Analysis of knowledge and awareness of commercial determinants of health among pediatricians and pediatric residents in the province of Guipúzcoa

Introduction: commercial determinants of health (CDOH) refer to the activities and strategies of the private sector aimed at promoting products that impact people’s health. One example is the marketing of commercial infant formulas (CIF), which targets both healthcare professionals and the general population, thereby putting WHO breastfeeding recommendations at risk.

In 1982, the International Code of Marketing of Breast-milk Substitutes (ICMBS) was established to protect families from the aggressive tactics of the infant formula industry. However, violations of the Code occur frequently.

Material and Methods: a descriptive, observational study was conducted using a Google Forms survey, with data analyzed using SPSS. Participants included primary care pediatricians, hospital pediatricians, and pediatric residents from Guipúzcoa.

Results: a total of 82 surveys were collected. 56.1% of respondents work in primary care, and approximately 25% are familiar with the concepts of CDOH and ICMBS. They rated the influence of the industry on their clinical activity with a median score of 4. 100% had received gifts from the pharmaceutical industry, 97.5% the past year. 57% avoid displaying advertisements in their consultation rooms, although 80% currently have some form of advertisement. 48.4% believe commercial visits interrupt their clinical activity, 60.9% report that they delay consultations, and 50% have considered rejecting them. 86% of attending physicians receive free samples of CIF (66% offer only hydrolyzed formula). 90.2% had their first contact with a sales representative during their medical residency training.

Conclusions: 75% of respondents are unaware of the concepts of CDOH and the ICMBS, and current practices in Guipúzcoa continue to violate the Code's guidelines.