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THE MINISTRY OF
HEALTH
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THE SOCIALIST
REPUBLIC OF VIETNAM
Independence - Freedom - Happiness
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No. 3451/QD-BYT
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Hanoi, August 6,
2019
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DECISION
ON APPROVAL FOR
“CRITERIA AND GUIDELINES FOR EVALUATION OF RECOGNITION OF “HOSPITALS FOR
EXCELLENCE IN BREASTFEEDING SUPPORT”
MINISTER OF HEALTH
Pursuant to Government's Decree No.
75/2017/ND-CP dated June 20, 2017 defining the functions, tasks, entitlements
and organizational structure of the Ministry of Health;
Government's Decree No. 100/2014/ND-CP dated
November 6, 2014 on business and use of dietary products for infants, baby
bottles and pacifiers;
Circular No. 38/2016/TT-BYT dated October 31,
2016 of the Minister of Health on certain measures to promote breastfeeding at
health facilities;
At the request of Director of Department of
Pediatric and Maternal Health affiliated to the Ministry of Health,
HEREBY DECIDES:
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Article 2. “Criteria and guidelines for
evaluation of recognition of hospitals for excellence in breastfeeding support”
is the basis for health facilities specialized in obstetrics and gynecology to
carry out the evaluation and recognition under guidance of the Ministry of
Health.
Article 3. This Decision shall enter into
force upon signing and promulgation.
Article 4. The
Chief of the Ministry Office, Director of Department of Pediatric and Maternal
Health, Director of Department of Medical Examination and Treatment Management;
Heads of affiliates of the Ministry of Health; Directors of Department of
Health of provinces and central-affiliated cities; Heads of relevant units
shall implement this Decision./.
PP. MINISTER
DEPUTY MINISTER
Nguyen Viet Tien
CRITERIA AND GUIDELINES
EVALUATION OF
RECOGNITION OF “HOSPITALS FOR EXCELLENCE IN BREASTFEEDING SUPPORT”
(Issued together with Decision No. 3451/QD-BYT dated August 6, 2019)
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- Government's Decree No.
100/2014/ND-CP dated November 6, 2014 on business and use of dietary products
for infants, baby bottles and pacifiers.
- Circular No. 38/2016/TT-BYT
dated October 31, 2016 of the Minister of Health on certain measures to promote
breastfeeding at health facilities.
- Decision No. 4128/QD-BYT
dated July 29, 2016 of the Minister of Health on approval for national
guidelines for reproductive healthcare services.
- Decision No. 4673/QD-BYT
dated November 10, 2014 of the Minister of Health on approval for guidance
documents on early essential newborn care.
- Decision No. 6743/QD-BYT
dated November 15, 2016 of the Minister of Health on approval for guidance
documents on early essential newborn care in and right after caesarean
sections.
- Decision No. 6858/QD-BYT
dated November 18, 2016 of the Minister of Health on promulgation of the set of
criteria for Vietnamese hospital quality assessment.
II. Criteria for recognition of
“Hospitals for excellence in breastfeeding support”:
A hospital must meet 3 criteria below:
- Criterion 1: The
hospital at least achieves level 4 (at least 1 year prior to the evaluation) of
criterion E1.3 concerning breastfeeding under the set of criteria for
Vietnamese hospital quality assessment.
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- Criterion 3: The
hospital qualifies for exit interviews of postpartum mothers via cell phones.
III. Guidelines for evaluation of recognition:
1. Requests for evaluation
of recognition:
- If the Criterion 1 is
satisfied:
+ For hospitals affiliated to the Ministry of
Health: send a written request to the Ministry of Health to establish an
evaluation team.
+ For hospitals affiliated to the Department of
Health: send a written request to the Department of Health to establish an
evaluation team.
