Differences between international recommendations on breastfeeding in the presence of HIV and the attitudes and counselling messages of health workers in Lilongwe, Malawi

Ellen G. Piwoz; Yvonne Owens Ferguson; Margaret E. Bentley; Amy L. Corneli; Agnes Moses; Jacqueline Nkhoma; Beth Carlton Tohill; Beatrice Mtimuni; Yusuf Ahmed; Denise J. Jamieson; Charles van der Horst; Peter Kazembe; Linda Adair; Sandra Albrecth; Mounir Alt-Khaled; Kant Bangdiwala; Ronald Bayer; Sal Butera; Joseph Chigwenembe; David Chilongozi; Grace Chiudzu; Ann Cole; Amanda Corbett; Ann Duerr; Henry Eliya; Susan Fiscuss; Shannon Galvin; Chad Heilig; Irving Hoffman; Elizabeth Hooten; Tien Hsiao; Stacey Hurst; George Joaki; David Jones; Gift Kamanga; Portia Kamthunzi; Cecilia Kanyama; Angela Kashuba; Dansom Kathyola; Rod Knight; Robert Krysiak; Edde Loeliger; Misheck Luhanga; Alice Maida; Francis Martinson; Douglas Mayers; Isabel Mayuni; Marita McDonough; Ceppei Merry; Wezi Msungama; Jane Multa; Charles Mwansambo; Gerald Mwapasa; Richard Pendame; Byron Raines; Mairin Ryan; Diane Shugars; Dorothy Sichali; Jean Marc Steens; Gerald Tegha; Martin Tembo; Roshan Thomas; Esther Waalberg; Chifundo Zimba

doi:10.1186/1746-4358-1-2

Differences between international recommendations on breastfeeding in the presence of HIV and the attitudes and counselling messages of health workers in Lilongwe, Malawi

Ellen G. Piwoz, Yvonne Owens Ferguson, Margaret E. Bentley, Amy L. Corneli, Agnes Moses, Jacqueline Nkhoma, Beth Carlton Tohill, Beatrice Mtimuni, Yusuf Ahmed, Denise J. Jamieson, Charles van der Horst, Peter Kazembe, Linda Adair, Sandra Albrecth, Mounir Alt-Khaled, Kant Bangdiwala, Ronald Bayer, Sal Butera, Joseph Chigwenembe, David ChilongoziGrace Chiudzu, Ann Cole, Amanda Corbett, Ann Duerr, Henry Eliya, Susan Fiscuss, Shannon Galvin, Chad Heilig, Irving Hoffman, Elizabeth Hooten, Tien Hsiao, Stacey Hurst, George Joaki, David Jones, Gift Kamanga, Portia Kamthunzi, Cecilia Kanyama, Angela Kashuba, Dansom Kathyola, Rod Knight, Robert Krysiak, Edde Loeliger, Misheck Luhanga, Alice Maida, Francis Martinson, Douglas Mayers, Isabel Mayuni, Marita McDonough, Ceppei Merry, Wezi Msungama, Jane Multa, Charles Mwansambo, Gerald Mwapasa, Richard Pendame, Byron Raines, Mairin Ryan, Diane Shugars, Dorothy Sichali, Jean Marc Steens, Gerald Tegha, Martin Tembo, Roshan Thomas, Esther Waalberg, Chifundo Zimba

Mailman School of Public Health

Research output: Contribution to journal › Article › peer-review

33 Citations (Scopus)

Abstract

Background: To prevent postnatal transmission of HIV in settings where safe alternatives to breastfeeding are unavailable, the World Health Organization (WHO) recommends exclusive breastfeeding followed by early, rapid cessation of breastfeeding. Only limited data are available on the attitudes of health workers toward this recommendation and the impact of these attitudes on infant feeding counselling messages given to mothers. Methods: As part of the Breastfeeding, Antiretroviral, and Nutrition (BAN) clinical trial, we carried out an in-depth qualitative study of the attitudes, beliefs, and counselling messages of 19 health workers in Lilongwe, Malawi. Results: Although none of the workers had received formal training, several reported having counseled HIV-positive mothers about infant feeding. Health workers with counselling experience believed that HIV-infected mothers should breastfeed exclusively, rather than infant formula feed, citing poverty as the primary reason. Because of high levels of malnutrition, all the workers had concerns about early cessation of breastfeeding. Conclusion: Important differences were observed between the WHO recommendations and the attitudes and practices of the health workers. Understanding these differences is important for designing effective interventions.

