Poster Topical Area: Maternal, Perinatal and Pediatric Nutrition

Location: Hall D

Poster Board Number: 277

P13-019 - Facilitators and barriers to implementing the Becoming Breastfeeding Friendly (BBF) process in Ghana.

Sunday, Jun 10
8:00 AM – 6:00 PM

Objectives: In 2016, a country committee of 15 Ghanaian nutrition, health, and breastfeeding experts implemented Becoming Breastfeeding Friendly (BBF), an initiative designed to help countries assess readiness to scale-up breastfeeding programs and develop key recommendations to strengthen their breastfeeding environment. We sought to: a) identify drivers and barriers to implementing BBF, and b) determine how BBF strengthens the breastfeeding enabling environment in Ghana.

Semi-structured interviews were conducted with 13 committee members (CMs). Using a grounded theory approach, two investigators collaboratively developed a codebook by independently applying open-coding schemes to transcripts, iteratively discussing code applications and adapting the codebook to incorporate emerging concepts. Once the codebook was finalized, all transcripts were coded in Dedoose v.8.

Results: A dynamic committee representing multiple sectors drove the implementation of BBF. Participation provided personal enrichment for CMs while also strengthening the existing breastfeeding environment by: generating an understanding and appreciation for work conducted by different sectors, facilitating information sharing between sectors, and providing a platform for discussions and networking across various sectors. CMs faced logistical and methodological challenges with implementing BBF, including intensive time and work commitments, difficulty accessing data, and the need for strong in country coordination and technical support for adhering to all BBF implementation steps. CMs felt well positioned to facilitate the dissemination of recommendations, take key leadership roles to implement recommendations and communicate progress. CMs agreed that moving recommendations to action requires advocacy as the first step and identified BBF as a key advocacy tool to facilitate that step. Accountability of government agencies was identified as essential to ensure recommendations were being implemented effectively.

Conclusions: BBF can help Ghana strengthen its breastfeeding governance, policies, and programs.

Funding Source: The Family Larsson-Rosenquist Foundation
Figure. Conceptual model of facilitators and barriers identified by Ghanaian committee members for implementing the BBF.

CoAuthors: Afua Atuobi-Yeboah – University of Ghana; Amber Hromi-Fielder – Yale School of Public Health; Richmond Aryeetey – University of Ghana; Cara Safon – Yale School of Public Health; Rafael Perez-Escamilla – Yale School of Public Health

Grace Carroll

Yale School of Public Health
New Haven, Connecticut