Knowledge and Compliance of the Health Workers on the International Code of Breastmilk Substitute (BMS Code) in Nigeria.

BACKGROUND: Despite global and national efforts to promote exclusive breastfeeding, rates remain below international targets, partly due to the marketing of breastmilk substitutes (BMS). Nigeria adopted the International Code of Marketing of Breastmilk Substitutes and revised it as the National Regulations on the Marketing of Infant and Young Children's Foods and Other Designated Products. However, enforcement appears weak, and there is a dearth of information on health workers' knowledge and compliance with updated regulations. RESEARCH AIM: To assess the knowledge and level of compliance with the national regulations among the health workers. METHODS: This cross-sectional study (N = 100) was conducted with health workers in three selected states. A pretested self-administered questionnaire was used to elicit responses on knowledge and compliance with the national regulations. Interviews were conducted with senior-level officials, observational compliance checklist was used to assess compliance at the facility level. RESULTS: About a quarter (27%) of the health workers had adequate knowledge of the national regulations, 18% reported a high level of personal compliance, and 16% believed their health facility had a high level of compliance. Interviews with the participants further revealed limited awareness and lack of access to the regulations, indirect access to BMS, selective use of BMS, and a lack of protocols to address violations, all of which reinforce the overall low levels of knowledge and compliance with the regulations. CONCLUSIONS: Health workers' knowledge of and compliance with regulations and low. Attention should be given to ensuring proper dissemination, sensitization, training, and facility-level procedures to improve regulation adherence and protect breastfeeding.