RESEARCH SUMMARY

December 2003

Infant Feeding Counseling Within Kenyan and Zambian PMTCT Services: How Well Does It Promote Good Feeding Practices?

Infant feeding counseling is an important intervention for the prevention of mother-to-child transmission (PMTCT) of HIV. More than one-third of HIV transmission to infants occurs through breastfeeding, and up to 20 percent of infants born to HIV-infected mothers acquire the virus from breast milk in countries where extended breastfeeding of children is the norm (WHO 2001). The World Health Organization advises that HIV-positive mothers should be offered nondirective counseling on various infant feeding options that are feasible, affordable, safe, sustainable, and effective in the local context.

The Horizons Program collaborated with NARESA in Kenya, the MTCT Working Group in Zambia, and UNICEF to examine the implementation of infant feeding counseling as part of a comprehensive study in each country to document the acceptability, operational barriers, cost, and impact of pilot PMTCT services. The major research activities included tracking the utilization of various services; following a cohort of clinic users for 12 to 18 months to determine outcomes of service utilization on knowledge, practices, and rates of mother-to-child HIV transmission; observation of the quality of care delivered by providers; and an economic analysis of the PMTCT program. In addition, a midterm rapid assessment of the intervention at the Zambia PMTCT sites was undertaken as part of a global evaluation of UN-supported pilot PMTCT services (see Rutenberg et al. 2003). These studies contribute critically needed information for informing policy and program design and for documenting best practices for PMTCT.

A particularly challenging component of PMTCT services is providing counseling that promotes good infant feeding practices. This summary presents key findings from the Kenya and Zambia studies on the content of counseling, provider attitudes about infant feeding options, and the extent to which actual infant feeding practice by mothers is consistent with recommended practice.

• Methods
• Box: Infant Feeding Guidelines in Kenya and Zambia 
• Key Findings
• Box: HIV and Infant Feeding Intervention Strengthens Exclusive Breastfeeding Rates
• Recommendations
• References
• PDF format of summary (100 KB)

Study investigators include Margaret Siwale and Chipepo Kankasa of the MTCT Working Group in Zambia; Ruth Nduati, Dorothy Mbori Ngacha, and Jennifer Oyieke of NARESA in Kenya; Naomi Rutenberg and Scott Geibel of Horizons/Population Council; and Sam Kalibala of the International AIDS Vaccine Initiative (formerly of Horizons).

Suggested citation: Rutenberg, N. et al. 2003. “Infant Feeding Counseling Within Kenyan and Zambian PMTCT Services: How Well Does It Promote Good Feeding Practices?,” Horizons Research Summary. Washington, D.C.: Population Council.

Photo courtesy of Photoshare, a service of the INFO Project.

About Horizons

Horizons conducts global operations research to improve prevention, care, and support program. Horizons is implemented by the Population Council under a cooperative agreement with the U.S. Agency for International Development. Horizons is implemented by the Population Council in partnership with the International Center for Research on Women (ICRW), the Program for Appropriate Technology in Health (PATH), the International HIV/AIDS Alliance, Tulane University, Family Health International (FHI), and Johns Hopkins University.

Copyright © 2003 The Population Council

---

See Also

• Population Council – Gender, Family, and Development Program
• Population Council – HIV/AIDS
• Robert H. Ebert Program on Critical Issues in Reproductive Health

---

For additional information please contact: 
Horizons 
Population Council 
4301 Connecticut Ave. NW, Suite 280 
Washington, DC 20008
Telephone: +1 202 237 9400 
Facsimile: +1 202 237 8410 
E-mail: horizons@popcouncil.org 

---

---

This page updated
19 Oct 2007