Abstract:
Background: In the Kilimanjaro region the mother-in-law has traditionally had an important role in matters related
to reproduction and childcare. The aim of this study was to explore the role of the mothers-in-law in prevention of
mother-to-child transmission (PMTCT) service utilization and adherence to infant feeding guidelines.
Methods: The study was conducted during 2007-2008 in rural and urban areas of Moshi district in the Kilimanjaro
region of Tanzania. Mixed methods were used and included focus group discussions with mothers-in-law, mothers
and fathers; in-depth interviews with mothers-in-law, mothers, fathers and HIV-infected mothers, and a survey of
446 mothers bringing their four-week-old infants for immunisation at five reproductive and child health clinics.
Results: The study demonstrated that the mother-in-law saw herself as responsible for family health issues in
general and child care in particular. However she received limited trust, and couples, in particular couples living in
urban areas, tended to exclude her from decisions related to childbearing and infant feeding. Mothers-in-law
expected their daughters-in-law to breastfeed in a customary manner and were generally negative towards the
infant feeding methods recommended for HIV-infected mothers; exclusive replacement feeding and exclusive
breastfeeding.
Conclusions: Decreasing influence of the mother-in-law and increasing prominence of the conjugal couples in
issues related to reproduction and child care, reinforce the importance of continued efforts to include male
partners in the PMTCT programme. The potential for involving mothers-in-law in the infant feeding component,
where she still has influence in some areas, should be further explored.
