Abstract:
Effective infant feeding makes an important contribution to good nutrition, health status, survival and development of children with effects reflecting up to adulthood. Among many cultures and diverse populations traditionally, infants are fed breast milk which is nutritionally balanced and provides immunity against diseases. However breast milk can transmit Human Immunodeficiency Virus (HIV) from the mother to child and this poses a public health dilemma. A lot has already been done in HIV including mother to child transmission (MTCT) though there still remains a gap in knowledge and attitude of postnatal mothers on the World Health Organization (WHO) recommended infant feeding options (RIFO). The study was designed to determine the factors associated with knowledge, attitude and practice of postnatal mothers attending Mbagathi District Hospital on RIFO for HIV positive mothers. The study was carried out in Nairobi district between April and June 2011. This was a cross-sectional hospital based study that utilized both quantitative and qualitative methods. A total of 384 postnatal mothers with children 0-24 months attending the hospitals maternal, child health and nutrition clinics during the study period who consented to participate in the study were interviewed. Systematic sampling was used to select the participants. Data was collected using structured interview tool which focused on assessing the postnatal’s mothers socio demographic profiles, their knowledge, attitude and practice in relation to RIFO. In-depth interviews to postnatal mothers and key informant interviews to health care providers were used to collect qualitative data. Quantitative data was entered, analyzed using Statistical Package for Social Sciences (SPSS Version 16.0) software while transcripts from interviews were manually analysed based on themes developed from the study objectives. Overall 45.6% of the respondents were adequately knowledgeable of the RIFO for HIV positive mothers, 83.9% had a positive attitude towards the RIFO for HIV positive mothers and 73.2% had good practice with regard to infant feeding. The predictors of adequate knowledge of recommended feeding for infants were number of births (p<0.001) and level of education attained (p<0.001) while predictors of positive attitude towards recommended feeding for infants born to HIV positive mothers were religion (p=0.010) and education (p=0.013). Out of the seven socio-demographic characteristics number of births was the only characteristic having an association with current feeding practice (p=0.015). The study showed that the knowledge of the postnatal mothers on RIFO was below average. They had a positive attitude towards the WHO RIFO and their feeding practices complied with the WHO RIFO. Education proved to be proxy for adequate knowledge and positive attitude towards RIFO set by WHO. In conclusion, more than half of the postnatal mothers were inadequately knowledgeable of the RIFO for HIV positive mothers. The postnatal mothers embraced well the RIFO guidelines by WHO in terms of attitude and practice. Among the younger mothers the findings showed that they were not much concerned with the RIFO. The younger mothers need health education to understand and embrace knowledge of the RIFO in both HIV positive and HIV negative.
