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http://hdl.handle.net/123456789/1900
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| Title: | Infant feeding counselling in Uganda in a changing environment with focus on the general population and HIV-positive mothers - a mixed method approach |
| Authors: | Fadnes, Lars T.
Engebretsen, Ingunn Marie S.
Moland, Karen Marie
Nankunda, Jolly
Tumwine, James K.
Tylleskär, Thorkild |
| Keywords: | Health workers
Counselling
Feeding practices
HIV/AIDS
Eastern Uganda
NGOs |
| Issue Date: | 2010 |
| Publisher: | BioMed Central |
| Citation: | Fadnes, L.T., Engebretsen, I.M.S., Moland, K.M., Nankunda, J., Tumwine, J.K., Tylleskär, T. (2010). Infant feeding counselling in Uganda in a changing environment with focus on the general population and HIV-positive mothers - a mixed method approach. BMC Health Services Research, 10(260) |
| Abstract: | Background: Health workers’ counselling practices are essential to improve infant feeding practices. This paper will
assess how infant feeding counselling was done and experienced by counsellors and mothers in Eastern Uganda
in the context of previous guidelines. This has implications for implementation of the new infant feeding
guidelines from 2009.
Methods: This paper combines qualitative and quantitative data from Mbale District in Eastern Uganda. Data was
collected from 2003 to 2005 in a mixed methods approach. This includes: key-informant interviews among
eighteen health workers in the public hospital, health clinics and non-governmental organisations working with
people living with HIV, fifteen focus group discussions in the general population and among clients from an HIV
clinic, two cross-sectional surveys including 727 mothers from the general population and 235 HIV-positive
mothers.
Results: The counselling sessions were often improvised. Health workers frequently had pragmatic approaches to
infant feeding as many clients struggled with poverty, stigma and non-disclosure of HIV. The feasibility of the infant
feeding recommendations was perceived as challenging among health workers, both for HIV-positive mothers and
in the general population. Group counselling with large groups was common in the public health service. Some
extra infant feeding teaching capacities were mobilised for care-takers of undernourished children. A tendency to
simplify messages giving one-sided information was seen. Different health workers presented contradicting
simplified perspectives in some cases. Outdated training was a common concern with many health workers not
being given courses or seminars on infant feeding since professional graduation. Other problems were minimal
staffing, lack of resources, and programs being started and subsequently stopped abruptly. Many of the HIVcounsellors
in the non-governmental organisations got extended training in counselling which seemed to be
beneficial.
Conclusions: Health workers were faced with challenges related to workload, resources, scientific updating, and
also a need to adjust to frequent changes in programs, recommendations and guidelines. The clients were faced
with difficult choices, poverty, lack of education and stigma. Feasibility of the recommendations was a major
concern. Systematic approaches to update health workers should be a priority. |
| URI: | http://www.biomedcentral.com/1472-6963/10/260
http://hdl.handle.net/123456789/1900 |
| ISSN: | 1472-6963 |
| Appears in Collections: | Research Articles (Health-Sciences)
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Files in This Item:
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Description |
Size | Format |
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| Fadnes-chs-res.pdf | | 234Kb | Adobe PDF | View/Open |
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