Die keuse van babavoedingswyse binne die MIV/VIGS-epidemie : voorligtingsimplikasies

Abstract

Approximately one third of the women who visit the antenatal clinics in the North West Province are HIV positive. These women need to decide on the most appropriate method of feeding for their babies. As early as 1985 it was proven that HIV transmission through breast milk could take place. Although total avoidance of breast-feeding entirely rules out the risk of HIV-transmission, it is not necessarily the best choice for all women. Other factors that make it dangerous for some women and their babies to avoid breast-feeding must also be taken into consideration. These factors are the risk of infection as a result of unhygienic circumstances, the mothers' fear that she, should she act contrary to the cultural norm of breast-feeding, can be identified as HIV positive and therefore be stigmatised, and the risk of the spill-over effect if also those mothers who cannot do it safely, feed their babies with a breast milk substitute. Because the risk of HIV transmission through breast milk depends on factors such as the virus load in the mother's blood and milk, and whether the mother's and baby's skin and mucus membrane are intact or not, a HIV positive mother who breast feeds, can make adjustments to limit the risk of HIV transmission. In order to be able to make an informed decision on the most appropriate baby-feeding method, pregnant women must be empowered. In her contact with midwives and pregnant women the researcher observed that health education regarding baby-feeding normally only incidentally mentions HIV and that it appears as if the midwives themselves are uncertain as how to address the problem. The aim of this study was to explore and describe the factors that should be taken into consideration by midwives in their health education of pregnant women on HIV and baby-feeding, the perceptions of midwives and pregnant women pertaining to these factors, as well as the level of knowledge of the midwives and pregnant women regarding HIV-transmission and baby-feeding. The final aim therefore is to compile guidelines from the findings for health education by midwives to pregnant women in order to empower them to make a choice pertaining to the most appropriate baby-feeding mode. A quantitative survey design was used. Two structured questionnaires were used to do data collection. The questionnaires that were based on the literature were laid before research and subject experts, after which it was adjusted before it was

applied. First of all permission was obtained from the District Manager of the Department of Health. An all-inclusive sample of midwives who work in the antenatal clinics in the Potchefstroom district of the North West Province and an availability sample of pregnant women who visit these clinics were used. Trained field-workers assisted in collecting the data in the clinics. A total of 17 midwives and 93 pregnant women took part in the study after having giving their consent. Data analysis was done by means of frequency analysis and cross-references. On the basis of the findings the conclusion was made that, although the midwives have a basic knowledge of HIV and baby-feeding, specific knowledge-gaps and confusion regarding distinct themes do exist. The aspects that the midwives do not have sufficient knowledge of are those of recent tendencies and discoveries. On the aspects final clearance has not yet been reached in the literature and through research, confusion still exists. Furthermore it has been found that the knowledge the midwives do indeed have is not efficiently conveyed to the pregnant women. According to the perceptions of the midwives and the pregnant women, they aren't sufficiently empowered by the health education to be able to make an informed decision. Recommendations subsequently were formulated for the nursing education, research and practice. The study especially focused on efficient health education by midwives that will lead to empowering pregnant women to be able to make an informed choice regarding the most appropriate baby-feeding method. These guidelines are aspects such as updating the knowledge of the midwives, the creation of a positive climate in which the health education can be presented, as well as the method of conveyance of information and its contents.