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Evaluating Implementation of a Baby Friendly Hospital Initiative

VanDevanter, Nancy DrPH, RN, FAAN; Gennaro, Susan PhD, RN, FAAN; Budin, Wendy PhD, RN, FAAN; Calalang-Javiera, Helene MSN, RNC-OB, IBCLC, RLC; Nguyen, Minh BSN, RN

MCN: The American Journal of Maternal/Child Nursing: July/August 2014 - Volume 39 - Issue 4 - p 231–237
doi: 10.1097/NMC.0000000000000046

Purpose: The study evaluates the implementation of a United Nations Children's Fund (UNICEF)/WHO Baby-Friendly Hospital Initiative (BFHI) in a large urban hospital in New York City that serves primarily poor, minority women.

Study Design and Methods: A descriptive qualitative evaluation study that included focus groups, key informant interviews, and observations of the clinical environment was conducted using a community-based participatory research approach with healthcare providers.

Results: Findings revealed strengths and challenges in the implementation process at the system, provider, and patient levels. Strategies for enhancing program implementation and outcomes include expansion of provider education, development of additional patient interventions, enhancement of environmental structural supports, and continuation and expansion of program evaluation activities.

Clinical Implications: Evaluation of program implementation at multiple levels of the organization in collaboration with providers is critical to understanding program outcomes.

Implementing the Baby Friendly Hospital initiative has many challenges but is worth the energy. These authors describe evaluation of their efforts to achieve Baby Friendly Hospital status in a large urban hospital in New York City.

Nancy VanDevanter is an Associate Professor, New York University, College of Nursing, New York, NY. She can be reached via e-mail at

Susan Gennaro is the Dean and Professor, Boston College, William F. Connell School of Nursing, Boston, MA.

Wendy Budin is the Director of Nursing Research, NYU Langone Medical Center, Adjunct Professor, NYU College of Nursing, Research Professor of Nursing, NYU School of Medicine, New York, NY.

Helene Calalang-Javiera is an Associate Director Maternal Child Health Nursing, Bellevue Hospital Center, NYC Health and Hospitals Corporation, New York, NY.

Minh Nguyen is Staff Nurse, Medical City Dallas Hospital, Dallas, TX.

The authors declare no conflicts of interest.

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