Cross-Country Context Analysis of Baby-Friendly Community Initiatives in Europe: the JA PreventNCD

Abstract Background Effective healthcare during the first 1000 days is crucial for public health, with breastfeeding support playing a pivotal role. The present study, realized under the JAPreventNCD, addresses the context of Baby-Friendly Community & Health Services (BFC&HS) across several European countries, examining the implementation of the WHO/UNICEF Baby-Friendly Standard in the community health services and other settings. Methods A context analysis was conducted to map BFC&HS in Task 6.5 countries. The analysis included surveys on national policy, funding, governance, organization/provision of health services, capacity building, and breastfeeding prevalence. Results National recommendations regarding breastfeeding exist in all 7 countries. However, the implementation and adaptation of the Baby-Friendly Standard in community health services vary significantly. While antenatal and well-baby check-ups are generally free of charge, the timing of check-ups and the national guidance are heterogeneous. A significant number of community health centers have been designated as Baby-Friendly in some countries, but data is lacking in others. Key barriers to implement the Baby-Friendly Standard in community health services include lack of political will, issues related to the WHO International Code of marketing of breast-milk substitutes, lack of national breastfeeding policy, staff resistance in community and health services, insufficient structural and sustained funding for long-term impact, and hospitals not being Baby-Friendly, with low exclusive breastfeeding rates at discharge. Conclusions The study highlights the diverse landscape of BFC&HS implementation across countries. Public health actions are needed to strengthen national policies, improve coordination, and address barriers to implementing the Baby-Friendly Standard in community settings. This includes enhancing capacity building, increasing the number of designated BFC&HS, and improving breastfeeding support. Key messages • BFC&HS implementation requires targeted strategies to overcome barriers and promote Baby-Friendly Standards. • Strengthening community health services is crucial for improving breastfeeding outcomes.