Rapid assessment of infant feeding support to HIV-positive women accessing prevention of mother-to-child transmission services in Kenya, Malawi and Zambia

Health Systems Research Unit, Medical Research Council, Francie Van Zyl Drive, Parow, Western Cape 7535, South Africa.
Public Health Nutrition (Impact Factor: 2.48). 05/2009; 12(12):2323-8. DOI: 10.1017/S1368980009005606
Source: PubMed

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

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    • "Original Article review of programmatic experience by the World Health Organization (WHO)/United Nations Children's Fund found a number of shortcomings in the coverage and quality of infant feeding counselling and support in most prevention of mother-to-child transmission programmes (World Health Organization 2007a). Inadequate infant feeding counselling was found in programmes in Kenya, Malawi and Zambia (Chopra et al., 2009). Mothers may therefore be confused about what feeding mode is best for their infants. "
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