期刊论文详细信息
International Breastfeeding Journal
Infant feeding in the context of HIV: a qualitative study of health care workers’ knowledge of recommended infant feeding options in Papua New Guinea
Heather Worth3  Glen DL Mola1  John M Kaldor2  Voletta Fiya4  Ruthy Neo4  Martha Kupul4  Angela Kelly3  Lisa M Vallely4 
[1] School of Medicine and Health Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea;Kirby Institute, University of New South Wales, Sydney, Australia;International HIV Research Group, School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia;Sexual & Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands Province, Papua New Guinea
关键词: Health care worker knowledge;    Exclusive breastfeeding;    Infant feeding practices;    Prevention of mother to child transmission;   
Others  :  801117
DOI  :  10.1186/1746-4358-8-6
 received in 2012-10-16, accepted in 2013-06-02,  发布年份 2013
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【 摘 要 】

Background

Interventions to prevent mother to child transmission of human immunodeficiency virus (HIV) during childbirth and breastfeeding can reduce HIV infections in infants to less than 5% in low and middle income countries. The World Health Organization (WHO) recommends all mothers, regardless of their HIV status, practice exclusive breastfeeding for the first six months of an infant’s life. In line with these recommendations and to protect, promote and support breastfeeding, in 2009 the PNG National Department of Health revised their National HIV infant feeding guidelines, reinforcing the WHO recommendation of exclusive breastfeeding for the first six months followed by the introduction of other food and fluids, while continuing breastfeeding.

The overall aim of this paper is to explore health care workers’ knowledge regarding infant feeding options in PNG, specifically as they relate to HIV exposed infants.

Methods

As part of a study investigating women’s and men’s experiences of prevention of mother to child transmission (PMTCT) services in two sites in PNG, 28 key informant interviews were undertaken. This paper addresses one theme that emerged from thematic data analysis: Health care workers’ knowledge regarding infant feeding options, specifically how this knowledge reflects the Papua New Guinea National HIV Care and Treatment Guidelines on HIV and infant feeding (2009).

Results

Most informants mentioned exclusive breastfeeding, the majority of whom reflected the most up-to-date National Guidelines of exclusive breastfeeding for six months. The importance of breastfeeding continuing beyond this time, along with the introduction of food and fluids was less well understood. The most senior people involved in PMTCT were the informants who most accurately reflected the national guidelines of continuing breastfeeding after six months.

Conclusion

Providing advice on optimal infant feeding in resource poor settings is problematic, especially in relation to HIV transmission. Findings from our study reflect those found elsewhere in identifying that key health care workers are not aware of up-to-date information relating to infant feeding, especially within the context of HIV. Greater emphasis needs to be placed on ensuring the most recent feeding guidelines are disseminated and implemented in clinical practice in PNG.

