Effect of structured quality improvement interventions on early initiation of breastfeeding among newborns at a tertiary health care hospital: A Quasi-experimental Study

The proposed study titled “Effect of Structured Quality Improvement Interventions on Early Initiation of Breastfeeding Among Newborns at a Tertiary Health Care Hospital: A Quasi-experimental Study” aims to enhance the rate of breastfeeding initiation within one hour of birth (EIBF), a WHO-recommended practice proven to reduce neonatal morbidity and mortality. Despite known benefits, EIBF rates remain low, particularly in tertiary settings. This study will be conducted in the Departments of Pediatrics and Obstetrics & Gynaecology at Maharaja Agrasen Medical College, Agroha, and will use the Plan-Do-Study-Act (PDSA) cycle framework to implement structured quality improvement (QI) interventions. Healthcare providers—doctors, residents, and nurses—will be sensitized through educational sessions, posters, checklists, and digital reminders. The intervention will be conducted in two phases, assessing baseline data followed by implementation and post-intervention analysis to track improvements. Exclusions include neonates with congenital feeding issues, NICU admissions, or severe maternal complications. Sample size will include all eligible 85 newborns during the study window, estimated using OpenEpi. The primary outcome will be the improvement in EIBF rates, and secondary outcomes include identifying barriers like staff training gaps, interdepartmental miscommunication, and post-operative delays. Data will be collected in structured proformas and analyzed using standard statistical tools. Ethical clearance will be obtained, and written informed consent will be taken. This study aims to offer a scalable, sustainable model for enhancing early breastfeeding, with the potential to impact neonatal care policies and protocols in similar healthcare settings across low- and middle-income countries.