The Message Environment and Salience of Infant and Young Child Feeding Messages for Health Workers, HIV‐infected and HIV‐uninfected Mothers in Urban Haiti

Abstract

Worldwide, mothers with young children receive many infant and young child feeding (IYCF) messages. Some of these messages are health provider generated, while others are culturally influenced and community generated. We aimed to determine the scope, content and salience of these messages in urban Haiti. We applied the qualitative method of “free listing” with 13 health workers (HW), and 15 HIV‐infected and 15 uninfected mothers with infants 0‐6 months old at GHESKIO. Participants were asked to list all messages women receive about IYCF, and specifically HIV and IYCF. Message salience was determined by message frequency and rank order using FLAME 1.1, and messages were coded for key themes using NVivo 10. For all groups, WHO IYCF recommendations were highly salient, but community‐based messages were also highly salient for mothers. Maternal‐centered messages were more salient for mothers than for HW, who focused on infant‐centered messages. In addition, HW and HIV‐uninfected women identified a wider range of breastfeeding benefits compared to HIV‐infected women who focused primarily on the health of their infants. As many salient messages are community generated and differences exist between HIV‐infected and uninfected women, we conclude that IYCF messages provided to women should be more sensitive to the broader message environment and the consequences of these messages for mothers' breastfeeding behaviors.