Breastfeeding promotion and baby-friendly health facilities in Turkey: A systematic approach to scale up the program

Abstract

Objectives: In Turkey, Breastfeeding Promotion and Baby-Friendly Health Facilities Program (BFHF) was launched in 1991 with the collaboration of the Ministry of Health (MoH) and United Nations International Children's Emergency Fund (UNICEF). Since 2002, the program has been extended from hospitals to the primary health care services and the community level. This paper aims to present the current status of BFHF and development of new strategies to revitalize the program and thus, to contribute to the progress. Materials and Methods: All information about health facilities and provinces was collected from the database of the Child and Adolescent Health Department. Discussions about Initiative with stakeholder institutions and baby-friendly advocates took place in the National Breastfeeding Committee Meeting and in Annual Breastfeeding Symposium. Then a SWOT (strengths, weaknesses, opportunities, threats) analysis of the Program was performed by the working group. Using this analysis results, new strategies and course of action were identified. Results: The current number of baby-friendly hospitals has reached a total of 1051(69.42% of all hospitals). Of those, 46 were maternity hospitals, which were 93.50% approved as baby-friendly at the end of 2017. Between 2008 and 2017, 120 (%11.42) of those pre-certified hospitals were reassessed. Between 2002 and 2013, all 81 provinces have been designated Baby-Friendly Provinces. Since 2008, 61 of the 81 provinces have been designated Golden Baby-Friendly Provinces and 95% of Family Medicine Units have been certified as baby-friendly. According to the SWOT analysis result, the main strength of the program was strong recognition and support of the BFHF by the government. The difficulties in maintaining of baby-friendly standards in health facilities and inadequate reassessment of pre-certified facilities were determined as the main weaknesses of the BFHF by the working group. Conclusion: To protect, promote and support breastfeeding effectively and to reach the national and global breastfeeding goals, interventions should be planned in a combination of settings by concurrently involving health policies, health systems, home, family and the community.