2. Evaluation:
2.1 Composition of evaluation team:
a) Evaluation team of the Ministry of Health:
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- Composition: Department of
Pediatric and Maternal Health, experts of breastfeeding and EENC
b) Evaluation team of the Department of Health:
- Leading role: Department of
Health
- Composition: Department of
Health, Center for Disease Control (Department of Reproductive Healthcare) or
equivalent units, staff with expertise in breastfeeding and EENC
(Obstetrics/Obstetrics and Pediatrics Hospitals).
2.2 Evaluation of Criterion 2 (through
checklists):
a) Evaluation:
- Interview 5 ≥ 7 month
pregnant women at prenatal care rooms (Checklist 1).
- Evaluation of implementation
of EENC (for breathing babies) through observation of at least 3 vaginal
deliveries; observation of model-based practices in case of absence of vaginal
delivery at the evaluation time (Checklist 2).
- Evaluation of implementation
of EENC after caesarean sections (for breathing babies) through observation of
at least 2 caesarean sections; observation of model-based practices in case of
absence of caesarean sections at the evaluation time (Checklist 3).
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- Observe practices of 5
health workers giving counseling on breastfeeding (Checklist 6).
- Review hospital quality
criteria (Checklist 7) and observe breastfeeding friendly environment
(Checklist 8).
b) Results:
Checklist No.
Description
Notes
Checklist 1
Interview with ≥ 7 month pregnant women
“QUALIFIED” if 4 out of 5 pregnant women
have a total score of ≥ 7/9 points
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Observation of implementation of EENC in vaginal
deliveries (breathing babies)
“QUALIFIED” if 3 out of 3 vaginal
deliveries have a total score of ≥ 72/80 points
Checklist 3
Observation of implementation of EENC in
caesarean sections (breathing babies)
“QUALIFIED” if 2 out of 2 caesarean
sections have a total score of ≥ 40/44 points
Checklist 4
Interviews with postpartum mothers with full-term
birth
“QUALIFIED” if 8 out of 10 mothers have a
total score of ≥ 15/18 points
Checklist 5
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“QUALIFIED” if 4 out of 5 mothers have a
total score of ≥ 23/28 points
Checklist 6
Observation of health workers giving counseling
on breastfeeding
“QUALIFIED” if 4 out of 5 health wokers
have a total score of ≥ 26/28 points
Checklist 7
Hospital criteria for breastfeeding
“QUALIFIED” if all criteria are met
Checklist 8
Breastfeeding friendly environment
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2.3 Evaluation of Criterion 3
a) Units in charge of interviews via cell
phones:
- The Ministry of Health shall
conduct interviews at affiliated hospitals and Quang Ninh Obstetrics and Pediatrics
Hospital, Da Nang Obstetrics and Pediatrics Hospital, Tu Du Hospital, Hung
Vuong Hospital, Can Tho City Obstetrics Hospital (2019-2020).
- Department of Health shall
conduct interviews at affiliated hospitals.
- The interview team is
composed of staff with expertise in EENC and breastfeeding.
b) Organization of evaluation:
- Quarterly, hospitals shall
send data on postpartum mothers discharged from hospitals in the quarters to
the unit in charge of interview.
- The unit will conduct
interviews with 100 random mothers/quarters/hospital (50 mothers with caesarean
sections) in case of hospitals of provinces/cities and 50
mothers/quarter/hospital (25 mothers with caesarean sections) in case of
hospitals of districts.
- The interview result shall
be encrypted and entered into software for analysis.
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c) Evaluation results:
Question
Criteria
Was the baby placed in skin-to-skin contact with
you right after birth?
“Qualified” if more than 80% of mothers
with vaginal deliveries and 50% of mothers with caesarean sections answer
“Yes”.
How long did the baby remain in skin-to-skin
contact with you?
“Qualified” if more than 80% of mothers
with vaginal deliveries and 50% of mothers with caesarean sections answer
“more than 90 minutes”.
How long after birth did the baby lie with you?
“Qualified” if more than 95% of mothers
with vaginal deliveries answer that her baby lied with her.
