(P02-021-25) Evaluating Breastfeeding and Lactation Competencies in Mexican Primary Healthcare Providers Through Clinical Vignettes

Objectives: Clinical vignettes are short, descriptive scenarios that present specific clinical situations and are used to assess and enhance the clinical competencies of healthcare providers. While they have been widely used in primary health care (PHC) settings, they have rarely been used in maternal and child nutrition. This study designed and tested clinical vignettes targeted at assessing breastfeeding (BF) competencies among PHC providers in Mexico.

Methods: Four vignettes were developed considering the main reasons why caregivers introduce commercial milk formulas or stop breastfeeding prematurely, as well as the clinical guidelines for breastfeeding support available in Mexico. The vignettes were tested through a cross-sectional study in 20 PHC units in the Southeast of Mexico. Subsequently, standardized scores for the vignettes were generated to analyze and compare competencies in BF.

Results: Forty-six health professionals completed the vignettes. The overall score was 8.169 (± 5.68) with a mean normalized expert score of 16.17.8 ± 10.6 (out of a maximum score of 100). In general, all healthcare providers underperformed, with nurses performing worse than physicians. The vignettes with the highest scores were those requiring less complex competencies (i.e., knowledge about benefits versus actual counseling).

Conclusions: This study innovates by using clinical vignettes to assess BF competencies among PHC providers. Its primary contribution lies in identifying training needs, enabling the design and implementation of tailored programs, and improving BF services.

Funding Sources: Research Center for Equitable Development EQUIDE, Universidad Iberoamericana Ciudad de México