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Implementation Strategies for a Brazilian Policy Aimed at Promoting Breastfeeding and Healthy Complementary Feeding in Primary Care

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The Brazilian Breastfeeding and Feeding Strategy (EAAB—Estratégia Amamenta e Alimenta Brasil) was launched in 2013 to improve the quality of the actions that promote breastfeeding and healthy complementary feeding in primary health care. The EAAB has had a positive influence on infant feeding practices, however, numerous challenges have been found in its implementation. The Ministry of Health launched the Project to Strengthen and Expand the EAAB (PFE-EAAB—Projeto de Fortalecimento e Expansão da EAAB), which uses implementation strategies to support management, train health professionals, and improve monitoring and evaluation processes. The objective of this article is to identify, code, and describe the implementation strategies adopted from 2019 to 2022, to improve the adoption, effectiveness, and sustainability of the EAAB. This case study used qualitative and quantitative research approaches. We triangulated eight sources of data to describe the implementation strategies and preliminary results. The implementation strategies were coded using the Expert Recommendations for Implementing Change (ERIC) framework and followed guidelines for specifying and reporting implementation strategies. The implementation strategies adopted were coded in seven categories of ERIC framework: use evaluative and iterative strategies; provide interactive assistance; adapt and tailor to context; develop stakeholder interrelationships; train and educate stakeholders; utilize financial strategies and change the infrastructure. Preliminary results show great attendance of managers at meetings, a significant number of professionals trained, and an increase in monitoring of food consumption markers and nutritional status of children under two years of age. ERIC framework and guidelines for specifying and reporting proved to be adequate and useful for the detailed description of implementation strategies in the context of implementing a large-scale food and nutrition policy in Brazil.

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This study was developed with resources from the Ministry of Health of Brazil for the Project "Implementation of interventions aimed at the protection, promotion and support of breastfeeding and healthy complementary feeding in the Unified Health System" (TED 163/2018) managed by the Federal Fluminense University.

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Correspondence to Sonia Isoyama Venancio or Daiane Sousa Melo.

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Venancio, S.I., Relvas, G.R.B., Melo, D.S. et al. Implementation Strategies for a Brazilian Policy Aimed at Promoting Breastfeeding and Healthy Complementary Feeding in Primary Care. Glob Implement Res Appl (2023).

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