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or: While the baby lied on your breast, was the
baby able to breastfeed?
“Qualified” if more than 80% of mothers
with vaginal deliveries and 50% of mothers with caesarean sections answer
“Yes”.
During the hospital stay after birth, did you let
the baby drink or eat infant formula?
“Qualified” if more than 90% of mothers
with vaginal deliveries and caesarean sections answer “No”.
During the hospital stay, did health workers show
you how to breastfeed?
“Qualified” if more than 80% of mothers
with vaginal deliveries and caesarean sections answer “Yes”.
Did health workers counsel on feeding infant
formula?
“Qualified” if 100% of mothers with vaginal
deliveries and caesarean sections answer “No” (unless medically indicated).
Did you see any advertisement or marketing of
infant formula?
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Conclusion:
The hospital qualifies for exit interviews with
postpartum mothers via cell phones if it is “qualified” for all critiera
mentioned above.
IV. Maintenance of “Hospitals for excellence in
breastfeeding support”
After a hospital was recognized, it shall conduct
annual self-evaluation according to the checklists mentioned above and send
reports to the Ministry of Health (if it is affiliated to the Ministry of
Health) or Department of Health (if it is affiliated to Department of Health).
The validity period of the certificate of recognition of “hospital for
excellence in breastfeeding support” is 5 years. 3 months before its expiry
date, the hospital shall submit an application for extension to the Ministry of
Health or Department of Health. The Ministry of Health/Department of Health
shall conduct a re-evaluation and consider granting extension to the hospital.
APPENDIX 1.
CHECKLIST FOR
SUPERVISION OF EVALUATION TEAM AT HOSPITAL
(CRITERION 2)
Checklist 1.
INTERVIEW WITH ≥ 7 MONTH PREGNANT WOMEN
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Answer No/Wrong: 0 point
Description
Pregnant woman
#1
Pregnant woman
#2
Pregnant woman
#3
Pregnant woman
#4
Pregnant woman
#5
Be counseled on breastfeeding during prenatal
check-ups by health workers
1
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2
Harmful effects of baby bottles and infant
formula
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3
The baby’s stomach size in the first 3 days of
life
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Exclusive breastfeeding duration
5
Continued breastfeeding duration
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Able to list 3 benefits of breastfeeding
6
Able to list correctly 3 benefits of
breastfeeding
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Able to define exclusive breastfeeding
7
Right (no water, no honey, medicines presribed by
doctors are acceptable)
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Right (exclusive breastfeeding for the first six
months of life)
9
Right (continued breastfeeding until 24 months
and beyond)
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Total score
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“QUALIFIED”
if 4 out of 5 pregnant women have a total score of ≥ 7/9 points
Checklist 2.
EARLY ESSENTIAL NEWBORN CARE IN AND IMMEDIATELY AFTER VAGINA DELIVERY (FOR
BREATHING BABIES)
Adequate/proper performance (2 points); inadequate
performance (1 point); none (0 point)
Observational
checklists
Delivery #1
Delivery #2
Delivery #3
I. PRE-BIRTH PREPARATIONS:
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1. Checked room temperature,
turned off fans
2. Washed hands (first of
two handwashings)
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3. Placed dry cloth on
mother’s abdomen
4. Prepared the
resuscitation area, turned on heated bed (dry, clean and warm resuscitation
bed)
5. Checked that bag and mask
in newborn resuscitation area are functional
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6. Checked the vacuum
extractor and vacuum pressure
7. Washed hands (second of
two handwashings)
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8. Put on two pairs of clean
gloves (if there is only 1 midwife)
9. Put forceps, cord clamp/ties
in easy-to-use order
10. Checked if all
conditions are met (the perineum is ballooning, the fetal head emerges)
before initiating the delivery
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II. ASSISTING THE BIRTH:
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12. Used the fingers 2 and 3
of the other hand to pull down the occiput for the head down
13. When the occiput has come
out of the vulva, a hand embraces the occiput upwards so that the forehead,
eyes, nose, mouth and chin may come out. Told the mother to stop pushing when
doing these actions
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14. The other hand still
kept the perineum from tearing
15. Waited for the fetal
head rotate itself, the midwife would help the head rotate so that the
occiput rotate to one side (left transverse or right transverse)
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16. Check if the cord wraps around
the neck. If yes, loosed it further. If the cord was tight around the neck,
clamped the cord with two forceps, and cut the cord between the two clamps
17. Applied 2 hands to the
temples of the fetus
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18. Gently pulled the fetus
downwards to the foot of the midwife and instructed the mother to gently push
until the anterior shoulder is delivered.
