政策尚未在全国范围内传播。此外，该政策缺乏关于能力监测和核实的指导，也没有提到岗前培训，尽管存在关于母乳喂养支持的岗前培训。为了实现卫生专业人员能力的全民覆盖，吉尔吉斯斯坦使用岗前、在职和进修培训。然而，与新指导方针保持一致的主要限制因素是缺乏 BFHI 和母乳喂养特定课程、经验丰富的培训师以及足够的时间和资金用于实践技能的发展。本研究是在 COVID-19 大流行期间进行的，它证实了 BFHI 培训和服务提供的中断，但也记录了吉尔吉斯斯坦通过在机构层面上的个人冠军和对培训的调整（例如上网），减轻对母乳喂养支持的影响的弹性举措。通过加强岗前培训、全面和一致的在职培训、为工作过度的服务提供者提供解决方案以及明确和有足够资金支持的监测指导，可以有机会加强服务提供者的能力。
