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Table 1 – Initial Program Theories

From: A realist review of infant feeding counselling to increase exclusive breastfeeding by HIV-positive women in sub Saharan-Africa: what works for whom and in what contexts

Context Mechanism Outcome
Mother aware of HIV status and has received infant feeding counselling Desire for motherhood
Motivated by prospect of child survival
Mother values education by HCP
Motivated to maximise child survival through appropriate feeding method
Maintains EBF, avoiding alternate or mixed feeding.
Frequent counselling sessions
Uniform message by all HCPs (health care providers) - based on up to date, evidence-based counselling.
High quality counselling appropriate to local context
Clarity around expectations, Trust of HCP
Correct learning and understanding about infant feeding occurs for mother
Increased health literacy regarding infant feeding
EBF adherence
Community with high levels of stigma regarding HIV and breastfeeding avoidance Mother desires to avoid stigma Avoidance of replacement feeding, choosing EBF
Partner and healthcare worker support Empowerment to adhere to EBF and be assertive about feeding choices Supported in EBF choice and activities necessary for adherence
Feeding decisions are reinforced – to promote adherence