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Table 5 CMO for EBF when understanding of EBF implications competes with strong cultural norms

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

HCP challenges cultural beliefs of mother, teaching on appropriate ages for introduction of other foods

Mother has good knowledge and understanding of implications of EBF

Mother has trusting relationship with HCP

Prioritisation of counselling advice over cultural understanding and practices

No fear/insecurity about the impact of opposing cultural beliefs on child health

Belief in capacity to EBF

Adheres to feeding advice

Does not mix feed

Belief that breastmilk is safe and sufficient for infant feeding