【 授权许可】

   
2013 Vallely et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]WHO: PMTCT Strategic Vision 2010–2015, Preventing mother to child transmission of HIV to reach the UNGASS and Millenium Goals. Moving towards the elimination of Paediatric HIV. WHO; 2010.
  • [2]De Cock KM, Fowler MG, Mercier E, de Vincenzi I, Saba J, Hoff E, Alnwick DJ, Rogers M, Shaffer N: Prevention of mother-to-child HIV transmission in resource-poor countries: translating research into policy and practice. JAMA 2000, 283(9):1175-1182.
  • [3]Iliff PJ, Piwoz EG, Tavengwa NV, Zunguza CD, Marinda ET, Nathoo KJ, Moulton LH, Ward BJ, Humphrey JH: Early exclusive breastfeeding reduces the risk of postnatal HIV-1 transmission and increases HIV-free survival. AIDS 2005, 19(7):699-708.
  • [4]Coovadia HM, Rollins NC, Bland RM, Little K, Coutsoudis A, Bennish ML, Newell ML: Mother-to-child transmission of HIV-1 infection during exclusive breastfeeding in the first 6 months of life: an intervention cohort study. Lancet 2007, 369(9567):1107-1116.
  • [5]Thomas TK, Masaba R, Borkowf CB, Ndivo R, Zeh C, Misore A, Otieno J, Jamieson D, Thigpen MC, Bulterys M, et al.: Triple-antiretroviral prophylaxis to prevent mother-to-child HIV transmission through breastfeeding–the Kisumu Breastfeeding Study, Kenya: a clinical trial. PLoS Med 2011, 8(3):e1001015.
  • [6]UNICEF, UNAIDS, WHO, UNFPA: HIV and Infant feeding. A guide for healthcare managers and supervisors. WHO; 2003.
  • [7]Ziegler JB, Cooper DA, Johnson RO, Gold J: Postnatal transmission of AIDS-associated retrovirus from mother to infant. Lancet 1985, 1(8434):896-898.
  • [8]Dunn DT, Newell ML, Ades AE, Peckham CS: Risk of human immunodeficiency virus type 1 transmission through breastfeeding. Lancet 1992, 5(340(8819)):585-588.
  • [9]WHO: ART drugs for treating pregnant women and preventing HIV infection in infant: towards univsersal acces - recommendations for a public health. WHO; 2010.
  • [10]Group KBS: Eighteen-month follow-up of HIV-1-infected mothers and their children enrolled in the Kesho Bora study observational cohorts. Kesho Bora study group. J Acquir Immune Defic Syndr 2010, 54(5):533-541.
  • [11]Group KBS: Safety and effectiveness of antiretroviral drugs during pregnancy, delivery and breastfeeding for prevention of mother-to-child transmission of HIV-1: the Kesho Bora multicentre collaborative study rationale, design, and implementation challenges. Kesho Bora study group. Contemp Clin Trials 2011, 32(1):74-85.
  • [12]Shapiro RL, Lockman S, Kim S, Smeaton L, Rahkola JT, Thior I, Wester C, Moffat C, Arimi P, Ndase P, et al.: Infant morbidity, mortality, and breast milk immunologic profiles among breast-feeding HIV-infected and HIV-uninfected women in Botswana. J Infect Dis 2007, 196(4):562-569.
  • [13]Mepham SO, Bland RM, Newell ML: Prevention of mother-to-child transmission of HIV in resource-rich and -poor settings. BJOG 2010, 118(2):202-218.
  • [14]Bahl R, Frost C, Kirkwood BR, Edmond K, Martines J, Bhandari N, Arthur P: Infant feeding patterns and risks of death and hospitalization in the first half of infancy: multicentre cohort study. Bull World Health Organ 2005, 83(6):418-426.
  • [15]WHO: Special program on AIDS: AIDS Statement: Breast-feeding/Breast Milk and Human Immunodeficiency Virus. Geneva: WHO; 1987. WHO/SPA/INF/87.8.
  • [16]WHO: Global Programme on AIDS: Consensus Statement from the WHO/UNICEF Consultation on HIV Transmission and Breast-feeding. Geneva: WHO; 1992. WHO/GPA/INF/92
  • [17]WHO: New data on the Prevention of Mother-to-child Transmission of HIV and their Policy Implications: Conclusions and Recommendations. WHO Technical Consultation on behalf of UNFPA/UNICEF/WHO/UNAIDS Inter-agency Task Team on Mother-to-child Transmission of HIV. Geneva 11–13 October, 2000. Geneva: WHO; 2001. WHO/RHR/01.28
