13 Compliance Afatinib in vivo with the ten steps of the BFPCI was assessed by verifying compliance with the parameters, as a number ranging from 2 to 11 per step, comprising in total 55 parameters. These parameters were scored as inversely

proportional to the number of parameters for each step, with the score for each step varying from 0 to 1 point, yielding a final score that could range from 0 to 10 points. The assessment tools were applied in each unit by two accredited assessors who were not in the PA, under the supervision of the first author of this article. These tools consisted of structured questionnaires to interview the manager of the unit, the health professionals, pregnant women, and mothers, as well as forms for reviewing the written norms and routines, and observation of antenatal and pediatric services. The evaluation of the structure was performed by applying the aforementioned forms and interviewing the unit manager and ten members of the healthcare team, from different professional categories, randomly selected. The evaluation process included the interview of ten pregnant women and ten mothers of children younger than 1 year, randomly selected BMS387032 among the patients

assisted by the unit on evaluation days. Inclusion criteria for members of the healthcare team included working with the mother-child pair and working in the unit for at least six months. The mother and child should have been attended to at the unit at least twice. To evaluate the outcome, i.e., the prevalence of EBF, a data collection form was applied in the weighing room of 56 sampled units, to all mothers of children younger than 6 months who came to these units during the month of November of 2007. Previously trained professionals working in the weighing room routine

filled this form, recording the number in the child’s records and asking the mothers the child’s date of birth, the current feeding status of the infant, whether they worked outside very the home, and whether they had received support for breastfeeding from the maternity ward staff. This study was approved by the Research Ethics Committee of the Municipal Secretariat of Health and Civil Defense of Rio de Janeiro, Edict 158A/2007. The interviews for the evaluation of the structure and process were performed after the signing of an informed consent; the form for data collection was applied in the weighing room after verbal consent. Data from the questionnaires were entered into the Epi-date software. The generated performance scores with the scores of 55 parameters included in the assessment of compliance to ten steps of the BFPCI13 were classified into tertiles: upper, intermediate, and lower. EBF was considered as the outcome.