Infant Feedings Options Among HIV Positive Mothers Attending Health Facilities Essay

Infant Feedings Options Among HIV Positive Mothers Attending Health Facilities Essay

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The survey study was conducted on factors influencing the choice of infant feeding options among HIV positive mothers attending health facilities in Ogoja, Cross River State. The purpose was to investigate factors influencing the choice of infant feeding options among HIV positive mothers in Ogoja, Cross River State. Four objectives and four research questions were used to guide the study. Literatures were reviewed. The population for the study was all HIV positive mothers attending health facilities in Ogoja from January-December 2011-2013, with a total of 136 registered HIV positive mothers. There was no sampling because the total population was included in the study. The instrument for data collection was questionnaire with two sections. Section A had 8 items on socio-demographic characteristics. Section B was made up of 10 items rating scale of Yes and No. Data was analyzed using chi-square statistics. Result revealed that marital status (x2= 20.924, p<.00), religious status (x2 = 14.972, p<.05), maternal health condition (x2=12.436, p<.02), limited time to breastfeed baby because of work (x2 =11.065, p<.04) and baby’s refusal to take breast milk (x2 = 18.318, p<.00) significantly influenced HIV positive mothers’ choice of infant feeding options. Major findings reveal that marital status, religious status, maternal health condition, limited time to breast feed baby because of work and baby’s refusal to take breast milk had significant influence on infant feeding options. Based on the findings it was recommended that HIV positive mothers should be sensitized by HIV/PMTCT counselors with necessary knowledge for the choice of infant feeding options.Infant Feedings Options Among HIV Positive Mothers Attending Health Facilities Essay

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CHAPTER ONE

INTRODUCTION

Background to the Study

Human immune-deficiency virus (HIV) is a chronic, health problem with symptoms appearing anytime from several months to years. HIV is found among all known populations of the world, including the embryonic population (unborn babies) and the breastfed babies. World Health Organization, (WHO, 2011) revealed that more than eleven million people worldwide had died of AIDS, while another 3.6 million of people are already infected with HIV, with a daily infection rate of over 16,000 people globally. It was observed by Anyebe, Whiskey, Ajayi, Garba, Ochigbo and Lawal (2011) that by 2002, 42 million people had been infected with HIV/AIDS globally, 38.6 million of them were adults of which 19.2 million were women. More than 3 million children below the age of 15 were infected worldwide within the same period with about 5 million new infections being recorded yearly. Nearly two thirds of these are in Sub-Saharan Africa. Globally, an estimated 600,000 children are infected vertically (in utero) each year, while in places where women do not breastfeed, most of the transmission occurs at the time of labor and delivery, (Okon, 2011).Infant Feedings Options Among HIV Positive Mothers Attending Health Facilities Essay

In Nigeria where most women breastfeed, there is an additional risk. About 800,000 were infected out of 5.8 million in 2003 were infants and children of which 90% of these got infected through their mothers, occurring at three levels; antepartum, intrapartum and breastfeeding (Okon, 2011). There is no cure for HIV currently available, but prevention of mother to child transmission (PMTCT) appears to be the most important intervention (Family Health International, 2004). American international health alliance (AIHA, 2008) in Ajayi, Hellandendu and Odekunle (2011) posited that ‘’ther e is no cure for HIV, but prevention of vertical transmission of HIV to include voluntary counseling and testing, (VCT) , ante-retroviral therapy, elective caesarean section; replacement of infant feed or modified breastfeeding, and restrictive use of invasive procedure such as artificial rupture of membrane, (ARM),episiotomies and cleansing of the birth canal with a microbite during labor and delivery.Infant Feedings Options Among HIV Positive Mothers Attending Health Facilities Essay

