Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2011

Open Access 01-12-2011 | Research article

The potential role of mother-in-law in prevention of mother-to-child transmission of HIV: a mixed methods study from the Kilimanjaro region, northern Tanzania

Authors: Eli Fjeld Falnes, Karen Marie Moland, Thorkild Tylleskär, Marina Manuela de Paoli, Sebalda Charles Leshabari, Ingunn MS Engebretsen

Published in: BMC Public Health | Issue 1/2011

Login to get access

Abstract

Background

In the Kilimanjaro region the mother-in-law has traditionally had an important role in matters related to reproduction and childcare. The aim of this study was to explore the role of the mothers-in-law in prevention of mother-to-child transmission (PMTCT) service utilization and adherence to infant feeding guidelines.

Methods

The study was conducted during 2007-2008 in rural and urban areas of Moshi district in the Kilimanjaro region of Tanzania. Mixed methods were used and included focus group discussions with mothers-in-law, mothers and fathers; in-depth interviews with mothers-in-law, mothers, fathers and HIV-infected mothers, and a survey of 446 mothers bringing their four-week-old infants for immunisation at five reproductive and child health clinics.

Results

The study demonstrated that the mother-in-law saw herself as responsible for family health issues in general and child care in particular. However she received limited trust, and couples, in particular couples living in urban areas, tended to exclude her from decisions related to childbearing and infant feeding. Mothers-in-law expected their daughters-in-law to breastfeed in a customary manner and were generally negative towards the infant feeding methods recommended for HIV-infected mothers; exclusive replacement feeding and exclusive breastfeeding.