  • [18]WHO: HIV and Infant feeding. Technical Consultation held on behalf of the inter-agency Task Team on Prevention of HIV infections in pregnant women, mothers and their infants. Geneva: WHO; 2007.
  • [19]WHO: HIV and infant feeding. Revised principles and recommendations. Rapid Advice. Geneva: WHO; 2009.
  • [20]Moland KM, de Paoli MM, Sellen DW, van Esterik P, Leshabari SC, Blystad A: Breastfeeding and HIV: experiences from a decade of prevention of postnatal HIV transmission in sub-Saharan Africa. Int Breastfeed J 2010, 5:10.
  • [21]Edmond KM, Zandoh C, Quigley MA, Amenga-Etego S, Owusu-Agyei S, Kirkwood BR: Delayed breastfeeding initiation increases risk of neonatal mortality. Pediatrics 2006, 117(3):380-386.
  • [22]Leshabari SC, Blystad A, Moland KM: Difficult choices: infant feeding experiences of HIV-positive mothers in northern Tanzania. SAHARA J 2007, 4(1):544-555.
  • [23]van Lettow M, Bedell R, Landes M, Gawa L, Gatto S, Mayuni I, Chan AK, Tenthani L, Schouten E: Uptake and outcomes of a prevention of mother to child transmission (PMTCT) program in Zomba district, Malawi. BMC Public Health 2011, 11:426.
  • [24]Rujumba J, Tumwine JK, Tylleskar T, Neema S, Heggenhougen HK: Listening to health workers: lessons from Eastern Uganda for strengthening the programme for the prevention of mother-to-child transmission of HIV. BMC Health Serv Res 2012, 12:3.
  • [25]Fadnes LT, Engebretsen IM, Moland KM, Nankunda J, Tumwine JK, Tylleskar T: Infant feeding counselling in Uganda in a changing environment with focus on the general population and HIV-positive mothers - a mixed method approach. BMC Health Serv Res 2010, 10:260.
  • [26]Sprague C, Chersich MF, Black V: Health system weaknesses constrain access to PMTCT and maternal HIV services in South Africa: a qualitative enquiry. AIDS Res Ther 2011, 8:10.
  • [27]Blystad A, van Esterik P, de Paoli MM, Sellen DW, Leshabari SC, Moland KM: Reflections on global policy documents and the WHO’s infant feeding guidelines: lessons learnt. Int Breastfeed J 2010, 5:18.
  • [28]NDoH, NACS: Papua New Guinea National HIV and AIDS Strategy 2011–2015. Papua New Guinea: National Department of Health; 2010.
  • [29]NDoH: The 2010 STI, HIV and AIDS Annual Surveillance Report. Papua New Guinea: National Department of Health; 2012.
  • [30]UNGASS, NACS: Country Progress Report Papua New Guinea UN. Papua New Guinea: National AIDS Council secretariat; 2010.
  • [31]NDoH-NHIS: National Health Information Systems. Papua New Guinea: National Department of Health; 2009.
  • [32]NDoH: Prevention of Parent to Child Transmission of HIV and Paediatric AIDS in Papua New Guinea: Operational plan 2010–2015. Papua New Guinea: National Department of Health; 2010.
  • [33]Friesen HVJ, Boas P, Danaya R, Mokela D, Ogle G, Asuo P, Kemiki A, Lagani W, Rongap T, Varughese M, Saweri W: Infant feeding practices in papua new guinea. Ann Trop Paediatr 1998, 18:209-215.
  • [34]Anga G, Vince JD, Kaupa M: Early introduction of solids and pneumonia in young infants in Papua New Guinea: a case control study. J Trop Pediatr 2008, 54(3):192-195.
  • [35]NDoH: PPTCT and paediatric HIV care and treatment review. Papua New Guinea: National Department of Health; 2009.
  • [36]Kuhn L, Aldrovandi GM, Sinkala M, Kankasa C, Semrau K, Mwiya M, Kasonde P, Scott N, Vwalika C, Walter J, et al.: Effects of early, abrupt weaning on HIV-free survival of children in Zambia. N Engl J Med 2008, 359(2):130-141.
  • [37]NDoH: Protection, promotion and support of breastfeeding. Papua New Guinea: National Department of Health; 2009.
  • [38]Biddulph J: Legislation to protect breast feeding. Papua N Guinea Med J 1983, 26(1):9-12.
  • [39]NDoH: Child Health plan 2008–2015. Papua New Guinea: National Department of Health; 2008.
  • [40]NDoH: Guidelines for HIV Care and Treatment in PNG. Papua New Guinea: National Department of Health; 2009.
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