Improving access to human milk for vulnerable infants in resource-limited health systems: Ethics and implementation of human milk banks in sub-Saharan Africa

I joined ETHOX in October 2020. My DPhil is supported by a Nuffield Department of Population Health Scholarship and I am supervised by Professor Maureen Kelley and Professor Sassy Molyneux. My work is around creating an evidence base for ethical and equitable access to human milk for vulnerable infants in resource-limited settings, through an empirical ethics study.

Following the WHO’s guidelines for optimal infant feeding, human milk banks (HMBs) have been developed to improve access to human milk for vulnerable infants—e.g., preterm, underweight, or seriously ill newborns—and to ensure that milk is safely collected, checked for quality, safely stored, and fairly distributed.

While there are more than 600 banks in neonatal units worldwide, most are in higher income countries, with very few in Africa. What are the ethical considerations when implementing this complex intervention in low-resource and culturally diverse contexts? Why have so few banks been implemented in Africa? My DPhil project seeks to answer these questions through a qualitative empirical ethics study, investigating and critically analysing practical, social, and ethical issues in HMB implementation in low resource health systems by focusing on lessons from the sub-Saharan African context.