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Breast milk as the "water that supports and preserves life"--socio-cultural constructions of breastfeeding and their implications for the prevention of mother to child transmission of HIV in sub-Saharan Africa.

Abstract

OBJECTIVES

Complementary breastfeeding represents an important source of risk of HIV infection for infants born to HIV positive mothers. The World Health Organisation recommends that infants born to HIV positive mothers receive either replacement feeding or exclusive breastfeeding (EBF) followed by early weaning. Beyond the clinical and epidemiological debate, it remains unclear how acceptable and feasible the two options are for rural populations in sub-Saharan Africa. This qualitative study aims to fill this gap in knowledge by exploring both the socio-cultural construction and the practice of breastfeeding in the Nouna Health District, rural Burkina Faso.

METHODS

Information was collected through 32 individual interviews and 3 focus group discussions with women of all ages, and 6 interviews with local guérisseurs.

RESULTS

The findings highlight that breastfeeding is perceived as central to motherhood, but that women practice complementary, rather than exclusive, breastfeeding. The findings also indicate that women recognise both the nutritional value of breast milk and its potential to act as a source of disease transmission.

CONCLUSIONS

The findings suggest that given the socio-cultural importance attributed to breastfeeding and the prevailing poverty, it may be more acceptable and more feasible to promote EBF followed by early weaning than replacement feeding. A set of operational strategies are proposed to favour the prevention of mother to child transmission of HIV in the respect of the local socio-cultural setting.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Institute of Ethnology, University of Heidelberg, Sandgasse 7, 69117 Heidelberg, Germany. siewlei@web.de

    , , ,

    Source

    MeSH

    Adolescent
    Adult
    Aged
    Breast Feeding
    Burkina Faso
    Culture
    Female
    Focus Groups
    HIV Infections
    HIV Seropositivity
    Humans
    Infectious Disease Transmission, Vertical
    Interviews as Topic
    Middle Aged
    Milk, Human
    Social Control, Informal
    Young Adult

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    18676049

    Citation

    Hofmann, Jennifer, et al. "Breast Milk as the "water That Supports and Preserves Life"--socio-cultural Constructions of Breastfeeding and Their Implications for the Prevention of Mother to Child Transmission of HIV in sub-Saharan Africa." Health Policy (Amsterdam, Netherlands), vol. 89, no. 3, 2009, pp. 322-8.
    Hofmann J, De Allegri M, Sarker M, et al. Breast milk as the "water that supports and preserves life"--socio-cultural constructions of breastfeeding and their implications for the prevention of mother to child transmission of HIV in sub-Saharan Africa. Health Policy. 2009;89(3):322-8.
    Hofmann, J., De Allegri, M., Sarker, M., Sanon, M., & Böhler, T. (2009). Breast milk as the "water that supports and preserves life"--socio-cultural constructions of breastfeeding and their implications for the prevention of mother to child transmission of HIV in sub-Saharan Africa. Health Policy (Amsterdam, Netherlands), 89(3), pp. 322-8. doi:10.1016/j.healthpol.2008.06.005.
    Hofmann J, et al. Breast Milk as the "water That Supports and Preserves Life"--socio-cultural Constructions of Breastfeeding and Their Implications for the Prevention of Mother to Child Transmission of HIV in sub-Saharan Africa. Health Policy. 2009;89(3):322-8. PubMed PMID: 18676049.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Breast milk as the "water that supports and preserves life"--socio-cultural constructions of breastfeeding and their implications for the prevention of mother to child transmission of HIV in sub-Saharan Africa. AU - Hofmann,Jennifer, AU - De Allegri,Manuela, AU - Sarker,Malabika, AU - Sanon,Mamadou, AU - Böhler,Thomas, Y1 - 2008/08/03/ PY - 2007/10/09/received PY - 2008/06/06/revised PY - 2008/06/10/accepted PY - 2008/8/5/pubmed PY - 2009/5/27/medline PY - 2008/8/5/entrez SP - 322 EP - 8 JF - Health policy (Amsterdam, Netherlands) JO - Health Policy VL - 89 IS - 3 N2 - OBJECTIVES: Complementary breastfeeding represents an important source of risk of HIV infection for infants born to HIV positive mothers. The World Health Organisation recommends that infants born to HIV positive mothers receive either replacement feeding or exclusive breastfeeding (EBF) followed by early weaning. Beyond the clinical and epidemiological debate, it remains unclear how acceptable and feasible the two options are for rural populations in sub-Saharan Africa. This qualitative study aims to fill this gap in knowledge by exploring both the socio-cultural construction and the practice of breastfeeding in the Nouna Health District, rural Burkina Faso. METHODS: Information was collected through 32 individual interviews and 3 focus group discussions with women of all ages, and 6 interviews with local guérisseurs. RESULTS: The findings highlight that breastfeeding is perceived as central to motherhood, but that women practice complementary, rather than exclusive, breastfeeding. The findings also indicate that women recognise both the nutritional value of breast milk and its potential to act as a source of disease transmission. CONCLUSIONS: The findings suggest that given the socio-cultural importance attributed to breastfeeding and the prevailing poverty, it may be more acceptable and more feasible to promote EBF followed by early weaning than replacement feeding. A set of operational strategies are proposed to favour the prevention of mother to child transmission of HIV in the respect of the local socio-cultural setting. SN - 0168-8510 UR - https://www.unboundmedicine.com/medline/citation/18676049/Breast_milk_as_the_"water_that_supports_and_preserves_life"__socio_cultural_constructions_of_breastfeeding_and_their_implications_for_the_prevention_of_mother_to_child_transmission_of_HIV_in_sub_Saharan_Africa_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0168-8510(08)00140-1 DB - PRIME DP - Unbound Medicine ER -