Infant and Young Child Feeding Counseling, Decision-Making, and Practices Among HIV-Infected Women in Malawi’s Option B+ Prevention of Mother-to-Child Transmission Program: A Mixed Methods Study

This mixed-methods study aimed to determine the level of male involvement in the prevention of mother-to-child transmission (PMTCT) services in Haiti and identify barriers and associated factors. From May to June 2018, a questionnaire was used to measure the level of male involvement. Semistructured interviews with pregnant women were also conducted. Multivariate linear regression and qualitative content analyses were performed to explore factors associated and barriers to male partners’ involvement in PMTCT services. One hundred and two pregnant women living with HIV completed the questionnaire. About 47% of male partners had a high level of involvement. Specifically, 90% financially supported their spouse, and 82% knew her appointment date at the antenatal clinic (ANC). Only 25% of male partners accompanied their spouse to the ANC, and 19% routinely used a condom during sexual intercourse. Factors associated with male involvement in PMTCT were being married and sharing HIV status with the male partner. Male partners with a positive HIV status were more likely to be involved in PMTCT. Qualitative findings revealed that barriers to male involvement included the conflict between opening hours of the ANC and the male partner’s schedule, waiting time at the ANC, and the perception of antenatal care as being women’s business. Overall male partners’ involvement in PMTCT services is moderate. Gender relations, sociocultural beliefs, and care organization are likely to hinder this involvement. Developing and implementing contextually and culturally accepted strategies for male partners of pregnant women could contribute to strengthening their involvement in the PMTCT program.

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The potential role of mother-in-law in prevention of mother-to-child transmission of HIV: a mixed methods study from the Kilimanjaro region, northern Tanzania

BMC Public Health ◽

10.1186/1471-2458-11-551 ◽

2011 ◽

Vol 11 (1) ◽

Cited By ~ 7

Author(s):

Eli Fjeld Falnes ◽

Karen Marie Moland ◽

Thorkild Tylleskär ◽

Marina Manuela de Paoli ◽

Sebalda Charles Leshabari ◽

...

Keyword(s):

Mixed Methods ◽

Potential Role ◽

Mixed Methods Study ◽

Mother To Child Transmission ◽

Child Transmission ◽

Northern Tanzania ◽

Kilimanjaro Region ◽

Mother To Child

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Infant and Young Child Feeding Decision Making and Practices: Malawian Mothers’ and Fathers’ Roles in the Context of HIV

Journal of Human Lactation ◽

10.1177/0890334417719245 ◽

2017 ◽

Vol 34 (1) ◽

pp. 68-76 ◽

Cited By ~ 7

Author(s):

Nainisha Chintalapudi ◽

Gloria Hamela ◽

Innocent Mofolo ◽

Suzanne Maman ◽

Mina C. Hosseinipour ◽

...

Keyword(s):

Decision Making ◽

Young Child ◽

Complementary Feeding ◽

Hiv Positive ◽

Child Feeding ◽

Mothers And Fathers ◽

Young Child Feeding ◽

Infant And Young Child ◽

Catchment Areas ◽

Feeding Decision

Background: Few studies in low- and middle-income countries have examined the roles of couples in infant and young child feeding decision making and practices, and there is no corresponding data in the context of human immunodeficiency virus (HIV). Research aim: This study aimed to explore mothers’ and fathers’ perceptions of their roles in feeding decision making and practices. Methods: The authors conducted in-depth interviews with 15 mothers and their male partners, recruited from the catchment areas of two urban and two rural government clinics in Lilongwe District, Malawi. The mothers were ≥ 18 years of age, were HIV positive, and had a child < 24 months of age. Twelve of the 15 fathers were also HIV positive. The interviews were analyzed using content analysis. Results: Mothers were responsible for child care, including breastfeeding and complementary feeding. Fathers provided monetary support for purchasing food and offered verbal support to encourage mothers to implement recommended feeding practices. Many fathers found it difficult to support adequate complementary feeding because of household food insecurity. Mothers were advised on child feeding during prevention of mother-to-child transmission clinic visits. No fathers in this study accompanied women to clinic appointments, so they were less well-informed about feeding than mothers. Fathers usually deferred to mothers in feeding decision making. One-third of mothers wanted fathers to be more involved in child feeding. Conclusion: Malawian mothers’ and fathers’ roles in feeding decision making in the context of HIV align with local gender norms. Strategies are needed to improve fathers’ knowledge of and involvement in child feeding, as desired by mothers.

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Big Sister, Big Brother: A Mixed Methods Study on Older Siblings’ Role in Infant and Young Child Feeding and Care in Rural Tanzania (P10-020-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz034.p10-020-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Morgan Boncyk ◽

Ramya Ambikapathi ◽

Dominic Mosha ◽

Evidence Matangi ◽

Lauren Galvin ◽

...

Keyword(s):

Child Care ◽

Young Child ◽

Mixed Methods Study ◽

Older Children ◽

Nutrition Interventions ◽

Child Feeding ◽

Young Child Feeding ◽

Rural Tanzania ◽

Infant And Young Child ◽

Older Siblings

Abstract Objectives Nutrition interventions to improve infant and young child feeding (IYCF) and care in developing countries usually target mothers, while critical roles of other family members, particularly older siblings, are not well known. As part of the Engaging Fathers for Effective Child Nutrition and Development in Tanzania (EFFECTS) cluster-randomized trial (ClinicalTrials.gov: NCT03759821), we examined the roles of older children and adolescents in IYCF and care in rural Tanzania to develop and administer informed quantitative questionnaires on IYCF and care by older siblings. Methods Twelve mothers, 12 fathers, 4 grandmothers, and 4 older siblings (7–17 years of age) were purposively sampled for qualitative interviews conducted July-August 2018. Open-ended questions explored older siblings’ roles in IYCF and care, managing time for child care, and responsiveness to young children's hunger cues. Inductive and deductive approaches were used to identify themes from transcribed interviews. Findings supported development of two questionnaires on older children's roles in IYCF and care (14 questions each) that were administered to mothers and siblings in the EFFECTS baseline. Results Qualitative data indicate older siblings (male and female) are involved in food preparation (e.g., starchy staples), daily feeding, hygiene (e.g., washing baby after toileting) and care when the mother is unavailable due to other household activities. The EFFECTS study enrolled 960 households across 80 villages in Mara, Tanzania, and 53% of households identified at least one sibling who cares for an index child aged 0–18 months. Baseline data collection is ongoing and indicates prevalence and types of child care (e.g., feeding, playing, hygiene, responding to crying) provided by older siblings. Conclusions To our knowledge, this is the first mixed methods study developing instruments to investigate the role of older siblings in providing IYCF and care in a rural, developing country setting. As parents seek to meet household and livelihood needs, older siblings are often engaged in child feeding and care. Nutrition interventions should consider roles of all family members, including older children, in child feeding and care. Further research is needed to evaluate the effect of family-based interventions. Funding Sources Eleanor Crook Foundation and Conrad N. Hilton Foundation.

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