TITLE:
Practice environment related barriers to exclusive breastfeeding among HIV-positive mothers in Blantyre, Malawi
AUTHORS:
Ursula K. Kafulafula, Mary K. Hutchinson, Susan Gennaro, Sally Guttmacher, Ellen Chirwa
KEYWORDS:
Barriers; Practice Environment; Exclusive Breastfeeding; HIV-Positive Mothers; Malawi
JOURNAL NAME:
Health,
Vol.5 No.9,
September
12,
2013
ABSTRACT: Rates of exclusive breastfeeding in Malawi remain low despite the
acknowledged benefits of exclusive breastfeeding for the infant’s wellbeing
and the prevention of mother-to-child transmission of HIV. Creating an environment supportive of exclusive breastfeeding is critical to
increase the rate of exclusive breastfeeding among HIV-positive
mothers. However, little is known on factors that influence the
environment within which HIV-positive mothers in Malawi practise exclusive
breastfeeding. Therefore, the exploratory qualitative study on which this article
is based was conducted at the Chatinkha maternity unit of Queen Elizabeth Central
Hospital in Malawi from April 16, 2009 to May 8, 2009 to explore perceived
practice environment related barriers to exclusive breastfeeding among HIV-positive mothers. Data were obtained through indepth interviews with 16 purposively selected breastfeeding HIV-positive
mothers between 18 and 35 years old and two focus group discussions with
women of unknown HIV status. Semi-structured interview and focus group guides
were utilised. Content analysis of data was done. Five main themes emerged regarding factors that may influence the
environment within which exclusive breastfeeding was practised: 1) availability of resources; 2) societal norms and cultural
practices; 3) mother-baby proximity; 4) health workers’ attitudes and 5)
disclosure of the mothers’ HIV status. A
multi-sectoral approach to promote exclusive breastfeeding is suggested.
Thisshould include community involvement because it is in the community where breastfeeding norms and cultural
practices associated with breast-feeding are propagated.