Determinants of Infant Feeding Practices among Mothers Living With HIV Attending Kiambu Level 4 Hospital, Kiambu County, Kenya
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Date
2017
Authors
Andare, Naureen Achieng'
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
Despite the evidence that safe infant feeding practices by mothers living with HIV are
major determinants of effective PMTCT services, most researches show that infant
feeding decisions made by mothers living with HIV are influenced by a number of factors
thus leading to poor feeding practices. This study therefore investigated infant feeding
practices and its determinants among mothers living with HIV with infant 0-12 months of
age attending PMTCT clinic at the Kiambu Level 4 Hospital. The study adopted a cross
sectional analytical design that targeted 180 randomly selected mothers and Key
Informants (health workers) at the hospital. The study employed purposive sampling
method to select the hospital while systematic random sampling was used to select the
respondents. A researcher-administered questionnaire, Focus Group Discussion (FGD)
guides and Key Informant Interview (KII) guides were used to gather information from
the respondents. The results showed that 68.9% of the mothers were married with 53.0%
unemployed. Most of the children (91.7%, 95% CI; 86.6 - 95.3) had ever been breastfed
with 69.7% having been initiated to breastfeeding within 1 hour of birth. Majority of the
mothers (79%, 95% CI; 71.8 - 84.8) still breastfeeding. Exclusive breastfeeding rate was
71.4%, mixed feeding (18.2%) and replacement feeding (10.4%) for children below 6
months old. For children above 6 months, complementary feeding with continued
breastfeeding rate was 63.1% and complementary feeding without breast-milk was
36.9%. Based on the findings of the FGDs and KIIs, the majority of the mothers were
aware of the importance of practicing exclusive breastfeeding for the first 6 months of
life and continued breastfeeding from 6-12 months when the infant is on ARVs. The
mothers were also knowledgeable on dangers of mixed feeding. Mothers perceived infant
feeding choice as the responsibility of the health worker and yet the health workers had
contradicting information about the recommended guidelines. Young mothers were more
likely to practice exclusive breastfeeding (chi square test; p=0.048) than the older
mothers. Maternal age was a determinant of exclusive breastfeeding (Odds Ratio [OR]
0.15; 95% CI 0.03 - 0.82; P = 0.028), mother's occupation a determinant of replacement
feeding (OR 0.3; 95% CI 0.17 - 0.72; P = 0.005), education a determinant of
complementary feeding with continued breastfeeding (OR 0.35; 95% CI 0.19 - 0.66; P =
0.001) and maternal knowledge a determinant of mixed feeding practices (OR 0.12; 95%
GI 0.02 - 0.63; P = 0.013). Mothers living with HIV should be provided with counseling
on safe infant feeding options and assisted in making appropriate feeding choices. The
Ministry of Health should strengthen health support systems by empowering stakeholders
that have great influence on mothers' infant feeding choice such as health workers. The
Ministry of Health should target mothers with behavior change communication
programmes to address negative maternal attitudes towards infant feeding practices in the
context of HIV. Longitudinal studies should be conducted to investigate infant feeding
practices over time.
Description
Thesis Submitted in Partial Fulfilment of the Requirements for the Award of the Degree of Master of Science (Food, Nutrition and Dietetics) in the School of Applied Human Sciences of Kenyatta University, July 2017