Adongo Awinaba Amoah, Akuoko Kofi Osei, Dapaah Jonathan Mensah, Manful Esmeranda
Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
PLoS One. 2025 Jul 1;20(7):e0327353. doi: 10.1371/journal.pone.0327353. eCollection 2025.
Although World Health Organization (WHO) policies aim to promote exclusive breastfeeding and replacement feeding for HIV-exposed infants, limited research explores the social and cultural barriers encountered by mothers living with HIV in rural health facilities in Ghana. This study investigates the challenges associated with exclusive breastfeeding and, where feasible, alternative replacement feeding among mothers living with HIV in rural areas, with a specific focus on how cultural beliefs influence adherence to recommended breastfeeding guidelines.
This qualitative study was conducted in two rural community health facilities in Ghana, targeting mothers living with HIV who were actively seeking maternal and child health services. A purposive sampling technique was employed to ensure the inclusion of diverse experiences and perspectives, resulting in a sample of 32 respondents. Participants were selected based on their HIV status and engagement with maternal health services. Data collection involved in-depth interviews and interview guide as data collection tool designed to explore personal experiences and cultural influences on infant feeding practices. All interviews were transcribed verbatim and analysed using Colaizzi's descriptive phenomenological approach, facilitated by NVivo 12 software to ensure systematic data management and theme identification.
The study identified specific sociocultural barriers that hinder the prevention of mother-to-child transmission of HIV in rural communities. Key themes included breastfeeding as a deeply rooted cultural practice, the customary use of water for infant feeding, traditional roles of mothers-in-law in infant care decisions, and food security concerns. Sub-themes further elaborated on breastfeeding as a long-standing tradition, perceived health benefits of breastfeeding, and respect for elders' advice, among others. These cultural norms and beliefs were found to significantly influence adherence to exclusive breastfeeding and, where feasible, alternative replacement feeding guidelines among mothers living with HIV.
This study provides valuable insights into the sociocultural barriers affecting efforts to prevent mother-to-child transmission of HIV in Ghana rural areas. It highlights the need for culturally adaptive health policies and the development of community-based breastfeeding intervention programmes that align with traditional values while promoting safe feeding practices.
尽管世界卫生组织（WHO）的政策旨在促进艾滋病毒暴露婴儿的纯母乳喂养和替代喂养，但有限的研究探讨了加纳农村卫生设施中感染艾滋病毒的母亲所面临的社会和文化障碍。本研究调查了农村地区感染艾滋病毒的母亲在纯母乳喂养方面面临的挑战，以及在可行的情况下的替代喂养方式，特别关注文化信仰如何影响对推荐母乳喂养指南的遵守情况。
这项定性研究在加纳的两个农村社区卫生设施中进行，目标是积极寻求母婴健康服务的感染艾滋病毒的母亲。采用了目的抽样技术，以确保纳入不同的经历和观点，最终样本为32名受访者。参与者根据其艾滋病毒状况和对孕产妇保健服务的参与情况进行选择。数据收集包括深入访谈，并使用访谈指南作为数据收集工具，旨在探索个人经历和文化对婴儿喂养做法的影响。所有访谈均逐字转录，并使用Colaizzi的描述性现象学方法进行分析，借助NVivo 12软件以确保系统的数据管理和主题识别。
该研究确定了阻碍农村社区预防艾滋病毒母婴传播的具体社会文化障碍。关键主题包括母乳喂养是一种根深蒂固的文化习俗、习惯用开水喂养婴儿、婆婆在婴儿护理决策中的传统角色以及粮食安全问题。子主题进一步阐述了母乳喂养作为一项长期传统、母乳喂养的健康益处以及对长辈建议的尊重等。这些文化规范和信仰被发现对感染艾滋病毒的母亲遵守纯母乳喂养以及在可行情况下的替代喂养指南有显著影响。
本研究为影响加纳农村地区预防艾滋病毒母婴传播努力的社会文化障碍提供了有价值的见解。它强调了制定具有文化适应性的卫生政策以及开展基于社区的母乳喂养干预项目的必要性，这些项目既要符合传统价值观，又要促进安全的喂养做法。