Conclusions

Decreasing influence of the mother-in-law and increasing prominence of the conjugal couples in issues related to reproduction and child care, reinforce the importance of continued efforts to include male partners in the PMTCT programme. The potential for involving mothers-in-law in the infant feeding component, where she still has influence in some areas, should be further explored.
Appendix
Available only for authorised users
Literature
1.
WHO, Unicef, The Interagency Task Team (IATT) on Prevention of HIV: Guidance on global scale-up of the prevention of mother-to-child transmission of HIV Towards universal access for women, infants and young children and eliminating HIV and AIDS among children. 2007, Geneva
2.
World Health Organization, United Nations Children's Fund, UNAIDS: Towards universal access: scaling up priority HIV/AIDS interventions in the health sector Progress report 2009. 2009, Geneva
3.
Aubel J, Toure I, Diagne M: Senegalese grandmothers promote improved maternal and child nutrition practices: the guardians of tradition are not averse to change. Social Science & Medicine. 2004, 59: 945-959. 10.1016/j.socscimed.2003.11.044.CrossRef
4.
Nyblade L, Field-Nguer ML: Women, Communities, and the Prevention of Mother-to-Child Transmission of HIV: Issues and Findings from Community Research in Botswana and Zambia. 2001
5.
Moland KM: Mother's milk - an ambiguous blessing in the era of AIDS. The case of the Chagga in Kilimanjaro. African Sociological Review. 2004, 8:
6.
de Paoli MM, Manongi R, Klepp KI: Factors influencing acceptability of voluntary counselling and HIV-testing among pregnant women in Northern Tanzania. AIDS Care. 2004, 16: 411-425. 10.1080/09540120410001683358.CrossRefPubMed
7.
Becquet R, Ekouevi DK, Viho I, Sakarovitch C, Toure H, Castetbon K, Coulibaly N, Timite-Konan M, Bequet L, Dabis F, Leroy V: Acceptability of exclusive breast-feeding with early cessation to prevent HIV transmission through breast milk, ANRS 1201/1202 Ditrame Plus, Abidjan, Cote d'Ivoire. J Acquir Immune Defic Syndr. 2005, 40: 600-608. 10.1097/01.qai.0000171726.17436.82.CrossRefPubMedPubMedCentral
8.
Bezner Kerr R, Dakishoni L, Shumba L, Msachi R, Chirwa M: "We Grandmothers Know Plenty". Breastfeeding, complementary feeding and the multifaceted role of grandmothers in Malawi. Social Science & Medicine. 2008, 66: 1095-1105. 10.1016/j.socscimed.2007.11.019.CrossRef
9.
Leshabari SC, Koniz-Booher P, Astrom AN, de Paoli MM, Moland KM: Translating global recommendations on HIV and infant feeding to the local context: the development of culturally sensitive counselling tools in the Kilimanjaro Region, Tanzania. Implementation Science. 2006, 1: 22-10.1186/1748-5908-1-22.CrossRefPubMedPubMedCentral
10.
Moland KM: Giving birth in Kilimanjaro: The politics of knowledge in moral contexts. Doctoral dissertation, University of Bergen. 2002, University of Bergen
11.
Leshabari SC, Blystad A, Moland KM: Difficult choices: infant feeding experiences of HIV-positive mothers in northern Tanzania. Journal of Social Aspects of HIV/AIDS. 2007, 4: 544-555.CrossRefPubMed
12.
Tanzania Commision for AIDS: UNGASS country progress report Tanzania mainland. 2008, Dar es Salaam
13.
Schwartzendruber A, Msamanga G: Evaluation of the UNICEF-sponsored Prevention of Mother-to-Child Transmission (PMTCT) Pilot Project in Tanzania. 2002
14.
National AIDS Control Programme of Tanzania: HIV/AIDS/STI Surveillance Report. 2009, Dar es Salaam
15.
Ministry of Health the United Republic of Tanzania: National guidelines for prevention of mother to child transmission of HIV (PMTCT). 2004, Dar es Salaam
16.
World Health Organization: New data on the prevention of mother-to-child transmission of HIV and their policy implications Conclusions and recommendations WHO Technical consultation on behalf of the UNFPA/UNICEF/WHO/UNAIDS Inter-Agency Task Team on Mother-to-Child Transmission of HIV Geneva, 11-13 October 2000. 2001, Geneva
17.
Falnes EF, Moland KM, Tylleskär T, de Paoli MM, Msuya SE, Engebretsen IMS: "It is her responsibility": partner involvement in prevention of mother to child transmission of HIV programmes, northern Tanzania. J Int AIDS Soc. 2011, 14 (1): 21.
18.
National Bureau of Statistics Dar es Salaam T, United Republic of Tanzania, ORC Macro Calverton, Maryland, USA: Tanzania Demographic and Health Survey 2004-2005. 2005
19.
de Paoli M, Manongi R, Helsing E, Klepp KI: Exclusive breastfeeding in the era of AIDS. J Hum Lact. 2001, 17: 313-320. 10.1177/089033440101700405.CrossRefPubMed
20.
Howard M: Socio-economic causes and cultural explanations of childhood malnutrition among the Chagga of Tanzania. Social Science & Medicine. 1994, 38: 239-251. 10.1016/0277-9536(94)90394-8.CrossRef
21.
Hollos M, Larsen U: From lineage to conjugality: the social context of fertility decisions among the Pare of northern Tanzania. Social Science & Medicine. 1997, 45: 361-372. 10.1016/S0277-9536(96)00351-6.CrossRef
22.
Falnes EF, Tylleskar T, de Paoli MM, Manongi R, Engebretsen IM: Mothers' knowledge and utilization of prevention of mother to child transmission services in northern Tanzania. J Int AIDS Soc. 13: 36-
23.
Creswell JW, Clark VLP, Gutmann ML, Hanson WE: Advanced mixed methods research designs. Handbook of mixed methods in social and behavioural research. Edited by: Tashakkori A, Teddlie C. 2003, London: SAGE Publications, 209-240.
24.
Huskinsson EC: Measurement of pain. The Lancet. 1974, 304: 1127-1131. 10.1016/S0140-6736(74)90884-8.CrossRef
25.
Gould D, Kelly D, Goldstone L, Gammon J: Examining the validity of pressure ulcer risk assessment scales: developing and using illustrated patient simulations to collect the data. Journal of Clinical Nursing. 2001, 10: 697-706. 10.1046/j.1365-2702.2001.00525.x.CrossRefPubMed
26.
Pope C, Mays N: Qualitative research in health care. 2006, Oxford: Blackwell Publishing, thirdCrossRef
27.
Graneheim UH, Lundman B: Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004, 24: 105-112. 10.1016/j.nedt.2003.10.001.CrossRefPubMed
28.
Mullany BC: Barriers to and attitudes towards promoting husbands' involvement in maternal health in Katmandu, Nepal. Social Science & Medicine. 2006, 62: 2798-2809. 10.1016/j.socscimed.2005.11.013.CrossRef
29.
Tijou Traore A, Querre M, Brou H, Leroy V, Desclaux A, Desgrees-du-Lou A: Couples, PMTCT programs and infant feeding decision-making in Ivory Coast. Social Science & Medicine. 2009, 69: 830-837. 10.1016/j.socscimed.2009.06.001.CrossRef
30.
World Health Organisation: Guidance on global scale-up of the prevention of mother-to-child transmission of HIV Towards universal access for women, infants and young children and eliminating HIV and AIDS among children. 2007, Geneva
31.
Dahlgren L, Emmelin M, Winkvist A: Qualitative Methodology for International Public Health. 2004, Print och Media, Umeå University
32.
Dixon JS, Bird HA: Reproducibility along a 10 cm vertical visual analogue scale. Annals of the Rheumatic Diseases. 1981, 40: 87-89. 10.1136/ard.40.1.87.CrossRefPubMedPubMedCentral
33.
National Bureau of Statistics Tanzania, ORC Macro Calverton USA: Tanzania Demographic and Health Survey 2004-2005. 2005, Dar es Salaam
Metadata
Title
The potential role of mother-in-law in prevention of mother-to-child transmission of HIV: a mixed methods study from the Kilimanjaro region, northern Tanzania
Authors
Eli Fjeld Falnes
Karen Marie Moland
Thorkild Tylleskär
Marina Manuela de Paoli
Sebalda Charles Leshabari
Ingunn MS Engebretsen
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2011
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-11-551

Other articles of this Issue 1/2011

BMC Public Health 1/2011 Go to the issue

Research article

Sun protection and sunbathing practices among at-risk family members of patients with melanoma

Research article

Risk of metabolic syndrome among children living in metropolitan Kuala Lumpur: A case control study

Research article

Quantification of the healthy worker effect: a nationwide cohort study among electricians in Denmark

Study protocol

The effectiveness of Stepping stones Triple P: the design of a randomised controlled trial on a parenting programme regarding children with mild intellectual disability and psychosocial problems versus care as usual

Research article

The influence of both individual and area based socioeconomic status on temporal trends in Caesarean sections in Scotland 1980-2000

Research article

Prevalence of disability in a composite ≥75 year-old population in Spain: A screening survey based on the International Classification of Functioning