19. To assist the birth of
posterior shoulder, one hand embraced the fetal head for the nape of the neck
between fingers 1 and 2 to pull the head up.
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Birth of buttocks and limbs
21. Kept holding the nape of
the neck when delivering the posterior shoulder, moved the hand keeping
perineum along the abdomen, buttocks and lower limbs of the fetus
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22. When reaching the feet of
the fetus, quickly catched it so that the foot is between fingers 2, 3, 4
supporting the buttocks. The baby was held in a transverse position.
III. IMMEDIATE POSTPARTUM/NEWBORN CARE
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24. Drying started within 5
seconds of birth
25. Dried the baby
thoroughly (wiped the eyes, face, head, chest, abdomen, arms, legs, back,
buttocks, and genitals) in 30 seconds
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26. Removed the wet cloth
27. Put baby in direct
skin-to-skin contact with mother
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29. Checked for a second
baby
30. Gave oxytocin to mother within
1 minute of delivery
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31. Removed outer pair of
gloves
32. Checked cord pulsations
before clamping, clamped after cord pulsations stopped (usually 1-3 min)
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34. Placed the second clamp
at 3 cm from the first clamp/ties (or at 5 cm from umbilical base). Cut the
cord near the first clamp using a sterile scissors.
35. Delivered placenta: One
hand holded the clamp. One hand placed on the suprapublic abdomen, waited for
the uterus to tighten and held and pushed the uterus towards the sternum.
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36. Pulled the umbilical cord
with control, gently in the direction of the delivery while the hand on the
mother’s abdomen pushed the uterus conversely
37. When the placenta
reached the vulva, lifted the umbilical cord so that the weight of the
placenta pulls the membranes. If the membranes did not slip out, lifted the
placenta with both hands and twisted in one direction to allow the placenta
to separate completely.
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39. Examined placenta: when
the uterus was well contracted and no sign of bleeding was found, examined the
placenta
40. Counselled mother on
feeding cues (drooling, mouth opening, tonguing/licking, biting hand,
crawling). Explained that the baby will be placed skin-to-skin with the
mother continuously in at least 90 minutes and complete the first
breast-feeding before being separated to weigh and receive other care
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Total score
“QUALIFIED” if 3 out of 3 vaginal
deliveries have a total score of ≥ 72/80 points
Checklist
3. EARLY ESSENTIAL NEWBORN CARE IN AND IMMEDIATELY AFTER CAESAREAN SECTIONS
(FOR BREATHING BABIES)
Adequate/proper performance (2 points); inadequate
performance (1 point); none (0 point)
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C-section #1
C-section #2
I. PRE-BIRTH PREPARATIONS:
1. Checked room temperature,
turned off fans
2. Nurse/midwife washed
hands
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3. Prepared the newborn
resuscitation area, turned on heated bed
4. Checked that bag, mask and
vacuum extractor are functional
5. Washed hands before
surgery, wore sterile clothes, wore gloves (surgeons and midwife picking up
the baby)
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6. Prepared cord clamp/ties
7. Placed a sterile cloth over
the woman's thighs below the incision at the time of caesarean section
II. IMMEDIATE POSTPARTUM/NEWBORN CARE
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9. Placed dry cloth on
mother’s thigh.
