An investigation into the knowledge and beliefs of women in the Gilgal area (Swaziland) with regard to infant feeding practices in the context of HIV/AIDS

Abstract

The study was conducted to describe the knowledge and beliefs of mothers regarding infant feeding practices in the context of HIV/AIDS. The mothers of infants aged 0 - 6 months attending at the Gilgal clinic in Manzini region, Swaziland were sampled for the study. This was a cross sectional descriptive survey in the quantitative paradigm. A qualitative research technique (focus groups) was used for support purposes. The aim of the study was to describe the knowledge and attitUdes of the mothers with regard to infant feeding practices in the context of HIV, to describe the relationships among these three concepts, and to describe the influence of social referents on mothers' beliefs. The research was carried out in the month of June 2006 in Swaziland. A stratified (age) and convenience (clinic attendance) sampling technique was used to select the sample from mothers and their babies attending at the Gilgal clinic. An adapted 24-h recall was used to assess infant feeding practices; questionnaires and focus group discussions were used to assess knowledge, beliefs and demographic information. Descriptive, inferential and multivariate statistics were used on the quantitative data and content analysis and ethnography on the qualitative data. The results indicated that as much as breastfeeding is still a norm (94.5%), exclusive breastfeeding (11 %) is rarely understood and practiced in this community. Focus group data revealed that the matter is complicated by the fact that some mothers fed ORT to their babies immediately after birth. Generally knowledge on HIV and infant feeding practices was high and beliefs on HIV and infant feeding were negative. Partners and nurses advice on infant feeding was most regarded by mothers. There was no significant relationship found between knowledge and attitudes. A significant relationship between knowledge and beliefs/attitudes was found in mothers who practiced predominant breastfeeding, complementary and replacement feeding. However, the relationships were weak and negative, proving the necessity to strengthen the relationship between knowledge and attitudes. There was no statistical relationship found between knowledge and attitude of mothers who practiced exclusive breastfeeding. In conclusion attitudes were dominant predictors of behavior compared to knowledge. This indicated that good knowledge does not warrant positive attitudes and appropriate behavior. Therefore it is vital to investigate the other factors that influence attitudes in efforts to improve infant feeding. The study was successful in identifying gaps that supported the recommendations for a PMTC program focusing on nutritional aspects.