| dc.description.abstract | Background: Mother To Child Transmission (MTCT) of HIV still remains a threat especially in resource limited settings like Uganda where breastfeeding is the norm and remains the largest source of HIV transmission in children below the age of 5 years. HIV positive mother’s choice of feeding option and her compliance to the MoH IYCF set of guidelines has a lot to do with the child’s HIV status as well as the child’s general nutritional status. The MoH IYCF guidelines 2012/13 stress the indisputable benefits of breastfeeding for the first six months of the child’s life and thereafter complementary feeding up to one year while the mother and baby are both on ARV prophylaxis and this results in the greatest protection against infant morbidity and mortality as well as preventing the risk of transmission of HIV.
Objective: To assess the compliance of HIV positive breast feeding mothers to the MoH recommended infant and young child feeding options to prevent Mother To Child Transmission of HIV in Mukono district hospitals and health centre IVs.
Methodology: This was a cross-sectional descriptive study combining quantitative and qualitative methods. This study enrolled a total of 380 HIV positive mothers of reproductive age 17 to 44 years between June 2013 to August 2013 with infants aged four years and below attending hospitals of Mukono district and the two health centre IVs found in Mukono district where PMTCT services are being provided. These were Naggalama hospital, Mukono COU hospital, Mukono Municipality health centre IV and Kojja health centre IV. Information was collected concerning the mother’s knowledge on IYCF, counselling on IYCF, the capacity of the health facilities to provide IYCF services and information on mothers’ feeding practices. All this information was collected from these mothers using a standard pre-tested semi-structured questionnaire alongside Focus Group Discussions (FGDs), and Key informant interviews. Data was entered in EPIDATA and analysed in STATA version 10.
Results: The results of the study revealed that 62.11% (236/380) of the respondents complied with the recommended MoH IYCF options while of the 144/380 (37.89%) mothers who did not comply, 25.69% mothers had infected their children with HIV. Mothers who had babies aged between 13-24 months were 2.55 times more likely to comply with IYCF options (OR = 2.55, 95% C.I (1.25-5.19) while mothers with secondary education were found to be 2.29 times more likely to comply with IYCF options 95% C.I (1.23-4.28) P= 0.004. Mothers who practiced Mixed feeding after 6 months were 0.002 times less likely to comply with IYCF options (95% C.I, <0.000- 0.0000 P = 0.000) while mothers who practiced Exclusive replacement feeding after 6 months were 0.02 times less likely to comply with IYCF options (95% C.I, <0.000- 0.0000 P = 0.000). Mothers having HIV positive children were 0.13 times less likely to comply with IYCF options (95% C.I (0.04 – 0.43) P= 0.001).
Conclusions and Recommendations: This leaves the health sector with a challenge of boosting capacity of these PMTCT sites at the various health facilities in the district to curb the infection rate as well as strengthening the option B-Plus policy. This will require initiating the non-existent community awareness programmes by the health workers especially in the areas of IYCF in the context of HIV to be planned for by the district health office and design strategies focussing on mothers with babies of 0-12 months which are targeted to increase IYCF compliance | en_US |
