Factors Influencing Choice of Infant Feeding Options Among HIV Positive Mothers in South Sudan:
Abstract
Objectives: This study was set to determine the factors that influence the choice of infant feeding options among HIV positive mothers in Yei County, South Sudan by assessing the knowledge level of HIV-positive mothers on PMTCT and infant feeding guidelines, assessing HIV- positive mothers’ attitudes towards specific infant feeding options and identify the socio-economic factors that influence HIV-positive mothers’ choice of specific infant feeding options in Yei County, South Sudan.
Methodology: A cross-sectional study design was used where quantitative and qualitative data collection methods were used to obtain information from 100 mothers living with HIV/AIDS. Focus group discussions with 20 HIV positive mothers (10 from each heath facility), and 2 Key informants from Yei Hospital MCH, and St Bakhita Primary Health Care Center. Data was analyzed using SPSS and the thematic content analysis.
Results: The level of knowledge among HIV Positive mothers regarding PMTCT infant feeding guidelines was high (97.0%) and the HIV positive mothers mostly preferred exclusive breast feeding as compared to exclusive replacement feeding due to its health advantages. Education, knowledge about PMTCT, cultural beliefs, were socio-economic factors that had significant relationship with the choice of infant feeding options among mothers living with HIV/AIDS. Cost of infant feeding option and income also have significant relationship with the choice of infant feeding options among mothers living with HIV/AIDS.
Conclusions:
HIV-positive mothers in Yei County of South Sudan had differences in relation to their socio-economic characteristics, some of which such as education, knowledge about PMTCT, cultural beliefs and income were responsible for the differences in the choice of the infant feeding options made by these mothers.
The level of knowledge among HIV-positive mothers regarding PMTCT and infant feeding guidelines was high; this was attributed to the counseling and supportive services rendered by health workers to mothers upon their enrollment for antenatal, post natal care and PMTCT services. HIV-positive mothers had a positive attitude and preference towards exclusive breast feeding option, and it is the most preferred option followed by exclusive replacement feeding, and mixed feeding comes last. Education, income, cost of infant feeding option, knowledge about PMTCT/infant feeding guide lines and cultural beliefs were socio-economic and cultural factors that had influence on HIV-positive mothers’ choice of the feeding options for their infants.
Recommendations:
Health workers in the Republic of South Sudan should continue to provide more information on advantages of exclusive breast feeding for six months among HIV-positive mothers or exclusive replacement, with more emphasis on the disadvantages of mixed feeding so that HIV positive mothers completely avoid this practice and save their infants from vertical transmission of HIV.
Due to poor status of most women living with HIV/AIDS, there is need to support HIV-positive mothers to improve their socio- economic status to enable them afford replacement feeding option as some mother showed preference for this option.
PMTCT of HIV counseling and sensitization should be extended beyond HIV-positive mothers, especially in rural areas of South Sudan to make larger populations become aware and change cultural beliefs that are contrary to information regarding PMTCT and infant feeding guidelines.
The Government of the Republic of South Sudan and health partners should strategically scale up the scope of PMTCT programing country-wide as an intervention for prevention of new HIV infection among children and maintain the safety of HIV-positive mothers.