Naslov
THE RISE AND FALL (AND RISE AGAIN) OF THE BFHI IN CROATIA

Autori
Zakarija-Grković, Irena

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Skup
Australian Lactation Consultant Association Biennial Conference

Mjesto i datum
Canberra, Australija, 2009

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Nema ključnih riječi

Sažetak
Background: The Republic of Croatia is a country in the southeast of Europe with a population of approx. 4.5 million. In 2006 there were 41 thousand births with an infant mortality rate of 5 per 1000. There are currently 34 maternity facilities. A New Initiative: The Baby Friendly Hospital Initiative (BFHI) was launched in 1991 as a global UNICEF/WHO campaign to encourage maternity hospitals to create a breastfeeding- supportive environment. Despite the difficulties of war during 1991-1995, Croatia took up this challenge in 1993, and with the support of UNICEF, began implementing the 'Ten Steps to Successful Breastfeeding'. By 1999, 15 out of 34 maternity facilities were 'Baby– friendly' placing Croatia in third place in Europe, following Sweden and Norway. As a leader in the region, Croatia trained health professionals from neighbouring countries to adopt the BFHI. In 1998, plans for introducing the '10 steps' into the primary care setting were announced but not realized due to unforseen circumstances that led to the downfall of the BFHI in Croatia. 'Code' Violations: On the 1st November 1998, a hospital discharge pack entitled 'Happy Baby' was distributed to mothers throughout Croatia. Under the guise of 'Family Services' a Belgian company, Anfap, won the support of the Croatian Ministry of Health (MoH) resulting in a blanket recommendation of endorsement of these packages. The pack contained advertising material that violated the International Code of Marketing of Breast Milk Substitutes (Code), including a self-addressed envelope for mothers to send their contact details. Consequently, UNICEF withdrew its support of the BFHI in Croatia, the standard of care in maternity facilities deteriorated with none of the Baby- friendly hospitals renewing their title, and breastfeeding rates began to fall. Revitalization of the BFHI: In response to its periodic report as a member state, Croatia received a letter of recommendation in 2004 from the UN Committee on the Rights of the Child, encouraging compliance with the Code and promotion of breastfeeding. This gave strength to two national documents published in 2006, dealing with population health, which led to the formation of a National Breastfeeding Committee (NBC). Intense lobbying by the NBC, resulted in the MoH withdrawing its support for the 'Happy Baby' packs, which was confirmed by an official letter sent to all maternity units in September 2007. Concurrently, UNICEF began a 'Young Child Development Program' encompassing positive parenting and optimal infant feeding, with a strong emphasis on renewing the BFHI. A national BFHI team was formed and coordinators were assigned. The country was divided into 5 regions with each region allocated a community coordinator, coordinator for breastfeeding education and a coordinator for each hospital. Assessors and coordinators were trained and all 34 hospitals began working towards the '10 steps'. As of January 2009, 10 hospitals have been recertified, several are awaiting external assessment, and discussions are being held on how to make primary health care 'Baby- friendly'. Conclusion: Despite attempts by formula manufacturers to undermine the BFHI in Croatia, determination and hard work by dedicated individuals, a favourable political climate and international support led to a renaissance of this worthy initiative. Although some ‘battles’ have been won, the ‘war’ is not over - ‘Happy Baby’ is now being distributed through local pharmacies.

Izvorni jezik
Engleski

Znanstvena područja
Javno zdravstvo i zdravstvena zaštita

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