Health Systems Research Unit, Medical Research Council, Francie Van Zyl Drive, Parow, Western Cape 7535, South Africa.
Public Health Nutr. 2009 Dec;12(12):2323-8. doi: 10.1017/S1368980009005606. Epub 2009 Apr 30.
The possibility of mother-to-child transmission (MTCT) of HIV through breast-feeding has focused attention on how best to support optimal feeding practices especially in low-resource and high-HIV settings, which characterizes most of sub-Saharan Africa. To identify strategic opportunities to minimize late postnatal HIV transmission, we undertook a review of selected country experiences on HIV and infant feeding, with the aims of documenting progress over the last few years and determining the main challenges and constraints.
Field teams conducted national-level interviews with key informants and visited a total of thirty-six facilities in twenty-one sites across the three countries--eighteen facilities in Malawi, eleven in Kenya and seven in Zambia. During these visits interviews were undertaken with key informants such as the district and facility management teams, programme coordinators and health workers.
A rapid assessment of HIV and infant feeding counselling in Kenya, Malawi and Zambia, undertaken from February to May 2007.
Infant feeding counselling has, until now, been given low priority within programmes aimed at prevention of MTCT (PMTCT) of HIV. This is manifest in the lack of resources - human, financial and time--for infant feeding counselling, leading to widespread misunderstanding of the HIV transmission risks from breast-feeding. It has also resulted in lack of space and time for proper counselling, poor support and supervision, and very weak monitoring and evaluation of infant feeding. Finally, there are very few examples of linkages with community-based infant feeding interventions. However, all three countries have started to revise their feeding policies and strategies and there are signs of increased resources.
In order to sustain this momentum it will be necessary to continue the advocacy with the HIV community and stress the importance of child survival--not just minimization of HIV transmission - and hence the need for integrating MTCT prevention.
通过母乳喂养实现母婴传播（MTCT）艾滋病毒的可能性引起了人们对如何支持最佳喂养实践的关注，特别是在资源匮乏和艾滋病毒高发的环境中，这是撒哈拉以南非洲的大多数国家的特点。为了确定最大限度减少产后后期艾滋病毒传播的战略机会，我们对艾滋病毒和婴儿喂养方面的一些国家经验进行了审查，目的是记录过去几年的进展情况，并确定主要挑战和制约因素。
实地小组与主要信息提供者在国家一级进行了访谈，并在三个国家的二十一个地点总共访问了三十六个设施 - 马拉维十八个设施，肯尼亚十一个设施，赞比亚七个设施。在这些访问中，与主要信息提供者（如区和设施管理团队、方案协调员和卫生工作者）进行了访谈。
2007 年 2 月至 5 月在肯尼亚、马拉维和赞比亚进行的艾滋病毒和婴儿喂养咨询快速评估。
在预防母婴传播艾滋病毒（PMTCT）方案中，婴儿喂养咨询迄今一直被置于低优先级。这表现在婴儿喂养咨询方面缺乏资源 - 人力、财力和时间 - 导致对母乳喂养传播艾滋病毒风险的广泛误解。这也导致缺乏适当咨询的空间和时间、支持和监督不力，以及对婴儿喂养的监测和评估非常薄弱。最后，很少有将其与社区婴儿喂养干预措施联系起来的例子。然而，所有三个国家都开始修订其喂养政策和战略，并出现了资源增加的迹象。
为了保持这一势头，有必要继续向艾滋病毒界进行宣传，强调儿童生存的重要性 - 不仅是最大限度地减少艾滋病毒传播 - 因此需要将母婴传播预防纳入其中。
