Cost-effectiveness analysis of Baby-Friendly Hospital Initiative in promotion of breast-feeding and reduction of late neonatal infant mortality in Brazil

Autor(es)

Silva, Osvaldinete Lopes de Oliveira ^[1] ; Rea, Marina Ferreira ^[2] ; Sarti, Flavia Mori ^[3] ; Buccini, Gabriela ^[4]

Afiliação do(s) autor(es)

^[1] Univ Fed Mato Grosso do Sul, Campo Grande, MS - Brazil

^[2] Sch Publ Hlth USP, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Sao Paulo - Brazil

^[4] Yale Sch Publ Hlth, Dept Social & Behav Sci, New Haven, CT - USA

• Tipo de documento: Artigo Científico
• Fonte: PUBLIC HEALTH NUTRITION; v. 24, n. 8, p. 2365-2375, JUN 2021.
• Citações Web of Science: 3

Resumo

Objective: To analyse the cost-effectiveness of Baby-Friendly Hospital Initiative (BFHI) in promoting breast-feeding during the first hour of life (BFFHL) and reducing late neonatal mortality. Design: Cost-effectiveness economic assessment from the health system perspective, preceded by a prospective cohort of mother-baby followed from birth to 6 months of life. The direct costs associated with two health outcomes were analysed: intermediate end point (BFFHL) and final end point (reduction in late neonatal mortality). Setting: Study was carried out in six hospitals in the city of Sao Paulo (Brazil), three being Baby-Friendly Hospitals (BFH) and three non-BFH. Participants: Mothers with 24 h postpartum, over 18 years old, single fetus and breast-feeding at the time of the interview were included. Poisson regressions adjusted for maternal age and level of education were estimated to identify factors related to BFFHL and late neonatal mortality. Sensitivity analysis was performed to ensure robustness of the economic assessment. Results: Cost-effectiveness analysis showed that BFHI was highly cost-effective in raising BFFHL by 32 center dot 0 % at lower cost in comparison with non-BFHI. In addition, BFHI was cost-effective in reducing late neonatal mortality rate by 13 center dot 0 % from all causes and by 13 center dot 1 % of infant mortality rate from infections. Conclusions: The cost-effectiveness of the BFHI in promoting breast-feeding and reducing neonatal mortality rates justifies the investments required for its expansion within the Brazilian health system. (AU)

• Processo FAPESP: 16/11688-1 - Análise do custo-efetividade da Iniciativa Hospital Amigo da Criança na promoção do aleitamento materno exclusivo e redução da mortalidade infantil.
• Beneficiário: Marina Ferreira Rea
• Modalidade de apoio: Auxílio à Pesquisa - Regular