Barriers and promoters of home-based pasteurization of breastmilk among HIV-infected mothers in greater Dar es Salaam, Tanzania.
Barriers and promoters of home-based pasteurization of breastmilk among HIV-infected mothers in greater Dar es Salaam, Tanzania.
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坦桑尼亚大达累斯萨拉姆感染艾滋病毒的母亲对母乳进行家庭巴氏灭菌的障碍和推动者。
DOI：
10.1089/bfm.2012.0044
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发表时间：
2013
期刊：
影响因子：
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通讯作者：
Chantry,Caroline
中科院分区：
文献类型：
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作者：
Young,Sera;Leshabari,Sebalda;Arkfeld,Chaele;Singler,Jennifer;Dantzer,Emily;Israel-Ballard,Kiersten;Mashio,Clara;Maternowska,Catherine;Chantry,Caroline
背景：过去十年来，热处理母乳一直是世界卫生组织推荐的婴儿喂养选择，作为减少垂直传播的一种策略。然而，鲜为人知的是，现场经验与it.Our的主要目标是探讨的障碍和促进剂的实施母乳巴氏消毒，“闪热”（FH），在现实世界中设置的达累斯萨拉姆，Tanzania.Subjects和Methods：十九个深入的访谈进行了与参与者在一个家庭为基础的婴儿喂养咨询干预，FH促进后6个月的纯母乳喂养。此外，还与同伴辅导员进行了三次焦点小组讨论。使用NVivo 8软件（QSR International）独立转录、翻译和编码采访。数据进行了分析，使用socioceological framework.Results：信息和同伴辅导员提供的支持是最重要的推动者FH的启动和继续，这影响了个人，人际，和机构层面的成功推动者。其他促进因素包括认为成功的母乳表达，开始FH后的婴儿健康，以及无法支付替代牛奶。成见是最重要的障碍，贯穿框架的各个层面。其他障碍包括对巴氏灭菌母乳的安全性或重要性的怀疑、挤奶困难（通常归因于不良饮食）以及相互竞争的责任。最常见的建议，以提高FH的摄取和持续时间是社区education.Conclusions：鉴于母乳巴氏杀菌法在预防垂直传播的公认作用，需要进一步的实施研究。一个多层次的干预措施，解决障碍，FH可能会提高吸收。
Background:For the past decade, heat-treating breastmilk has been an infant feeding option recommended by the World Health Organization as a strategy to reduce vertical transmission. However, little is known about field experiences with it. Our primary objective was to explore the barriers and promoters of the implementation of breastmilk pasteurization, “flash-heating” (FH), in the real-world setting of Dar es Salaam, Tanzania.Subjects and Methods:Nineteen in-depth interviews were conducted with participants in a home-based infant feeding counseling intervention in which FH was promoted after 6 months of exclusive breastfeeding. Additionally, three focus group discussions were conducted with peer counselors. Interviews were transcribed, translated, and coded independently using NVivo 8 software (QSR International). Data were analyzed using the socioecological framework.Results:Information and support provided by peer counselors were the most important promoters of initiation and continuation of FH; this impacted individual-, interpersonal-, and institutional-level promoters of success. Other promoters included perceived successful breastmilk expression, infant health after initiation of FH, and the inability to pay for replacement milks. Stigma was the most important barrier and cut across all levels of the framework. Other barriers included doubt about the safety or importance of pasteurized breastmilk, difficulties with expressing milk (often attributed to poor diet), and competing responsibilities. The most common suggestion for improving the uptake and duration of FH was community education.Conclusions:Given the acknowledged role of breastmilk pasteurization in the prevention of vertical transmission, further implementation research is needed. A multilevel intervention addressing barriers to FH would likely improve uptake.