\u2018If nurses were in our shoes would they breastfeed their own babies?\u2019 A qualitative inquiry on challenges faced by breastfeeding mothers on the PMTCT programme in a rural community in Zimbabwe

Zibusiso Nyati-Jokomo,James January,Inam Chitsike,Elizabeth Mbizvo

doi:10.1186/s12884-019-2336-1

Abstract

BackgroundThe Prevention of Mother to Child Transmission (PMTCT) of HIV programme in Zimbabwe has had remarkable success despite the country’s economic challenges. The aim of this study was to explore the challenges faced by breastfeeding mothers on the PMTCT programme.MethodNarratives from 15 women (age range 19–35 years) were collected at two rural health facilities in Zimbabwe through in-depth interviews over a period of 6 months. Thematic analysis was used to describe breastfeeding mothers’ experiences and challenges of being on the PMTCT programme.ResultsThe findings suggest that breastfeeding women on the PMTCT programme face challenges that include internal, external and institutional stigma and discrimination. Women reported a sense of powerlessness in decision making on following through with the PMTCT programme and were ambivalent regarding disclosure of their HIV status to their partners and significant others.ConclusionHIV and AIDS programmes should pay attention to women’s readiness for interventions. There is need to understand women’s life experiences to ensure informed and targeted programming for PMTCT.

Highlights

The Prevention of Mother to Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) programme in Zimbabwe has had remarkable success despite the country’s economic challenges
The percentages of pregnant mothers in the country who received ART to reduce the risk of mother to child transmission of HIV (MTCT) reached 93% in 2013 and 86% of babies born to HIV positive mothers were initiated on ART [4]
This is similar to findings by Schechter et al (2014) in Cote d’Ivoire and Uganda where it was shown that women experienced depression when they became aware of their HIV positive status [6, 18]

Summary

Introduction

The Prevention of Mother to Child Transmission (PMTCT) of HIV programme in Zimbabwe has had remarkable success despite the country’s economic challenges. The aim of this study was to explore the challenges faced by breastfeeding mothers on the PMTCT programme. Prevention of mother-to-child transmission (PMTCT) services have over the years been expanding dramatically with data between 2002 and 2013 showing that new infections among children dropped by more than 50%, there remains a treatment gap due to several reasons [1]. The World Health Organization (WHO) guidelines recommend lifelong ART (Option B+) to all HIV positive women who are pregnant or breastfeeding regardless of CD4 count or clinical staging to reduce vertical transmission. In 2013, Zimbabwe adopted Option B+ as a means of ensuring elimination of pediatric HIV infections. With the newly recommended Option B+ regimen, Zimbabwe has seen an expansion in access to

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