Barriers and Recommendations for Implementing the Baby-Friendly Hospital Initiative in Cairo University Hospitals: a Qualitative study

Background: University hospitals face many challenges on their way to achieving Baby
friendly hospital imitative (BFHI) as they carry a dual role of teaching and service provision.
Objective: to estimate health care providers’ perspectives for implementing the Baby-
Friendly Hospital Initiative in Kasr Al-Aini- Obstetrics and Gynecology Hospital. Method: A
qualitative exploratory study was performed in the Gynecology and Obstetrics Department, as
well as the neonatal intensive care Unit (NICU) at Cairo University Hospital. A semistructured
interview was used to get data from a purposive sample of 26 consented
participants: 9 physicians, 15 nurses, and 2 medical staff with managerial positions. Results:
Responses were analyzed using thematic content analysis. The priorities identified by
thematic analysis were barriers and recommendations for Baby-friendly hospital initiative
implementation from the perspective of health care providers. All interviewees cited lack of
staff training and high turnover rate of health care providers, lack of resources, heavy
workload in addition to lack of time spent with new mothers especially those with cesarean
deliveries or with health problems of mothers or babies that lead to early mother-infant
separation as the main barriers. All interviewees recommended on-going training and the use
of audiovisual aids. Conclusion: Lack of staff training, heavy workload per staff, and lack of
resources required for providing training courses and educational materials were the main
barriers reported by the participants to proper BFHI implementation. Strong external support
and incentive are required in order to enhance the implementation of BFHI.