Hi Vicki I don't have one, but I would be more than happy to help you develop one. I guess it will need to be flexible enough to be applied in a variety of situations ... camps; rural communities; urban communities ... Cheers Nina

Hi Vicky, In an emergency situation the FASS criteria are used to determine how to make artificial feeding as safe as it can possible be after it has been determined that there is no other option for this infant (very different from a non-emergency HIV context where AFASS is used to consider whether replacement feeding might be an option). So FASS is a risk management tool rather than a tool to assess whether artificial feeding should be supported. I think that this distinction is really important. As far as I am aware a checklist has not been developed to help highlight the risks and how to minimise them when an infant must be artificially fed but it would certainly be worth working on.

Hi Vicky I came across a resource developed in Ethiopia by Linkages/AED, which is a counselling tool for infant feeding options in PMTCT sites. It goes into AFASS in some detail and how you would counsel individual mothers and help them in their decision making on infant feeding options. It is in the IFE Resource Library, exact link is: http://www.ennonline.net/pool/files/ife/infant-feeding-tools-at-pmtct-in-ethiopia-linkages.pdf There may also be more relevant content in there, if you the search engine. I'm sure there must be more relevant resources and experiences from the PMTCT programmes around on this, that could be used/applied to the context you are outlining. Best regards Marie

Hi Vicky I've posted your question to Pronut-HIV, to see if the members there could contribute. Regards Marie

Dear Vicky The AED/Linkages tool from Ethiopia that Marie has cited is the most user-friendly tool for assessing AFASS that I know of. It is easy to adapt and I have successfully adapted it for use in Nigeria.

From Ann Burgess: There is an excellent set of counselling cards developed for Tanzania by the 'QAP' project which includes guidelines on preparing 'formula or modified milk feeds'. See under http://www.qaproject.org/strat/stratHIVjobaids.htm. I think they have similar materials for other countries. Ann Burgess