Counseling and choosing between infant-feeding options: Overall limits and local interpretations by health care providers and women living with HIV in resource-poor countries (Burkina Faso, Cambodia, Cameroon)

Desclaux, Alice; Alfieri, Chiara

doi:10.1016/j.socscimed.2009.06.007

Cited by 62 publications

(67 citation statements)

References 6 publications

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“…Although some encounters between HCPs and mothers started out as open-ended and client-centered, most soon transitioned to a prescriptive mode of information delivery, with HCPs communicating through one-way rather than collaborative discussion, allowing little room to address concerns (Buskens & Jaffe, 2008) or alternative approaches (Desclaux & Alfieri, 2009). …”

Section: Resultsmentioning

confidence: 99%

Challenges faced by health-care providers offering infant-feeding counseling to HIV-positive women in sub-Saharan Africa: a review of current research

2014

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Exclusive breastfeeding (EBF) has been identified as the optimal nutrition and critical behavior in attaining human immunodeficiency virus (HIV)-free infant survival in resource-limited settings. Healthcare providers (HCPs) in clinic- and community-settings throughout sub-Saharan Africa (sSA) provide infant feeding counseling. However, rates of EBF at 6 months of age are suboptimal. Healthcare providers (HCPs) are uniquely positioned to educate HIV-positive mothers and provide support by addressing known barriers to EBF. However, limited evidence exists on the experiences faced by HCPs in providing counseling on infant feeding to HIV-positive women. Our objective is to describe experiences faced by HCPs when delivering infant feeding counseling in the context of HIV in program settings in sSA. We searched a range of electronic databases, including PubMed, CINAHL, and PsycINFO from January 1990 to February 2013, in addition to hand-searching, cross-reference searching and personal communications. The search was limited to publications in English. Empirical studies of HCP experiences providing infant feeding counseling in prevention of mother-to-child transmission of HIV (PMTCT) programs in sSA were selected. We identified 10 peer-reviewed articles reporting HCP challenges in infant feeding counseling that met inclusion criteria. Articles included qualitative, cross-sectional and mixed-method studies, and cumulatively reported 31 challenges faced by HCPs. Among the challenges identified, the most commonly reported were personal beliefs held by the HCPs toward infant feeding in the context of HIV, contradictory messages, staff workload, directive counseling styles, and a lack of practical strategies to offer mothers, often leading to improvised counseling approaches. Counseling strategies need to be developed that are relevant, meaningful and responsive to the needs of both HCPs and mothers.

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Section: Resultsmentioning

confidence: 99%

Challenges faced by health-care providers offering infant-feeding counseling to HIV-positive women in sub-Saharan Africa: a review of current research

2014

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“…PLWHA, like all individuals, should be given the support and counselling they need to make the best decisions they can to achieve their fertility desires. Childbearing counselling for the HIV-positive should include general information about the risks and benefits of contraceptive use while on ART, pregnancy risks for HIV-positive women, and education about available safe termination options (Desclaux and Alfieri 2009). Addressing stigma towards childbearing decisions by HIV-positive women is an area that deserves further attention if we are to achieve an AIDS-free generation.…”

Section: Discussionmentioning

confidence: 99%

Attitudes of women and men living with HIV and their healthcare providers towards pregnancy and abortion by HIV-positive women in Nigeria and Zambia

Moore

Bankole

Awolude

et al. 2015

African Journal of AIDS Research

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Fertility decisions among people living with HIV/AIDS (PLWHA) are complicated by disease progression, the health of their existing children and possible antiretroviral therapy (ART) use, among other factors. Using a sample of HIV-positive women (n = 353) and men (n = 299) from Nigeria and Zambia and their healthcare providers (n = 179), we examined attitudes towards childbearing and abortion by HIV-positive women. To measure childbearing and abortion attitudes, we used individual indicators and a composite measure (an index). Support for an HIV-positive woman to have a child was greatest if she was nulliparous or if her desire to have a child was not conditioned on parity and lowest if she already had an HIV-positive child. Such support was found to be lower among HIV-positive women than among HIV-positive men, both of which were lower than reported support from their healthcare providers. There was wider variation in support for abortion depending on the measure than there was for support for childbearing. Half of all respondents indicated no or low support for abortion on the index measure while between 2 and 4 in 10 respondents were supportive of HIV-positive women being able to terminate a pregnancy. The overall low levels of support for abortion indicate that most respondents did not see HIV as a medical condition which justifies abortion. Respondents in Nigeria and those who live in urban areas were more likely to support HIV-positive women's childbearing. About a fifth of HIV-positive respondents reported being counselled to end childbearing after their diagnosis. In summary, respondents from both Nigeria and Zambia demonstrate tempered support of (continued) childbearing among HIV-positive women while anti-abortion attitudes remain strong. Access to ART did not impart a strong effect on these attitudes. Therefore, pronatalist attitudes remain in place in the face of HIV infection.

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“…Other studies have in the same light reported that women who were financially independent, living within a nuclear family setting or supported by an HIV-positive partner were more likely to exclusively breastfeed (Doherty et al, 2006b;Desclaux et al, 2009;Ostergaard et al, 2010;Mataya et al, 2013).…”

Section: Effect Of Financial Dependencementioning

confidence: 91%

Barriers to the practice of exclusive breastfeeding among HIV-positive mothers in sub-Saharan Africa: A Scoping Review of counselling, socioeconomic and cultural factors

Al-Mujtaba¹,

Sam-Agudu²,

Khatri³

2016

J. AIDS HIV Res.

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The World Health Organization (WHO) recommends exclusive breast-feeding (EBF) for HIV exposed infants for six months; this is considered best practice for reducing mother-to-child transmission of HIV in the postpartum period. This is a scoping review of the barriers affecting women's decision-making and choice to sustain the practice of EBF in sub-Saharan Africa (SSA). An online literature search via PubMed, Science Direct, Google Scholar, WHO and Joint United Nations Programme on HIV and AIDS (UNAIDS) websites identified research studies and reports that explored socio-economic, cultural and infant feeding counselling-related barriers to EBF among HIV-positive mothers in SSA. A total of 341 relevant articles were identified only 35 (23 qualitative, 3 quantitative and 9 mixed methods) met the inclusion criteria. Findings reveal that key barriers to choice and sustained practice of EBF are healthcare workers' personal biases, inadequate counselling skills and guideline knowledge, a culture of mixed feeding norms, and maternal lack of decision-making power and fear of vertical transmission. Transmission of HIV programs in countries where major challenges persist should evaluate and address the identified healthcare worker and community-level factors impeding EBF.

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Counseling and choosing between infant-feeding options: Overall limits and local interpretations by health care providers and women living with HIV in resource-poor countries (Burkina Faso, Cambodia, Cameroon)

Cited by 62 publications

References 6 publications

Challenges faced by health-care providers offering infant-feeding counseling to HIV-positive women in sub-Saharan Africa: a review of current research

Challenges faced by health-care providers offering infant-feeding counseling to HIV-positive women in sub-Saharan Africa: a review of current research

Attitudes of women and men living with HIV and their healthcare providers towards pregnancy and abortion by HIV-positive women in Nigeria and Zambia

Barriers to the practice of exclusive breastfeeding among HIV-positive mothers in sub-Saharan Africa: A Scoping Review of counselling, socioeconomic and cultural factors

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