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

Integrated Programme Strategy 6:
Modification of a supplementary feeding programme
to better meet the needs of population subgroups affected
by HIV/AIDS
Supplementary feeding in normal camp contexts is usually triggered by a high
prevalence of child malnutrition or other aggravating factors.
Typically the supplementary feeding ration provides between 1000 to 1200 kcals
per person per day in the form of a take-home ration, which is targeted to children,
pregnant and lactating women, or other at-risk groups. In situations where
supplementary feeding programmes are already set up, it may be useful to broaden
eligibility criteria to offer nutritional support to people with HIV/AIDS,
particularly those who are symptomatic. Where possible, the energy content of the
supplementary ration for people with symptomatic AIDS should be raised to meet
increased energy needs associated with HIV and opportunistic infections;
absolute protein content should also be raised (to continue to account for 10–12%
of energy) (see Box 3). Micronutrient content should be adequate to allow RDA levels
to be met through micronutrient fortification and consumption of fresh foods.
Blended foods should be emphasized where possible to provide an energy-
and nutrient-dense, easy to prepare food in the ration.
What does this integrated programme strategy aim to achieve?
Population groups at risk of malnutrition (e.g., pregnant and lactating women, children
under 5 years of age, people living with HIV/AIDS or TB) or with acute malnutrition
(e.g., moderately wasted children) receive an enhanced supplementary ration, modified
to account for increased nutritional needs associated with symptomatic HIV infection,
opportunistic illnesses and AIDS. Where the energy content of the general ration has been
increased to account for HIV/AIDS (see Box 3), an increase in the supplementary ration is not
necessary. However if HIV prevalence is known to be significant and the general ration has not
been modified accordingly, the supplementary feeding programme is the main way to target
nutritional support to people living with AIDS.
How would this integrated programme strategy be implemented?
Institutional collaboration and coordination. Health staff should collaborate with UN and
cooperating partner agency staff in charge of food and nutrition planning to make appropriate
modifications to the supplementary feeding programme based on HIV prevalence data. Participation
should be linked at the community level with health care and health education for the
chronically ill, as well as with food security interventions.
Emphasis on participatory and community-led approaches. For the chronically ill, the supplementary
ration should be presented as part of their health care rather than as an additional
food ration entitlement to facilitate public acceptance of the programme.
Logistics of implementation. Additional commodities must be sourced and distributed to
programme participants. Adjustments in the SFP should take into account any adjustments
to the general food ration (see above), as well as whether the ration is consumed on site (“wet
feeding”) or at home (“dry feeding”). It is vital that stigmatization of AIDS-affected families is
avoided in the targeting process.
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