Addressing Early-Stage Malnutrition through the Baby-Friendly Hospital Initiative: A Case Study in Kinango Subcounty Hospital

Kwale County continues to be significantly affected by malnutrition according to the SMART Survey of 2022 Kinango subcounty hospital (KSCH) with 40% of children under 5 being stunted and 20% being underweight, alongside low rates of exclusive breastfeeding (EBF). In response, the USAID Stawisha Pwani initiative trained healthcare workers in KSCH including subordinate staff, through Continuous Medical Education Sessions (CMES) and established a BFHI facility committee. This initiative aimed to address early-stage malnutrition by implementing the Baby-Friendly Hospital Initiative (BFHI). The primary objectives of the BFHI implementation in KSCH were to improve rates of EBF, encourage early initiation of breastfeeding, enhance maternal knowledge on breastfeeding initiation and maintenance, and establish breastfeeding-friendly policies and practices within healthcare facilities. Through the concerted efforts of trained healthcare workers and the establishment of a BFHI committee, significant improvements were observed within one year. The project supported a BFHI self-assessment and the facility scored 93 %. These included increased rates of exclusive breastfeeding, higher rates of early initiation of breastfeeding, enhanced maternal knowledge of breastfeeding practices, and the implementation of breastfeeding-friendly policies within healthcare facilities. Visual cues such as baby-friendly drawings on facility walls and adherence to the Baby-Friendly Hospital Initiative guidelines, including the avoidance of artificial feeding, further supported these positive outcomes. Additionally, the formation of 30 Mothers-to-Mothers Support Group (M2MSG) facilitated ongoing breastfeeding support in the community. The implementation of the Baby-Friendly Hospital Initiative in Kinango sub-county Hospital has shown promising results in addressing early-stage malnutrition by improving breastfeeding practices and establishing supportive healthcare environments. These findings underscore the importance of targeted interventions and community engagement in addressing childhood malnutrition at its earliest stages Keywords: Baby-Friendly Hospital Initiative, exclusive breastfeeding, early initiation, maternal knowledge, breastfeeding-friendly policies.