Social-cultural factors influencing continued breastfeeding among PMTCT program mothers: a case of mothers in Buyaga County, Kibaale District.

Abstract

This study focused on establishing the socio-cultural factors influencing continued breastfeeding among mothers enrolled in the PMTCT program. The justification of the study is to highlight the need for thorough understanding of the socio-cultural and economic values associated with breastfeeding that influence the decisions of HIV positive mothers in order to promote child survival in the context of HIV/AIDS. The study was exploratory, analytical and descriptive in nature covering HIV positive mothers and expectant mothers who were attending antenatal services at Kagadi Hospital. Structured interviews were administered to mothers enrolled in the program and those attending antenatal services, In-depth interviews were conducted with health workers in the PMTCT clinic and Focus group discussions were held with community members. Documents in the hospital PMTCT clinic were reviewed and two research assistants helped in data collection.

Breastfeeding is strongly valued for cultural, psychosocial and economic reasons. There is a strong attachment between breastfeeding and the baby’s health and while there is general awareness about channels of HIV transmission and available safe infant feeding options, it is not matched with enrolment and positive outcomes on the PMTCT program. There are conflicting messages both to the health workers and to mothers with regards to breastfeeding: ie on one part, HIV positive mothers are advised not to breastfeed at all yet on the other hand, breastfeeding is emphasised and recommended as the best option. This confuses the health workers and the mothers. Male involvement in the PMTCT program is low and there is low awareness about PMTCT in the community. Incentives to attract mothers to enrol in the PMTCT program are limited. The PMTCT program in the community is perceived to focus only to the mother and her baby. Mothers have limited social networks and are less supported and empowered economically to cope up with the breastfeeding dilemma.

The study recommends emphasis on community ownership of the PMTCT program to enhance community involvement, awareness creation on mother to child transmission of HIV and mobilization to fight socio-cultural stigma for better child survival as a primary solution. Guidelines relating to breast feeding and safe infant feeding options in the context of HIV need to be popularised and clearly understood by the health workers so that they ably counsel mothers.

The PMTCT program needs to be redefined and refocused to embrace the mother, farther/husbands (Family), the entire community through vigorous awareness campaigns. Mothers need social and economic support for meaningful and gainful involvement in the PMTCT program.S

The researcher invites the attention, commitment and involvement of all stake holders: Policy makers, health providers, CBO’s/NGO’s and the entire community to address the socio-cultural issues that influence breastfeeding so as to prevent Mother to Child transmission of HIV through breastfeeding for increased child survival in the context of HIV/AIDS.