Infant feeding counseling within Kenyan and Zambian PMTCT services: How well does it promote good feeding practices?

Infant feeding counseling is an important intervention for the prevention of mother-to-child transmission (PMTCT) of HIV. More than one-third of HIV transmission to infants occurs through breastfeeding, and up to 20 percent of infants born to HIV-infected mothers acquire the virus from breast milk in countries where extended breastfeeding of children is the norm. The World Health Organization advises that HIV-positive mothers should be offered nondirective counseling on various infant feeding options that are feasible, affordable, safe, sustainable, and effective in the local context. The Horizons Program collaborated with NARESA in Kenya, the MTCT Working Group in Zambia, and UNICEF to examine the implementation of infant feeding counseling as part of a comprehensive study in each country to document the acceptability, operational barriers, cost, and impact of pilot PMTCT services. This brief presents key findings from the Kenya and Zambia studies on the content of counseling, provider attitudes about infant feeding options, and the extent to which actual infant feeding practice by mothers is consistent with recommended practice.

REPORTS FROM THE CANADIAN COORDINATING OFFICE FOR HEALTH TECHNOLOGY ASSESSMENT (CCOHTA)

This qualitative review describes the current molecular basis of breast and prostate cancer, assesses the clinical relevance of genetic susceptibility, addresses nondirective counseling, and explores the ethical, psychosocial, and policy implications associated with genetic testing.