Jackson DJ, Chopra M, Doherty T, Ashworth A; International Conference on AIDS (15th : 2004 : Bangkok, Thailand).
Int Conf AIDS. 2004 Jul 11-16; 15: abstract no. ThPeE7998.
School of Public Health, University of the Western Cape, Cape Town, South Africa
Background: South Africa introduced Prevention of Mother-to-Child-Transmission programmes in 18 pilot sites across the country in 2002. The aim of this study was to assess the quality of counselling provided to women in the programme, particularly on infant feeding. Methods: Structured observations of consultations and exit interviews with women were conducted in 3 different PMTCT pilot sites. The structured observation tool was based on the expected content of counselling sessions found in the South African PMTCT protocol. Exit interviews used structured questionnaires that measured opinion and knowledge of women. Results: 60 observations/interviews were conducted (34 HIV+, 26 HIV-). 22 counsellors were observed (mean 4 per counsellor). Mean duration of sessions was 18 minutes. The quality of communication skills was very good. 73% of HIV- women were informed of the advantages of exclusive breastfeeding (EBF). Most women were told what the nevirapine was for and when and how to take it. Issues and advantages of disclosure were discussed with only 13 of 34 HIV+ women. Only 2 HIV+ women were asked about essential conditions for safe formula feeding before an infant feeding choice was made. None of the 12 HIV+ women choosing to breastfeed was shown how to position the baby correctly on the breast or asked whether EBF was feasible. 85% of women could not define the term EBF. Only 5 of 15 HIV+ women choosing exclusive formula feeding were provided with instructions. The site with more training and supervised support performed better. With regard to women's knowledge, there remained substantial confusion regarding the risks of breast-feeding and formula feeding, however a majority understood mixed feeding to be a risk for both HIV transmission and other infections. Conclusion The poor quality of counselling in the PMTCT programme will reduce programme effectiveness. There needs to be more attention to the counselling of women, especially on optimal infant feeding.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Breast Feeding
- Child
- Counseling
- Female
- HIV Infections
- HIV Seropositivity
- Humans
- Infant
- Infant Care
- Infant Food
- Infant Nutrition Physiology
- Nevirapine
- Program Evaluation
- South Africa
Other ID:
UI: 102281759
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