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The Infant Feeding Research Project (IFRP) started in 2003 with anthropological research (Phase 1) in primary care settings in South Africa, Namibia and Swaziland. Phase 2 is the action-research intervention in response to these findings.
The IFRP's Vision is to contribute to reducing the number of children dying through Mother to Child Transmission (MTCT) of HIV...
In Southern Africa, HIV rates amoung mothers varies between 15 and 40%, and gains in preventing MTCT before birth are commonly reversed by transmission after birth. However, formula feeding poses an even larger risk of death to infants in resource poor settings. While exclusive-feeding and anti-retroviral (ARV) treatment both hold great promise, our Phase1 findings confirm that mixed-feeding (adding water, solids, and herbal treatment) remains standard practice despite programmes to prevent MTCT. Mixed-feeding carries the highest risk of HIV transmission. Our analysis revealed that most counselling encounters between the (usually female) health workers and the mothers were experienced as unsatisfactory and apparently ineffective,
with each bringing opposing agendas into the encounters. This is partly from the way the counselling is structured, and partly because of the woman-to-woman relationship dynamics. Women within our highly sexist contexts tend to view themselves and each other as inadequate, deficient, or victims. And female counselling/health workers tend to use subconscious defence mechanism to create enough emotional distance to protect them from the pain of identification.
By intention, Phase2 was designed to focus..
…on the positive potential of the woman and counsellor relationship to promote safe infant feeding practices.
Brief Motivational Interviewing (BMI) was selected as the format that is, firstly, more appropriate to motivating clients that need to make risky or difficult changes (transforming lifestyle, identity or entrenched behaviours), and secondly, being more coherent with the clients need for professional guidance. To contextualise BMI to local realities, we combine it with what we are calling Woman Centeredness (WC)We have selected research, training and monitoring approaches (AI; PAR; OM) that are also highly motivational and evocative.
In Phase 3 we hope to be able to extend the research to other countries in Africa, as well as deepen the understanding of the role female gender dynamics are playing in HIV/AIDS counselling.
Imagine the encounter as a sacred space where women and health workers are empowered by their interactions to realise autonomy, self-love and mutual respect and where the communication is a genuine collaboration to promote health and well being.
Imagine that the woman-centred interaction will build the capacity of both groups of women to acknowledge and transform female internalised sexist consciousness and sexist attitudes and behaviour.
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