Knowledge and perception on infant feeding options among PMTCT program nurses counselors in Dar es salaam, Tanzania

Abstract

Background: Counseling is a professional guidance in solving personal conflicts and emotional problems, also counseling is an act of exchanging opinions and ideas. Quality counseling is the central to successful infant feeding practices, the HIV infant feeding guidelines emphasize that the counseling should be based on the principle of informed choice. HIV-positive women should be given the best available information on the risk and benefits of each infant feeding method with the specific guidance in selecting the option most likely to be suitable for women’s situation. Nurse counselors being the major group counseling women at the PMTCT programs in Tanzania carry the heavy burden of informing women about HIV status and about the precaution on the prevention of HIV transmission. Objectives: The main objective was to assess the knowledge and perception on recommended infant feeding options among nurse counselors working in PMTCT program in Dar es salaam, Tanzania. Methods Descriptive, cross-sectional study using both quantitative and qualitative method was used in assessing knowledge and perception of Nurses counselors in PMTCT program in Dar es Salaam on recommended infant feeding options. Self-administered, structured questionnaires and Focused Group Discussion were used. Study sample consisted of eighty five Nurse Counselors working from public and private PMTCT clinics in Dar es salaam City. Results: Study findings showed that there are few nurse counselors are trained in Infant feeding options for HIV-positive women; meanwhile up-to-date counseling training for that purpose is non-existing. Nurse counselors have limited knowledge on infant feeding options hence insufficient information is shared to HIV positive women on how best way to feed infants. Despite that, nurse counselors rated themselves as competent in Infant feeding options with low perception in their competence and performance as PMTCT counselors. Employers do not provide enough support in job aids to enable counselors perform their job well. Consequently, the quality of infant feeding counseling to HIV positive women is jeopardized. Furthermore, nurse counselors have negative perception on suitability for some of WHO recommended infant feeding methods for infants born with HIV positive women in particular Wet nursing and Heat treated expressed Breast milk. Conclusion: This study clearly shows that, few nurse counselors are trained in Infant feeding Options for HIV positive women. Also the health care system does not provide the guideline on up to date training on such counseling services. Ministry of health should collaborate with PMTCT partners to develop the on job training on infant feeding counseling and distribute job aid in order to improve the quality services to HIV positive mothers as par WHO recommended infant feeding options. Recommendations. 1. Dar es salaam based health care facilities owners should train nurse counselors regularly on infant feeding options in order to improve the quality of service delivery on PMTC related services. 2. Employers should provide nurse counselors with enough job Aids and other form of support needed as well as learning and teaching materials that will enable them to stay abreast with up-to-date knowledge on HIV and AIDS

3. Workloads due to chronic shortage of human resources for health services provision is a serious problem resulting in poor quality of health services. Increase in human resources for health services provision (both number and skill) is an urgent priority for improved quality and scale up of health services (including PMTCT program) in Dar es salaam. 4. Information and education on recommended infant feeding option as well as ways of alleviating stigma related to some of those options must be given priority in PMTCT programs to address issues of negative perception of nurse counselors on WHO recommended infant feeding options.