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

RESEARCH SUMMARY

December 2003

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

Methods

Researchers looked at the infant feeding practices of mother and infant pairs who received newly introduced PMTCT services at Chipata Clinic in Lusaka, Zambia, and Karatina and Homa Bay district hospitals in Kenya. Chipata Clinic serves a densely populated, poor, peri-urban settlement in Lusaka, where service statistics show that one out of four antenatal clients is HIV-positive. At Homa Bay District Hospital, which serves a very poor area in western Kenya, HIV prevalence among antenatal clients is about 33 percent, one of the highest in Kenya. In contrast, less than 10 percent of pregnant women seen at the District Hospital in Karatina, a town in the relatively prosperous central highlands about two hours north of Nairobi, are HIV-positive.

Midwife/counselors administered questionnaires to HIV-positive and HIV-negative women. In Zambia, 422, 374, and 322 women were interviewed, respectively, at one week, three months, and six months postpartum about their infant feeding practices. Women were interviewed at six weeks, three months, and six months postpartum in Kenya; 380, 313, and 286 women in Homa Bay and 588, 412, and 339 women in Karatina were interviewed, respectively, at the three points in time. A pre-intervention comparison group of 264 women in Lusaka, 329 in Homa Bay, and 328 in Karatina were interviewed at three months (Zambia) and six weeks (Kenya) postpartum.

Data from the rapid assessment of UN-supported PMTCT services in Zambia reveal providers’ approach to and actual delivery of infant feeding counseling. Interviews were conducted at all six pilot sites with 35 clinical and counseling providers who conduct infant feeding counseling, and with 67 women who were either pregnant (> 20 weeks gestation) or had an infant less than six months old and received infant feeding counseling on the day of the assessment. Study staff also observed 42 infant feeding counseling sessions and noted the content, using a checklist.

Box: Infant Feeding Guidelines in Kenya and Zambia

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