Maternity Nurses’ Perception Regarding Challenges Facing Ten Steps to Successful Breastfeeding Implementation: Qualitative Research Approach

Background: Breastfeeding is one of the most effective ways to ensure child health and survival. It is also a critical key to achieve many of the Sustainable Development Goals (SDGs). Promotion, supporting and protecting breastfeeding has been a mandate of the global strategy of Infant and Young Child Feeding (IYCF). The implementation of such strategy is intensified by positive nurses’ perception and commitment to do so. Aim: The study aimed to explore maternity nurses’ perception regarding challenges facing ten steps to successful breastfeeding implementation at El-Shatby University Hospital Alexandria Egypt as well as to identify their suggestions for improvement and enhance successful implementation. Methods: By using descriptive qualitative research methodology approach a focus group discussion and in-depth personal interviews were used to explore maternity nurses’ perception regarding challenges and constraints to implement tens steps at El-Shatby University Hospital and also to identify their suggestions for improvement. A focus Group Discussion Questions Guide, and Interview Questionnaire were developed and utilized for data collection by the researchers. This study was conducted 6 months later after the onset of the implementation of The Baby-friendly Hospital Initiative (BFHI) first monitoring survey at El-Shatby hospital by Abul-Fadl et al,2018. Subjects: Fifty-five nurses had participated in the study; 12 nurses attended the focus group and 43 nurses had interviewed by the researchers. The nurses’ responses were transcribed and coding using Nvivo software program. Thematic analysis was conducted and consensus between the researchers was reached to validate the themes. Results: Nurses had positive perception regarding ten steps of breastfeeding implementation, but they perceived a lot of barriers and challenges to implement ten steps to successful breast feeding. Five main themes were raised by the study including; Nurses related issues, Physician related issues Maternal related issues, Postpartum related issues and lastly Administrative related issues Conclusion: Various challenges in implementing the ten steps were identified and suggestions were directed to improve the staff education especially hands on education including counseling and communication technique. More health education messages especially during antenatal period were highly recommended for both new mothers and their family members as well. Intensified need for managerial support for skin to skin (STS) practice at delivery room was recommended. Keywords: Breastfeeding, Maternity nurses, Baby-Friendly, Ten steps, University hospitals DOI: 10.7176/JHMN/69-06 Publication date: December 31st 201