Translating Global Recommendations on HIV and Infant Feeding to the Local Context: The Development of Culturally Sensitive Counseling Tools in the Ki

Leshabari, Sebalda C., Peggy Koniz-Booher, Anne N. Astrom, Marina M. de Paoli, and Karen M. Moland. “Translating Global Recommendations on HIV and Infant Feeding to the Local Context: The Development of Culturally Sensitive Counseling Tools in the Kilimanjaro Region, Tanzania.” Implementation Science 1, no. 22 (October 3, 2006). http://www.ncbi.nlm.nih.gov/pmc/
pmc/articles/PMC1599750/ (accessed February 10, 2011).

This journal article describes how researchers worked with women in Tanzania to develop culturally sensitive material about breastfeeding practices. Specifically, researchers sought to develop culturally relevant “job aids” to help women with HIV reduce the risk of passing the virus to their breastfeeding infants. While women with HIV are generally advised to avoid breastfeeding, in some areas access to formula or animal milk is limited, or these alternatives are just too expensive for women to purchase.HIV positive women who alternate between feeding their baby breastmilk and breastmilk substitutes has been shown to increase the risk of HIV transmission from mother to infant. Researchers interviewed community elders, birth attendants, health care workers, and conducted focus groups with community members to determine attitudes on breastfeeding, safe sex, and ways to decrease HIV transmission to infants. Researchers also took digital photos that were adapted into colorful illustrations for the educational material. The illustrations were field tested in the focus groups. Upon reviewing data gained from interviews and focus groups, researchers determined a set of performance objectives for HIV positive mothers—to exclusively breastfeed for up to6 months, or exclusively replacement feed. Researchers developed materials first in English to outline these objectives. The material was then translated into Swahili. While the materials incorporated quite a bit of text, colorful illustrations were also included for to enhance comprehension. The illustrations included aspects of the culture and locally available technologies to the reader could better identify with the situation depicted in the illustration. This article could be a useful case study on how to use a participatory approach to design culturally relevant materials for non-Western audiences.