scholarly journals Realities and challenges of breastfeeding policy in the context of HIV: a qualitative study on community perspectives on facilitators and barriers related to breastfeeding among HIV positive mothers in Baringo County, Kenya

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Betty Mogesi Samburu ◽  
Judith Kimiywe ◽  
Sera Lewise Young ◽  
Frederick Murunga Wekesah ◽  
Milka Njeri Wanjohi ◽  
...  
Keyword(s):  
Exclusive Breastfeeding ◽  
Cultural Practices ◽  
Health Workers ◽  
Male Involvement ◽  
Holistic Approach ◽  
Antiretroviral Drugs ◽  
Hiv Positive ◽  
Community Perspectives ◽  
Hiv Positive Mothers ◽  
Facilitators And Barriers

Abstract Background Although recent policies have sought to increase the rates of exclusive breastfeeding (EBF) and continued breastfeeding for HIV exposed infants, few programs have considered the multiple social and cultural barriers to the practice. Therefore, to generate evidence for exclusive and continued breastfeeding policies in Kenya, we examined community perspectives on the facilitators and barriers in adherence to EBF for the HIV positive mothers. Methods Qualitative research was conducted in Koibatek, a sub-County in Baringo County Kenya, in August 2014 among 205 respondents. A total of 14 focus group discussions (n = 177), 14 In-depth Interviews and 16 key informant interviews were conducted. Transcribed data was analyzed thematically. NVivo version 10.0 computer qualitative software program was used to manage and facilitate the analysis. Results Facilitators to exclusive breastfeeding were perceived to include counselling at the health facility, desire to have a healthy baby, use of antiretroviral drugs and health benefits associated with breastmilk. Barriers to EBF included poor dissemination of policies, knowledge gap, misinterpretation of EBF, inadequate counselling, attitude of mother and health workers due to fear of vertical HIV transmission, stigma related to misconception and misinformation that EBF is only compulsory for HIV positive mothers, stigma related to HIV and disclosure, social pressure, lack of male involvement, cultural practices and traditions, employment, food insecurity. Conclusions There are multiple facilitators and barriers of optimal breastfeeding that needs a holistic approach to interventions aimed at achieving elimination of mother to child transmission. Extension of infant feeding support in the context of HIV to the community while building on existing interventions such as the Baby Friendly Community Initiative is key to providing confidential support services for the additional needs faced by HIV positive mothers.

The Voices That Influence HIV-Positive Mothers’ Breastfeeding Practices in an Urban, Ghanaian Society

2017 ◽  
Vol 34 (1) ◽  
pp. 176-183 ◽  
Author(s):  
Angela Kwartemaa Acheampong ◽  
Florence Naab ◽  
Adzo Kwashie
Keyword(s):  
Health Professionals ◽  
Health Workers ◽  
Cultural Influences ◽  
World Health ◽  
Hiv Positive ◽  
Exploratory Research ◽  
Breastfeeding Practices ◽  
Hiv Positive Mothers ◽  
Decision Making Processes ◽  
Health Organization

Background: The World Health Organization recommends that HIV-positive mothers should breastfeed for at least 1 year. There are people in the lives of these mothers who influence their decisions. Research aim: The aim was to explore the role of social persuasion in the decision-making processes of HIV-positive breastfeeding mothers. Methods: A qualitative, exploratory research design was employed ( N = 13). Participants were recruited from a public hospital in the Greater Accra Region of Ghana. One-on-one interviews were recorded and transcribed verbatim, and the contents of the transcripts were analyzed for emerging themes. Results: The perspectives of spouses, health workers, counselors, and siblings about breastfeeding affect the breastfeeding practices of mothers living with HIV in Ghana. Most of the women had negative experiences with their midwives. Because of complex social and cultural influences, the opinions of spouses, health professionals, siblings, and members of the communities in which breastfeeding mothers with HIV live influence breastfeeding practices. Conclusion: This study described HIV-positive, breastfeeding mothers’ perceptions of the role played by spouses, health professionals, siblings, and the community in breastfeeding decisions and practices. Influential people in the lives of breastfeeding mothers with HIV should be involved during interventions by HIV counselors to promote breastfeeding practices.

scholarly journals Knowledge, attitudes and practices of HIV-positive mothers regarding the benefits of exclusive breastfeeding at a regional hospital in the north east of Namibia

