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

CHAPTER 4:
Incorporating food and nutrition activities
into HIV/AIDS programmes in refugee settings
4.1 Introduction
This chapter presents an additional eight integrated programme strategies, each of which is
based on an HIV/AIDS programme, enhanced to protect or improve the food security or nutritional
status of people affected by HIV. The programme strategies are presented in three groups:
strategies that incorporate food and nutrition support into health care and treatment services for
people living with HIV/AIDS (section 4.2); strategies that use food and nutrition resources to
support training and capacity-building activities for clinic-based and community-based care providers
(section 4.3); and strategies that use food and nutrition resources to support the establishment
or continuation of community-level HIV/AIDS-related activities
4.2 Integrated programme strategies that incorporate food
and nutrition support into health care and treatment services
for people living with HIV/AIDS (strategies 13-16)
Four programme strategies focus on integrating nutritional support into medical care and treatment
services (Figure 6):
Strategy 13 Establishment of an inpatient hospital/clinic feeding programme with nutrition education
Strategy 14 Establishment of a hospital/clinic demonstration garden with nutrition education
Strategy 15 Integration of a supplementary ration and nutrition education into a home-based care programme
Strategy 16 Integration of a supplementary ration and nutrition education into an antiretroviral therapy
programme
An inpatient hospital feeding programme may be appropriate in settings where at least the following
two conditions are met: (1) a high percentage of hospital patients are seeking care for
HIV/AIDS-related conditions, and (2) it is known or suspected that lack of food is adversely
affecting the health outcomes of these individuals. Hospital feeding is a significant logistic and
financial undertaking, in terms of securing adequate and diverse food commodities, and managing
the associated preparation, delivery and disposal tasks. In most settings, it would be inappropriate
to target people living with HIV/AIDS with food to the exclusion of other patients.
Hospital feeding programmes, therefore, should generally include all inpatients, regardless of
HIV status.
A complementary intervention is the establishment of demonstration gardens at health facilities.
These can be used to demonstrate how locally appropriate and nutrient-dense food crops
should be cultivated. The produce from demonstration gardens is distributed to inpatients of
the health facility, thus supporting the inpatient feeding programme. This programme provides
an additional benefit by educating the public about crops that grow well in the local environment,
providing a reliable source of food and income for refugee families, and nutrient-dense
foods for people suffering illness. Diverse crops should be cultivated, such as fruits, vegetables,
legumes and cereals.
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