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Infant feeding in the time of HIV: rapid assessment of infant feeding policy and programmes in four African countries scaling up prevention of mother to child transmission programmes.
Arch Dis Child 2008; 93(4):288-91AD

Abstract

OBJECTIVE

To assess the infant feeding components of prevention of mother to child HIV transmission (PMTCT) programmes.

METHODS

Assessments were performed across Botswana, Kenya, Malawi and Uganda. 29 districts offering PMTCT were selected by stratified random sampling with rural and urban strata. All health facilities in the selected PMTCT district were assessed. The facility level manager and the senior nurse in charge of maternal care were interviewed. 334 randomly selected health workers involved in the PMTCT programme completed self-administered questionnaires. 640 PMTCT counselling observations were carried out and 34 focus groups were conducted amongst men and women.

RESULTS

Most health workers (234/334, 70%) were unable to correctly estimate the transmission risks of breastfeeding irrespective of exposure to PMTCT training. Infant feeding options were mentioned in 307 of 640 (48%) observations of PMTCT counselling sessions, and in only 35 (5.5%) were infant feeding issues discussed in any depth; of these 19 (54.3%) were rated as poor. Several health workers also reported receiving free samples of infant formula in contravention of the International Code on Breastmilk Substitutes. National HIV managers stated they were unsure about infant feeding policy in the context of HIV. Finally, there was an almost universal belief that an HIV positive mother who breastfeeds her child will always infect the child and intentional avoidance of breastfeeding by the mother indicates that she is HIV positive.

CONCLUSION

These findings underline the need to implement and support systematic infant feeding policies and programme responses in the context of HIV programmes.

Authors+Show Affiliations

Health Systems Research Unit, Medical Research Council, Tygerberg, 7535, Western Cape, South Africa. mickey.chopra@mrc.ac.za

Pub Type(s)

Journal Article
Multicenter Study
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

17686796

Citation

Chopra, M, and N Rollins. "Infant Feeding in the Time of HIV: Rapid Assessment of Infant Feeding Policy and Programmes in Four African Countries Scaling Up Prevention of Mother to Child Transmission Programmes." Archives of Disease in Childhood, vol. 93, no. 4, 2008, pp. 288-91.
Chopra M, Rollins N. Infant feeding in the time of HIV: rapid assessment of infant feeding policy and programmes in four African countries scaling up prevention of mother to child transmission programmes. Arch Dis Child. 2008;93(4):288-91.
Chopra, M., & Rollins, N. (2008). Infant feeding in the time of HIV: rapid assessment of infant feeding policy and programmes in four African countries scaling up prevention of mother to child transmission programmes. Archives of Disease in Childhood, 93(4), pp. 288-91.
Chopra M, Rollins N. Infant Feeding in the Time of HIV: Rapid Assessment of Infant Feeding Policy and Programmes in Four African Countries Scaling Up Prevention of Mother to Child Transmission Programmes. Arch Dis Child. 2008;93(4):288-91. PubMed PMID: 17686796.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Infant feeding in the time of HIV: rapid assessment of infant feeding policy and programmes in four African countries scaling up prevention of mother to child transmission programmes. AU - Chopra,M, AU - Rollins,N, Y1 - 2007/08/08/ PY - 2007/8/10/pubmed PY - 2008/4/22/medline PY - 2007/8/10/entrez SP - 288 EP - 91 JF - Archives of disease in childhood JO - Arch. Dis. Child. VL - 93 IS - 4 N2 - OBJECTIVE: To assess the infant feeding components of prevention of mother to child HIV transmission (PMTCT) programmes. METHODS: Assessments were performed across Botswana, Kenya, Malawi and Uganda. 29 districts offering PMTCT were selected by stratified random sampling with rural and urban strata. All health facilities in the selected PMTCT district were assessed. The facility level manager and the senior nurse in charge of maternal care were interviewed. 334 randomly selected health workers involved in the PMTCT programme completed self-administered questionnaires. 640 PMTCT counselling observations were carried out and 34 focus groups were conducted amongst men and women. RESULTS: Most health workers (234/334, 70%) were unable to correctly estimate the transmission risks of breastfeeding irrespective of exposure to PMTCT training. Infant feeding options were mentioned in 307 of 640 (48%) observations of PMTCT counselling sessions, and in only 35 (5.5%) were infant feeding issues discussed in any depth; of these 19 (54.3%) were rated as poor. Several health workers also reported receiving free samples of infant formula in contravention of the International Code on Breastmilk Substitutes. National HIV managers stated they were unsure about infant feeding policy in the context of HIV. Finally, there was an almost universal belief that an HIV positive mother who breastfeeds her child will always infect the child and intentional avoidance of breastfeeding by the mother indicates that she is HIV positive. CONCLUSION: These findings underline the need to implement and support systematic infant feeding policies and programme responses in the context of HIV programmes. SN - 1468-2044 UR - https://www.unboundmedicine.com/medline/citation/17686796/Infant_feeding_in_the_time_of_HIV:_rapid_assessment_of_infant_feeding_policy_and_programmes_in_four_African_countries_scaling_up_prevention_of_mother_to_child_transmission_programmes_ L2 - http://adc.bmj.com/cgi/pmidlookup?view=long&pmid=17686796 DB - PRIME DP - Unbound Medicine ER -