Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-14T15:15:13.022Z Has data issue: false hasContentIssue false
  • English
  • Français

Community-based assessment of infant feeding practices within a programme for prevention of mother-to-child HIV transmission in rural Zimbabwe

Published online by Cambridge University Press:  02 January 2007

J Orne-Gliemann ,
T Mukotekwa ,
A Miller ,
F Perez ,
M Glenshaw ,
P Nesara  and
F Dabis
J Orne-Gliemann*
Affiliation:
ISPED, Université Victor Segalen – Bordeaux 2, 146 rue Leo Saignat, F-33076 Bordeaux, France ISPED Zimbabwe, 33 Lawson Avenue, Milton Park, Harare, Zimbabwe
T Mukotekwa
Affiliation:
ISPED Zimbabwe, 33 Lawson Avenue, Milton Park, Harare, Zimbabwe
A Miller
Affiliation:
ISPED Zimbabwe, 33 Lawson Avenue, Milton Park, Harare, Zimbabwe EGPAF Zimbabwe, 33 Lawson Avenue, Milton Park, Harare, Zimbabwe
F Perez
Affiliation:
ISPED, Université Victor Segalen – Bordeaux 2, 146 rue Leo Saignat, F-33076 Bordeaux, France
M Glenshaw
Affiliation:
Murambinda Mission Hospital, PO Box 20, Murambinda Growth Point, Zimbabwe
P Nesara
Affiliation:
ISPED Zimbabwe, 33 Lawson Avenue, Milton Park, Harare, Zimbabwe
F Dabis
Affiliation:
ISPED, Université Victor Segalen – Bordeaux 2, 146 rue Leo Saignat, F-33076 Bordeaux, France
*
*Corresponding author: Email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective

To describe the infant feeding practices and attitudes of women who used prevention of mother-to-child transmission of HIV (PMTCT) services in rural Zimbabwe.

Design

A cross-sectional study including structured interviews and focus group discussions was conducted between June 2003 and February 2004.

Setting

The study took place in Murambinda Mission Hospital (Buhera District, Manicaland Province), the first site offering PMTCT services in rural Zimbabwe.

Subjects

The interviews targeted HIV-infected and HIV-negative women who received prenatal HIV counselling and testing and minimal infant feeding counselling, and who delivered between 15 August 2001 and 15 February 2003. The focus groups were conducted among young and elderly men and women.

Results

Overall, 71 HIV-infected and 93 HIV-negative mothers were interviewed in clinics or at home. Most infants (97%) had ever been breast-fed. HIV-negative mothers introduced fluids/foods other than breast milk significantly sooner than HIV-infected mothers (median 4.0 vs. 6.0 months, P = 0.005). Infants born to HIV-negative mothers were weaned significantly later than HIV-exposed infants (median 19.0 vs. 6.0 months, P = 10−5). More than 90% of mothers reported that breast-feeding their infant was a personal decision, a third of whom also mentioned having taken into account health workers' messages.

Conclusion

The HIV-infected mothers interviewed were gradually implementing infant feeding practices recommended in the context of HIV. Increased infant feeding support capacity in resource-limited rural populations is required, i.e. training of counselling staff, decentralised follow-up and weaning support.

Keywords

HIVMother-to-child transmissionBreast-feedingProgramme evaluationZimbabwe
Type
Research Article
Information
Public Health Nutrition , Volume 9 , Issue 5 , August 2006 , pp. 563 - 569
Copyright
Copyright © The Authors 2006

