Development of an AFASS assessment and screening tool towards the prevention of mother-to-child HIV transmission (PMTCT) in sub-Saharan Africa - A Delphi survey

BMC Public Health

Research Article

Stella M Adegbehingbe¹  Debbie Marais¹  Virginia Paul-Ebhohimhen² 

[1] Division of Applied Health Sciences, University of Aberdeen, AB25 2ZD, Aberdeen, UK;Health Services Research Unit, University of Aberdeen, AB25 2ZD, Aberdeen, UK;

关键词: Health Care Worker;    Exclusive Breastfeed;    Infant Feeding;    Delphi Survey;    Replacement Feeding;   

DOI  :  10.1186/1471-2458-12-402

 received in 2011-11-07, accepted in 2012-06-06,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundThe rate of mother-to-child transmission of HIV, occurring during pregnancy, delivery/labour and breastfeeding, still remains high in Sub-Saharan Africa (SSA). The World Health Organization recommends HIV infected mothers exclusively breastfeed their infants, unless replacement feeding is Acceptable, Feasible, Affordable, Sustainable and Safe (AFASS). Health care workers are responsible for providing counselling to mothers on the risks and benefits of infant feeding options allowing mothers to make an ‘informed choice’, but this role is challenging and mostly subjective. The aim of this study was to develop and content validate an AFASS assessment tool that could be used for infant feeding counselling in SSA.MethodsAn AFASS assessment tool was developed based on the evidence and tools available regarding why replacement feeding is not AFASS in SSA (15 questions). Fifty seven experts involved in PMTCT programmes in five SSA countries were approached to participate as members of the Delphi expert panel (purposive sampling and snowballing). A web-based survey, utilising a 4-point Likert scale, was employed to gain consensus (>75% agreement) from the expert panel following the Delphi technique.ResultsA final panel of 15 experts was obtained. Thirteen of the 15 questions in the tool achieved consensus agreement. Experts suggested some additional questions, and that double-barrelled questions were split. Consensus was achieved regarding the applicability and appropriateness of the tool within a SSA context. Experts all agreed that the tool will be useful for the purpose for which it was designed. Suggestions made by the expert panel were incorporated into the revised tool.ConclusionsThe findings of this study confirm that this AFASS counselling tool may be appropriate and useful for SSA. Ideally the revised tool should be tested by providers of infant feeding advice with the aim of adoption into routine PMTCT programmes in SSA. Within the context of the 2010 WHO guidelines which advocate a public health rather than an individualised approach, it may inform the WHO process of improving counselling tools for health care workers involved in PMTCT programmes.

【 授权许可】

CC BY   
© Adegbehingbe et al.; licensee BioMed Central Ltd. 2012