2021 ◽  
Vol 21 (3) ◽  
Author(s):  
Daniel Opotamutale Ashipala ◽  
Getruida Shikukumwa ◽  
Medusalem Hangula Joel
Keyword(s):  
Exclusive Breastfeeding ◽  
Sub Saharan Africa ◽  
Good Knowledge ◽  
Hiv Positive ◽  
Cross Sectional Survey ◽  
Attitudes And Practices ◽  
North East ◽  
Hiv Positive Mothers ◽  
Mother To Child ◽  
Knowledge Attitudes And Practices

Background: In sub-Saharan Africa, over 1,000 newborns are infected with HIV every day, despite available medical in- terventions. Mother-to-child transmission (MTCT) remains one of the primary sources of HIV infection in children and without interventions 40% of babies born from HIV-positive mothers would be infected with the virus. It is estimated that 300 000 children become infected with HIV worldwide, whilst 1.5 million children die when their mothers opt for other choices instead of breastfeeding. Objective: The purpose of the study was to assess and describe the knowledge, attitudes and practices of HIV-positive mothers regarding the benefits of exclusive breastfeeding at Rundu Intermediate Hospital, Kavango East Region in Namibia. Method: The study was a descriptive cross-sectional survey that used convenience sampling, as the researcher sought to use subjects available during the time of study to select 79 HIV positive mothers. Results: Participants in this study (94%; n=51) had good knowledge of the benefit of exclusive breastfeeding and that the benefits of breastfeeding outweigh the risk of HIV transmission from mother to child. The results confirmed that (77.2%; n=42) of the mothers opted to take ART with the babies until they stop breastfeeding. Conclusion: HIV positive mothers had good knowledge, attitudes and practices regarding the benefits of exclusive breast- feeding. A significant number of mothers were, however, not sure about breastfeeding exclusively for 6 months as they would stop if offered free formula milk for the baby. Support by the fathers and others in the community is vital. Keywords: Knowledge; HIV; breastfeeding; attitudes; practices; HIV-positive mothers; Namibia.

scholarly journals A descriptive study of HIV positive pregnant mothers on antiretroviral drugs (ARVS) in the Gambian tertiary hospital

2020 ◽  
Vol 6 (4) ◽  
pp. 93-97
Author(s):  
Anyanwu Matthew
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Antiretroviral Drugs ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Hiv Positive Mothers ◽  
Gestation Age ◽  
The Mean ◽  
The Impact ◽  
In Pregnancy

Background:/Aims: The use of antiretroviral drugs (ARVs) in pregnancy has shown remarkable improvement in immune status and have revolutionized the approach of care to people living with HIV (PLHIV). Some adverse pregnancy conditions have been reported which may depend on type of regimen, time and duration of use. The use of ARVs in pregnancy have been dynamic and transition from one regimen to the other have setting and country based variations. Therefore, knowing the impact of ARVs in pregnancy among PLHIV in our settings deserve evidence based information. Methods: Pregnant women attending antenatal clinic at the hospital were prospectively recruited and followed up. HIV positive mothers were recruited irrespective of gestation age. At the time of delivery, obstetric and neonatal characteristics were entered into computer database. Mothers and their children were followed until 6 weeks postpartum. The data was analyzed with Epi-info version 7.1.5. Chi square at significant level of 0.05 and confidence level of 95% was used to determine significance. Results: A total of 55 HIV positive mothers were in the study. The age range was between 18 to 45 years and parity was 0 to 8. The mean birth weight and gestation age at delivery was 2.92kg (SD 0.556) and 36 weeks (SD 2.8 weeks) respectively. The absolute CD4 count of 500cells/mm3 and above (43.3%) was associated with no low birth weight. The mean glycaemic results were within normal range, 4.02-4.75 and 5.00-6.79 Mmol/l pre and post prandial respectively. Conclusion: Low birth weight was not associated with HAART in pregnancy and good immune condition was not associated with low birth weight. There was no association of protease inhibitors and gestational diabetes mellitus.

scholarly journals "Once the child is delivered, he is no more your baby," Exclusive Breastfeeding experiences of first-time mothers in Kassena-Nankana Municipality, Ghana - a qualitative study

