Training, confidence and knowledge of healthcare workers with regard to HIV and infant feeding in eThekwini, South Africa
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Abstract
Background. Healthcare workers play an important role in educating mothers living with HIV regarding appropriate infant and young child feeding (IYCF) practices. However, it is not known if healthcare workers in eThekwini, KwaZulu-Natal (KZN), have been adequately trained regarding IYCF in the context of HIV and how knowledgeable and confident they are.
Objectives. To assess the training, confidence and knowledge of healthcare workers regarding IYCF in the context of HIV.
Methods. This was a descriptive cross-sectional study, which used a self-administered questionnaire developed for this survey. Healthcare workers (n=188), primarily doctors and nurses in antiretroviral, antenatal and paediatric departments at three regional hospitals (Addington Hospital, Prince Mshiyeni Memorial Hospital and RK Khan Hospital) in eThekwini, KZN, participated.
Results. Only 47.3% (n=89) of the participants had attended formal training on IYCF in the context of HIV. Most participants (n=171; 91.4%) felt they required more training. The mean overall confidence score of the group was 4.54 (standard deviation (SD) 1.28)%. The mean knowledge score of participants regarding IYCF in the context of HIV was 51.7%. The attendance of training did not equate to improved knowledge scores.
Conclusions. Although the healthcare workers were confident with counselling on IYCF in the context of HIV, their knowledge levels were lower than expected. This could be attributed to a lack of training or outdated or inefficient training. There is a need to improve the coverage and quality of IYCF and HIV training. Training courses should address behaviour change and test for understanding.
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References
Victora CG, Bahl R, Barros AJD, et al. Breastfeeding in the 21st century: Epidemiology, mechanisms, and lifelong effect. Lancet 2016;387(10017):475-490. https://doi.org/10.1016/S0140-6736(15)01024-7
World Health Organization. Guideline: Updates on HIV and Infant Feeding: The Duration of Breastfeeding, and Support from Health Services to Improve Feeding Practices among Mothers Living with HIV. Geneva: WHO, 2016.
National Department of Health. Infant and Young Child Feeding Policy. Pretoria: NDoH, 2013.
National Department of Health. Amendment of the 2013 Infant and Young Child Feeding (IYCF) Policy. Pretoria: NDoH, 2017.
World Health Organization. Revisiting Optimal Breast Feeding Durations: Modelling the Impact of Maternal ARV Use and Infant Mortality. Geneva: WHO, 2015.
National Department of Health. National Consolidated Guidelines for the Prevention of Mother-to-Child Transmission of HIV (PMTCT) and the
Management of HIV in Children, Adolescents and Adults. Pretoria: NDoH, 2015.
Burton R, Giddy J, Stinson K. Prevention of mother-to-child transmission in South Africa: An ever-changing landscape. Obstet Med 2015;8(1):5-12. https://doi.org/10.1177/1753495X15570994
Shayo EH, Våga BB, Moland KM, Kamuzora P, Blystad A. Challenges of disseminating clinical practice guidelines in a weak health system: The case of HIV and infant feeding recommendations in Tanzania. Int Breastfeed J 2014;9(188):1-13. https://doi.org/10.1186/s13006-014-0024-3
Van Rensburg LJ, Nel R, Walsh CM. Knowledge, opinions and practices of healthcare workers related to infant feeding in the context of HIV. Health SA Gesondheid 2016;21(a943):129-136. https://doi.org/10.4102/hsag.v21i0.943
Adetokunboh OO, Oluwasanu M. Eliminating mother-to-child transmission of the human immunodeficiency virus in sub-Saharan Africa: The journey so far and what remains to be done. J Infect Public Health 2016;9(4):396-407. https://doi.org/10.1016/j.jiph.2015.06.010
Murila F, Obimbo MM, Musoke R, Tsikhutsu I, Migiro S, Ogeng’o J. Breastfeeding and human immunodeficiency virus infection: Assessment of knowledge among clinicians in Kenya. Int J Nurs Pract 2015;21(1):27-42. https://doi.org/10.1111/ijn.12218
Sint TT, Lovich R, Hammond W, et al. Challenges in infant and young child nutrition in the context of HIV. AIDS 2013;27(Suppl 2):S169-S177. https://doi.org/10.1097/qad.0000000000000089
West NS, Schwartz SR, Yende N, et al. Infant feeding by South African mothers living with HIV: Implications for future training of health care workers and the need for consistent counselling. Int Breastfeed J 2019;14(11):1-7. https://doi.org/10.1186/s13006-019-0205-1
National Department of Health. National Antiretroviral Treatment Guidelines. Pretoria: NDoH, 2004.
National Department of Health. A Breastfeeding Course for Health Care Providers: Toolkit. Pretoria: NDoH, 2014.
World Health Organization. Global Strategy for Infant and Young Child Feeding. Geneva: WHO, 2003.
KwaZulu-Natal Department of Health. Guidelines for the Implementation of the Mother Baby Friendly Initiative in KwaZulu-Natal Healthcare Facilities. Pietermaritzburg: KZN DoH, 2017.
Mphasha MH, Skaal L. Infant and young child feeding policy: Do primary health care nurses adhere to the HIV breastfeeding recommendations in Limpopo province? S Afr J Clin Nutr 2019;4(1):1-6. https://doi.org/10.1080/16070658.2018.1457863
Rujumba J, Tumwine JK, Tylleskär T, Neema S, Heggenhougen HK. Listening to health workers: Lessons from Eastern Uganda for strengthening the programme for the prevention of mother-to-child transmission of HIV. BMC Health Serv Res 2012;12(3):1-12. https://doi.org/10.1186/1472-6963-12-3
Leshabari SC, Blystad A, de Paoli M, Moland KM. HIV and infant feeding counselling: Challenges faced by nurse-counsellors in northern Tanzania. Hum Resour Health 2007;5(18):11. https://doi.org/10.1186/1478-4491-5-18
Piwoz EG, Ferguson YO, Bentley ME, et al. Differences between international recommendations on breastfeeding in the presence of HIV and the attitudes and counseling messages of health workers in Lilongwe, Malawi. Int Breastfeed J 2006;1(2):1-8. https://doi.org/10.1186/1746-4358-1-2
Horwood C, Jama NA, Haskins L, Coutsoudis A, Spies L. A qualitative study exploring infant feeding decision-making between birth and 6 months among HIV-positive mothers. Matern Child Nutr 2019;15(2):1-13. https://doi.org/10.1111/mcn.12726
National Department of Health. Guideline for the Prevention of Mother to Child Transmission of Communicable Infections (HIV, Hepatitis, Listeriosis, Malaria, Syphilis and TB). Pretoria: NDoH, 2019.
National Department of Health. Policy and Guidelines for the Implementation of the PMTCT Programme. Pretoria: NDoH, 2008.
Schmied V, Beake S, Sheehan A, McCourt C, Dykes F. Women’s perceptions and experiences of breastfeeding support: A metasynthesis. Birth 2011;38(1):49-60. https://doi.org/10.1111/j.1523-536x.2010.00446.x