IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v105y2014icp22-29.html
   My bibliography  Save this article

Reflections on informed choice in resource-poor settings: The case of infant feeding counselling in PMTCT programmes in Tanzania

Author

Listed:
  • Våga, Bodil Bø
  • Moland, Karen Marie
  • Evjen-Olsen, Bjørg
  • Blystad, Astrid

Abstract

A growing emphasis on patient involvement in health care has brought ‘informed choice’ to the core of the debate on provider–patient interaction in global health-care programmes. How the principles of patient involvement and informed choice are implemented and experienced in diverging health systems and cultural contexts are issues of increasing interest. Infant feeding and infant feeding counselling of HIV-positive women have posed particular challenges related to choice. Based on ethnographic research conducted from 5 November 2008 to 5 August 2009 within prevention of mother-to-child transmission of HIV (PMTCT) programmes in two hospitals in rural and semi-urban Tanzania, this study explores nurse counsellors' and HIV-positive women's experiences of infant feeding counselling and patient choice. One of the hospitals (hospital A) promoted exclusive breastfeeding as the only infant feeding option, while the other hospital (hospital B) aimed to follow the Tanzanian PMTCT infant feeding guidelines of 2007 promoting patient choice in infant feeding methods. Women in hospital A expressed trust in the advice given and confidence in their own ability to practice exclusive breastfeeding, while women in hospital B expressed great uncertainty and confusion about how best to feed their infants. This paper reflects on the feasibility of a counselling procedure that promotes choice of infant feeding methods in PMTCT programmes in severely resource-poor settings where HIV-positive women have limited access to resources and to up-to-date knowledge on HIV and infant feeding outside the counselling room. We suggest that a universalistic procedure presenting the same unambiguous message on infant feeding to all women enrolled in the PMTCT programme in this and similar settings is likely to produce more confidence, less confusion and, hence, better results in terms of HIV-free survival of the baby.

