However, we report findings from the HIV-negative and breastfeeding intending South African women in this paper so HIV as such cannot explain all the challenges this intervention had in South Africa. Furthermore, the counsellors were not recruited from the communities in the same way as in Burkina Faso and Uganda, thus, did not provide the same sense of community belonging. They were geographically from the respective cluster area, but recruited in a more formal manner through advertisements and interviews which is the regulated way to identify and appoint personnel.