Factors Associated with Compliance with World Health Organization-Recommended Infant-Feeding Practices by Mothers with HIV Infection in Northwest Ethiopia

Amare Belachew Dagnew; Tilahun Tewabe; Asmamaw Birhie; Mastewal Birehanu; Tirualem Alehegn; Abigiya Simachew; Agereselam Tsegaw

doi:10.1016/j.curtheres.2019.100568

Factors Associated with Compliance with World Health Organization-Recommended Infant-Feeding Practices by Mothers with HIV Infection in Northwest Ethiopia

Curr Ther Res Clin Exp. 2019 Oct 18:91:39-44. doi: 10.1016/j.curtheres.2019.100568. eCollection 2019.

Authors

Amare Belachew Dagnew¹, Tilahun Tewabe¹, Asmamaw Birhie¹, Mastewal Birehanu¹, Tirualem Alehegn¹, Abigiya Simachew¹, Agereselam Tsegaw¹

Affiliation

¹ College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.

Abstract

Background: The World Health Organization has recommended either exclusive replacement feeding or exclusive breastfeeding options for HIV-exposed infants for the first 6 months of life.

Objective: The purpose of this study was to assess the factors associated with noncompliance with these recommendations among a population of HIV-infected mothers of young infants in Bahir Dar City, Amhara Regional State, Ethiopia.

Methods: An institutional based cross-sectional study was conducted from March 1 to May 15, 2018. A structured interview was conducted with 213 HIV-positive mothers. Descriptive statistics were used to show the frequency distributions of factors associated with noncompliance with World Health Organization-recommended infant-feeding practices. Both bivariate and multivariate logistic regression analyses were performed to identify the variables predictive of infant-feeding practices.

Results: All mothers were undergoing antiretroviral therapy. Only 83.5% claimed to be following World Health Organization-recommended infant-feeding practices. Bivariate analysis showed that high school or greater educational status [Adjusted odds ratio (AOR) = 3.6 (95% CI = 4.2, 9.5)], having attended antenatal visits [AOR = 6.7 (95% CI = 5.6, 10.9)] and postnatal follow-up visits [AOR = 6.9 (95% CI = 4.2, 9.3)], and disclosure of HIV status to their spouse [AOR = 8.2 (95% CI = 6.2, 10.7)] were associated with adherence to recommended infant-feeding practices.

Conclusions: The prevalence of recommended infant feeding practices among HIV-exposed infants in the study area was suboptimal compared with the ≥90% recommended by the World Health Organization. Higher educational status of the mother, antenatal and postnatal follow-ups, and disclosure of HIV status to spouses were predictors of adherence to the recommended infant-feeding practices. Although not yet proven in a prospective clinical trial, providing more education for women, improving attendance at antenatal and postnatal follow-up visits, encouraging the disclosure of HIV status to spouses, and educating mothers about proper infant-feeding options during follow-up visits may all be useful to increase compliance.

Keywords: Bahir Dar; Ethiopia; HIV-positive mother; infant; infant feeding.