Policymakers’ Perspectives on Baby-Friendly Hospital Initiative in Ebonyi State, Nigeria: A Qualitative Study
Main Article Content
Abstract
Introduction: Nigeria, like other low- and middle-income countries, has a consistently high prevalence of malnutrition among children under 5 years. Baby-Friendly Hospital Initiative (BFHI) was established by the World Health Organization and United Nations Children’s Fund (UNICEF) to protect, promote and support breastfeeding practices. Nigeria initiated this policy decades ago. However, studies show a lack of political commitment.
Objective: To explore policymakers’ perspectives on BFHI based on the UNICEF Conceptual Framework on Determinants of Maternal and Child Nutrition.
Method: An explorative qualitative cross-sectional study involving 10 interviews with policymakers, members of the State Committee on Food and Nutrition, in Ebonyi State, Nigeria.
Results: All participants were knowledgeable about BFHI practices, and the majority were aware of the Code and its significance. According to policymakers’ perspectives, BFHI improved breastfeeding practices by mothers in Nigeria: breastfeeding rate increased from 3% in 2009 before implementation to 29% in 2018; mothers’ knowledge and exposure to more BFHI interventions improved breastfeeding continuation; delivery of BFHI interventions across a variety of settings enhanced breastfeeding practices; however, shortages of healthcare staff, cultural norms and inadequate enforcement of the Code at the grassroots level remained significant barriers.
Discussion and Conclusion: Nigeria has implemented BFHI and the Code; however, policymakers reported limited enforcement across government levels, pointing to the need for stronger monitoring mechanisms and greater political commitment at the community and workplace levels. Additionally, addressing staffing shortages requires sustained funding and ongoing education.
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