2020 ◽  
Author(s):  
Louisa Adda ◽  
Kwabena Opoku-Mensah ◽  
Phyllis Dako-Gyeke
Keyword(s):  
Exclusive Breastfeeding ◽  
English Language ◽  
Cultural Practices ◽  
Health Workers ◽  
Economic Value ◽  
Computer Software ◽  
Traditional Birth Attendants ◽  
Birth Attendants ◽  
First Time Mothers ◽  
First Time

Abstract Background Exclusive Breastfeeding (EBF) is globally accepted as the preferred method for infant feeding. In Ghana, an estimated 84% of children < 2 months old are exclusively breastfed. But by age 4 to 5 months, only 49% continue to receive EBF. This situation continues to deteriorate. Thus, the need to explore perceptions, practices as well as factors that influence EBF in Ghana. Method Using a qualitative design, four focus group discussions were conducted among first-time mothers and eight in-depth interviews with health workers and traditional birth attendants. The study was conducted in four communities in the Kassena-Nankana municipality of Ghana. Discussions and interviews were recorded and later transcribed verbatim to English language. The transcribed data was then coded with the aid of analysis computer software (Nvivo version 10.0) and later analyzed for the generation of themes. Result Exclusive breastfeeding is practiced among first-time mothers due to its perceived benefits; which include nutritional advantage, ability to enhance growth whilst boosting immunity and its economic value. However misconceptions as well as, certain cultural practices (e.g. giving herbal concoctions, breastmilk purification rites), and relational influences, may threaten a mother’s intention to exclusively breastfeed. Relational influences are mainly from mother in-laws, traditional birth attendants, grandmothers, herbalists and other older adults in the community. Conclusion Although first time mothers attempt EBF, external influences make it practically challenging. The availabilty and utilization of information on EBF was found to positively influence perceptions towards EBF, leading to change in attitude towards the act. Recommendations The provision of education on EBF should be targeted to mothers during antenatal and postnatal clinics in order to help address misconceptions of EBF. Again, the practice of community based health services should be strengthened to provide support to first-time mothers as well as continuous education to the family and community leaders who influence decision making on breastfeeding of infants.

scholarly journals Are we doing enough? Improved breastfeeding practices at 14weeks but challenges of non-initiation and early cessation of breastfeeding remain: findings of two consecutive cross-sectional surveys in KwaZulu-Natal, South Africa

2020 ◽  
Author(s):  
Christiane Horwood ◽  
Lyn Haskins ◽  
Ingunn Marie Engebretsen ◽  
Catherine Connolly ◽  
Anna Coutsoudis ◽  
...  
Keyword(s):  
Exclusive Breastfeeding ◽  
Hiv Positive ◽  
Breastfeeding Initiation ◽  
Structured Interviews ◽  
Breastfeeding Support ◽  
Cross Sectional ◽  
Breastfeeding Practices ◽  
Hiv Positive Mothers ◽  
Kwazulu Natal ◽  
Before And After

Abstract Background KwaZulu-Natal (KZN) Initiative for breastfeeding support (KIBS) was a multipronged intervention to support breastfeeding initiation and sustained breastfeeding implemented between 2014 and 2017. We present results of two surveys conducted before and after KIBS implementation to assess changes in feeding practices in KZN over this time period. Methods Two cross-sectional surveys were conducted in primary health care clinics. Multistage stratified random sampling was used to select clinics and participants. Sample size was calculated to provide district estimates of 14-week exclusive breastfeeding (EBF) rates at baseline (KIBS1), and provincial estimates at endpoint (KIBS2). At KIBS1 the sample required was nine participating clinics in each of 11 districts (99 clinics) with 369 participants per district (N=4059), and at KIBS2 was 30 clinics in KZN with 30 participants per clinic (N=900). All caregivers aged ≥ 15 years attending the clinic with infants aged 13- <16 weeks were eligible to participate. Data was collected using structured interviews on android devices. Multi-variable logistic regression was used to adjust odds ratios for differences between time points. Results At KIBS1 (May2014- March2015), 4172 interviews were conducted with carers, of whom 3659 (87.6%) were mothers. At KIBS2 (January-August 2017), 929 interviews were conducted which included 788 (84.8%) mothers. Among all carers the proportion of EBF was 44.6% and 50.5% (p= 0.1) at KIBS1 and KIBS2 respectively, but greater improvements in EBF were shown among mothers (49.9 vs 59.1: p=0.02). There were reductions in mixed feeding among all infants (23.2% vs 16.3%; p=0.016). Although there was no change in the proportion of carers reporting not breastfeeding (31.9% vs 32.8%; p= 0.2), the duration of breastfeeding among mothers who had stopped breastfeeding was longer at KIBS2 compared to KIBS1 (p=0.0015). Mothers who had returned to work or school were less likely to be breastfeeding (AOR 3.76; 95% CI 3.1-4.6), this was similar among HIV positive mothers (AOR 2.1; 95% CI 1.7-2.6). Conclusion Despite improvements to exclusive breastfeeding, failure to initiate and sustain breastfeeding is a challenge to achieving optimal breastfeeding practices. Interventions are required to address these challenges and support breastfeeding particularly among working mothers and HIV positive mothers.

