BARRIERS OF SKIN-TO-SKIN CONTACT IN THE FIRST HOUR OF LIFE IN HEALTHY TERM INFANTS: A QUALITATIVE STUDY

Abstract

Background & Aims : Making skin-to-skin contact between mother and baby immediately after birth and starting breastfeeding within the first hour of birth is the fourth step of the ten steps of the Baby-Friendly Hospital Initiative (BFHI). However, this step is still not properly done in Iran. This study was designed with the aim of analyzing the factors preventing skin-to-skin contact in the first hour of life in healthy term infants. Materials & Methods : This research is a qualitative study with a content analysis approach. Data were collected by in-depth and semi-structural interviews using open-ended questions. Sampling was done in a purpose-based manner and continued until data saturation was reached. In total, we interviewed 27 experts, managers, and personnel of maternity service providers. Results : A total of 824 codes were extracted from the interviews, which were compared based on content affinity and then organized into 7 themes, 19 categories, and 75 subcategories. After qualitative data analysis, the themes were compared based on the four components of Walt and Gilson's policy triangle in four categories of creators, content, background, and process and included in them. We categorized instruction challenges as part of the content barriers within the topic, deficiencies of knowledge and awareness, skills, and the nature of the platform for conducting the contact process as part of the process barriers two topics, the challenge of supervision and monitoring at all levels of the system as well as the effective environmental components in the implementation of the contact program as part of the structural obstacles two topics, and finally the topic of the effective actors including the beneficiaries and their subordinates as part of obstacles related to the actors. Conclusion : Maternity ward staff face serious obstacles to skin-to-skin contact in the first hour of birth, especially in receiving continuous and sufficient training, having the necessary motivation and support from managers, and establishing modern supervision and reward system for optimal skin-to-skin contact in the first hour of birth.