Assessment of Knowledge, Attitude, & Practice among Mothers about VCT and Feeding of Infants Born to HIV Positive Women in Jimma Town, Ethiopia
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Date
2005-06
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Addis Abeba Universty
Abstract
Background: In Ethiopia, 96 000 children under fifteen live with HIV, which is related to the
prevalence rate of HIV/AIDS and mother to child transmission (MTCT) of the virus.Without
intervention, the risk of MTCT of HIV is 15-30% in non breastfeeding populations;
breastfeeding by an infected mother increases the risk by 5-20% to a total of 20-45%. Studies
have also shown the variation in MTCT rates by duration of breastfeeding, exclusivity of
breastfeeding, and the danger of mixed feeding.
Objectives: This study was aimed at describing the levels and identifying determinants of
knowledge, attitude, and practice (KAP) of mothers about VCT and feeding of infants born to
HIV positive women.
Methods: A cross-sectional descriptive study was conducted using quantitative method on
876 mothers (231 pregnant and 645 lactating) residing in Jimma town in December 2004 to
January 2005, and in-depth interviews on 12 health workers working in VCT/PMTCT service
providing health institutions of the town.
Results: Among the mothers (n=876), 38.8% had sufficient knowledge about MTCT (during
pregnancy, labor, breastfeeding), 41.8% had sufficient knowledge about PMTCT, 30.5% had
sufficient knowledge about infant feeding options recommended to HIV positive women,
62.4% had favorable attitude to wards VCT, 4.7% had favorable attitude towards the feeding
options, 84.5% visited health institutions for antenatal care and 35.7% used VCT service
during their last pregnancy. The lactating mothers (n=643) practiced mixed feeding 81%,
exclusive breastfeeding 13.4% and exclusive replacement feeding 0.4%, and most (90.9%) of
the pregnant mothers intended to mixed feed their infants of age 0-6 months. Based on
logistic regression analysis, knowledge of the mothers about the infant feeding options was
significantly associated with their address, age, husbands being important persons for mothers
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to decide on how to feed their infants, and counseling mothers on infant feeding during ANC.
Mothers’ attitude towards the feeding options significantly associated with their address.
Infant feeding practices of lactating mothers was also having a statistically significant
association with their ANC use, place of delivery, and address. Most of the health workers
(in-depth interview participants) provided directive advice about the infant feeding optios, and
most didn’t include the options heat treated expressed breast milk and HIV negative wet
nurse. The participants mentioned mainly failure to afford formula milk, fear of
stigma/discrimination, and partners not involved in HIV test as reasons for non adherence of
HIV positive mothers to exclusive replacement feeding; while the mothers’ sickness to
exclusive breast feeding. In turn, the mothers shifted to mixed feeding.
Conclusion: Mixed feeding increases the risk of non HIV diseases like diarrhea and
malnutrition for infants of age 0-6 months, and for most of mothers didn’t know their HIV
status potentially increases risk of MTCT of HIV. Therefore, strengthening counseling
mothers on safe infant feeding practices, and introducing an appropriately designed BCC
program to the community on safe infant feeding practices and importance of partners’
involvement in HIV testing and other recommendations are forwarded.
Key words: - Infant feeding, VCT, PMTCT, MTCT.
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Keywords
Infant feeding, VCT, PMTCT, MTCT.