Journal of Community Medicine & Health Education
Open Access

Abstract

Background: Option B+ recommends lifelong antiretroviral treatment for all pregnant and breastfeeding women living with Human Immunodeficiency Virus. The study aimed at investigating challenges and opportunities in implementing IYCF in the context of PMTCT guidelines among HIV infected mothers of children aged 0�¢����24 months. The study also examined implications presented by implementing the 2013 PMTCT consolidated guidelines in the transition phase from the 2010 approach in Zambia. Method: A mixed methods approach was employed in the descriptive cross-sectional study utilizing semi-structured questionnaires and Focused Group Discussions. Further, data was captured from the HIMS. Results: During the PMTCT transition, associated needs and challenges in institutionalizing the enhanced guidelines from option A and B to option B+ were observed. Nonetheless, there was a decline in MTCT of HIV rates with an average of 4%. Mothers faced challenges in complying with optimal breastfeeding practices owing to lack of community support systems and breast infections due to poor breastfeeding occasioned by infants�¢���� oral health challenges. Moreover, some mothers were hesitant of lifelong ARVs. Health workers faced programmatic and operational challenges such as compromised counseling services. Conclusion: Despite the ambitious timelines for PMTCT transition, the need to inculcate new knowledge and very known practice among mothers and the shift in counseling content for health workers, the consolidated guidelines for PMTCT proved effective. Some mothers were hesitant of lifelong ARVs, rationalizing the debated paradigm that prolonged chemotherapy/ polypharmacy may be a future challenge in the success of ART in PMTCT. Conflicting breastfeeding practices was a common observation across mothers thus underpinning the need to strongly invigorate IYCF information sharing across the continuum of health care from facility level to community and up to the family; for cultural norms, practices, and attitudes enshrined within communities play a vital role in childcare.

Biography

Nkandu Chibwe is a nutritionist in the Ministry of Health. Nkandu has served in the Ministry for 20 years now. She has a passion for infants and young children especially in the areas of breastfeeding and complementary feeding. This has helped her to maintain levels of Malnutrition in the district below acceptable levels. She has vast experience in conducting various training because of her experience in clinical skills training. She just obtained her Bachelor of Science degree at the University of Zambia in Human Nutrition in 2015. She recently conducted her first research under the guidance of a lecturer Dr. Marinda Pamela and published in Public Health Biomed Central Journal. However, she has assisted in conducting research five times at different times with other organisations. Nkandu lives in Choma Southern Zambia and holds a Diploma in Food and Nutrition and a Bachelor of Science in Human Nutrition.
Email:nkanduckatongo@gmail.com