INFANT AND YOUNG CHILD FEEDING PRACTICES AMONG HIV POSITIVE MOTHERS IN MANYA KROBO DISTRICT, EASTERN REGION, GHANA.

Abstract

This study was aimed at providing comprehensive information on infant and young child feeding practices adopted by HIV positive mothers participating in the nation’s pilot PMTCT programme in the Manya Krobo District, Eastern Region of Ghana. It also drew comparisons with the same feeding practices among mothers of unknown HIV status. Secondly, the study provided information on the relationships between infant and young child feeding practices and selected background factors of both sero-positive mothers and mothers of unknown sero-status in the project area. All available and accessible HIV positive mothers with children aged 0-23 months and participating in the PMTCT programmes and mothers of unknown HIV status with children 0-23 months attending child welfare clinics in the two major hospitals were the study targets. The sample comprised of all qualified HTV positive mothers participating in PMTCT programme (49 out of the 100 registered). In addition, mothers of unknown HIV status (100) were purposely sampled as they attended child welfare clinics. Data was collected using structured questionnaires to interview the respondents at child welfare clinics. In addition, in-depth interviews were conducted among service providers and HIV positive mothers. The data was analyzed using EPI Info data analysis package.

The first level of analysis used simple frequency tables and column charts to describe the nature and type of infant and young child feeding practices and compared and contrasted such practices among mothers of unknown HIV status and positive mothers. The second level o f analysis similarly used simple frequency tables and column charts to examine the relationships between selected background characteristics of respondents and their infant and young child feeding practices. The findings on the demographic and socio-economic background of the respondents showed that both positive mothers and mothers of unknown HIV status fell within the ages of 18 to 40 years. However, while 19% of mothers of unknown HIV status were teenage mothers, none o f the positive mothers were in their teens. Furthermore, a higher proportion (91%) of mothers o f unknown HIV status constituted town dwellers than HTV positive mothers (80%). Respondents who were natives (born in their places of current residence) or had stayed in their places of residence for more than five years made up the majority (48-54%) among both HIV positive mothers and mothers of unknown HIV status. The percentage of respondents with any level of education was higher (92%) among mothers of unknown HTV status than among positive mothers (71%). While 24% of mothers of unknown HIV status said they could read a letter or newspaper without difficulty, only 10 percent of HIV positive respondents said they were capable o f doing so.

While about 90% of mothers of unknown HTV status listened to radio daily, 74% of positive mothers did so. A higher percentage (75%) of mothers of unknown HIV status claimed to be in stable marriages than positive mothers (60%) who claimed so. The major findings related to the type/nature of infant and young child feeding practices adopted by the two categories of respondents showed that all (100%) children of mothers of unknown HIV status were ever breastfed while 86% of children of positive mothers were ever breastfed. While 60% of HTV positive mothers initiated breastfeeding immediately (within one hour after birth) only 37% of mothers of unknown HIV status did so.

The proportion of infants fed using feeding bottle with nipple was as high as 15% among HIV positive mothers but only 1.3% among mothers of unknown HIV status. Furthermore, the study found that the proportion of mothers using iodized salt in the preparation of child food was generally low irrespective of HTV status with only 40% and 35% of mothers of unknown HTV status and positive mothers respectively making use of the salt. Over 90% of children of HIV positive mothers received Vitamin A while only 57% of the children of mothers of unknown HIV status did so. The complementary feeding adopted for more than 75% of all children of both positive mothers and mothers of unknown HTV status did not contain commonly available, affordable and easy to use nutritious food items such as vitamin A-rich oranges and other fruits, yellow vegetables and dark green vegetables. Certain factors were found to have influenced infant and young child feeding. The percentage of mothers who ever breastfed was high (75% to 100%) in stable and unstable relationships among both mothers of unknown HTV status and positive mothers. However, greater proportions of mothers in stable relationships (100% and 93% among mothers of unknown HIV status and positive mothers respectively) had ever breastfed than women in unstable relationships (95% and 75% among mothers of unknown HIV status and positive mothers respectively). The use of iodized salt among mothers of unknown HIV status and positive mothers tended to be higher in those mothers in stable relationship. Among mothers in stable relationships, positive mothers used less iodized salt (38%) than mothers of unknown status (42%). A greater percentage of mothers in unstable relationships (84% and 75% among mothers of unknown HTV status and positive mothers respectively) initiated breastfeeding immediately (within an hour after delivery} than those mothers in stable relationships irrespective of HTV status (70% and 60% among mothers of unknown HIV status and positive mothers respectively). The percentage of all mothers who ever breastfeed their current babies’ increased with age to a peak within either 20-24 age group (for mothers of unknown HTV status) or 25-29 age group (for HTV positive mothers) and from hence decreased progressively with age. The study made recommendations towards improving infant and young child feeding practices in the study area. These related to improving community mobilization and advocacy, strengthening social support for stable marriages, conduct of ethnographic studies to support evidence based policies and programmes, and income generating activities for mothers. Other recommendations related to the improvement of girl child education, capacity building for health workers, male involvement, repackaging and launching of national BCC campaigns on critical maternal and child health issues*