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Infant feeding choices of HIV positive women: Do the WHO/UNICEF guidelines improve infant HIV-free survival?
Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Women's and Children's Health.
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Article in journal (Refereed) Submitted
Identifiers
URN: urn:nbn:se:uu:diva-95145OAI: oai:DiVA.org:uu-95145DiVA: diva2:169244
Available from: 2006-11-21 Created: 2006-11-21Bibliographically approved
In thesis
1. HIV and Infant Feeding: Operational Challenges of Achieving Safe Infant Feeding Practices
Open this publication in new window or tab >>HIV and Infant Feeding: Operational Challenges of Achieving Safe Infant Feeding Practices
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis assesses the uptake of the national Prevention of Mother to Child Transmission of HIV (PMTCT) programme in South Africa, and the challenges of achieving safe infant feeding practices in the context of HIV. The research studies contained in this thesis utilised a variety of quantitative and qualitative research methods in order to provide a full understanding of the challenges of moving from efficacy to effectiveness in PMTCT programmes. The first paper utilised a cross-sectional approach to a programme evaluation, papers two and three utilised qualitative methodologies, and paper four was based on a longitudinal cohort study design. The findings highlight the low uptake of PMTCT interventions and inappropriate infant feeding choices. The experiences of women with HIV provide an important insight into the difficulties of operationalising the WHO/UNICEF HIV and infant feeding recommendations in real life settings, where rates of HIV disclosure are low and mixed feeding is the norm. Several personal and environmental characteristics were identified that contributed to success in maintaining exclusive infant feeding practices. The research provides some guidance on the definition of appropriateness in infant feeding choices, and highlights the poor outcomes associated with formula feeding under unsafe conditions. Modifying infant feeding practices is essential in order to reduce postnatal HIV transmission and improve child survival. Interventions to improve infant feeding need to include improving the quality of counselling and support provided by health workers, with more structured assessments used to guide infant feeding choices. Efforts are also needed at the community level to increase rates of disclosure and to promote exclusive infant feeding as a norm.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2006. 83 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 200
Keyword
International health, HIV/AIDS, Prevention of Mother to Child Transmission of HIV, infant feeding, child health, qualitative research, cohort study, programme evaluation, nutrition, Internationell hälsa
Identifiers
urn:nbn:se:uu:diva-7291 (URN)91-554-6720-2 (ISBN)
Public defence
2006-12-13, Rosénsalen, Kvinnokliniken, Akademiska sjukhuset, Ing. 95/96, Uppsala, 09:15
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Available from: 2006-11-21 Created: 2006-11-21Bibliographically approved

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