Assessment of the prevalence and factors influencing adherence to exclusive breast feeding among HIV positive mothers in selected health institution of Addis Ababa, Ethiopia

Abstract

Background: Exclusive breastfeeding (EBF) offers an affordable, culturally accepatable and effective means of reducing mother to child transmission of HIV while maintaining the benfits of breastfeeding. Despite its benefits, the practice of EBF among HIV positive mothers is low in Ethiopia.
Objective: This study is intended to assess factors influencing adherence to exclusively breast feeding among HIV positive mothers in selected health institutions of Addis Ababa.
Methods: A facility based cross-sectional study design supplemented by a qualitative method was conducted among 384 HIV positive mothers drawn from purposively selected 3 hospitals and 10 health centers with ART and PMTCT service in Addis Ababa City from January 1 to February 30, 2012. Data were collected using a pre-tested structured questionnaire and entered into a computer and analyzed using the SPSS software version 16.
Results: The prevalence of EBF adherence and non-adherence were (73.0%) and (27.0%) respectively. Among mothers who did not adhere to EBF, the commonest reasons mentioned were family opposition and infant illness in 44.0% and 19.0% of mothers respectively. The major determinants identified were inadequate ANC follow up, negative attitude towards EBF and maternal illnesses. Accordingly mothers who attended more than or equal to four ANC follow-ups were 1.9 times more likely to adhere to EBF than those who attended less (AOR=1.04; 95% CI=1.043.4). Likewise, mothers who experienced illnesses were 74% less likely to adhere to EBF than those who had no illnesses (AOR=0.26; 95%CI, 0.13-0.53) and those mothers who had negative attitudes towards EBF were 68% less likely to adhere to EBF than their counterparts (AOR=0.32; 95%CI= 0.16-0.63).
Conclusions: Although the majority of mothers adhered to EBF, still more actions that focus on the importance of ANC follow-up and strengthening of the mother support group in each health facility are necessary. Other important actions are to change the negative attitudes of mothers towards EBF through BCC and continuously advising them to get timely treatment whenever they experience illnesses.