Before and after Group Standards: a longitudinal study on operational quality, cost-effectiveness, and health equity promotion in Southwest China’s first human milk bank

Human milk banks are a critical component of neonatal healthcare, providing donor human milk to high-risk infants, especially preterm and low-birth-weight newborns. However, in resource-limited settings, the lack of standardized operational protocols poses challenges to ensuring the safety and cost-effectiveness of donor human milk, and equitable access to it. This study evaluated the impact of implementing the Group Standards for Establishment and Management of Human Milk Banks in Medical Institutions (T/CNSS2020-003) on infection control, operational quality, and cost-effectiveness in the first human milk bank in Southwest China. Data from the human milk bank were collected and compared for the periods before (2016–2020) and after (2021–2024) implementation of the Group Standards. Following implementation, the microbiological qualification rate of donor human milk increased from 76.77% (661/861) to 88.96% (685/770), while the pathogen detection rate declined from 6.39% (55/861) to 3.25% (25/770). The detection rate of environmental indicator bacteria decreased from 16.84% (145/861) to 7.79% (60/770), accompanied by a significant improvement in compliance with environmental hygiene monitoring. The utilization rate of donor human milk rose from 83.00% to 97.51%, whereas the volume of milk discarded due to microbial contamination decreased from 306 L to 111 L. Further, the unit processing cost of donor human milk was reduced by 54.78%. The establishment and implementation of the Group Standards substantially enhanced infection control and overall quality management in the human milk bank, improving safety while lowering operational costs. These results provide a practical framework for developing safe, efficient, and sustainable human milk banks, particularly in resource-limited settings.