Cost-effectiveness analysis of Baby-Friendly Hospital Initiative in promotion of breast-feeding and reduction of late neonatal infant mortality in Brazil

Abstract

Objective: To analyse the cost-effectiveness of Baby-Friendly Hospital Initiative (BFHI) in promoting breast-feeding during the first hour of life (BFFHL) and reducing late neonatal mortality. Design: Cost-effectiveness economic assessment from the health system perspective, preceded by a prospective cohort of mother–baby followed from birth to 6 months of life. The direct costs associated with two health outcomes were analysed: intermediate end point (BFFHL) and final end point (reduction in late neonatal mortality). Setting: Study was carried out in six hospitals in the city of São Paulo (Brazil), three being Baby-Friendly Hospitals (BFH) and three non-BFH. Participants: Mothers with 24 h postpartum, over 18 years old, single fetus and breast-feeding at the time of the interview were included. Poisson regressions adjusted for maternal age and level of education were estimated to identify factors related to BFFHL and late neonatal mortality. Sensitivity analysis was performed to ensure robustness of the economic assessment. Results: Cost-effectiveness analysis showed that BFHI was highly cost-effective in raising BFFHL by 32·0 % at lower cost in comparison with non-BFHI. In addition, BFHI was cost-effective in reducing late neonatal mortality rate by 13·0 % from all causes and by 13·1 % of infant mortality rate from infections. Conclusions: The cost-effectiveness of the BFHI in promoting breast-feeding and reducing neonatal mortality rates justifies the investments required for its expansion within the Brazilian health system.

The Association between a Novel Baby-Friendly Hospital Program and Equitable Support for Breastfeeding in Vietnam

“…The launch of the Baby Friendly Hospital Initiative (BFHI) in 1991 aimed to institutionalize the WHO Ten Steps on a global scale. If implemented effectively, BFHI has the potential to influence breastfeeding practices [ 21 , 22 , 23 ]. At the population level, however, the coverage of BFHI interventions remains low [ 6 ].…”

Improving breastfeeding support through the implementation of the baby friendly hospital and community initiatives: a scoping review

“…Advocacy for additional government resources is needed to support scale-up of BFCI [154], alongside an assessment of the scaling-up environment for BFCI in the context of BFHI, using the Becoming Baby Friendly Index at subnational levels. BFCI indicators should be integrated into the routine community reporting tools and the District Health Information Systems for sustainability [6].…”

“…The importance of conducting studies with a control group and the need to carry out more experimental studies was highlighted multiple times [19,142,[151][152][153]. More cost-effectiveness studies are also required, as highlighted in a recent study [154]. Ducharme-Smith et al, [155] highlighted that there is still a need for studies using larger samples to robustly test for differences in practices associated with BFHI and to examine implementation of all steps among different groups of women.…”

Efek Ekstrak Basah Daun Plectranthus amboinicus (L.) Terhadap Produksi Susu, Konsumsi Pakan, Pertumbuhan Bobot Badan Tikus dan Anakan

“…Laktasi juga dapat memberikan interaksi yang intim antara ibu dan anak yang berkaitan dengan pelepasan hormon anti-stres oksitosin (Takahashi, 2021), sehingga bermanfaat bagi kesehatan ibu dan bayi (Belfort et al, 2013). Selain itu, menyusui memberikan nutrisi yang paling tepat dan air yang cukup untuk anak, mengatur kesehatan usus (Akagawa et al, 2019), mencegah infeksi, menurunkan angka kematian neonatal (Silva et al, 2020), mengurangi resiko pendarahan postpartum, menurunkan risiko kanker payudara dan ovarium, mengurangi nyeri postpartum, dan meningkatkan pemulihan postpartum (Desai et al, 2019).…”