The socio-cultural factors influencing infant feeding practices among HIV positive women attending post-natal clinic at Kisumu East sub-county hospital, Western Kenya

Abstract

Prevention of Mother-To-Child Transmission of HIV (PMTCT) intervention is a global health priority, whose aim is to increase child survival and to reduce HIV infections in infants. Reducing post-natal MTCT of HIV especially in Kisumu with high HIV prevalence (17%) through appropriate intervention such as adoption of recommended infant feeding practices is important. Studies show supplementation before 6 months from birth is common, yet non-adherence to safe infant feeding poses a risk to MTCT, hence the need to investigate the infant weaning practice in relation to the recommendations. Despite increased PMTCT awareness aimed at addressing barriers to safe infant feeding practices among HIV infected women, the practices are still sub-optimal and, yet little research has focused on the socio-cultural factors influencing these practices. Also, perception is context specific and translates to practice, thus prompting the study to assess the perception toward feeding guidelines. The specific objectives of the research were to: find out the weaning of infant feeding as practiced among the HIV positive women; examine the socio-cultural factors that influence weaning practices and assess the perception of the women towards PMTCT infant feeding guidelines. Social network theory and theory of planned behaviour/theory of reasoned action were used to explain the relations of the respondents within their social networks, beliefs toward specific infant feeding practices, motivational factors, perception on their ability to perform it and whether their close associates would approve/disapprove the practice in question that played a critical role in influencing the emerging patterns of their infant feeding practices. This was a cross-sectional study. Study population was 270 respondents who were attending the post-natal clinic or were members of post-test support group. 158 respondents were sampled though convenience sampling of which semi-structured questionnaires were administered while purposive sampling was done for 10 in-depth interviews and 3 FGDs where, IDI and FGD guide was administered, respectively. Quantitative data was summarized into frequencies while qualitative data was analyzed using manual content analysis. The findings show, exclusive breast feeding was at 24.8% and, weaning at 4-6 months was common while at below 1 month was rare. Most of the respondents (46.2%) had a monthly family income of below kshs.1000 and only 24% had disclosed their HIV status to their male partners. Respondents’ knowledge and perception on the benefits/sufficiency/risk of breast milk and its replacements; the norm of mixed feeding were found to influence weaning of infants. Respondents’ social and economic activities and their outcome that revolve around support by the male partner/peers, also determined the weaning practice. The respondents agreed to the regulation of exclusive breast feeding yet in practice, they were sub-optimal. Conclusion is that infant feeding depend mainly on the information respondents receive from their networks’ socio-cultural perspectives that in turn influenced their perception and belief in the ability to practise them. The recommendations proposed include a multi-dimensional strategy involving the various networks of the respondents that influence her perception aimed at capacity building them on the recommended infant feeding methods and their implications thereby increasing acceptance at the community and individual level.