OBJECTIVES: To conduct a rapid assessment of the impact of the Khayelitsha Prevention of Mother-to-Child Transmission (MTCT) programme on infant care practices among programme participants and the local population. STUDY DESIGN: Cross-sectional survey and qualitative in-depth interviews. SETTING. Khayelitsha, a large formal and informal settlement of about 300,000 people on the outskirts of Cape Town. At the time of the study the HIV seroprevalence rate among antenatal women was about 15% and the MTCT programme had enrolled nearly 800 infected women. SUBJECTS: Seventy randomly selected caregivers with young children in the survey; in-depth structured interviews with 11 nutrition counsellors and 11 mothers enrolled in the programme. RESULTS: Caregivers have good knowledge of the spread and prevention of HIV. A majority knew that breast-feeding can transmit HIV but 90% stated that this did not affect their feeding decisions. Over 80% had stopped exclusively breast-feeding by the time their infants were 3 months of age. All of the respondents felt that being diagnosed HIV-positive would result in serious social and domestic consequences. None of the health workers could correctly estimate the risk of spreading HIV through breast-feeding and many reported feeling confused about what they should counsel mothers. All the mothers on the programme reported exclusive formula-feeding. Some had serious problems with preparation and feeding of formula milk. Nearly all reported running out of feeds before being able to fetch new supplies. None reported any negative social effects of not breast-feeding. Most of the mothers endorsed the programme and felt that it had given them strength to face up to and plan for the consequences of their diagnosis. CONCLUSION: This rapid appraisal of the infant feeding and care component of the MTCT programme has raised a number of important challenges which health managers and policymakers need to address. Similar assessments in the new pilot sites will be important.
OBJECTIVES: To conduct a rapid assessment of the impact of the Khayelitsha Prevention of Mother-to-Child Transmission (MTCT) programme on infant care practices among programme participants and the local population. STUDY DESIGN: Cross-sectional survey and qualitative in-depth interviews. SETTING. Khayelitsha, a large formal and informal settlement of about 300,000 people on the outskirts of Cape Town. At the time of the study the HIV seroprevalence rate among antenatal women was about 15% and the MTCT programme had enrolled nearly 800 infected women. SUBJECTS: Seventy randomly selected caregivers with young children in the survey; in-depth structured interviews with 11 nutrition counsellors and 11 mothers enrolled in the programme. RESULTS: Caregivers have good knowledge of the spread and prevention of HIV. A majority knew that breast-feeding can transmit HIV but 90% stated that this did not affect their feeding decisions. Over 80% had stopped exclusively breast-feeding by the time their infants were 3 months of age. All of the respondents felt that being diagnosed HIV-positive would result in serious social and domestic consequences. None of the health workers could correctly estimate the risk of spreading HIV through breast-feeding and many reported feeling confused about what they should counsel mothers. All the mothers on the programme reported exclusive formula-feeding. Some had serious problems with preparation and feeding of formula milk. Nearly all reported running out of feeds before being able to fetch new supplies. None reported any negative social effects of not breast-feeding. Most of the mothers endorsed the programme and felt that it had given them strength to face up to and plan for the consequences of their diagnosis. CONCLUSION: This rapid appraisal of the infant feeding and care component of the MTCT programme has raised a number of important challenges which health managers and policymakers need to address. Similar assessments in the new pilot sites will be important.
Authors: Megan E Parker; Valerie L Flax; Martin Tembo; Ellen G Piwoz; Linda S Adair; Margaret E Bentley Journal: Matern Child Nutr Date: 2015-10 Impact factor: 3.092
Authors: Yvonne Owens Ferguson; Eugenia Eng; Margaret Bentley; Margarete Sandelowski; Allan Steckler; Elizabeth Randall-David; Ellen G Piwoz; Cynthia Zulu; Charles Chasela; Alice Soko; Martin Tembo; Francis Martinson; Beth Carlton Tohill; Yusuf Ahmed; Peter Kazembe; Denise J Jamieson; Charles van der Horst; Linda Adair; Yusuf Ahmed; Mounir Ait-Khaled; Sandra Albrecht; Shrikant Bangdiwala; Ronald Bayer; Margaret Bentley; Brian Bramson; Emily Bobrow; Nicola Boyle; Sal Butera; Charles Chasela; Charity Chavula; Joseph Chimerang'ambe; Maggie Chigwenembe; Maria Chikasema; Norah Chikhungu; David Chilongozi; Grace Chiudzu; Lenesi Chome; Anne Cole; Amanda Corbett; Amy Corneli; Ann Duerr; Henry Eliya; Sascha Ellington; Joseph Eron; Sherry Farr; Yvonne Owens Ferguson; Susan Fiscus; Shannon Galvin; Laura Guay; Chad Heilig; Irving Hoffman; Elizabeth Hooten; Mina Hosseinipour; Michael Hudgens; Stacy Hurst; Lisa Hyde; Denise Jamieson; George Joaki; David Jones; Zebrone Kacheche; Esmie Kamanga; Gift Kamanga; Coxcilly Kampani; Portia Kamthunzi; Deborah Kamwendo; Cecilia Kanyama; Angela Kashuba; Damson Kathyola; Dumbani Kayira; Peter Kazembe; Rodney Knight; Athena Kourtis; Robert Krysiak; Jacob Kumwenda; Edde Loeliger; Misheck Luhanga; Victor Madhlopa; Maganizo Majawa; Alice Maida; Cheryl Marcus; Francis Martinson; Navdeep Thoofer; Chrissie Matika; Douglas Mayers; Isabel Mayuni; Marita McDonough; Joyce Meme; Ceppie Merry; Khama Mita; Chimwemwe Mkomawanthu; Gertrude Mndala; Ibrahim Mndala; Agnes Moses; Albans Msika; Wezi Msungama; Beatrice Mtimuni; Jane Muita; Noel Mumba; Bonface Musis; Charles Mwansambo; Gerald Mwapasa; Jacqueline Nkhoma; Richard Pendame; Ellen Piwoz; Byron Raines; Zane Ramdas; John Rublein; Mairin Ryan; Ian Sanne; Christopher Sellers; Diane Shugars; Dorothy Sichali; Wendy Snowden; Alice Soko; Allison Spensley; Jean-Marc Steens; Gerald Tegha; Martin Tembo; Roshan Thomas; Hsiao-Chuan Tien; Beth Tohill; Charles van der Horst; Esther Waalberg; Jeffrey Wiener; Cathy Wilfert; Patricia Wiyo; Onnocent Zgambo; Chifundo Zimba Journal: AIDS Educ Prev Date: 2009-04
Authors: Ellen G Piwoz; Yvonne Owens Ferguson; Margaret E Bentley; Amy L Corneli; Agnes Moses; Jacqueline Nkhoma; Beth Carlton Tohill; Beatrice Mtimuni; Yusuf Ahmed; Denise J Jamieson; Charles van der Horst; Peter Kazembe Journal: Int Breastfeed J Date: 2006-03-09 Impact factor: 3.461
Authors: Chris Desmond; Ruth M Bland; Gerard Boyce; Hoosen M Coovadia; Anna Coutsoudis; Nigel Rollins; Marie-Louise Newell Journal: PLoS One Date: 2008-06-18 Impact factor: 3.240