This research was done for the organization Give Milk Stop Aids that promotes artificial
bottle-feeding among HIV-positive mothers. In this study, the motives towards feeding
options of HIV-positive women in Cameroon were investigated. The WHO recommends
HIV-positive women to either exclusively breastfeed, or give artificial bottle-feeding to
their child, while a mixture of both feeding options is the norm in Cameroon. Give Milk
Stop Aids works with a program that distributes free artificial milk and promotes giving
artificial bottle milk to exclude the child from HIV-contaminated breastfeeding, and to
protect children from contacting the virus through the mother. This program is located
at three health care clinics in Cameroon; one hospital and one health clinic in rural areas
and one hospital in the largest city of Cameroon. The program has been a success in the
city, but this does not count for the programs in the rural area. This research consists
of 2 studies. Study 1 aims to explain through which determinants women choose their
feeding options. It also aims to explain why the Give Milk Stop Aids program is a success
in the city, but not in the rural areas. 26 HIV-positive women who almost delivered or
delivered recently were interviewed by a semi-structured questionnaire. The participants were divided into 3 groups. The first group were women who intended non-bottle-feed and lived in rural areas (n=9). The second group were women who intended
to non-bottle-feed and lived in the city (n=12). The third were women who intended to
bottle-feed and lived both in rural areas and the city (n=5). Analysis of results led to the
conclusion that HIV-positive women who are aware of the fact that breast milk is contaminated with HIV, primarily choose to feed their baby artificial milk. Women that prefer to breastfeed believe strongly in the nutritious value of breast milk. The difference
in success of the program between city and rural areas can be explained by differences
in attitudes about stigma and coping strategies. Women in rural areas perceive stigma
together with great consequences for their personal life, because revealing an HIV-positive status might lead to rejection from their relatives, which means that they lose their
social safety net. Women in the city are more often employed and depend less on their
relatives. The level of coping with HIV influences the willingness to give bottle-feeding.
Women from rural areas cope slightly worse with the HIV diagnosis than women from
the city, because they do not know much about HIV, except that it kills. Their bad coping
strategies might influence their dismissive attitude towards bottle-feeding. Study 2 expressed the experiences of the health workers, working for Give Milk Stop Aids. Infant Feedings Options Among HIV Positive Mothers Attending Health Facilities Essay
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study, the health workers told about their experiences with the Give Milk Stop Aids program, the participants of the program and the women who refused to join the program.
The answers of the health workers have been compared with the results of Study 1.
6
Preface
In the period of November 2011 to April 2012,
I went to Cameroon to do my bachelor research
about HIV and AIDS for the Dutch organization
Give Milk Stop Aids. Two Dutch medical students founded this organization in 2004. They
examined HIV positive pregnant women during
their internship in the Apostolic Hospital Banga Bakundu, a rural area in Cameroon. HIV is
present in the breast milk and for that reason it
was better for the pregnant women to give bottle-feeding, according to the medical students.
These pregnant women were generally poor and
couldn’t afford the milk. That is why the two interns founded Give Milk Stop Aids.
The Give Milk Stop Aids program runs in three areas in Cameroon; Douala, a large city
of two million inhabitants, and two small rural villages where approximately 500 to
1000 people live: Banga Bakundu and Munyenge. The program that Give Milk Stop Aids
designed for the hospitals in Cameroon exists partially of the free provision of formula milk for HIV positive women. Other aspects of the program are the organization of
support group meetings for all HIV positive mothers and psychological counselling to
cope with the HIV positive status. The program offers poor HIV-positive women to give
artificial bottle-milk, even when they cannot afford it themselves.
The aim of this research
Although the number of participating women in the program has increased over the
years, the management team of Give Milk Stop Aids has noticed that there is a large
amount of HIV-positive women who refuse to join the program and decide to breastfeed
their child. This phenomenon especially occurs with the programs in the rural areas.
The management team has sent me to Cameroon to find out why women refuse to join.
I will present the results of my research in the following report.
Front of the hospital Banga Bakundu  Infant Feedings Options Among HIV Positive Mothers Attending Health Facilities Essay
7
Acknowledgements
Before I start to present the results of my research, I would like to thank all the people
who supported and helped me to realise this research. At first I would like my Cameroonian colleagues; Lorraine Tanga and Hannah Ebob, who guided me and helped me
to perform my research in the Cameroonian hospitals. Without them I would be lost
in Cameroon. I would like to thank the Apostolic Church in Cameroon, for receiving me
and letting me perform my research in their hospitals. I would like to give my thanks to
the management team of Give Milk Stop Aids, who provided this internship to me. Specifically Wendie Botjes, who was my Dutch supervisor at Give Milk Stop Aids. Living in
a country that is so different from what you are used to is not always easy and she got
me through the tough times during my stay. I would also like to thank my first tutor of
the University of Twente, dr. Henk Boer. He was closely involved with the process of my
report and was always prepared to give me feedback in order to present my research as
clear as possible. I would like to thank my second tutor, dr. Marcel Pieterse as well. Infant Feedings Options Among HIV Positive Mothers Attending Health Facilities Essay

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