10. Drying started within 5
seconds of birth
11. Dried the baby
thoroughly in order (wiped the eyes, face, head, chest, abdomen, arms, legs,
back, buttocks, and genitals) in 30 seconds
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12. Removed the wet cloth,
covered baby’s body with cloth and the head with a hat
13. Checked for a second
baby
14. Gave oxytocin to mother
within 1 minute of delivery
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15. Checked cord pulsations before
clamping, clamped after cord pulsations stopped (usually 1-3 min)
16. Placed the first clamp
at 2 cm from umbilical base, push the blook in the cord towards the mother.
17. Placed the second clamp at
3 cm from the first clamp (or at 5 cm from umbilical base). Cut the cord near
the first clamp using a sterile scissors.
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19. Put baby prone on the mother’s
breast in direct skin-to-skin contact
20. Covered baby’s back with
dry cloth
22. Counselled mother on
feeding cues (drooling, mouth opening, tonguing/licking, biting hand, crawling)
and support the baby to attach well to the breast. Explained that the baby
will be placed skin-to-skin with the mother continuously in at least 90
minutes and complete the first breast-feeding before being separated to weigh
and receive other care
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Total score:
“QUALIFIED” if 2
out of 2 ceasarean sections have a total score of ≥ 40/44 points
Checklist 4.
INTERVIEWS WITH POSTPARTUM MOTHERS WITH FULL-TERM BIRTH
Question
Mother with
vaginal delivery
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#1
#2
#3
#4
#5
#1
#2
#3
#4
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1. Did anyone push down on
the mother’s belly? (Yes = 1 point, No = 0 point)
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2. Was the baby placed in direct
skin-to-skin contact with mother right after birth? (Yes = 1 point, No = 0
point)
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3. How long did the baby
remain in uninterrupted skin-to-skin contact? (≥ 90 min = 1 point; < 90
min = 0 point)
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4. How long after birth did
the baby first breastfeed? (15-90 min = 1 point; other = 0 point)
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5. How long after birth was
the baby bathed? (≥ 24 h = 1 point; < 24 h = 0 point)
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6. Did the baby stay with
the mother during the entire hospital stay (rooming in)? (Yes = 1 point, No =
0 point)
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7. Since delivery, was the baby
fed anything other than breast-milk? (Yes = 1 point, No = 0 point)
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8. Did the baby use baby
bottles and pacifiers? (Yes = 1 point, No = 0 point)
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9. Was anything applied to
the cord stump and was the umbilical cord tape placed? (Both no = 1 point;
yes in one or both cases = 0 point)
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11. Did the mother get medical
advice from health workers at the hospital about the benefits of
breastfeeding? (Yes = 1 point, No = 0 point)
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12. Was mother counselled on
feeding cues by health workers at the hospital? (Yes = 1 point, No = 0 point)
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13. Was mother counselled on
how to place the baby in the breast by health workers at the hospital? (Yes =
1 point, No = 0 point)
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14. Was mother counselled on
how to help the baby to attach to the breast by health workers at the
hospital? (Yes = 1 point, No = 0 point)
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15. Was mother counselled on
signs of baby’s proper attachment to the breast by health workers at the
hospital? (Yes = 1 point, No = 0 point)
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16. Did
mother tell exactly that the baby has breastfeeded 8-12 times in 24 hours or
on demand? (Yes = 1 point, No = 0 point)
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17. Did mother tell
correctly size of the baby’s stomach in the first 3 days of life? (Yes = 1
point, No = 0 point)
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18. Was the baby given
Vitamin K1 after 90 minutes of first breastfeeding and skin-to-skin contract?
(Yes = 1 point, No = 0 point)
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Total score:
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Checklist 5.
