Integration of HIV/AIDS activities with food and nutrition support in ...

• health facility staff, e.g., doctors, nurses, midwives, counsellors in VCT or prevention
of mother-to-child transmission (PMTCT) programmes, laboratory staff;
• traditional and agency-affiliated health extension workers, e.g., community health
workers, community reproductive health workers, community counselling aides, peer
educators, community social workers, traditional birth attendants, traditional healers/
spiritualists;
• beneficiaries of relevant agency programmes, e.g., beneficiaries of general food
distribution programmes, supplementary feeding programmes, therapeutic feeding
programmes, VCT and PMTCT programmes, agricultural projects, income-generating
projects, microcredit and community banking projects; and
• people with HIV infection, including community members who have formally joined
groups of people living with HIV/AIDS (PLWHA), as well as individuals not yet living
“openly” with HIV infection.
Focus group discussions typically lasted 1½–2 hours, and explored topics relevant to the
group being interviewed. Broadly, the mission members strove to achieve three goals: (1) to
understand and observe the services being provided in the areas of HIV/AIDS and nutrition;
(2) to discover how these programmes were perceived by beneficiaries, including determinants
of use and non-use; and (3) most important, to identify opportunities and constraints for more
effective integration of HIV/AIDS and nutrition/food security activities at field level.
Despite the similarities between the national refugee policies of Zambia and Uganda – the
Zambia Initiative and the Uganda Self-Reliance Strategy – in practice, the two refugee settings
were highly divergent. Kala and Mwange camps in northern Zambia each host 25 000 refugees
in densely populated, closed areas. The Congolese refugees depend heavily on the United
Nations and cooperating partner agencies for food, health care, water and education. Local
restrictions on land allocation limit the implementation of food security programmes such as
farming. Equally restrictions on refugee movement limit their ability to earn income outside
the camps. In contrast, the Self-Reliance Strategy in Uganda encourages refugees to settle in
small, scattered communities and to be integrated into national health and educational systems.
Agricultural cultivation is far more widespread among refugees in Uganda than in northern
Zambia. The differences between the two settings allowed the mission teams to explore integrated
programmes that might be appropriate at different points along the integration/isolation
spectrum.
In conducting a comprehensive analysis of the findings, every attempt was made to cross-check
results between UN and implementing agency reports, government interviews and documents,
refugee interviews, and direct observations. The guidelines for programme implementation
were developed collaboratively with partners in the field. Space limitations do not allow us to
present the evidence base for each programme strategy, and users are strongly encouraged to
systematically implement monitoring and evaluation systems as part of their interventions, to
strengthen the evidence base for both effectiveness and cost-effectiveness.
1.7 Structure of the document
Figures 2 and 3 in Chapter 2 summarize the integrated programme strategies described in this
document. Chapter 3 presents programme strategies that incorporate HIV/AIDS activities into
food and nutrition programmes, while Chapter 4 presents programme strategies that integrate
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