Original language	English
Article number	2
Journal	International Breastfeeding Journal
Volume	1
DOIs	https://doi.org/10.1186/1746-4358-1-2
Publication status	Published - Mar 9 2006

ASJC Scopus Subject Areas

Pediatrics, Perinatology, and Child Health
Obstetrics and Gynaecology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1186/1746-4358-1-2

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Piwoz, E. G., Ferguson, Y. O., Bentley, M. E., Corneli, A. L., Moses, A., Nkhoma, J., Tohill, B. C., Mtimuni, B., Ahmed, Y., Jamieson, D. J., van der Horst, C., Kazembe, P., Adair, L., Albrecth, S., Alt-Khaled, M., Bangdiwala, K., Bayer, R., Butera, S., Chigwenembe, J., ... Zimba, C. (2006). Differences between international recommendations on breastfeeding in the presence of HIV and the attitudes and counselling messages of health workers in Lilongwe, Malawi. International Breastfeeding Journal, 1, Article 2. https://doi.org/10.1186/1746-4358-1-2

Differences between international recommendations on breastfeeding in the presence of HIV and the attitudes and counselling messages of health workers in Lilongwe, Malawi. / Piwoz, Ellen G.; Ferguson, Yvonne Owens; Bentley, Margaret E. et al.
In: International Breastfeeding Journal, Vol. 1, 2, 09.03.2006.

Research output: Contribution to journal › Article › peer-review

Piwoz, EG, Ferguson, YO, Bentley, ME, Corneli, AL, Moses, A, Nkhoma, J, Tohill, BC, Mtimuni, B, Ahmed, Y, Jamieson, DJ, van der Horst, C, Kazembe, P, Adair, L, Albrecth, S, Alt-Khaled, M, Bangdiwala, K, Bayer, R, Butera, S, Chigwenembe, J, Chilongozi, D, Chiudzu, G, Cole, A, Corbett, A, Duerr, A, Eliya, H, Fiscuss, S, Galvin, S, Heilig, C, Hoffman, I, Hooten, E, Hsiao, T, Hurst, S, Joaki, G, Jones, D, Kamanga, G, Kamthunzi, P, Kanyama, C, Kashuba, A, Kathyola, D, Knight, R, Krysiak, R, Loeliger, E, Luhanga, M, Maida, A, Martinson, F, Mayers, D, Mayuni, I, McDonough, M, Merry, C, Msungama, W, Multa, J, Mwansambo, C, Mwapasa, G, Pendame, R, Raines, B, Ryan, M, Shugars, D, Sichali, D, Steens, JM, Tegha, G, Tembo, M, Thomas, R, Waalberg, E & Zimba, C 2006, 'Differences between international recommendations on breastfeeding in the presence of HIV and the attitudes and counselling messages of health workers in Lilongwe, Malawi', International Breastfeeding Journal, vol. 1, 2. https://doi.org/10.1186/1746-4358-1-2

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title = "Differences between international recommendations on breastfeeding in the presence of HIV and the attitudes and counselling messages of health workers in Lilongwe, Malawi",

abstract = "Background: To prevent postnatal transmission of HIV in settings where safe alternatives to breastfeeding are unavailable, the World Health Organization (WHO) recommends exclusive breastfeeding followed by early, rapid cessation of breastfeeding. Only limited data are available on the attitudes of health workers toward this recommendation and the impact of these attitudes on infant feeding counselling messages given to mothers. Methods: As part of the Breastfeeding, Antiretroviral, and Nutrition (BAN) clinical trial, we carried out an in-depth qualitative study of the attitudes, beliefs, and counselling messages of 19 health workers in Lilongwe, Malawi. Results: Although none of the workers had received formal training, several reported having counseled HIV-positive mothers about infant feeding. Health workers with counselling experience believed that HIV-infected mothers should breastfeed exclusively, rather than infant formula feed, citing poverty as the primary reason. Because of high levels of malnutrition, all the workers had concerns about early cessation of breastfeeding. Conclusion: Important differences were observed between the WHO recommendations and the attitudes and practices of the health workers. Understanding these differences is important for designing effective interventions.",

author = "Piwoz, {Ellen G.} and Ferguson, {Yvonne Owens} and Bentley, {Margaret E.} and Corneli, {Amy L.} and Agnes Moses and Jacqueline Nkhoma and Tohill, {Beth Carlton} and Beatrice Mtimuni and Yusuf Ahmed and Jamieson, {Denise J.} and {van der Horst}, Charles and Peter Kazembe and Linda Adair and Sandra Albrecth and Mounir Alt-Khaled and Kant Bangdiwala and Ronald Bayer and Sal Butera and Joseph Chigwenembe and David Chilongozi and Grace Chiudzu and Ann Cole and Amanda Corbett and Ann Duerr and Henry Eliya and Susan Fiscuss and Shannon Galvin and Chad Heilig and Irving Hoffman and Elizabeth Hooten and Tien Hsiao and Stacey Hurst and George Joaki and David Jones and Gift Kamanga and Portia Kamthunzi and Cecilia Kanyama and Angela Kashuba and Dansom Kathyola and Rod Knight and Robert Krysiak and Edde Loeliger and Misheck Luhanga and Alice Maida and Francis Martinson and Douglas Mayers and Isabel Mayuni and Marita McDonough and Ceppei Merry and Wezi Msungama and Jane Multa and Charles Mwansambo and Gerald Mwapasa and Richard Pendame and Byron Raines and Mairin Ryan and Diane Shugars and Dorothy Sichali and Steens, {Jean Marc} and Gerald Tegha and Martin Tembo and Roshan Thomas and Esther Waalberg and Chifundo Zimba",

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AU - Piwoz, Ellen G.

