Sustainability of the Breastfeeding-Friendly Primary Care Initiative: a cross-sectional study

ABSTRACT Objectives: to assess the sustainability of the Breastfeeding-Friendly Primary Care Initiative by analyzing compliance with the Ten Steps in accredited units; and association with maternal satisfaction and exclusive breastfeeding. Methods: a cross-sectional study conducted in 2016. An assessment of compliance, conducted by interviews with health professionals, pregnant women, and mothers. An association between compliance and satisfaction, analyzed by Spearman›s correlation test; and association between contextual/individual characteristics and exclusive breastfeeding, by the multilevel Poisson regression. Results: compliance was 5.4-10 points and satisfaction was 36.8%-100%. Prevalence of exclusive breastfeeding was 56.7%. There was a correlation between compliance and satisfaction. Higher education, prenatal orientation, hospital discharge on exclusive breastfeeding, attendance in mixed units, and female gender of the child were associated with higher prevalence of exclusive breastfeeding; on the other hand, increasing age and pacifier use were associated with lower prevalence. Conclusions: the Initiative proved to be sustainable; compliance with the Ten Steps was high and was reflected in maternal satisfaction.

摘要：
研究目的：通过分析认证医疗单位对十项措施（Ten Steps）的依从情况，评估爱婴基层医疗倡议（Breastfeeding-Friendly Primary Care Initiative）的可持续性，并探讨其与产妇满意度及纯母乳喂养（exclusive breastfeeding）率的关联。
研究方法：本研究为2016年开展的横断面研究（cross-sectional study）。通过对卫生专业人员、孕妇及产妇进行访谈完成依从性评估；依从性与满意度之间的关联采用斯皮尔曼相关性检验（Spearman's correlation test）进行分析；情境/个体特征与纯母乳喂养之间的关联则通过多水平泊松回归（multilevel Poisson regression）分析。
研究结果：依从性评分范围为5.4~10分，产妇满意度区间为36.8%~100%；纯母乳喂养患病率为56.7%。研究发现依从性与产妇满意度存在相关性。更高的受教育水平、产前指导、出院时维持纯母乳喂养、在混合型医疗单位就诊以及新生儿为女性，均与更高的纯母乳喂养患病率相关；反之，产妇年龄增长及使用安抚奶嘴则与更低的纯母乳喂养患病率相关。
研究结论：本研究证实该倡议具备可持续性；认证医疗单位对十项措施的依从性较高，且该依从性水平可反映在产妇满意度的提升上。