References

1Cunningham, AS, Jelliffe, DB, Jelliffe, EF. Breast-feeding and health in the 1980s: a global epidemiologic review. Journal of Pediatrics 1991; 118(5): 659–66.CrossRefGoogle ScholarPubMed
2De Cock, KM, Fowler, MG, Mercier, E, de Vincenzi, I, Saba, J, Hoff, E, et al. Prevention of mother-to-child HIV transmission in resource-poor countries: translating research into policy and practice. Journal of the American Medical Association 2000; 283(9): 1175–82.CrossRefGoogle ScholarPubMed
3Coutsoudis, A. Pillay, K, Spooner, E, Kuhn, L, Coovadia, HM. Influence of infant-feeding patterns on early mother-to-child transmission of HIV-1 in Durban, South Africa: a prospective cohort study. South African Vitamin A Study Group. Lancet 1999; 354(9177): 471–6.CrossRefGoogle ScholarPubMed
4Iliff, PJ, Piwoz, EG, Tavengwa, NV, Zunguza, CD, Marinda, ET, Nathoo, KJ, et al. Early exclusive breastfeeding reduces the risk of postnatal HIV-1 transmission and increases HIV-free survival. AIDS 2005; 19(7): 699–708.CrossRefGoogle ScholarPubMed
5World Health Organization (WHO)/United Nations Children's Fund/United Nations Population Fund/Joint United Nations Programme on HIV/AIDS. HIV and Infant Feeding: Guidelines for Decision Makers. Geneva: WHO, 2003. Available at http://www.who.int/child-adolescent-health/New_Publications/NUTRITION/HIV_IF_DM.pdf. Accessed 26 August 2005.Google Scholar
6World Health Organization (WHO). Global Strategy on Infant and Young Child Feeding. Geneva: WHO, 2003. Available at http://whqlibdoc.who.int/publications/2003/9241562218.pdf. Accessed 26 August 2005.Google Scholar
7Rollins, N, Meda, N, Becquet, R, Coutsoudis, A, Humphrey, J, Jeffrey, B, et al. Preventing postnatal transmission of HIV-1 through breast-feeding: modifying infant feeding practices. Journal of Acquired Immune Deficiency Syndromes 2004; 35(2): 188–95.CrossRefGoogle ScholarPubMed
8Zimbabwe Ministry of Health and Child Welfare (MOH/CW)/Zimbabwe Centres for Disease Control/Joint United Nations Programme on HIV/AIDS. Zimbabwe National HIV and AIDS Estimates, 2003. Harare: MOH/CW, 2003.Google Scholar
9Zimbabwe Ministry of Health and Child Welfare (MOH/CW). National HIV/AIDS Policy, Republic of Zimbabwe. Harare: MOH/CW, 1999.Google Scholar
10Zimbabwe Ministry of Health and Child Welfare (MOH/CW), National Nutrition Unit. Infant Feeding and HIV/AIDS. Guidelines for Health Workers in Zimbabwe. Harare: MOH/CW, 2000.Google Scholar
11Perez, F, Orne-Gliemann, J, Mukotekwa, T, Miller, A, Glenshaw, M, Mahomva, A, et al. Prevention of mother to child transmission of HIV: evaluation of a pilot programme in a district hospital in rural Zimbabwe. British Medical Journal 2004; 329(7475): 1147–50.CrossRefGoogle Scholar
12United Nations Children's Fund (UNICEF). Innocenti Declaration on the Protection, Promotion and Support of Breastfeeding. Florence, Italy: UNICEF, 1990. Available at http://www.unicef.org/programme/breastfeeding/innocenti.htm. Accessed 15 May 2005.Google Scholar
13World Health Organization (WHO)/Joint United Nations Programme on HIV/AIDS (UNAIDS)/United Nations Children's Fund (UNICEF). HIV and Infant Feeding Counselling: A Training Course (Trainer's Guide). Report Nos. WHO/FCH/CAH/00.2–4, UNICEF/PD/NUT/(J)00–2 and UNAIDS/99.56E. Geneva: WHO/UNAIDS/UNICEF, 2000. Available at http://www.who.int/child-adolescent-health/New_Publications/NUTRITION/HIV_Inf_Feeding/Trainers%20_Guide.pdf. Accessed 15 May 2005.Google Scholar
14Central Statistical Office, Zimbabwe Ministry of Health and Child Welfare (MOH/CW)/Macro International. Zimbabwe Demographic and Health Survey. Harare: MOH/CW, 1999. Available at http://www.measuredhs.com/pubs/pdftoc.cfm?ID=296. Accessed 21 February 2005.Google Scholar
15Origo, D, Karemba, M, Serima, E. HIV affected couples in a support group addressing issues of alternative infant feeding without disclosing their HIV status. Paper presented at the XIVth International AIDS ConferenceBarcelona, Spain7–12 July 2002; abstract no. WePeF6834Google Scholar
16Gaillard, P, Piwoz, E, Farley, TM. Collection of standardized information on infant feeding in the context of mother-to-child transmission of HIV. Statistics in Medicine 2001; 20(23): 3525–37.CrossRefGoogle ScholarPubMed
17World Health Organization (WHO). Breastfeeding and Replacement Feeding Practices in the Context of Mother-To-Child Transmission of HIV – An Assessment Tool for Research. Report No. WHO/RHR/01.12. Geneva: WHO, 2001. Available at http://www.who.int/reproductive-health/rtis/docs/Tool_breast_feeeding.doc. Accessed 15 February 2003.Google Scholar
18Boerma, JT, Gregson, S, Nyamukapa, C, Urassa, M. Understanding the uneven spread of HIV within Africa – comparative study of biologic, behavioral, and contextual factors in rural populations in Tanzania and Zimbabwe. Sexually Transmitted Diseases 2003; 30(10): 779–87.CrossRefGoogle ScholarPubMed
19Bland, RM, Rollins, NC, Solarsh, G, VandenBroeck, J, Coovadia, HM. Maternal recall of exclusive breast feeding duration. Archives of Disease in Childhood 2003; 88(9): 778–83.CrossRefGoogle ScholarPubMed
20Kiarie, JN, Richardson, BA, Mbori-Ngacha, D, Nduati, RW, John-Stewart, GC. Infant feeding practices of women in a perinatal HIV-1 prevention study in Nairobi, Kenya. Journal of Acquired Immune Deficiency Syndromes 2004; 35(1): 75–81.CrossRefGoogle Scholar
21Medley, A, GarciaMoreno, C, McGill, S, Maman, S. Rates, barriers and outcomes of HIV serostatus disclosure among women in developing countries: implications for prevention of mother-to-child transmission programmes. Bulletin of the World Health Organization 2004; 82(4): 299–307.Google ScholarPubMed
22Piwoz, EG, Iliff, PJ, Tavengwa, N, Gavin, L, Marinda, E, Lunney, K, et al. An education and counseling program for preventing breast-feeding-associated HIV transmission in Zimbabwe: design and impact on maternal knowledge and behavior. Journal of Nutrition 2005; 135(4): 950–5.CrossRefGoogle ScholarPubMed
23Humphrey, J, Iliff, P. Is breast not best? Feeding babies born to HIV-positive mothers: bringing balance to a complex issue. Nutrition Reviews 2001; 59(4): 119–27.CrossRefGoogle Scholar