AU - Ferguson, Yvonne Owens

AU - Bentley, Margaret E.

AU - Corneli, Amy L.

AU - Moses, Agnes

AU - Nkhoma, Jacqueline

AU - Tohill, Beth Carlton

AU - Mtimuni, Beatrice

AU - Ahmed, Yusuf

AU - Jamieson, Denise J.

AU - van der Horst, Charles

AU - Kazembe, Peter

AU - Adair, Linda

AU - Albrecth, Sandra

AU - Alt-Khaled, Mounir

AU - Bangdiwala, Kant

AU - Bayer, Ronald

AU - Butera, Sal

AU - Chigwenembe, Joseph

AU - Chilongozi, David

AU - Chiudzu, Grace

AU - Cole, Ann

AU - Corbett, Amanda

AU - Duerr, Ann

AU - Eliya, Henry

AU - Fiscuss, Susan

AU - Galvin, Shannon

AU - Heilig, Chad

AU - Hoffman, Irving

AU - Hooten, Elizabeth

AU - Hsiao, Tien

AU - Hurst, Stacey

AU - Joaki, George

AU - Jones, David

AU - Kamanga, Gift

AU - Kamthunzi, Portia

AU - Kanyama, Cecilia

AU - Kashuba, Angela

AU - Kathyola, Dansom

AU - Knight, Rod

AU - Krysiak, Robert

AU - Loeliger, Edde

AU - Luhanga, Misheck

AU - Maida, Alice

AU - Martinson, Francis

AU - Mayers, Douglas

AU - Mayuni, Isabel

AU - McDonough, Marita

AU - Merry, Ceppei

AU - Msungama, Wezi

AU - Multa, Jane

AU - Mwansambo, Charles

AU - Mwapasa, Gerald

AU - Pendame, Richard

AU - Raines, Byron

AU - Ryan, Mairin

AU - Shugars, Diane

AU - Sichali, Dorothy

AU - Steens, Jean Marc

AU - Tegha, Gerald

AU - Tembo, Martin

AU - Thomas, Roshan

AU - Waalberg, Esther

AU - Zimba, Chifundo

PY - 2006/3/9

Y1 - 2006/3/9

N2 - Background: To prevent postnatal transmission of HIV in settings where safe alternatives to breastfeeding are unavailable, the World Health Organization (WHO) recommends exclusive breastfeeding followed by early, rapid cessation of breastfeeding. Only limited data are available on the attitudes of health workers toward this recommendation and the impact of these attitudes on infant feeding counselling messages given to mothers. Methods: As part of the Breastfeeding, Antiretroviral, and Nutrition (BAN) clinical trial, we carried out an in-depth qualitative study of the attitudes, beliefs, and counselling messages of 19 health workers in Lilongwe, Malawi. Results: Although none of the workers had received formal training, several reported having counseled HIV-positive mothers about infant feeding. Health workers with counselling experience believed that HIV-infected mothers should breastfeed exclusively, rather than infant formula feed, citing poverty as the primary reason. Because of high levels of malnutrition, all the workers had concerns about early cessation of breastfeeding. Conclusion: Important differences were observed between the WHO recommendations and the attitudes and practices of the health workers. Understanding these differences is important for designing effective interventions.

AB - Background: To prevent postnatal transmission of HIV in settings where safe alternatives to breastfeeding are unavailable, the World Health Organization (WHO) recommends exclusive breastfeeding followed by early, rapid cessation of breastfeeding. Only limited data are available on the attitudes of health workers toward this recommendation and the impact of these attitudes on infant feeding counselling messages given to mothers. Methods: As part of the Breastfeeding, Antiretroviral, and Nutrition (BAN) clinical trial, we carried out an in-depth qualitative study of the attitudes, beliefs, and counselling messages of 19 health workers in Lilongwe, Malawi. Results: Although none of the workers had received formal training, several reported having counseled HIV-positive mothers about infant feeding. Health workers with counselling experience believed that HIV-infected mothers should breastfeed exclusively, rather than infant formula feed, citing poverty as the primary reason. Because of high levels of malnutrition, all the workers had concerns about early cessation of breastfeeding. Conclusion: Important differences were observed between the WHO recommendations and the attitudes and practices of the health workers. Understanding these differences is important for designing effective interventions.

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Differences between international recommendations on breastfeeding in the presence of HIV and the attitudes and counselling messages of health workers in Lilongwe, Malawi

Abstract

ASJC Scopus Subject Areas

UN SDGs

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