{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T06:58:49Z","timestamp":1792479529971,"version":"4.5.0"},"reference-count":45,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2011,9,30]],"date-time":"2011-09-30T00:00:00Z","timestamp":1317340800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Public Health Nutr."],"published-print":{"date-parts":[[2012,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1368980011002394_abs1\" sec-type=\"general\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The WHO\/UNICEF Baby-Friendly Hospital Initiative (BFHI) is an effective strategy to increase breast-feeding exclusivity and duration but many countries have been slow to implement it. The present paper describes the development of a computer-based instrument that measures policies and practices outlined in the BFHI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1368980011002394_abs2\" sec-type=\"general\">\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>The tool uses clinical staff\/managers\u2019 and pregnant women\/mothers\u2019 opinions as well as maternity unit observations to assess compliance with the BFHI's Ten Steps to Successful Breastfeeding (Ten Steps) and the International Code of Marketing of Breastmilk Substitutes (Code) by measuring the extent of implementation of two to fourteen indicators for each step and the Code. Composite scores are used to summarize results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1368980011002394_abs3\" sec-type=\"general\">\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Examples of results from a 2007 assessment performed in nine hospitals in the province of Qu\u00e9bec are presented to illustrate the type of information returned to individual hospitals and health authorities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1368980011002394_abs4\" sec-type=\"subjects\">\n                    <jats:title>Subjects<\/jats:title>\n                    <jats:p>Participants included nine to fifteen staff\/managers per hospital randomly selected among those present during the interviewer-observer's 12 h hospital visit and nine to forty-five breast-feeding mothers per hospital telephoned at home after being randomly selected from birth certificates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1368980011002394_abs5\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The Ten Steps Global Compliance Score for the nine hospitals varied between 2\u00b787 and 6\u00b751 (range 0\u201310, mean 5\u00b706) whereas the Code Global Compliance Score varied between 0\u00b758 and 1 (range 0\u20131, mean 0\u00b783). Instrument development, examples of assessment results and potential applications are discussed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1368980011002394_abs6\" sec-type=\"conclusion\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A methodology to measure BFHI compliance may help support the implementation of this effective intervention and contribute to improved maternal and child health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1368980011002394","type":"journal-article","created":{"date-parts":[[2011,9,30]],"date-time":"2011-09-30T12:51:00Z","timestamp":1317387060000},"page":"894-905","source":"Crossref","is-referenced-by-count":23,"title":["Measuring compliance with the Baby-Friendly Hospital Initiative"],"prefix":"10.1017","volume":"15","author":[{"given":"Laura N","family":"Haiek","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2011,9,30]]},"reference":[{"key":"S1368980011002394_ref35","doi-asserted-by":"publisher","DOI":"10.1177\/0890334403258138"},{"key":"S1368980011002394_ref24","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1007\/BF03404254","article-title":"How Baby-Friendly are Manitoba hospitals? The Provincial Infant Feeding Study. Breastfeeding Promotion Steering Committee of Manitoba","volume":"91","author":"Martens","year":"2000","journal-title":"Can J Public Health"},{"key":"S1368980011002394_ref38","volume-title":"Initiative des h\u00f4pitaux amis des b\u00e9b\u00e9s. \u00c9tude sur le niveau d'implantation en Mont\u00e9r\u00e9gie","author":"Haiek","year":"2003"},{"key":"S1368980011002394_ref31","volume-title":"The Nicaragua Mother and Baby Friendly Health Units Initiative. Factors Influencing its Success and Sustainability","year":"2006"},{"key":"S1368980011002394_ref42","volume-title":"BFHI-100 Assessment Tool. A Methodology to Measure Compliance with the Baby-Friendly Hospital Initiative","author":"Haiek","year":"2004"},{"key":"S1368980011002394_ref7","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-1616"},{"key":"S1368980011002394_ref9","volume-title":"International Code of Marketing of Breast-milk Substitutes","year":"1981"},{"key":"S1368980011002394_ref25","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-536X.2007.00172.x"},{"key":"S1368980011002394_ref10","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-0537"},{"key":"S1368980011002394_ref28","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-536X.2009.00309.x"},{"key":"S1368980011002394_ref11","volume-title":"Monitoring de la promotion de l'allaitement maternel dans les maternit\u00e9s certifi\u00e9es favorables \u00e0 l'allaitement maternel et les cliniques et h\u00f4pitaux qui visent la certification (Initiative H\u00f4pitaux Amis des B\u00e9b\u00e9s)","year":"2008"},{"key":"S1368980011002394_ref5","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.4.413"},{"key":"S1368980011002394_ref12","doi-asserted-by":"publisher","DOI":"10.1177\/0890334407303899"},{"key":"S1368980011002394_ref26","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2007.0039"},{"key":"S1368980011002394_ref14","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.323.7325.1358"},{"key":"S1368980011002394_ref18","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2008-1315e"},{"key":"S1368980011002394_ref45","volume-title":"Plan d'action r\u00e9gional 2009\u20132012. 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