Exploring the barriers to the uptake and development of the Baby Friendly Health Initiative (BFHI) in Australia from its beginnings in 1992

Marjorie ATCHAN, Deborah DAVIS, Maralyn Foureur

Research output: Contribution to conference (non-published works)Abstractpeer-review


Background: Since 1995 the BFHI has been governed at a national and state-wide level by the Australian College of Midwives through a part-time manager together with volunteer committees. Nationally 20%, or seventy-four maternity facilities including attached birthing centres, are ‘baby friendly accredited’. This is a low uptake when compared with neighbouring countries such as New Zealand where the BFHI accreditation rate exceeds 90%. Purpose: This study aimed to investigate why there is such a low BFHI accreditation rate despite 20 years of governance by the ACM and a consistent cohort of volunteers.
Methods: An instrumental case study research design was used. The case is the quality assurance program known as the BFHI Australia. The case investigates the introduction and implementation of the global Baby Friendly Initiative into a national setting. Following ethical approval data collection included: 14 key stakeholder interviews, organisational minutes and correspondence, international and national policy documents and national and state-based government reports. This form of data triangulation increases confidence in the study findings and interpretation.
Findings: The BFHI was negatively impacted by its inclusion in a national food and nutrition policy framework that limited stakeholder engagement at all levels. A specific mandate for implementing the BFHI with measurable outcomes has not been included in national or state policy. The national government has little leverage over state-run hospital based health matters and deprioritisation has occurred at a local level.
Application to regulation/policy: Early action by the Australian national government to implement the four operational targets of the “Innocenti Declaration on the protection promotion and support of breastfeeding” could have provided a standalone program using a primary health care initiative that would have increased the uptake of the BFHI. These findings may better inform other jurisdictions attempting to introduce the BFHI into policy.
Original languageEnglish
Number of pages1
Publication statusPublished - 2017
Event"Midwives - Making a Difference" : International Confederation of Midwives (ICM) 31st Triennial Congress - International Convention Centre, Toronto, Canada
Duration: 18 Jun 201722 Jun 2017


Conference"Midwives - Making a Difference"


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