Suggested Citation

  • Våga, Bodil Bø & Moland, Karen Marie & Evjen-Olsen, Bjørg & Blystad, Astrid, 2014. "Reflections on informed choice in resource-poor settings: The case of infant feeding counselling in PMTCT programmes in Tanzania," Social Science & Medicine, Elsevier, vol. 105(C), pages 22-29.
    • Handle: RePEc:eee:socmed:v:105:y:2014:i:c:p:22-29
    DOI: 10.1016/j.socscimed.2014.01.005
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953614000306
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2014.01.005?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Charles, Cathy & Gafni, Amiram & Whelan, Tim, 1997. "Shared decision-making in the medical encounter: What does it mean? (or it takes at least two to tango)," Social Science & Medicine, Elsevier, vol. 44(5), pages 681-692, March.
    2. Desclaux, Alice & Alfieri, Chiara, 2009. "Counseling and choosing between infant-feeding options: Overall limits and local interpretations by health care providers and women living with HIV in resource-poor countries (Burkina Faso, Cambodia, ," Social Science & Medicine, Elsevier, vol. 69(6), pages 821-829, September.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Winskell, Kate & Kus, Landy & Sabben, Gaëlle & Mbakwem, Benjamin C. & Tiéndrébéogo, Georges & Singleton, Robyn, 2018. "Social representations of mother-to-child transmission of HIV and its prevention in narratives by young Africans from five countries, 1997–2014: Implications for communication," Social Science & Medicine, Elsevier, vol. 211(C), pages 234-242.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Manuel Antonio Espinoza & Andrea Manca & Karl Claxton & Mark Sculpher, 2018. "Social value and individual choice: The value of a choice‐based decision‐making process in a collectively funded health system," Health Economics, John Wiley & Sons, Ltd., vol. 27(2), pages 28-40, February.
    2. Hyojung Tak & Gregory Ruhnke & Ya-Chen Shih, 2015. "The Association between Patient-Centered Attributes of Care and Patient Satisfaction," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 8(2), pages 187-197, April.
    3. Miller, Nancy & Weinstein, Marcie, 2007. "Participation and knowledge related to a nursing home admission decision among a working age population," Social Science & Medicine, Elsevier, vol. 64(2), pages 303-313, January.
    4. France Légaré & Annette M. O'Connor & Ian D. Graham & Georges A. Wells & Stéphane Tremblay, 2006. "Impact of the Ottawa Decision Support Framework on the Agreement and the Difference between Patients' and Physicians' Decisional Conflict," Medical Decision Making, , vol. 26(4), pages 373-390, July.
    5. Odette Wegwarth & Wolfgang Gaissmaier & Gerd Gigerenzer, 2011. "Deceiving Numbers," Medical Decision Making, , vol. 31(3), pages 386-394, May.
    6. Karnieli-Miller, Orit & Eisikovits, Zvi, 2009. "Physician as partner or salesman? Shared decision-making in real-time encounters," Social Science & Medicine, Elsevier, vol. 69(1), pages 1-8, July.
    7. Paul C. Schroy III & Karen Emmons & Ellen Peters & Julie T. Glick & Patricia A. Robinson & Maria A. Lydotes & Shamini Mylvanaman & Stephen Evans & Christine Chaisson & Michael Pignone & Marianne Prout, 2011. "The Impact of a Novel Computer-Based Decision Aid on Shared Decision Making for Colorectal Cancer Screening," Medical Decision Making, , vol. 31(1), pages 93-107, January.
    8. Mei-Chun Cheung & Derry Law & Joanne Yip & Jason Pui Yin Cheung, 2022. "Adolescents’ Experience during Brace Treatment for Scoliosis: A Qualitative Study," IJERPH, MDPI, vol. 19(17), pages 1-10, August.
    9. Meike Müller-Engelmann & Norbert Donner-Banzhoff & Heidi Keller & Lydia Rosinger & Carsten Sauer & Kerstin Rehfeldt & Tanja Krones, 2013. "When Decisions Should Be Shared," Medical Decision Making, , vol. 33(1), pages 37-47, January.
    10. Margaret Gerteis & Rosemary Borck, "undated". "Shared Decision-Making in Practice: Lessons from Implementation Efforts," Mathematica Policy Research Reports f802e52b8442486594ecda927, Mathematica Policy Research.
    11. Mark Sculpher & Amiram Gafni, 2001. "Recognizing diversity in public preferences: The use of preference sub‐groups in cost‐effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 10(4), pages 317-324, June.
    12. Coast, Joanna, 2018. "A history that goes hand in hand: Reflections on the development of health economics and the role played by Social Science & Medicine, 1967–2017," Social Science & Medicine, Elsevier, vol. 196(C), pages 227-232.
    13. Ruth Astbury & Ashley Shepherd & Helen Cheyne, 2017. "Working in partnership: the application of shared decision‐making to health visitor practice," Journal of Clinical Nursing, John Wiley & Sons, vol. 26(1-2), pages 215-224, January.
    14. Vivek Goel & Carol A. Sawka & Elaine C. Thiel & Elaine H. Gort & Annette M. O’Connor, 2001. "Randomized Trial of a Patient Decision Aid for Choice of Surgical Treatment for Breast Cancer," Medical Decision Making, , vol. 21(1), pages 1-6, February.
    15. Solomon, Josie & Knapp, Peter & Raynor, D.K. & Atkin, Karl, 2013. "Worlds apart? An exploration of prescribing and medicine-taking decisions by patients, GPs and local policy makers," Health Policy, Elsevier, vol. 112(3), pages 264-272.
    16. Debra Kerr & Rosie Crone & Trisha Dunning, 2020. "Perspectives about dignity during acute care for older people and their relatives: A qualitative study," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(21-22), pages 4116-4127, November.
    17. Tate, Alexandra, 2020. "Invoking death: How oncologists discuss a deadly outcome," Social Science & Medicine, Elsevier, vol. 246(C).
    18. Wirtz, Veronika & Cribb, Alan & Barber, Nick, 2006. "Patient-doctor decision-making about treatment within the consultation--A critical analysis of models," Social Science & Medicine, Elsevier, vol. 62(1), pages 116-124, January.
    19. K. Tiller & B. Meiser & C. Gaff & J. Kirk & T. Dudding & K.-A. Phillips & M. Friedlander & K. Tucker, 2006. "A Randomized Controlled Trial of a Decision Aid for Women at Increased Risk of Ovarian Cancer," Medical Decision Making, , vol. 26(4), pages 360-372, July.
    20. Yoko Ueno & Mayumi Kako & Mitsuko Ohira & Hitoshi Okamura, 2020. "Shared decision‐making for women facing an unplanned pregnancy: A qualitative study," Nursing & Health Sciences, John Wiley & Sons, vol. 22(4), pages 1186-1196, December.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:105:y:2014:i:c:p:22-29. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.