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- Title
Health professional competency building for the Baby‐Friendly Hospital Initiative in Malawi.
- Authors
Mukuria‐Ashe, Altrena; Nyambo, Kanji; Uyehara, Malia; Guta, Janet; Mtengowadula, George; Nyirongo, Godwin; Alvey, Jeniece
- Abstract
Health professional competency building is one of nine national responsibilities (to achieve universal coverage and sustainability) described in the 2018 World Health Organization (WHO)/United Nations Children's Fund (UNICEF) implementation guidance for the Baby‐Friendly Hospital Initiative (BFHI). With stagnating rates of exclusive breastfeeding worldwide, skilled breastfeeding support as a standard of newborn care is critical to the establishment of lactation and exclusive breastfeeding. Few studies exist on how low‐income countries are integrating BFHI into their standards of care. This qualitative case study describes Malawi's experience. We interviewed 48 key informants and conducted a desk review of the literature on BFHI programming, national plans, policies and other related documents. We explored the findings using the seven key domains and 16 competencies to implement the Ten Steps to successful breastfeeding from the WHO and UNICEF Competency Verification Toolkit. The study found that although the focus of the guidance is on preservice training, continuing education and in‐service training remain important. To achieve universal coverage for health professional competency, Malawi uses preservice, in‐service and refresher training. However, their main limitations to aligning with the new guidance are a lack of preservice BFHI‐ and breastfeeding‐specific curricula, experienced lecturers and sufficient time to dedicate to practical skill development. Conducted during the coronavirus disease 2019 pandemic, this study confirmed disruptions to BFHI training and service delivery, while also documenting Malawi's resilient attempts to mitigate impacts on breastfeeding support through mentoring and coaching. Opportunities exist for strengthening and scaling up, including engaging preservice training institutions and standardizing mentoring, coaching and competency verification. Key messages: Future efforts to sustainably build health professional competencies in Malawi and elsewhere need to: Engage preservice training institutions for BFHI training to build breastfeeding counselling and support into standards of care and relieve hospitals of this competency‐building burdenFocus on foundational counselling skills, helping mothers and babies with special needs and care at dischargeStandardize mentoring and coaching processes to provide hands‐on experiences that do not overburden existing hospital staffAllow health professional associations to play a key role in monitoring and assessing the competencies of their members
- Subjects
KYRGYZSTAN; MALAWI; EDUCATION of executives; BREASTFEEDING; PUBLIC hospitals; CURRICULUM; RESEARCH funding; QUALITATIVE research; PERSONNEL management; GOVERNMENT policy; MEDICAL quality control; INTERVIEWING; GOVERNMENT agencies; MEDICAL care; RESPONSIBILITY; COLLEGE teachers; HEALTH occupations schools; MENTORING; JUDGMENT sampling; INFORMATION resources; LACTATION; CLINICAL competence; BREASTFEEDING promotion; UNIVERSAL healthcare; ABILITY; PROFESSIONAL employee training; SOCIAL support; CASE studies; CONTINUING education; PUBLIC administration; DATA analysis software; TRAINING; COVID-19 pandemic
- Publication
Maternal & Child Nutrition, 2024, Vol 20, Issue 3, p1
- ISSN
1740-8695
- Publication type
Article
- DOI
10.1111/mcn.13591