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Rapid assessment of infant feeding support to HIV-positive women accessing prevention of mother-to-child transmission services in Kenya, Malawi and Zambia.
Public Health Nutr 2009; 12(12):2323-8PH

Abstract

OBJECTIVE

The possibility of mother-to-child transmission (MTCT) of HIV through breast-feeding has focused attention on how best to support optimal feeding practices especially in low-resource and high-HIV settings, which characterizes most of sub-Saharan Africa. To identify strategic opportunities to minimize late postnatal HIV transmission, we undertook a review of selected country experiences on HIV and infant feeding, with the aims of documenting progress over the last few years and determining the main challenges and constraints.

DESIGN

Field teams conducted national-level interviews with key informants and visited a total of thirty-six facilities in twenty-one sites across the three countries--eighteen facilities in Malawi, eleven in Kenya and seven in Zambia. During these visits interviews were undertaken with key informants such as the district and facility management teams, programme coordinators and health workers.

SETTING

A rapid assessment of HIV and infant feeding counselling in Kenya, Malawi and Zambia, undertaken from February to May 2007.

RESULTS

Infant feeding counselling has, until now, been given low priority within programmes aimed at prevention of MTCT (PMTCT) of HIV. This is manifest in the lack of resources - human, financial and time--for infant feeding counselling, leading to widespread misunderstanding of the HIV transmission risks from breast-feeding. It has also resulted in lack of space and time for proper counselling, poor support and supervision, and very weak monitoring and evaluation of infant feeding. Finally, there are very few examples of linkages with community-based infant feeding interventions. However, all three countries have started to revise their feeding policies and strategies and there are signs of increased resources.

CONCLUSIONS

In order to sustain this momentum it will be necessary to continue the advocacy with the HIV community and stress the importance of child survival--not just minimization of HIV transmission - and hence the need for integrating MTCT prevention.

Authors+Show Affiliations

Health Systems Research Unit, Medical Research Council, Francie Van Zyl Drive, Parow, Western Cape 7535, South Africa. mickey.chopra@mrc.ac.za

Pub Type(s)

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

Language

eng

PubMed ID

19402947

Citation

Chopra, Mickey, et al. "Rapid Assessment of Infant Feeding Support to HIV-positive Women Accessing Prevention of Mother-to-child Transmission Services in Kenya, Malawi and Zambia." Public Health Nutrition, vol. 12, no. 12, 2009, pp. 2323-8.
Chopra M, Doherty T, Mehatru S, et al. Rapid assessment of infant feeding support to HIV-positive women accessing prevention of mother-to-child transmission services in Kenya, Malawi and Zambia. Public Health Nutr. 2009;12(12):2323-8.
Chopra, M., Doherty, T., Mehatru, S., & Tomlinson, M. (2009). Rapid assessment of infant feeding support to HIV-positive women accessing prevention of mother-to-child transmission services in Kenya, Malawi and Zambia. Public Health Nutrition, 12(12), pp. 2323-8. doi:10.1017/S1368980009005606.
Chopra M, et al. Rapid Assessment of Infant Feeding Support to HIV-positive Women Accessing Prevention of Mother-to-child Transmission Services in Kenya, Malawi and Zambia. Public Health Nutr. 2009;12(12):2323-8. PubMed PMID: 19402947.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rapid assessment of infant feeding support to HIV-positive women accessing prevention of mother-to-child transmission services in Kenya, Malawi and Zambia. AU - Chopra,Mickey, AU - Doherty,Tanya, AU - Mehatru,Saba, AU - Tomlinson,Mark, Y1 - 2009/04/30/ PY - 2009/5/1/entrez PY - 2009/5/1/pubmed PY - 2010/1/26/medline SP - 2323 EP - 8 JF - Public health nutrition JO - Public Health Nutr VL - 12 IS - 12 N2 - OBJECTIVE: The possibility of mother-to-child transmission (MTCT) of HIV through breast-feeding has focused attention on how best to support optimal feeding practices especially in low-resource and high-HIV settings, which characterizes most of sub-Saharan Africa. To identify strategic opportunities to minimize late postnatal HIV transmission, we undertook a review of selected country experiences on HIV and infant feeding, with the aims of documenting progress over the last few years and determining the main challenges and constraints. DESIGN: Field teams conducted national-level interviews with key informants and visited a total of thirty-six facilities in twenty-one sites across the three countries--eighteen facilities in Malawi, eleven in Kenya and seven in Zambia. During these visits interviews were undertaken with key informants such as the district and facility management teams, programme coordinators and health workers. SETTING: A rapid assessment of HIV and infant feeding counselling in Kenya, Malawi and Zambia, undertaken from February to May 2007. RESULTS: Infant feeding counselling has, until now, been given low priority within programmes aimed at prevention of MTCT (PMTCT) of HIV. This is manifest in the lack of resources - human, financial and time--for infant feeding counselling, leading to widespread misunderstanding of the HIV transmission risks from breast-feeding. It has also resulted in lack of space and time for proper counselling, poor support and supervision, and very weak monitoring and evaluation of infant feeding. Finally, there are very few examples of linkages with community-based infant feeding interventions. However, all three countries have started to revise their feeding policies and strategies and there are signs of increased resources. CONCLUSIONS: In order to sustain this momentum it will be necessary to continue the advocacy with the HIV community and stress the importance of child survival--not just minimization of HIV transmission - and hence the need for integrating MTCT prevention. SN - 1475-2727 UR - https://www.unboundmedicine.com/medline/citation/19402947/Rapid_assessment_of_infant_feeding_support_to_HIV_positive_women_accessing_prevention_of_mother_to_child_transmission_services_in_Kenya_Malawi_and_Zambia_ L2 - https://www.cambridge.org/core/product/identifier/S1368980009005606/type/journal_article DB - PRIME DP - Unbound Medicine ER -