OBSERVATION OF BREASTFEEDING
Adequate/proper performance (2 points); inadequate
performance (1 point); none (0 point)
Activity
Mother #1
Mother #2
Mother #3
Mother #4
Mother #5
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1.
The mother holds the baby so that the baby’s
belly is close to the mother’s belly
2.
The mother supports the baby’s whole body, not
just the neck and shoulders
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3.
Ensure the baby’s ears, shoulders and hips are in
a straight line
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4.
The baby faces the breast, with nose opposite
nipple
Attachment to the breast
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Touch the baby’s lips with the nipple
6.
Wait until the baby’s mouth is opended wide
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7.
Move the baby onto the mother’s breast, aiming
the lower lip well below the nipple
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Signs of good attachment to the breast
8.
The baby’s chin touching breast
9.
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10.
Lower lip turned outwards
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11.
More areola is visible above the baby’s mouth
than below
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12.
Baby feeds with slow deep sucks
13.
Occasional short pauses in sucking are normal; no
sucking sounds should be heard
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14.
The mother feels empty after feeding (feed on
both sides one after one)
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Total score:
“QUALIFIED”
if 4 out of 5 mothers have a total score of ≥ 23/28 points
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Adequate/accurate (2 points); inadequate (1 point);
none (0 point)
Activity
#1
#2
#3
#4
#5
Shows the mother how to position the baby
1.
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2.
Support the baby’s whole body, not just neck and
shoulders
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3.
Ensure the baby’s ears, shoulders and hips are in
a straight line
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Ensure that the baby’s face looks forwards
breast, with nose opposite nipple
Shows the mother how to help baby attach to
the breast
5.
Touch baby’s lips with her nipples
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6.
Wait for baby’s mouth to open wide
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7.
Move the baby onto the mother’s breast, aiming
the lower lip well below the nipple
Shows the mother how to help baby attach to
the breast
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Baby’s chin is touching the breast
9.
Baby’s mouth is wide open, puffed cheeks
...
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10.
Baby’s lower lip is curled out/downwards
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11.
More areola is visible above the baby’s mouth
than below
Discusses with the mother signs of good
breastfeeding
12.
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13.
Occasional short pauses in sucking are normal; no
sucking sounds should be heard
...
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14.
The mother feels empty after feeding (feed on
both sides one after one)
...
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“QUALIFIED”
if 4 out of 5 health workers have a total score of ≥ 26/28 points
* Health workers should avoid touching the baby but
showing the mother how to breastfeed herself.
Checklist 7.
HOSPITAL CRITERIA
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Source of
information authentication
Standard
achieved
1- At least 95% of obstetrics and neonatal staff
are trained on counseling and support for mothers to breastfeed
Certification/certificate of training for
breastfeeding
At least 95%
2- % of breastfeeding counselor staff
participating in training course in breastfeeding and obtaining
certifications/certificates
Hospital’s decision to assign staff to undertake
counseling of breastfeeding.
Certification
At least 95%
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Decision to establish the group “Breastfeeding
support” (list of members, action plan)
Yes
4- At least 80% of vaginal deliveries are fully
performed with EENC
EENC data of the hospital
At least 80%
There is a system of birth register and software
5- At least 50% of caesarean sections are fully
performed with EENC out of eligible cases
EENC data of the hospital
At least 50%
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6- No violation of marketing of substitutes for
breast-milk in hospital as prescribed in Government's Decree No.
100/2014/ND-CP dated November 6, 2014 on business and use of dietary products
for infants, baby bottles and pacifiers, including:
• No case in which a health worker prescribes a
breast-milk substitute for babies in unnecessary cases
• No display and sale of breast-milk substitutes
in hospital canteens.
• No breast-milk substitutes, baby bottles,
pacifiers in recovery rooms (in case of vaginal deliveries).
Observation at hospital
No violation
Checklist 8.
