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

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Figure 6. Integration of nutritional support into medical services for refugees living with HIV/AIDS Primary, secondary or tertiary care services Voluntary counselling and testing Long-term medical and nutritional management Integration of nutrition into facility-levels medical services (health clinics, hospitals) Hospital/clinic demonstration garden and nutritional education programme (Strategy 13) Hospital/clinic (inpatient) feeding programme with nutritional education (Strategy 14) Integration of nutrition into community-levels or health outreach services Home-based care programme with supplementary ration and nutrition education (Strategy 15) Antiretroviral therapy programme with supplementary ration and nutrition education (Strategy 16) Antenatal care services Integration of nutrition into prevention of mother-to-child transmission services Prevention of mother-tochild transmission programme with supplementary ration and maternal and child nutrition education (Strategy 15) 75
In medical inpatient settings, particularly in environments with high HIV prevalence, the provision of meals to patients and the caretakers attending to them at the facility should be considered. Meal provision supports nutritional status and medical recovery, and may reduce the need for family members to bring food to the facility. What does this integrated programme strategy aim to achieve? Provision of meals to patients and their principal caretakers with them at the facility helps to ensure that ill patients receive adequate nutrition to support rehabilitation, and to reduce the impact of the caretaking burden on the rest of the household. In many refugee communities, family members must provide food to relatives in clinics and hospitals. In settings with high HIV prevalence, affected families may be struggling to meet basic needs within the household and may be unable to consistently commit the time and resources needed to support an ill family member. Additionally, patients with HIV/AIDS will have higher nutritional requirements than many patients without HIV/AIDS. A hospital feeding programme also provides the opportunity to provide nutritional education to caretakers on long-term nutritional care of the patient. How would this integrated programme strategy be implemented? Institutional collaboration and coordination. Planning an inpatient feeding programme requires discussions among representatives of the Ministry of Health, hospital/clinic staff and nutrition/feeding programme staff. Agreement must be reached on how the foods will be sourced, paid for, prepared and delivered, as well as on target guidelines for the nutritional content of the meals. Emphasis on participatory and community-led approaches. The capability of the community to contribute to the feeding programme, particularly regarding fresh fruits and vegetables, should be assessed. Community members may also contribute to the maintenance of a hospital garden (see strategy 14). Logistics of implementation. While not all inpatients will be HIV-positive, it is neither logistically feasible nor socially acceptable to provide inpatient feeding only to patients with HIV/ AIDS. Meals should be provided to all inpatients, to avoid identifying specific ones as having HIV. Multiple micronutrient supplements and prevention/management of oral sores should be considered to help beneficiaries use the food received. The sustainability of the hospital feeding programme, or a phase-out strategy, should be considered from the outset. 76 Integrated Programme Strategy 13: Establishment of an inpatient hospital/clinic feeding programme with nutrition education
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Integration of HIV/AIDS activities
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Contents Acknowledgements 5 Preface
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Acknowledgements The document was p
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Preface This document provides prac
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Executive Summary This document pro
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The integrated programme strategies
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Care and Support for HIV/AIDS-Affec
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Care and Support for HIV/AIDS-Affec
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to protect children’s welfare and
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The 2004 update however did not exp
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food and nutrition components into
Page 25 and 26: 24 • Humanitarian charter and min
Page 27 and 28: families have important needs for s
Page 29 and 30: 28 5. Avoidance of stigma and discr
Page 31 and 32: Table 1. Epidemiological and situat
Page 33 and 34: Household Food and Livelihood Secur
Page 35 and 36: Box 2. The integrated programme str
Page 37 and 38: 36 3. A monitoring and evaluation s
Page 39 and 40: e gender-balanced, may elect an HIV
Page 41 and 42: sive opportunities existed for part
Page 43 and 44: pants. SFP staff should be trained
Page 45 and 46: Therapeutic feeding programmes (TFP
Page 47 and 48: How would this integrated programme
Page 51 and 52: and vegetables, dairy products, mea
Page 53 and 54: In populations that are highly affe
Page 55 and 56: practical experience exists at pres
Page 57 and 58: 56 Programme-level indicators Popul
Page 67 and 68: agriculture and horticulture, anima
Page 69 and 70: Palorinya Settlement, Uganda. AAH h
Page 75: Both types of programme should idea
Page 79 and 80: 78 Integrated Programme Strategy 14
Page 81 and 82: 80 Integrated Programme Strategy 15
Page 83 and 84: Refugee participants enrolled in an
Page 85 and 86: Everyone involved in HIV/AIDS preve
Page 87 and 88: Emphasis on participatory and commu
Page 89 and 90: HIV/AIDS prevention programmes must
Page 91 and 92: expected to provide their services
Page 93 and 94: workers and community counsellors -
Page 95 and 96: Food and related resources are a po
Page 97: ment. The group Madi AIDS Heroes As
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