Improving early initiation and exclusive breastfeeding practice through PDSA framework: the experience at a private hospital in Tanzania
BMJ Open Quality, ISSN: 2399-6641, Vol: 13, Issue: 4
2024
Metric Options: CountsSelecting the 1-year or 3-year option will change the metrics count to percentiles, illustrating how an article or review compares to other articles or reviews within the selected time period in the same journal. Selecting the 1-year option compares the metrics against other articles/reviews that were also published in the same calendar year. Selecting the 3-year option compares the metrics against other articles/reviews that were also published in the same calendar year plus the two years prior.
Example: if you select the 1-year option for an article published in 2019 and a metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019. If you select the 3-year option for the same article published in 2019 and the metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019, 2018 and 2017.
Citation Benchmarking is provided by Scopus and SciVal and is different from the metrics context provided by PlumX Metrics.
Example: if you select the 1-year option for an article published in 2019 and a metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019. If you select the 3-year option for the same article published in 2019 and the metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019, 2018 and 2017.
Citation Benchmarking is provided by Scopus and SciVal and is different from the metrics context provided by PlumX Metrics.
Article Description
Introduction Optimal breastfeeding can save the lives of over 800 000 children annually. WHO recommends that all babies initiate breastfeeding within first hour of life, exclusively breastfeed for the first 6 months and continue breastfeeding up to 2 years and beyond. In Tanzania, 70% of babies initiate breastfeeding within first hour and only 64% of infants under 6 months are exclusively breastfed. Objective Improve rate of early initiation and exclusive breastfeeding from birth to hospital discharge, with the aim of achieving 80% as per Baby Friendly Hospital Initiative standard through implementing quality improvement project. Methods A quality improvement project was conducted using a Plan-Do-Study-Act (PDSA) framework. Baseline rates of early initiation and exclusive breastfeeding were determined. Sequential strategies were implemented including drafting and implementing hospital policy on breastfeeding and use of formula milk, staff training on lactation management and antenatal education of pregnant women using breastfeeding videos. These were followed by immediate skin-to-skin contact after caesarean birth and modification of newborn feeding charts. Subsequently, daily lactation rounds were implemented, and monthly antenatal classes were conducted for women identified as high risk for breastfeeding challenges. Progress was monitored through monthly audits. Results After three PDSA cycles, early breastfeeding initiation improved from 22% to 84% and exclusive breastfeeding rate increased from 45% to 90%. Conclusion Early and exclusive breastfeeding rates in hospital can be improved by multidimensional approach including policies, staff training, antenatal education, interdepartmental involvement and having dedicated staff to support lactation.
Bibliographic Details
Provide Feedback
Have ideas for a new metric? Would you like to see something else here?Let us know