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South African Family Practice. 2014 Jul-Aug; 56(4):250-251.Globally, breastfeeding has been acknowledged as one of the most effective ways of ensuring the adequate health, development and survival of a child. In 1991, in order to ensure the right start for every infant and to extend the desired support to the postnatal mothers to execute successful breastfeeding, the World Health Organization and the United Nations Children’s Fund (UNICEF) implemented the Baby-Friendly Hospital Initiative (BFHI). Irrespective of the multiple advantages of baby-friendly hospitals, none of the evaluation studies have identified completely adherent facilities to the 10 steps. To ensure successful implementation and long-term sustainability of the BFHI in different healthcare facilities, different measures have been proposed. To conclude, despite the availability of a definitive evidence of BFHI having a successful impact on different breastfeeding outcomes, only a comprehensive and multisectoral approach can enable every mother and family to give every child the best start in life.
Barriers to implementing WHO's exclusive breastfeeding policy for women living with HIV in sub-Saharan Africa: an exploration of ideas, interests and institutions.
International Journal of Health Planning and Management. 2013 Jul-Sep; 28(3):257-68.The vertical transmission of HIV occurs when an HIV-positive woman passes the virus to her baby during pregnancy, delivery or breastfeeding. The World Health Organization's (WHO) Guidelines on HIV and infant feeding 2010 recommends exclusive breastfeeding for HIV-positive mothers in resource-limited settings. Although evidence shows that following this strategy will dramatically reduce vertical transmission of HIV, full implementation of the WHO Guidelines has been severely limited in sub-Saharan Africa. This paper provides an analysis of the role of ideas, interests and institutions in establishing barriers to the effective implementation of these guidelines by reviewing efforts to implement prevention of vertical transmission programs in various sub-Saharan countries. Findings suggest that WHO Guidelines on preventing vertical transmission of HIV through exclusive breastfeeding in resource-limited settings are not being translated into action by governments and front-line workers because of a variety of structural and ideological barriers. Identifying and understanding the role played by ideas, interests and institutions is essential to overcoming barriers to guideline implementation. Copyright (c) 2012 John Wiley & Sons, Ltd.