Swahili-based concepts: Explaining how social ties manage HIV and infant feeding

In Tanzania where HIV transmission is high, decisions to avoid or modify breastfeeding are crucial for infant survival yet difficult due to competing risks. A study in Central Tanzania explored the role of social dynamics in infant feeding decisions to prevent HIV. Qualitative data was collected from in-depth interviews and focus group discussions with people living with HIV and community members, including village leaders, traditional healers and midwives within the Dodoma region. Data was analysed using grounded theory and natural Swahili language.

Emerging themes were based on Swahili categorisations. In the context of HIV, infant feeding is a moral issue of fear and safety (salama); decisions seek to maximise kinga (immunity). Swahili-based conceptualisations were used to explain how social relations (jamii) manage HIV and infant feeding in complex, dynamic ways, by acting as kinga, and as gates of open paths for the flow of capacities (uwezo) into and within networks. The use of language in this study opened up Tanzanian ways of thinking, some of which are positive dimensions to more widely embraced negative concepts, especially ideas of maximising immunity (rather than reducing risk), building openness (rather than fighting stigma) and embracing responsibilities (rather than demanding rights).