Since 1994, Vietnam has implemented the Baby Friendly Hospital Initiative (BFHI). Less than 1% of hospitals have been certified as BFHI in over 10 years. In 2013, the BFHI criteria (numbered E1.4) was successfully linked with the health system through its inclusion within the Ministry of Health (MOH) Hospital Quality Assessment Criteria. Through these criteria, the steps for successful breastfeeding became mandatory for all hospitals both public and private, which provide maternal and child care. This report was to examine the impact of these criteria on breastfeeding practices among mothers at hospital levels, focussing on challenges and good practices for lessons learned. Using a mixed methods approach, this assessment looked at the official data on Criteria E1.4, qualitative observation and discussion visits to 8 hospitals in 2 large cities in Vietnam. The findings showed improvements in implementation of Criteria E1.4 since 2013, with both cities reaching an average of Grade 3 (the average acceptable standard) as well as increasing breastfeeding rates in terms of early initiation of breastfeeding within the first hour after delivery. Challenges in reaching higher grade scores on these criteria related to difficulties with early initiation of breastfeeding following C-section deliveries, no mechanism for support between departments of the hospital and no mechanism for continued breastfeeding support at the community level when mothers are discharged from hospital. Many learnings from this report can help contribute to the revision of the Hospital Quality Assessment Criteria, to further strengthen the regulatory environment around breastfeeding protection, promotion and support.
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