Improving the health of mothers and newborns in Slovakia

WHO

In line with the Sustainable Development Goals (SDGs) to improve the health of women and newborns and end all preventable deaths, to ensure care for health and well-being, and to expand an enabling environment, the Ministry of Health of Slovakia is preparing to renew the Baby-friendly Hospital Initiative certificates.

WHO and the United Nations Children’s Fund (UNICEF) set up the Baby-friendly Hospital Initiative in 1992 to implement practices that protect, promote and support breastfeeding. The renewal of the certificates will be part of an assessment of the quality of obstetric and neonatal wards in the country. The assessment will be conducted using WHO tools and guidelines.

“Maternity units carry an important responsibility. For example, skin-to-skin contact immediately after delivery and first attachment is a critical factor for the successful initiation of exclusive breastfeeding,” explains Dr Nino Berdzuli, Programme Manager for Maternal and Newborn Health at WHO/Europe. “During my clinical practice I saw many mothers who had no intention of breastfeeding, but who ended up breastfeeding when the baby had skin-to-skin contact.”

“Achieving Baby-friendly Hospital designation is a big commitment for a hospital, but it pays off: the process dramatically improves the quality of maternal and newborn care in general, but most importantly it is the best thing for the mother and baby,” continues Dr Berdzuli.

While Slovakia has improved substantially the health of mothers and newborns during the last decade, it is still lagging behind the most advanced European countries in this area. This initiative is a demonstration of the country’s commitment to further improvement.

“All health-care providers have the opportunity to obtain a Baby-friendly Hospital Initiative certificate. The prerequisite is to implement the ‘Ten steps to successful breastfeeding’ guidance to increase support for breastfeeding in health facilities that provide maternity and newborn services. This guidance was revised in 2018,” says Health Minister Andrea Kalavská.

“Ten steps to successful breastfeeding” includes a series of key clinical practices such as discussing the importance and management of breastfeeding with pregnant women and their families; counselling mothers on the use and risks of feeding bottles, teats and pacifiers; and not providing breastfed newborns with any food or fluids other than breast milk unless medically indicated.

Nearly 200 health workers from maternity and neonatal hospitals throughout the country have been trained to understand and develop skills to apply the 10 steps. The Ministry of Health has also prepared a standard procedure in accordance with the latest WHO recommendations.

“The procedure includes support for women during lactation to start breastfeeding as soon as possible and to learn the right technique in the hospital, because breastfeeding is a basic prerequisite for the healthy development of every child,” says Dr Jozef Šuvada, Chief Coordinator of Standard Preventive, Diagnostic and Therapeutical Guidelines at the Ministry of Health.

At a meeting on 2 July 2019 with representatives of the Ministry of Health and managers and ward chiefs of maternity and neonatal hospitals, Dr Darina Sedlakova, WHO Representative in Slovakia, affirmed that Slovak hospitals are well prepared to be awarded the Baby-friendly Hospital Initiative certificate. Support for exclusive breastfeeding for the first 6 months has been strong and effective in the country, and up to 60% of mothers observe this recommendation.

The major part of the work ahead is the full application of the International Code of Marketing of Breast-milk Substitutes and relevant World Health Assembly resolutions, as well as ongoing internal monitoring of adherence to the clinical practices. Dr Sedlakova indicated that Slovakia should also consider joining the international Baby-Friendly Hospital Initiative network, noting that WHO would provide assistance in this area.