scholarly journals Are we doing enough? Improved breastfeeding practices at 14weeks but challenges of non-initiation and early cessation of breastfeeding remain: findings of two consecutive cross-sectional surveys in KwaZulu-Natal, South Africa

2020 ◽  
Author(s):  
Christiane Horwood ◽  
Lyn Haskins ◽  
Ingunn Marie Engebretsen ◽  
Catherine Connolly ◽  
Anna Coutsoudis ◽  
...  
Keyword(s):  
Exclusive Breastfeeding ◽  
Hiv Positive ◽  
Structured Interviews ◽  
Breastfeeding Support ◽  
Cross Sectional ◽  
Health Care Clinics ◽  
Breastfeeding Practices ◽  
Hiv Positive Mothers ◽  
Kwazulu Natal ◽  
Before And After

Abstract Background: KwaZulu-Natal (KZN) Initiative for breastfeeding support (KIBS) was a multipronged intervention to support the initiation and sustaining of breastfeeding, implemented between 2014 and 2017. We present results of two surveys conducted before and after KIBS implementation to assess changes in infant feeding practices in KZN over this time period.Methods: Two cross-sectional surveys were conducted in primary health care clinics. Multistage stratified random sampling was used to select clinics and participants. Sample size was calculated to provide district estimates of 14-week exclusive breastfeeding (EBF) rates at baseline (KIBS1), and provincial estimates at endpoint (KIBS2). At KIBS1 the sample required was nine participating clinics in each of 11 districts (99 clinics) with 369 participants per district (N=4059), and at KIBS2 was 30 clinics in KZN with 30 participants per clinic (N=900). All caregivers aged ≥ 15 years attending the clinic with infants aged 13- <16 weeks were eligible to participate. Data was collected using structured interviews on android devices. Multi-variable logistic regression was used to adjust odds ratios for differences between time points. Results: At KIBS1 (May2014- March2015), 4172 interviews were conducted with carers, of whom 3659 (87.6%) were mothers. At KIBS2 (January-August 2017), 929 interviews were conducted which included 788 (84.8%) mothers. Among all carers the proportion exclusively breastfeeding was 44.6% and 50.5% (p= 0.1) at KIBS1 and KIBS2 respectively, but greater improvements in EBF were shown among mothers (49.9 vs 59.1: p=0.02). There were reductions in mixed feeding among all infants (23.2% vs 16.3%; p=0.016). Although there was no change in the proportion of carers who reported not breastfeeding (31.9% vs 32.8%; p= 0.2), the duration of breastfeeding among mothers who had stopped breastfeeding was longer at KIBS2 compared to KIBS1 (p=0.0015). Mothers who had returned to work or school were less likely to be breastfeeding (AOR 3.76; 95% CI 3.1-4.6), as were HIV positive mothers (AOR 2.1; 95% CI 1.7-2.6). Conclusion: Despite improvements to exclusive breastfeeding, failure to initiate and sustain breastfeeding is a challenge to achieving optimal breastfeeding practices. Interventions are required to address these challenges and support breastfeeding particularly among working mothers and HIV positive mothers.