ENVIRONMENT SUPPORTING BREASTFEEDING
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Delivery
room(s)
Recovery
room(s)
Neonatal care
unit
Qualified
1. Is there a board of breastfeeding
regulations: with adequate regulations of WHO on ten steps to successful
breastfeeding.
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2. Does the hospital
prohibit using infant formula and other linkages with milk formula publicly?
Yes
3. Are there any pictures
encouraging breastfeeding?
Yes
...
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Yes
5. Does the hospital encourage
the use of cups and spoons instead of using baby bottles when babies are not
breastfed directly?
Yes
6. Are posters, video,
pictures, etc. of milk formula companies visible in the hospital? (including infant
formula companies which advertise pregnant woman formula).
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No
7. Is there a breastfeeding
couseling program for mothers at the hospital?
Yes
8. Is there a breast-milk
storage refrigerator?
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Available at neonatal care unit
* Is there a separate and clean area with full of
supporting materials for mothers: nutrition when breastfeeding, proper feeding
position, breast massage, milking by hand of by machine.
Qualified when specified criteria are met
APPENDIX 2.
EXIT INTERVIEWS WITH
POSTPARTUM MOTHERS VIA CELL PHONES
(CRITERION 3)
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No.
Question
Answer
1
How many months old is your youngest child?
(Record the number of months)
2
Is he/she currently breastfed?
1) Yes (Go to question 2a)
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2a
In addition to breastfeeding, do you let him/her
eat or drink anything else?
a) Exclusive breastfeeding (breast-milk of
natural mother or others)
2) Breastfeeding and formula
3) Breastfeeding and water
3
Did you experience vaginal delivery or caesarean
section?
1) Vaginal delivery
2) Caesarean section
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Was the baby placed in skin-to-skin contact with
you right after birth?
1) Yes (Go to question 5a)
0) No (Go to question 5b)
8) No answer
9) Do not know/Do not remember
5a
How long did the baby remain in skin-to-skin
contact with you?
1) Under 90 minutes
2) Over 90 minutes
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5b
How long after birth did the baby lie with you?
1) Right after birth or less than 1 hour
2) From 1 to 6 hours
3) After 6 hours
9) Do not know/Do not remember
6
Was the baby breastfed within 90 minutes after
birth?
1) Yes
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8) No answer
9) Do not know/Do not remember
7
During the hospital stay after birth, did you let
the baby drink or eat infant formula?
1) Yes
0) No
8) No answer
9) Do not know/Do not remember
8
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1) Yes
0) No
8) No answer
9) Do not know/Do not remember
9
Did doctors and nurses counsel on using infant
formula for babies under 24 months old?
1) Yes (Go to question 9a)
0) No
8) No answer
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9a
Why was you given counseling for using infant
formula from doctors or nurses?
1) Less milk, no milk
2) Caesarean section
3) The mother is unable to breastfeed because of
maternal illness
4) The baby is unable to be breastfed because of
illness or premature birth
5) The mother wants to feed the baby infant
formula
6) No answer
7) Do not know/Do not remember
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Did you see any advertisement or marketing of
infant formula for babies under 24 months, baby bottles, pacifiers in the
hospital?
1) Are there any poster, pictures or promotional
materials of infant formula for babies under 24 months old
2) Are there any marketing staff of infant
formula for babies under 24 months old in the area of hospital
3) Did the hospital display or health workers
market or sell infant formula for babies under 24 months old
4) Someone called the mother (when she was at the
hospital and after leaving the hospital) and advised on formula for babies
under 24 months old, baby bottles, pacifiers
5) There are advertisements of pregnant woman
formula, formula for postpartum mothers
6) There are advertisements and display of baby
bottles, pacifiers
9) Other forms of advertisement and marketing of
infant formula for babies under 24 months old (description)
0) None of the above.
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Do you have any suggestions for the hospital to
do well or help with breastfeeding?
(Record suggestions)
If the mothers have more time and are interested,
more time should be spent on advising on breastfeeding. If
not, say thanks and end the interview.