Nurse's recommendations to HIV positive mothers about breastfeeding : A qualitative study performed in Dar es Salaam, Tanzania

Abstract: AIM: The aim of this study was to a) find out which recommendations are given by nurses regarding breastfeeding to HIV infected mothers, at Muhimbili hospital and the adherence of these, and (b) to find out the nurses’ opinions regarding the WHO recommendations and the parents’ adherence to these. The study will also look into if the nurses are aware of any changes in knowledge among the parents in an HIV context.METHOD: There were eight semi-structured interviews with open ended questions that were performed at Muhimbili Hospital. All the interviews were recorded and transcribed with content analysis.RESULT: The nurses’ recommendations are adapted to the mothers’ socio-economical situation. The benefits of replacement foods are emphasized if conditions are suitable, otherwise exclusive breast feeding is recommended. Some recommendations are difficult to follow due to poor sanitary standards, low economical standard and stigmatization. Cultural norms may affect the mothers’ choice of feeding method as it might raise suspicions in their community if they do not breastfeed. The knowledge of mother-to-child-transmission has increased but to reduce the transmission rates more knowledge is still needed and a change in attitude towards HIV infected mothers.CONCLUSION: The recommendations given by the nurses to HIV-positive mothers are not directly according to the ones by the WHO although the content is similar. The recommendations are adjusted in accordance to the Tanzanian women’s individual situation. Adherence problems to the recommendations are due to lack of economic recourses and stigmatization from the community. In order to improve the adherence of the given recommendations a reduction in stigmatization is needed, through increased knowledge and changes in attitudes.