A Cohort Study Of HIV Positive Pregnant Mothers On Antiretroviral Drugs (ARVs) In The Gambian Tertiary Hospital

2020 ◽  
Author(s):  
Matthew Anyanwu ◽  
Sam Anya ◽  
Richard Offiong ◽  
Bissallah Ekele
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Antiretroviral Drugs ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Hiv Positive Mothers ◽  
Gestation Age ◽  
The Mean ◽  
The Impact ◽  
In Pregnancy

Abstract BackgroundAims: The use of HAART in pregnancy has shown remarkable improvement in immune status and have revolutionized the approach of care to people living with HIV. Some adverse pregnancy conditions have been reported which may depend on type of regimen, time and duration of use. The use of ARVs in pregnancy have been dynamic and transition from one regimen to the other have setting and country based variations. Therefore, knowing the impact of ARVs in pregnancy among PLHIV in our settings deserve evidence based information.MethodsPregnant women attending antenatal clinic at the hospital were prospectively recruited and followed up. HIV positive mothers were recruited irrespective of gestation age. At the time of delivery, obstetric and neonatal characteristics were entered into computer database. Mothers and their children were followed until 6 weeks postpartum. The data was analyzed with Epi-info version 7.1.5. Chi square at significant level of 0.05 and confidence level of 95% was used to determine significance.ResultsA total of 55 HIV positive mothers were in the study. The age range was between 18 to 45 years and parity was 0 to 8. The mean birth weight and gestation age at delivery was 2.92 kg (SD 0.556) and 36 weeks (SD 2.8 weeks) respectively. The absolute CD4 count of 350cells/mm3 and above (57.13%) was associated with low incidence of low birth weight. The mean glycaemic results were within normal range, 4.02–4.75 and 5.00-6.79 Mmol/l pre and post prandial respectively.Conclusionlow birth weight was not associated with HAART in pregnancy and good immune condition was not associated any low birth weight. There was no association of protease inhibitors and gestational diabetes mellitus

scholarly journals Exclusive Breast-Feeding Practice and Associated Factors among HIV-Positive Mothers in Governmental Health Facilities, Southern Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-9 ◽  
Author(s):  
Lewam Mebratu ◽  
Selamawit Mengesha ◽  
Yadessa Tegene ◽  
Abraham Alano ◽  
Alemayehu Toma
Keyword(s):  
Infant Feeding ◽  
Exclusive Breastfeeding ◽  
Associated Factors ◽  
Infant Feeding Practice ◽  
Southern Ethiopia ◽  
Hiv Positive ◽  
Feeding Practice ◽  
Mixed Feeding ◽  
Hiv Positive Mothers ◽  
Mother To Child

Introduction. Globally, over 90% of HIV infections among children are due to mother-to-child transmission and breastfeeding accounts for 5–20% of the burden. Avoidance of inappropriate feeding practices and practicing exclusive breastfeeding is recommended to reduce mother-to-child HIV transmission, but it is hardly practiced. The aim of this study was to determine the prevalence of exclusive breastfeeding practice and associated factors among HIV-positive mothers attending governmental PMTCT clinics in Southern Ethiopia. Methods. An institution-based cross-sectional study was conducted from April to May 2019. The participants of the study were 209 HIV-positive mothers at the selected PMTCT sites. The study subjects were drawn from 10 health institutions located at 6 towns in Southern Ethiopia which constituted six hospitals and four health centers. Quantitative data were collected using the pretested structured questionnaire. Logistic regression analysis was used to determine the association between the predictors and outcome variable. Results. Among the 209 participants, 81.6% (95% CI: 75.8–86.5) practiced exclusive breastfeeding and 18.4% (95% CI: 13.5–23.7) practiced mixed feeding. Mothers who had attended the recommended four antenatal visits [AOR: 3.01, 95% CI (1.1–8.28)], who had disclosed their serostatus [AOR: 3.17, 95% CI (1.12–8.99)], who had sufficient knowledge about infant feeding practice [AOR: 3.32, 95% CI (1.15–9.55)], and favorable attitude towards infant feeding practice [AOR: 5.39, 95% CI (1.65–17.6)] were more likely to practice exclusive breastfeeding. Conclusion. Exclusive breastfeeding was predominantly practiced. But mixed feeding was also being practice considerably. Improving maternal knowledge and attitude towards appropriate infant feeding practice through appropriate counseling on ANC visits could significantly improve EBF practice. It was also evident that promoting disclose of serostatus could empower the mothers to make an informed decision on how to appropriately feed their newborn.

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