Evaluation of the implementation of human milk supply for prematures in a neonatal intensive care unit

Abstract Objectives: to assess the supply of human milk exclusively to prematures in a Neonatal Intensive Care Unit and the influence of external and organizational contexts on the degree of implementation of this intervention. Methods: this is an implementation evaluation with analysis of the external context (sociodemographic situation of mothers, support network and industry marketing) and organizational context (belonging to the hospital unit). To define the degree of implementation, the Analysis and Judgment Matrix was used, considering the compliance dimension, and the availability and technical-scientific quality sub-dimensions. The data used were obtained through interviews, semi-structured questionnaires and analysis of documents from the institution. Results: the degree of implementation of the intervention was 80.74%, proving to be satisfactory, with emphasis on the technical-scientific quality sub-dimension. Conclusions: the success in the supply of human milk is linked to public policies, the support and guidance offered to mothers in the hospital unit, presence of a support network, knowledge of mothers about the benefits of breastfeeding, adequate infrastructure and availability of supplies. The prematures being hospitalized in a child-friendly hospital contributed to the implementation of the intervention.摘要 研究目标：评估新生儿重症监护病房（Neonatal Intensive Care Unit）内仅为早产儿提供母乳供给的现状，以及外部与组织环境对该干预措施落实程度的影响。 研究方法：本研究为一项干预落实评价研究，对外部环境（产妇的社会人口学状况、支持网络及行业营销情况）与组织环境（所属医院病区属性）展开分析。为明确干预落实程度，本研究采用分析判断矩阵（Analysis and Judgment Matrix），从依从性维度、可及性子维度与技术科学质量子维度进行考量。研究数据通过访谈、半结构化问卷以及机构文件分析获取。 研究结果：该干预措施的落实程度达80.74%，整体处于令人满意的水平，其中技术科学质量子维度表现尤为突出。 研究结论：母乳供给的成功落实与多项因素密切相关：公共政策支持、医院病区为产妇提供的支持与指导、完善的支持网络、产妇对母乳喂养益处的认知水平、充足的基础设施以及物资供给。住院于儿童友好型医院的早产儿也对该干预措施的落实起到了积极推动作用。