Impact assessment of an educational intervention in pharmacies that use commercial promotion of products competing with maternal breastfeeding

Abstract

The Brazilian Code of Marketing of Infant and Toddlers Food, Nipples, Pacifiers, and Baby Bottles (Federal Law n. 11,265/2006) aims to control the abusive marketing of products that compete with breastfeeding. The objective was to assess the impact of an educational intervention on compliance with this law by pharmacies. A randomized intervention study was conducted in 155 pharmacies that were infringing the law in the Southern Zone of Rio de Janeiro, Brazil. The pharmacies' commercial practices were assessed before and after the intervention with the pharmacist and manager, compared to the control group. The interval between the intervention and the second assessment was one month. McNemar test was used to measure changes in the number of pharmacies infringing the law before and after the intervention. Wilcoxon test was used to compare variation in the number of violations in each group. A month after the intervention, there was a 16.1% reduction (n = 25) in the number of pharmacies committing violations. There was a decrease from 18.7% to 12.9% in products whose commercial promotion is banned by the law (p = 0.093) and from 92.9% to 80.5% in milk products (p = 0.001), but among processed complementary food there was an increase from 28.5% to 42.3% of pharmacies with illegal promotions (p = 0.006). The intervention group with the pharmacists showed a statistically significant reduction in violations related to discount prices (p = 0.022) and special displays (p = 0.002). The educational intervention reduced the number of pharmacies that infringed the law, mainly when the intervention involved the pharmacist.