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艾滋病毒背景下的婴幼儿喂养:

Infant and Young Child Feeding in the Context of HIV: .

作者信息

Augustino Goodluck, Anaeli Amani, Sunguya Bruno F

机构信息

School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, 9 United Nations Road, Upanga West 11103 Dar Es Salaam, Tanzania.

出版信息

medRxiv. 2023 Dec 26:2023.12.21.23300402. doi: 10.1101/2023.12.21.23300402.

Abstract

BACKGROUND

Ensuring optimal nutrition through early breastfeeding is vital for infant mental development and overall health. HIV infections complicate decisions regarding exclusive breastfeeding, jeopardizing effective infant and young child feeding, which affects nutrition and health outcomes. Recognizing the lack of evidence on barriers to infant feeding in the context of HIV in Tanzania, this study was conducted to explore individual, household, and community obstacles in the Ilala district, Dar es Salaam.

METHODS

The study used a hospital-based qualitative approach, focusing on HIV-positive mothers with infants aged 3-6 months in Dar es Salaam city. This involved reviewing mothers' files, conducting interviews with them, and interviewing Reproductive and Child Health clinics (RCH) and community healthcare providers. In total, 27 In-depth interviews were conducted until data saturation was reached, and thematic analysis was used to analyze collected data.

FINDINGS

The study identified various barriers to exclusive breastfeeding, encompassing individual factors like work schedules, postpartum depression, and breast conditions. On the household level, barriers included limited access to resources, family influence, and HIV status disclosure reluctance due to stigma. In the community, low retention in the Prevention of Mother-to-Child Transmission (PMTCT) programs plays a pivotal role in hindering exclusive breastfeeding support for HIV-positive mothers.

CONCLUSION AND RECOMMENDATIONS

HIV-positive mothers face diverse barriers ranging from individual, household, and community-based barriers. Policies supporting breastfeeding, early detection of postnatal depression and breast problems, and peer support for young mothers are of paramount importance. Food insecurity and HIV stigma should be tackled through income-generating activities, family involvement in PMTCT programs, and awareness campaigns. Community-based counselors play a crucial role in supporting HIV-positive mothers in their exclusive breastfeeding journey to improve PMTCT care retention.

摘要

背景

通过早期母乳喂养确保最佳营养对婴儿智力发育和整体健康至关重要。艾滋病毒感染使关于纯母乳喂养的决策变得复杂,危及有效的婴幼儿喂养,进而影响营养和健康结果。鉴于坦桑尼亚缺乏关于艾滋病毒背景下婴儿喂养障碍的证据,本研究旨在探索达累斯萨拉姆伊拉拉区的个人、家庭和社区层面的障碍。

方法

本研究采用基于医院的定性研究方法,聚焦于达累斯萨拉姆市年龄在3至6个月的艾滋病毒呈阳性的母亲及其婴儿。这包括查阅母亲的档案、与她们进行访谈,以及采访生殖健康和儿童健康诊所(RCH)及社区医疗服务提供者。总共进行了27次深度访谈,直至达到数据饱和,并采用主题分析来分析收集到的数据。

研究结果

该研究确定了纯母乳喂养存在的各种障碍,包括工作安排、产后抑郁和乳房状况等个人因素。在家庭层面,障碍包括资源获取有限、家庭影响以及因耻辱感而不愿透露艾滋病毒感染状况。在社区层面,预防母婴传播(PMTCT)项目的低留存率在阻碍为艾滋病毒呈阳性的母亲提供纯母乳喂养支持方面起到了关键作用。

结论与建议

艾滋病毒呈阳性的母亲面临着从个人、家庭到社区层面的各种障碍。支持母乳喂养的政策、产后抑郁和乳房问题的早期检测以及对年轻母亲的同伴支持至关重要。应通过创收活动、家庭参与预防母婴传播项目以及开展宣传活动来解决粮食不安全和艾滋病毒耻辱感问题。社区咨询师在支持艾滋病毒呈阳性的母亲进行纯母乳喂养以提高预防母婴传播护理留存率方面发挥着关键作用。

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