A Method for the Evaluation of Primary Health Care Units' Practice in the Promotion, Protection, and Support of Breastfeeding: Results from the State of Rio de Janeiro, Brazil

Abstract

A method to assess the effectiveness of primary health care (PHC) units in enabling mothers to breastfeed was developed from the tool used for accreditation of baby-friendly hospitals. A 10-step scoring system assessed the extent to which procedures known to be effective at extending breastfeeding duration were applied within PHC units. Using this method, 13 PHC units showed a fair performance, whereas 11 performed poorly in the state of Rio de Janeiro. More babies younger than 6 months were being exclusively breastfed in fair performance than in poor performance units (38.6% vs 23.6%, respectively, P < .001). Twice as many pregnant women and mothers in fair performance units (61.9%) were satisfied with the support provided for breastfeeding than in poor performance units (31.4%). The differences were not explained by hospital care or working status of the women. The association found between structure, process, and outcomes support the validity of the method. J Hum Lact. 19(4):365-373.