Abstract:
PMTCT during breastfeeding is one of the most public heath challenge confronting
researchers. About ~HIV infection in children is acquired through MTCT.
Breastfeeding contributes to the overall risk ofMTCT by 14%.
PMTCT has been implemented as the main strategy for preventing transmission of
HIV from mother to child in order to save the lives of large numbers of children born
to HIV infected mothers. However a number ofPMTCT programmes have
experienced a number of challenges during implementation.
A crossectional analytical study was done in Ilala district Dar es Salaam Tanzania
from June to July 2003 with the obj ective of finding out barriers to implementation
ofPMTCT during breastfeeding period.
A total of384 mothers aged 15-47 years were interviewed. Information on barriers
to implementation ofPMTCT was obtained through quantitative method by using
structured interviews and qualitative using focus group discussions (FGD's) method.
The results showed that most (92.4%) of the respondents were aware of mother to
child transmission of HI V, but the level of knowledge on the period of transmission
was not as high (54.3%). Similarly awareness ofPMTCT of HI V was high (91.9%)
but the level of knowledge of methods ofPMTCT was poor (62.6%). Factors that
contributed to the poor knowledge ofPMTCT were low level of education and
younger age.
VII
The prevalence of breast feeding was found to be 97.9 %( 376/384). The few who
were not breastfeeding were advised to stop breastfeeding by a doctor because their
mi lk was bad.
Information on MTCT was obtained from clinics 60.3% (246/408) and media where
radio was the commonest.
Regarding breastfeeding practice, about 83.0% (346/417) of mothers would give cow
milk or fonnula milk to the young babies. The remaining few said they usually let
the baby breastfeed from another woman.
Of the four breastfeeding options majority 97.2%(67/69) of the mothers would prefer
to give to their babies formula milk only two mothers favoured exclusive
breastfeeding, arguing that even little amount of mother's milk may contain viruses.
Asked whether they would advise a friend who is HIV positive to breastfeed or not,
majority (90.4%) of the mothers said they would advise not to breastfeed to avoid
transmission. The few who would advise others to continue breastfeeding argued that
formula milk is expensive and the mother's milk is important for the baby.
Majority 69.7 %( 267/383) of the mothers expressed worries on stigmatisation
should a mother who is HIV positive stop breastfeeding.
This study found that, mothers were aware ofMTCT, PMTCT and breastfeeding
options but their level of knowledge was poor. Stigma was the commonest barrier to
p
implementation o~MTCT; therefore there is a need to educate mothers on PMTCT,
and to develop strategies for reducing stigma.
