::What it is
:: Why it is Important
:: How it is Done
:: Human Resources, Infrastructure and Supplies Needed
What it is
Nutritional care and support includes many components, such as
- nutrition education and counselling in health facilities;
- water, hygiene and food safety interventions to prevent diarrhoea;
- adequate quality/quantity of food and food aid.
The goal of a program to provide nutrition support for people living with HIV/AIDS may vary from prevention of nutritional depletion to the provision of nutrition care and support for people with AIDS and for the families who care for them.
Why it is Important
- Nutrition and HIV are strongly related to each other. A person with HIV infection is more at risk for malnutrition for reasons such as reduced food intake, poor absorption, changes in metabolism, chronic infections and illnesses, anorexia, diarrhoea, fever, nausea, oral and oesophageal infections, and anaemia. The management of those conditions and the provision of nutritional support are effective interventions that are fundamental to other HIV/AIDS care activities.
- Good nutrition may result in increased resistance to infection and disease, improved energy and a person who is stronger and more productive.
- Antiretroviral therapy should often be taken together with good nutrition and safe water, making access to adequate food important to effective treatment.
- HIV infection has a significant impact on nutrition at the level of the family and community, as well. In places where HIV seroprevalence is high, food insecurity is often high as well.
How It Is Done
Nutrition support for people with HIV/AIDS should be provided in a holistic manner.
Identify and address food insecurity at the individual, family and community level:
- Health care providers and extension workers can identify people infected with HIV in need of nutritional support and refer them to groups or organisations providing food assistance;
- School feeding programmes can be instituted in areas of high HIV prevalence;
- Access to education/training can assist people infected with HIV and their families to support themselves;
- Programmes for orphans and street children can provide education/training to support income-generation as well as providing food-aid;
- Home-based care programmes can be supported to provide food-aid families in need;
- Efforts can be targeted at care programmes (e.g. Tuberculosis, HIV/AIDS) or at institutions (hospitals, clinics) to identify people in need.
Develop national level strategies:
- Ensure that food, assistance and nutritional support are integrated into the national strategic plan;
- Identify partners to be involved in food assistance at the community, national and international level;
- Define criteria in which food-assistance will be offered and when it will be discontinued;
- Develop accepted standard on composition and nutritional value of food basket;
- Integrate adequate food rations into home-based care kits;
- Define standard of nutritional support to be offered to pregnant women, nursing mothers and young children in the context of Preventing Mother to Child Transmission (PMTCT);
- Develop national policy for guidance to community based organisations wishing to provide nutritional support.
Human Resources, Infrastructure and Supplies needed
Incorporating nutritional support into HIV/AIDS care will require workers for the distribution of adequate food assistance to community-based organisations, hospitals, clinics, schools, etc. The provision of nutritional support need not require extensive human resources if integrated into existing services. A nutritional counsellor or adviser could be of assistance in developing national guidelines and policies related to nutritional support.
Transportation, storage facilities and food supplies will be required. Using locally produced foodstuffs and supplements should reduce the need for transportation and storage costs.
Cost of providing nutritional support will vary according to services provided: food-aid will likely be less costly in the short-term than providing services aimed at income generation, education and training. However, while initially more costly, activities focused on education, training and income generation may decrease the need for food assistance in the long-term.
One home care programme in Zambia was able to provide nutritional support at the cost of US$ 1 per day to people infected with HIV and their families. Reviewing costs cited by the World Food Programme, projects providing food assistance in several African countries cost less than US$ 1 per day per person.
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